Correction to: Assessment and Management of Long COVID.

[This corrects the article DOI: 10.1007/s42843-022-00055-8.].

Assessment and Management of Long COVID.

Almost two years into the pandemic, the scientific and healthcare communities continue to learn a great deal regarding COVID-19, the disease produced by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Broad variability during acute COVID-19 infection is seen, ranging from asymptomatic presentation to death. The vast majority of individuals who develop COVID-19 return to their pre-COVID-19 baseline within several weeks. However, a portion of patients will develop a post-COVID-19 syndrome of persistent cognitive, somatic, and behavioral symptoms. This syndrome, designated as post-acute sequelae of SARS-CoV-2 infection, is more commonly known as long COVID. The objectives of this paper are to inform psychologists regarding our current understanding of the underlying pathophysiology of COVID-19, review criteria for range of severity during acute illness, present clinical manifestations of long haul phenomena, and discuss the emerging literature base of evidence-based treatment and management approaches.

Long-term seizure and psychiatric outcomes following laser ablation of mesial temporal structures.

OBJECTIVE: Postsurgical seizure outcome following laser interstitial thermal therapy (LiTT) for the management of drug-resistant mesial temporal lobe epilepsy (MTLE) has been limited to 2 years. Furthermore, its impact on presurgical mood and anxiety disorders has not been investigated. The objectives of this study were (1) to identify seizure outcome changes over a period ranging from 18 to 81 months; (2) to investigate the seizure-free rate in the last follow-up year; (3) to identify the variables associated with seizure freedom; and (4) to identify the impact of LiTT on presurgical mood and anxiety disorders. METHODS: Medical records of all patients who underwent LiTT for MTLE from 2013 to 2019 at the University of Miami Comprehensive Epilepsy Center were retrospectively reviewed. Demographic, epilepsy-related, cognitive, psychiatric, and LiTT-related data were compared between seizure-free (Engel Class I) and non-seizure-free (Engel Class II + III + IV) patients. Statistical analyses included univariate and multivariate stepwise logistic regression analyses. RESULTS: Forty-eight patients (mean age = 43 ± 14.2 years, range = 21-78) were followed for a mean period of 50 ± 20.7 months (range = 18-81); 29 (60.4%) achieved an Engel Class I outcome, whereas 11 (22.9%) had one to three seizures/year. Seizure-freedom rate decreased from 77.8% to 50% among patients with 24- and >61-month follow-up periods, respectively. In the last follow-up year, 83% of all patients were seizure-free. Seizure freedom was associated with having mesial temporal sclerosis (MTS), no presurgical focal to bilateral tonic-clonic seizures, and no psychopathology in the last follow-up year. Presurgical mood and/or anxiety disorder were identified in 30 patients (62.5%) and remitted after LiTT in 19 (62%). SIGNIFICANCE: LiTT appears to be a safe and effective surgical option for treatment-resistant MTLE, particularly among patients with MTS. Remission of presurgical mood and anxiety disorders can also result from LiTT.

Status atual do tratamento em uma sessão para fobias específicas / Current status of one-session treatment for specific phobias

O tratamento em uma sessão (OST) é uma forma de exposição intensa para o tratamento das fobias especificas. O OST combina técnicas de exposição ao vivo, reestruturação cognitiva, modelagem participativa e reforço positivo em uma única sessão de 03 horas. O presente trabalho teve como objetivo analisar os artigos indexados nas bases de dados Medline e Psycinfo no período entre 2009 e 2020, identificando estudos sobre a eficácia do OST nas fobias especificas. A amostra final foi constituída por 13 artigos. Todos os artigos atestaram a eficácia positiva dessa forma de tratamento nos diversos estímulos fóbicos tratados. Uma maior divulgação do OST deve ser incentivada no Brasil, para que as pessoas acometidas por esse transtorno de ansiedade possam se beneficiar dos efeitos muito bem estabelecidos dessa forma de tratamento.(AU)

