Association of the BDNF rs6265 Polymorphism with Cognitive Impairment in Multiple Sclerosis: A Case-Control Study in Mexican Patients.

Cognition is a set of brain processes that allow the individual to interact with their environment. Multiple sclerosis (MS) is a chronic inflammatory disease that affects the cerebral white matter of the brain cortex and spinal cord, leading to cognitive impairment (CI) in 40-60% of the patients. Many studies have determined that CI is linked to genetic risk factors. We aimed to evaluate the association between BDNF gene rs6265 polymorphism and cognitive impairment in Mexican patients with MS by performing a case-control study. Mestizo-Mexican patients diagnosed with MS based on McDonald's criteria were enrolled. Cases were MS patients with CI (n = 31) while controls were MS patients without CI (n = 31). To measure cognitive functioning in MS patients, a neuropsychological screening battery for MS (NSB-MS) was used. Genotyping of the rs6265 gene variant was performed using quantitative real-time PCR (qPCR) with TaqMan probes. The results showed no statistically significant differences in sociodemographic and disease variables between case and control groups. qPCR analysis showed that there were 68% Val/Val wild-type homozygotes, 29% Val/Met polymorphic heterozygotes, and 3% Met/Met polymorphic homozygotes. The presence of BDNF gene rs6265 polymorphism showed an increased probability (3.6 times) of global cognitive impairment.

Validation of the Norma Latina neuropsychological assessment battery in individuals with multiple sclerosis in Mexico.

BACKGROUND: Between 50-60% of Multiple Sclerosis (MS) patients have cognitive alterations. There are several batteries to assess cognitive impairments in MS, however, few exist for Latin Americans. The objective of this study is to evaluate the neuropsychological profile of Mexican people with MS (PwMS) and assess the utility of Norma Latina, a new battery for cognitive assessment in Latin America, in differentiating cognitive test performance between PwMS and healthy controls (HCs). METHODS: 100 PwMS and 100 HCs from Mexico were evaluated with the Norma Latina battery. The following analyses were conducted: 1) low-percentiles of each participant were calculated, 2) Area Under the Curve was used to determine whether the battery discriminated between PwMS and HCs, 3) four composite scores were calculated, and student's t-test was used to compare groups according to these domains. RESULTS: PwMS obtained a greater number of impaired scores compared to HCs, principally in executive function. The battery successfully discriminated between PwMS and HCs, with the strongest capacity to discriminate in the executive functions, and the weakest in memory. CONCLUSION: Establishing validation of a neuropsychological battery for Mexican PwMS will help to more accurately detect cognitive alterations, which will guide the decisions of professionals in terms of cognitive rehabilitation.

Discrimination and Intimate Partner Violence Victimization and Perpetration Among a Convenience Sample of LGBT Individuals in Latin America.

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience intimate partner violence (IPV) at high rates, even bidirectionally, yet no studies to date have investigated IPV among LGBT individuals in Latin America. Thus, this study explored discrimination and IPV victimization and perpetration among LGBT individuals in Latin America. Participants (N = 99) were recruited for this online, cross-sectional survey via convenience sampling and completed measures of LGBT discrimination and lifetime IPV victimization and perpetration. Results indicated that 60.61% of the sample reported at least one form of IPV victimization at some point in their life, and 56.57% reported at least one form of perpetration. Psychological aggression was the most common type of IPV victimization and perpetration. Physical assault victimization was positively correlated with work/school heterosexism. Perpetration and victimization of physical assault, psychological aggression, and sexual coercion were correlated with the "other" heterosexism subscale. Cluster analysis revealed a three-cluster solution: participants in Cluster 1 were high in IPV victimization and perpetration; Cluster 2 participants were low in IPV victimization and perpetration; and Cluster 3 participants were moderate on psychological aggression perpetration and victimization, but low on the other three forms of IPV. Cluster 1 participants had a higher score for the "other" heterosexism subscale than Cluster 2. This study highlights the need to address certain aspects of IPV, such as bidirectionality, in clinical encounters such as safety planning. Future research should examine the role of Latinx identity in LGBT individuals' experiences of discrimination and IPV.

