['Tower of London': mental planning, validity and the ceiling effect]. / 'Torre de Londres': planificación mental, validez y efecto techo.

INTRODUCTION: The Tower of London (TL) is a neuropsychological test that is used to evaluate the capacity for planning. Different versions of the TL exist, including the classical version that presents certain psychometric problems (for example, the ceiling effect). AIMS: The aim of this study was to propose a new method of administering and correcting the classical version of the TL, thus increasing the mental resolution of the planning task through instruction, and varying the system of scoring in order to obtain a wider range of scores. PATIENTS AND METHODS: Two versions of the TL were administered to two independent, counterbalanced groups. One of them was the one designed by Krikorian and the other was the one proposed for this study. To compare the two versions, Porteus mazes were administered in each group as a criterion variable in the study of correlations. RESULTS: Both versions correlate with the Porteus mazes in a similar fashion. The variances found in each group are statistically different and the coefficient of covariance is clearly wider in the group that received the version proposed in this study. CONCLUSIONS: Changing the instruction for the mental resolution of planning tasks does not appear to alter the TL. The changes introduced in the correction and the system of scoring of the version proposed for this study present wider variance, which means that the ceiling effect has been overcome.

'Torre de Londres': planificación mental, validez y efecto techo / 'Tower of london': mental planning, validity and the ceiling effect

Introducción. La torre de Londres (TL) es una prueba neuropsicológica que se emplea para evaluar la capacidad de planificación. Existen diferentes versiones de la TL, entre ellas, la versión clásica, que presenta ciertos problemas psicométricos (por ejemplo, efecto techo). Objetivos. Proponer un nuevo método de administración y corrección de la versión clásica de la TL, incrementando con la instrucción la resolución mental de la tarea de planificación, y variando el sistema de puntuación para obtener un rango mayor de puntuaciones. Pacientes y métodos. Se administraron dos versiones de la TL a dos grupos independientes, contrabalanceados. Una de las versiones fue la que propuso Krikorian, y la otra, la propuesta para este estudio. Para comparar ambas versiones, se administraron los laberintos de Porteus en cada grupo como variable criterio en el estudio de correlación. Resultados. Ambas versiones correlacionan de forma semejante con los laberintos de Porteus. Las varianzas que se hallaron en cada grupo son estadísticamente diferentes, y el coeficiente de covariación es claramente más amplio en el grupo donde se administró la versión que se propuso para este estudio. Conclusiones. Con el cambio en la instrucción para una resolución mental de las tareas de planificación no parece alterarse la TL. El cambio en la corrección y en el sistema de puntuación de la versión propuesta para este estudio presentan una variancia más amplia, que se puede interpretar como una superación del efecto techo (AU)

Introduction. The Tower of London (TL) is a neuropsychological test that is used to evaluate the capacity for planning. Different versions of the TL exist, including the classical version that presents certain psychometric problems (for example, the ceiling effect). Aims. The aim of this study was to propose a new method of administrating and correcting the classical version of the TL, thus increasing the mental resolution of the planning task through instruction, and varying the system of scoring in order to obtain a wider range of scores. Patients and methods. Two versions of the TL were administered to two independent, counterbalanced groups. One of them was the one designed by Krikorian and the other was the one proposed for this study. To compare the two versions, Porteus mazes were administered in each group as a criterion variable in the study of correlations. Results. Both versions correlate with the Porteus mazes in a similar fashion. The variances found in each group are statistically different and the coefficient of covariance is clearly wider in the group that received the version proposed in this study. Conclusions. Changing the instruction for the mental resolution of planning tasks does not appear to alter the TL. The changes introduced in the correction and the system of scoring of the version proposed for this study present wider variance, which means that the ceiling effect has been overcome (AU)

[Assessment of frontal functions in psychiatric patients during maintenance electroconvulsive therapy]. / Evaluación de las funciones frontales en pacientes psiquiátricos durante el tratamiento con terapia electroconvulsiva de mantenimiento.