One-session treatment (OST) is a form of massed exposure therapy for the treatment of specific phobias. OST combines in vivo exposure techniques, cognitive restructuring, participant modeling and positive reinforcement in a single session of 03 hours. This study aimed to examine the articles indexed on the databases of Medline and Psycinfo in the period between 2009 and 2020, to identifying studies on the effectiveness of OST in specific phobias. The final sample consisted of 13 articles. Articles attested to the positive effectiveness of this form of treatment in the various specific phobic disorders. Greater dissemination of OST should be encouraged in Brazil, so that people affected by this anxiety disorder can benefit from the well-established effects of this form of treatment.(AU)

Cognitive outcomes following laser interstitial therapy for mesiotemporal epilepsies.

OBJECTIVE: To provide a review of cognitive outcomes across a full neuropsychological profile in patients who underwent laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). METHODS: We examined cognitive outcomes following LiTT for mTLE by reviewing a consecutive series of 26 patients who underwent dominant or nondominant hemisphere procedures. Each patient's pre- and postsurgical performance was examined for clinically significant change (>1SD improvement or decline on standardized scores), with a neuropsychologic battery that included measures of language, memory, executive functioning, and processing speed. RESULTS: Presurgical performance was largely consistent with previous research, where patients suffering from dominant hemisphere epilepsies demonstrated deficits in verbal learning and memory, whereas patients with nondominant hemisphere scored lower on visually mediated tests. Case-by-case review comparing presurgical to postsurgical scores revealed clinically significant improvement in both dominant and nondominant patients in learning and memory and other aspects of cognition such as processing speed and executive functioning. Of the few patients who did experience clinically significant decline following LiTT, a greater proportion had undergone dominant hemisphere procedures. CONCLUSIONS: Compared with the outcome literature of dominant open anterior temporal lobectomies (ATLs), where postsurgical decline has been documented in up to 40%-60% of cases, our LiTT case series exhibited a much lower incidence of postoperative language or verbal memory decline. Moreover, promising rates of postoperative improvements were also observed across multiple cognitive domains. Future studies exploring cognitive outcomes following LiTT should include comprehensive neuropsychological findings, rather than only select domains, as clinically significant change can occur in areas other than those typically associated with mesiotemporal structures.

Magnetic Resonance-Guided Laser Interstitial Thermal Therapy for Mesial Temporal Epilepsy: A Case Series Analysis of Outcomes and Complications at 2-Year Follow-Up.

BACKGROUND: Laser interstitial thermal therapy (LITT) presents an important new minimally invasive tool in the management of drug-resistant mesial temporal epilepsy (MTE). However, because of its relative novelty, not much is known about long-term seizure freedom rates. The objective of this study was to evaluate the postsurgical seizure outcome following LITT after a minimum follow-up period of 2 years. METHODS: Medical records of all patients who underwent LITT for MTE from 2013 to 2018 at our comprehensive epilepsy center under a single surgeon were retrospectively reviewed. Data related to demographics, presurgical evaluations, and seizure outcome were compared between seizure-free (SF) and non-seizure-free (NSF) patients. RESULTS: In all, 26 patients were identified with at least 2 years of follow-up. Mean age was 43.8 years ± 11.6 years, and 46.2% were female. After a mean follow-up time of 42.9 months (range, 24.3-58.8 months), 61.5% (16/26) were free of disabling seizures, and 26.9% (7/26) had only rare disabling seizures. Whereas seizure-freedom rates between patients with and without mesial temporal sclerosis (MTS) were not statistically different (68% vs. 43%, P = 0.23), NSF patients without MTS had a shorter median time to first seizure than did NSF patients with MTS (0.55 month vs. 10 months, log-rank test P = 0.007). Postoperative complications occurred in 2 patients (7.7%), consisting of 1 permanent and 1 transient homonymous hemianopia. CONCLUSIONS: LITT appears to be a safe and effective initial surgical option for treatment-resistant MTE. Among patients who have seizures after treatment, those without MTS appear to have seizures earlier than those with MTS.