Characterizing substance use in a sample of lesbian, gay, bisexual, and transgender adults in Mexico.

Background: Research from high-income countries on substance use among lesbian, gay, bisexual, and transgender (LGBT) adults is growing; however, limited empirical research exists on LGBT adults in Mexico. Filling this gap is critical as LGBT adults experience unique stressors that may place them at risk for substance use-related health outcomes. Objectives: This study sought to characterize substance use prevalence and magnitude among a convenience sample of Mexican LGBT adults. Methods: A cross-sectional online survey was conducted using a sample of Spanish-speaking, self-identified LGBT adults (n = 92) residing in Mexico who were recruited through online forums of LGBT-focused organizations. Descriptive and frequency analyses were conducted. Results: Participants predominantly identified as cisgender men (n = 44) and gay/lesbian (n = 68). Participants reported high rates of past 90-day legal substance use (>93% for alcohol and >57% for tobacco). The most commonly reported illicit drug used in the past 90 days was marijuana (>29%). Conclusions: While the sample reported lower prevalence and magnitude of substance use relative to other Mexican or United States LGBT samples, the findings highlight that legal and illicit substance use presents health risks for Mexican LGBT individuals. LGBT identity-affirming substance use treatment may reduce substance use-related health burden among this population.

Relationship between executive functions and impulsive behavior in adolescents: Comparative study / Relación entre funciones ejecutivas y la conducta impulsiva en adolescentes: Estudio comparativo

Abstract Introduction: Impulsivity can be directly related to maladaptive and disruptive behaviors; specifically, during adolescence, impulsivity is associated with behavioral and social problems, and it has been found that some behavioral difficulties are related to neuropsychological dysfunction of the prefrontal cortex, which is responsible for regulating impulse control and executive functions. Objective To compare the relationships among executive functions, particularly inhibitory control, behavioral planning and behavioral flexibility, in adolescents between 13 and 15 years old with and without impulsivity. Method This study was developed using an analytical, comparative design. The sample consisted of 62 participants whose impulsivity was measured using the BIS-11-A Impulsiveness Scale and whose data were compared with normative data from the same sample size. Executive functions were evaluated using the Tower of London test, Modified Wisconsin Card Sorting Test (M-WCST), Trail Making Test (TMT) and Stroop test. Results Young people between 13 and 15 years old who exhibited impulsive behavior showed impairment in the executive functions studied, such as inhibitory control, cognitive flexibility, and behavioral planning. Discussion and conclusion There is a direct correlation between impulsive behaviors and executive functions during adolescence. The results found here support the development of potential intervention protocols based on executive functioning.

Resumen Introducción La impulsividad puede relacionarse directamente con conductas desadaptativas y disruptivas; en el caso concreto del periodo adolescente, la impulsividad se asocia con problemas conductuales y sociales agregados, se ha encontrado que algunas dificultades en la conducta se relacionan con una disfunción neuropsicológica de la corteza prefrontal, la cual se encarga de regular el control de impulsos y de las funciones ejecutivas. Objetivo Describir la relación entre el funcionamiento ejecutivo, particularmente control inhibitorio, la planeación conductual y la flexibilidad conductual en adolescentes de edades entre 13 y 15 años que presentan un índice de impulsividad contra datos de adolescentes que no presentan impulsividad. Método El estudio se desarrolló mediante un diseño analítico, tipo comparativo. La muestra se compuso de 62 participantes con índice de impulsividad medida a través de la BIS-11-A, muestra que después se comparó con una muestra de igual tamaño procedente de los datos normativos. Se realizó la evaluación de las funciones ejecutivas con prueba Torre de Londres, M-Wisconsin, Trail Making Test y Test Stroop. Resultados Se identificó que los jóvenes de entre 13 y 15 años que muestran conducta impulsiva presentaron también una alteración en las funciones ejecutivas estudiadas, tales como control inhibitorio, flexibilidad cognitiva y planeación conductual. Discusión y conclusión Se identificó que existe una correlación directa entre las conductas impulsivas y las funciones ejecutivas evaluadas en la etapa de la adolescencia. Los resultados encontrados aquí pueden apoyar la construcción de potenciales protocolos de intervención basados en el funcionamiento ejecutivo.