INTRODUCTION: Previous studies on adverse cognitive effects of electroconvulsive therapy (ECT) have not found any significant alteration of the frontal functions after an acute treatment course. This study aims to assess frontal executive functions in psychiatric patients during maintenance electroconvulsive therapy (M-ECT). SUBJECTS AND METHODS: Thirty two patients treated with M-ECT and 29 psychiatric patients never treated with ECT were evaluated with neuropsychological tests that assessed the following frontal functions: work memory, planning, cognitive flexibility, attention, visuomotor velocity, verbal abstract reasoning and phonetic verbal fluency. RESULTS: Multivariate global analysis did not detect significant frontal function tests differences between both groups. The M-ECT group only scored significantly lower on the FAS test, a test that measures phonetic verbal fluency. A significant correlation between number of previous ECT sessions and performance in the FAS was found. CONCLUSIONS: The M-ECT patient group presented a phonetic verbal fluency alteration that may also be associated to the previous number of ECT sessions. No significant differences in the other frontal functions were detected.

Pattern of cognitive dysfunction in depressive patients during maintenance electroconvulsive therapy.

BACKGROUND: Objective data regarding adverse cognitive deficits associated with maintenance electroconvulsive therapy (M-ECT) are lacking. This study examined the cognitive state of depressive patients during M-ECT. METHOD: A cross-sectional study was carried out in 11 depressive patients in remission, all with a DSM-IV diagnosis of major depressive disorder. The mean number of previous ECT sessions was 36.1, and the mean intersession interval was 52.7 days. A group of 11 patients who had not received ECT was selected for comparison and matched for diagnosis, sex, age and years of schooling. All subjects were assessed using a complete neuropsychological battery including memory, attention and frontal function tests. RESULTS: Groups did not present differences in long delay verbal recall. Encoding of new information and results on the frontal function tests were significantly lower in the M-ECT patients. CONCLUSION: Depressed patients preserve long-term memory, but suffer short-term memory impairment and frontal function alteration during M-ECT. Further longitudinal studies are necessary to determine the influence of M-ECT on non-memory functions and different memory subtypes.

Evaluación de las funciones frontales en pacientes psiquiátricos durante el tratamiento con terapia electroconvulsiva de mantenimiento / Assessment of frontal functions in psychiatric patients during maintenance electroconvulsive therapy

Introducción. Los estudios previos sobre los efectos cognitivos adversos de la terapia electroconvulsiva (TEC) no han hallado una alteración significativa de las funciones frontales después de un curso de tratamiento agudo. El objetivo del estudio es evaluar las funciones ejecutivas frontales en pacientes psiquiátricos que siguen un tratamiento con TEC de mantenimiento (TEC-M) y que han recibido un número elevado de sesiones de TEC.Sujetos y métodos. Treinta y dos pacientes tratados con TEC-M y 29 pacientes psiquiátricos controles que nunca habían sido tratados con TEC fueron explorados con tests neuropsicológicos que evaluaban las siguientes funciones frontales: memoria de trabajo, planificación, flexibilidad cognitiva, atención, velocidad, pensamiento abstracto verbal y fluencia verbal con consigna fonética.Resultados. El análisis multivariante global no detecta diferencias significativas en las pruebas neuropsicológicas frontales entre los dos grupos. El grupo de TEC-M sólo obtuvo puntuaciones significativamente más bajas en la prueba de FAS, test que mide la fluencia verbal con consigna fonética. Se detecta una correlación significativa inversamente proporcional entre el número de sesiones de TEC previas y el resultado en la prueba del FAS.Conclusiones. El grupo de pacientes tratados con TEC-M presenta una alteración de la fluencia verbal con consigna fonética, que además podría estar asociada al número de sesiones de TEC previas. No se detectan diferencias significativas en el resto de funciones frontales evaluadas (AU)

[Neurobiology of addiction to drugs of abuse]. / Neurobiologia de la adiccion a las drogas de abuso.