Laser thermal ablation for mesiotemporal epilepsy: Analysis of ablation volumes and trajectories.

OBJECTIVE: To identify features of ablations and trajectories that correlate with optimal seizure control and minimize the risk of neurocognitive deficits in patients undergoing laser interstitial thermal therapy (LiTT) for mesiotemporal epilepsy (mTLE). METHODS: Clinical and radiographic data were reviewed from a prospectively maintained database of all patients undergoing LiTT for the treatment of mTLE at the University of Miami Hospital. Standard preoperative and postoperative evaluations, including contrast-enhanced magnetic resonance imaging (MRI) and neuropsychological testing, were performed in all patients. Laser trajectory and ablation volumes were computed both by manual tracing of mesiotemporal structures and by nonrigid registration of ablation cavities to a common reference system based on 7T MRI data. RESULTS: Among 23 patients with at least 1-year follow-up, 15 (65%) were free of disabling seizures since the time of their surgery. Sparing of the mesial hippocampal head was significantly correlated with persistent disabling seizures (p = 0.01). A lateral trajectory through the hippocampus showed a trend for poor seizure outcome (p = 0.08). A comparison of baseline and postoperative neurocognitive testing revealed areas of both improvement and worsening, which were not associated with ablation volume or trajectory. SIGNIFICANCE: At 1-year follow-up, LiTT appears to be a safe and effective tool for the treatment of mTLE, although a longer follow-up period is necessary to confirm these observations. Better understanding of the impact of ablation volume and location could potentially fine-tune this technique to improve seizure-freedom rates and associated neurologic and cognitive changes.

Atypical language representation in children with intractable temporal lobe epilepsy.

This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed. Atypical receptive language cortex correlated with lower intellectual capacity, verbal abstract conceptualization, receptive language abilities, verbal working memory, and a history of status epilepticus but did not correlate with higher seizure frequency or early seizure onset. Histopathologic substrate had only a minor influence on neuropsychological status. Greater verbal comprehension deficits were noted in children with atypical receptive language representation, a risk factor for cognitive morbidity.

The bacterial microbiome in paired vaginal and vestibular samples from women with vulvar vestibulitis syndrome.

Composition of the bacterial microbiome in the vagina and vestibule from 30 women with vulvar vestibulitis syndrome (VVS) and 15 healthy controls were compared by pyrosequencing 16S rRNA gene amplicons. Vaginal concentrations of interleukin (IL)-1ß were determined by ELISA. Questionnaires elicited clinical and symptom data. Eighteen genera were detected in vaginal samples, and 23 genera were identified in vestibule samples, from women with VVS. The genera at both sites and the mean number of genera in subjects with VVS were largely similar to those in control subjects. However, differences were noted including higher proportions of Streptococcus and Enterococcus in women with VVS. Furthermore, Lactobacillus iners was more frequently identified in women with VVS while L. crispatus was more frequent in the control women. The dominant bacterial genera in the vagina closely paralleled the dominant genera present in the corresponding vestibular sample in both groups, leading us to postulate that vaginal secretions are an important source of bacteria present on the vestibule. Vaginal IL-1ß levels were similar and varied depending on the dominant bacteria. We conclude in this pilot study that no major differences are apparent in the vagina and vestibule between women with or without VVS, except for an increased prevalence of Streptococcus and L. iners in some women with VVS.