Efficacy of the Spanish modified Story Memory Technique in Mexicans with multiple sclerosis: A pilot randomized controlled trial.

BACKGROUND: Memory impairments commonly afflict individuals with MS. While evidence-based cognitive rehabilitation treatments are available in English, the lack of such interventions in Spanish is an important barrier to care for Hispanics with MS. There is class I evidence that the modified Story Memory Technique (mSMT) improves learning in English. This intervention has been translated and adapted into Spanish. OBJECTIVE: To examine the preliminary efficacy of the Spanish mSMT to improve learning in Mexicans with MS. METHODS: Twenty individuals with relapsing-remitting MS were randomized to treatment (n = 10) or placebo control (n = 10) groups. The Spanish mSMT is a 10-session intervention that teaches imagery and context to facilitate learning. The control condition was matched to the treatment condition in treatment duration, and stimulus content and presentation. Participants completed baseline and post-treatment neuropsychological assessments. RESULTS: Individuals who received the Spanish mSMT showed significant improvements in learning and life satisfaction relative to the control group. Also observed were a near-moderate effect size on perceived memory complaints and a moderate-to-large effect size on the family's perception of the patient's competency. CONCLUSIONS: The Spanish mSMT showed preliminary efficacy in improving learning deficits in Mexicans with MS, and such improvements may extend to other domains.

Situación actual de la práctica profesional de la neuropsicología en México / Current state of professional Neuropsychological practice in Mexico

El objetivo de este estudio fue conocer las características de la práctica neuropsicológica en México, incluyendo la formación profesional, la situación laboral actual, el proceso de evaluación y diagnóstico, rehabilitación, docencia e investigación. Participaron 171 profesionales en México, quienes respondieron una encuesta electrónica entre el 1 de julio del 2013 y el 1 de enero del 2014. El 76% indicó haber obtenido su entrenamiento en neuropsicología durante el postgrado y, aunque indicaron estar muy satisfechos con su labor, su satisfacción con el salario fue menor. La mayoría trabajan con personas con problemas de aprendizaje (78%) y trastornos de atención e hiperactividad (74%). El 91% se dedica a evaluación y diagnóstico, 61% a rehabilitación, 67% a docencia y 60% a investigación. Los problemas más comunes fueron la falta de datos normativos (63%) y el alto coste de los test (58%). Las barreras más observadas en el desarrollo de la neuropsicología fueron la falta de colaboración entre los profesionales y la falta de programas de formación clínica. Durante las últimas décadas se han logrado importantes avances a nivel profesional en el campo de la neuropsicología en México. Sin embargo, aún quedan aspectos por mejorar como el establecimiento de criterios para la regulación de la práctica neuropsicológica en el país.

The objective of this study was to analyze the characteristics of the profession of neuropsychology in Mexico, including the background, professional training, current work situation, evaluation and diagnosis procedures, rehabilitation, teaching, and research. 171 professionals from Mexico completed an online survey between July 1, 2013 and January 1 of 2014. 76% indicated having obtained their training in neuropsychology in a postgraduate program, also to be very satisfied with their jobs, but less satisfied with their salary. The majority works with individuals with learning difficulties (78%) and attention and hyperactivity disorder (74%). 91% works in evaluation and diagnosis, 61% in rehabilitation, 67% in teaching, and 60% in research. Some of the most common problems with the instruments were the lack of normative data (63%) and their high cost (58%). The most common barriers for the development of neuropsychology in Mexico were the lack of collaboration between professionals and the lack of clinical training programs. Even though there have been important progresses in the field of professional neuropsychological practice during the last past decades in Mexico, there are still some aspects to improve, like the establishment of standards for the regulation in the country.