OBJECTIVE: In this review we study drug addiction from a neurobiological point of view, emphasizing the dopamine hypothesis. This is basic to explain how a genetic feature is related with an alteration of this neurotransmitter and can connect with environmental factors to develop the addiction problem. DEVELOPMENT: Toxic addiction is defined as the physical or psychophysiological dependence on a special chemical substance, whose suppression arouses deprivation symptoms in the person. The study of addiction to different drugs gives us a new approach for knowing the strengthening systems. Because even thought we do not know precisely the nervous mechanism of these substances that cause pleasure, we suppose that they are in the same place as rewarding and strengthening the behaviour mechanisms. In this way the dopamine hypothesis has been developed: in this hypothesis drug addiction is closely connected with a genetic upset of this neurotransmitter, so there is a defect in the reward system. This in turn stimulates the substance abuse that increases the brain s dopamine levels. CONCLUSION: Knowing the neurobiological mechanisms involved in addiction and its relation with dopamine and the reward system can help us understand that problem and aid the rational development of treatment

Neurobiología de la adicción a las drogas de abuso / Neurobiology of addiction to drugs of abuse

Objetivo. En esta revisión hacemos un abordaje, desde el punto de vista neurobiológico, del problema de la adicción a las drogas de abuso, haciendo hincapié en la hipótesis de la dopamina, marco básico para explicar cómo un rasgo genético, relacionado con la alteración de dicho neurotransmisor, puede relacionarse con factores ambientales para desarrollar el problema de la adicción. Desarrollo. La adicción a tóxicos se define como la dependencia física o psicofisiológica de una determinada sustancia química, cuya supresión causa síntomas de deprivación en el individuo. El estudio de la adicción a diversas drogas nos ha proporcionado un nuevo enfoque para el conocimiento de los sistemas de refuerzo, ya que aunque se conocen mal los mecanismos nerviosos por los cuales estas sustancias producen placer, parece razonable pensar que se superpongan o incluso coincidan con los de recompensa y refuerzo de la conducta. Así se ha desarrollado la hipótesis de la dopamina, por la cual la adicción a las drogas estaría relacionada con una alteración genética vinculada con dicho neurotransmisor, en el sentido de provocar una deficiencia en el sistema de gratificación; la ineficacia de dicho sistema recompensaría el abuso de sustancias que aumenten los niveles de dopamina en el cerebro. Conclusión. El conocimiento de los mecanismos neurobiológicos implicados en la adicción, y su relación con la dopamina y los sistemas de gratificación, nos llevará a la comprensión de dicho problema y al desarrollo racional de farmacoterapias para su tratamiento (AU)

Objective. In this review we study drug addiction from a neurobiological point of view, emphasizing the dopamine hypothesis. This is basic to explain how a genetic feature is related with an alteration of this neurotransmitter and can connect with environmental factors to develop the addiction problem. Development. Toxic addiction is defined as the physical or psychophysiological dependence on a special chemical substance, whose suppression arouses deprivation symptoms in the person. The study of addiction to different drugs gives us a new approach for knowing the strengthening systems. Because even thought we do not know precisely the nervous mechanism of these substances that cause pleasure, we suppose that they are in the same place as rewarding and strengthening the behaviour mechanisms. In this way the dopamine hypothesis has been developed: in this hypothesis drug addiction is closely connected with a genetic upset of this neurotransmitter, so there is a defect in the reward system. This in turn stimulates the substance abuse that increases the brain’s dopamine levels. Conclusion. Knowing the neurobiological mechanisms involved in addiction and its relation with dopamine and the reward system can help us understand that problem and aid the rational development of treatment (AU)

[Selective alteration of the declarative memory systems in patients treated with a high number of electroconvulsive therapy sessions]. / Alteracion selectiva de los sistemas declarativos de memoria en los pacientes tratados con un elevado numero de sesiones de terapia electroconvulsiva.