Gestational and congenital toxoplasmosis in two hospitals in Bogota, Colombia / Toxoplasmosis gestacionaly congénita en dos hospitales de Bogotá, Colombia

Background. Gestational toxoplasmosis is acquired during pregnancy and involves a risk of the parasite crossing the placenta, thereby leading to foetal infection, which can lead to serious sequelae in children, mainly chorioretinitis, cerebral calcification, hydrocephalus and intellectual disability. Objective. Determining the prevalence of maternal and neonatal toxoplasmosis in women attending the Engativa and La Victoria hospitals in Bogota, Colombia, for delivery. Correlating the results with those of a national multicentre study. Determining IgM and IgA anti-toxoplasma prevalence in newborn (NB) umbilical cord blood. Materials and methods. This was a cohort study, which was approved by the participating institutions' ethics committees. The patients signed informed consent forms and filled out a survey requesting demographic and prenatal care data. A blood sample was taken from the umbilical cord on delivery for determining anti-toxoplasma IgM. Anti-toxoplasma IgA was also measured in a subset of patients. Children suspected of having either clinical or serological congenital toxoplasmosis were followed-up for 12 months. Results. The study involved taking 3,224 NB umbilical cord blood samples between April 1st 2009 and July 16th 2010. Positive anti-toxoplasma IgG was found in 28.2% of pregnant women (26.1-29.8 95%CI). Anti-toxoplasma IgM was determined in 558 pregnant women and found positive in 34 patients (i.e. 1.1 per 100 NB gestational toxoplasmosis incidence). Nine blood samples were positive (7 for IgM and 2 for IgA). Five of the NB studied (0.15%) were positive for IgG after 12 months' follow-up, thereby confirming a diagnosis of congenital toxoplasmosis accounting for 1 in every 645 live births. Conclusion. This study showed that 70% of the pregnant women were not infected with T. gondii in the chosen hospitals in Bogotá. Gestational toxoplasmosis frequency was around 1% and 0.6% for congenital toxoplasmosis.

Antecedentes. La toxoplasmosis gestacional es la adquisición de la enfermedad durante la gestación, con el riesgo de que el parásito atraviese la placenta and produzca una infección fetal, que puede llevar a importantes secuelas en el niño, principalmente coroidoretinitis, calcificaciones cerebrales, hidrocefalia and retardo mental. Objetivo. Conocer la prevalencia de la toxoplasmosis materna and neonatal, de las mujeres que asistieron para la atención del parto, en los Hospitales Engativá and La Victoria, de Bogotá, Colombia y correlacionar los resultados con los del estudio multicéntrico nacional. Determinar la prevalencia de IgM and IgA en sangre de cordón umbilical de los recién nacidos (RN). Materiales and métodos. Estudio de cohorte. El estudio fue aprobado por los comités de ética de las instituciones. Las pacientes firmaron el consentimiento informado y, posteriormente, se les diligenció el formato de recolección de datos, para conocer las características demográficas and los datos del control prenatal. En el parto, después del pinzamiento del cordón, se tomó una muestra de sangre de este, para determinar IgM antitoxoplasma y en un subgrupo de pacientes también se midió la IgA antitoxoplasma. Los niños con datos clínicos o serológicos sospechosos de toxoplasmosis congénita, se siguieron hasta los 12 meses. Resultados. Se tomaron muestras de 3.224 RN, entre el 1 de abril de 2009 y el 16 de julio de 2010. En las gestantes se encontró IgG anti-Toxoplasma positiva en 28,2% (IC95% 26,1-29,8). Se determinó la IgM anti-Toxoplasma en 558 gestantes encontrando 34 positivas, calculando una incidencia de toxoplasmosis gestacional de 1,1 por cada 100 RN. Se estudiaron 3215 muestras de cordón umbilical y se encontraron nueve casos positivos (siete con IgM y dos con IgA). De los RN estudiados, cinco (0,15%) tuvieron resultado positivo de IgG al año de edad, con lo cual se confirmó el diagnostico de toxoplasmosis congénita; esto equivale a un diagnóstico de toxoplasmosis congénita en 1 de cada 645 nacidos vivos. Conclusión. En este estudio se encontró que, en los hospitales de Bogotá estudiados, aproximadamente el 70% de las mujeres al momento de la gestación no se han infectado con el T gondii. La frecuencia de la toxoplasmosis gestacional es de aproximadamente 1% y la de toxoplasmosis congénita de 0,6%.

Predictors of seizure-free outcome after epilepsy surgery for pediatric tuberous sclerosis complex.

PURPOSE: Variable predictors of postsurgical seizure outcome have been reported in children with tuberous sclerosis complex (TSC). We analyzed a large surgical series of pediatric TSC patients in order to identify prognostic factors crucial for selection of subjects for epilepsy surgery. METHODS: Thirty-three children with TSC who underwent excisional epilepsy surgery at Miami Children's Hospital were retrospectively reviewed. A total of 29 clinical, neuropsychological, electroencephalography (EEG), magnetic resonance imaging (MRI), and surgical variables were analyzed and related to seizure outcomes. Univariate Barnard's exact test, Wilcoxon's rank-sum test, and multivariate statistical Cox's model were used to examine the significance of associations between the variables and seizure outcome. KEY FINDINGS: Eighteen patients (55%) have been seizure-free 2 years after (final) surgery; postoperative complications occurred in five subjects (15%). Complete removal of epileptogenic tissue detected by both MRI and intracranial EEG, regional scalp interictal EEG patterns, and agreement of interictal and ictal EEG localization were the most powerful predictors of seizure-free outcome. Other significant predictors included occurrence of regional scalp ictal EEG patterns, fewer brain regions affected by tubers, presence of preoperative hemiparesis, and one-stage surgery. Remaining factors such as age at seizure onset, incidence of infantile spasms or other seizure types, duration of epilepsy, seizure frequency, mental retardation, as well as types and extent of resections did not influence outcome. SIGNIFICANCE: Perioperative features rather than preoperative variables are the most important determinants of postsurgical seizure outcome in patients with TSC. Our findings may assist in the surgical management of these patients.

Early seizure onset and dysplastic lesion extent independently disrupt cognitive networks.

OBJECTIVE: To determine the most important factors influencing neuropsychological performance in children with intractable epilepsy due to focal cortical dysplasia and the nature of the interaction among significant variables. METHODS: Surgical patients with histologically verified focal cortical dysplasia were retrospectively evaluated to determine the impact of histopathology, extent of lobar involvement, hemispheric laterality, age at onset, and duration of epilepsy on cognitive functioning. A composite neuropsychological variable was obtained by transforming data from 5 major cognitive domains using principal components analysis. Multiple regression was used to examine the unique contributions of predictor variables on composite cognition and Full Scale IQ. Data were qualitatively evaluated for nonstatistical trends. RESULTS: Poor cognitive outcomes were associated with early age at onset of epilepsy (AOE) and widespread dysplastic involvement. Extent of dysplasia and AOE together accounted for 35% of Full Scale IQ variance, and 21% of composite cognitive performance. Each factor contributed independently to cognitive dysfunction. CONCLUSIONS: Early AOE disrupts critical periods of development and leads to poor cognitive outcome, but children with multilobar dysplasia are likely to have diminished cognitive skills regardless of AOE. Later AOE is not expected to mitigate deficits because of widespread pathology, nor would a localized lesion be likely to mollify the developmental deficits resulting from early AOE.

Prevalence of metabolic syndrome in a predominantly cuban, psychiatrically ill, and homeless population.

OBJECTIVE: This study examined the prevalence of metabolic syndrome among a group of psychiatric outpatients enrolled in a homeless program that is located in a predominantly Hispanic geographic area of South Florida. METHOD: Data for this retrospective, cross-sectional analysis were obtained from a record review of 122 adult patients who received full medical and psychiatric assessments based on DSM-IV criteria during participation in our homeless program from January 2009 to May 2009. The primary outcome measure was the presence of metabolic syndrome. RESULTS: The prevalence of metabolic syndrome within this population was 29.5%. Elevated waist circumference (48.5%) and elevated blood pressure (44.3%) were the 2 most frequent risk factors for the syndrome. Mean length of homelessness was 3.93 years, with no significant relationship noted between the presence of metabolic syndrome and duration of homelessness. Ninety-three percent of the subjects had been diagnosed with either schizophrenia or a mood disorder, and 61% had been treated with an atypical antipsychotic for at least 2 months over the preceding year. Our sample was predominantly Hispanic (79.5%), with Cuban Americans comprising 95% of that group. Among Hispanics, the prevalence rate of metabolic syndrome was 28.9%. CONCLUSIONS: Within our sample, homeless individuals compared to the general adult population in the United States seem to be at equal risk for metabolic syndrome. Although other studies have suggested an increased prevalence for metabolic syndrome among Hispanics, the obtained rate for our particular Hispanic sample was consistent with estimated prevalence of non-Hispanic individuals in the United States. Intervention programs rendering services to this population should include routine screening for presence of cardiovascular risk factors constituting metabolic syndrome.