INTRODUCTION: The reversible electrochemical effects of electroconvulsive therapy (ECT) on specific areas of the brain enable the neuroanatomical bases of some cognitive functions to be studied. In research carried out on memory systems, a selective alteration of the declarative ones has been observed after treatment with ECT. Little work has been done to explore the differential alteration of the memory subsystems in patients with a high number of ECT sessions. AIM. To study the declarative and non declarative memory system in psychiatric patients submitted to maintenance ECT treatment, with a high number of previous ECT sessions. PATIENTS AND METHODS: 20 patients submitted to treatment with ECT (10 diagnosed as having depression and 10 with schizophrenia) and 20 controls, who were paired by age, sex and psychopathological diagnosis. For the evaluation of the declarative memory system, the Wechsler Memory Scale (WMS) logical memory test was used. The Hanoi Tower procedural test was employed to evaluate the non declarative system. RESULTS: Patients treated with ECT performed worse in the WMS logical memory test, but this was only significant in patients diagnosed as suffering from depression. No significant differences were observed in the Hanoi Tower test. CONCLUSIONS: A selective alteration of the declarative systems was observed in patients who had been treated with a high number of ECT sessions, while the non declarative memory systems remain unaffected.

Los deseos humanos, una revisión desde el punto de vista neuropsicobiológico / Human desires, a review from a neuropsychobiological point of view

No disponible

Alteración selectiva de los sistemas declarativos de memoriaen los pacientes tratados con un elevado número de sesionesde terapia electroconvulsiva / Selective alteration of the declarative memory systems in patients treated with a high number of electroconvulsive therapy sessions

Introducción. Los efectos electroquímicos reversibles de la terapia electroconvulsiva (TEC) sobre zonas cerebrales específicas permiten el estudio de las bases neuroanatómicas de algunas funciones cognitivas. Los estudios sobre los sistemas de memoria observan una alteración selectiva de los declarativos después de un tratamiento con TEC. Pocos trabajos han estudiado la alteración diferencial de los subsistemas de memoria en pacientes con un elevado número de sesiones de TEC. Objetivo. Estudiar el sistema declarativo y no declarativo de memoria en pacientes psiquiátricos sometidos a un tratamiento de TEC de mantenimiento, con un elevado número de sesiones de TEC previas. Pacientes y métodos. 20 pacientes sometidos a tratamiento con TEC (10 diagnosticados de depresión y 10 de esquizofrenia) y 20 pacientes controles apareados por edad, sexo y diagnóstico psicopatológico. Para la evaluación del sistema declarativo de memoria se utilizó la prueba de memoria lógica Wechsler Memory Scale (WMS). La prueba procedimental de la Torre de Hanoi se utilizó para valorar el sistema no declarativo. Resultados. Se observa un peor rendimiento de la prueba de memoria lógica de la WMS en pacientes tratados con TEC, que sólo es significativo en los pacientes diagnosticados de depresión. No se observan diferencias significativas en la Torre de Hanoi. Conclusiones. Se detecta una alteración selectiva de los sistemas declarativos en pacientes tratados con un número elevado de sesiones de TEC, mientras que los sistemas no declarativos de memoria se preservan (AU)

Neuropsicobiología de la relación entre la experiencia sensitiva posnatal y el desarrollo de la precisión en las conexiones neuronales / Neuropsychobiology of the relationship between postnatal sensory experience and development of precision in neuronal connections

No disponible

Subtypes of memory dysfunction associated with ECT: characteristics and neurobiological bases.

Electroconvulsive therapy (ECT) is an effective treatment for a variety of psychiatric syndromes. However, one of its adverse secondary effects is neurocognitive dysfunction. The aim of this paper is to review different subtypes of memory dysfunction associated with ECT from a neuropsychological perspective. Declarative memory is clearly impaired after ECT. Immediate memory, however, is broadly preserved. Few studies have addressed procedural and incidental memory. Selective memory is impaired, probably due to the disruption of specific brain regions. Some of the possible neurobiological bases of ECT memory dysfunction are discussed in this paper. Synaptic plasticity, the cerebral neurotransmission system, and cerebral metabolism are examined in relation to the dysfunction and subsequent recovery of each memory subtype.