Frontal activation and connectivity using near-infrared spectroscopy: verbal fluency language study.

Near infrared spectroscopy (NIRS) is an optical technique with high temporal resolution and reasonably good spatial resolution, which allows non invasive measurement of the blood oxygenation of tissue. The current work is focused in assessing and correlating brain activation, connectivity and cortical lateralization of the frontal cortex in response to language-based stimuli, using NIRS. Experimental studies were performed on 15 normal right-handed adults, wherein the participants were presented with a verbal fluency task. The hemodynamic responses in the pre- and anterior frontal cortex were assessed in response to a Word generation task in comparison to the baseline random Jaw movement and Rest conditions. The functional connectivity analysis was performed using zero-order correlations and the cortical lateralization was evaluated as well. An increase in oxy- and a decrease in deoxy-hemoglobin were observed during verbal fluency task in the frontal cortex. Unlike in the pre-frontal cortex, the hemodynamic response in the anterior frontal during verbal fluency task was not significantly different from that during random Jaw movement. Bilateral activation and symmetrical connectivity were observed in the pre-frontal cortex, independent of the stimuli presented. A left cortical dominance and asymmetry connectivity was observed in the anterior frontal during the verbal fluency task. The work is focused to target the pediatric epileptic populations in the future, where understanding the brain functionality (activation, connectivity, and dominance) in response to language is essential as a part of the pre-surgical evaluation in a clinical environment.

Low-grade focal cortical dysplasia is associated with prenatal and perinatal brain injury.

PURPOSE: Prenatal and perinatal adverse events are reported to have a pathogenetic role in focal cortical dysplasia (FCD). However, no data are available regarding the prevalence and significance of this association. A cohort of children with significant prenatal and perinatal brain injury and histologically proven mild malformations of cortical development (mMCD) or FCD was analyzed. METHODS: We retrospectively evaluated a surgical series of 200 patients with histologically confirmed mMCD/FCD. Combined historical and radiologic inclusion criteria were used to identify patients with prenatal and perinatal risk factors. Electroclinical, imaging, neuropsychological, surgical, histopathologic, and seizure outcome data were reviewed. RESULTS: Prenatal and perinatal insults including severe prematurity, asphyxia, bleeding, hydrocephalus, and stroke occurred in 12.5% of children with mMCD/FCD (n = 25). Their epilepsy was characterized by early seizure onset, high seizure frequency, and absence of seizure control. Patients with significant prenatal and perinatal risk factors had more abnormal neurologic findings, lower intelligence quotient (IQ) scores, and slower background EEG activity than mMCD/FCD subjects without prenatal or perinatal brain injury. MRI evidence of cortical malformations was identified in 74% of patients. Most patients underwent large multilobar resections or hemispherectomies; 54% were seizure-free 2 years after surgery. Histologically "milder" forms of cortical malformations (mMCD and FCD type I) were observed most commonly in our series. CONCLUSIONS: Surgically remediable low-grade cortical malformations may occur in children with significant prenatally and perinatally acquired encephalopathies and play an important role in the pathogenesis of their epilepsy. Presurgical detection of dysplastic cortex has important practical consequences for surgical planning.

Agenesis of the arcuate fasciculi in congenital bilateral perisylvian syndrome: a diffusion tensor imaging and tractography study.

OBJECTIVE: To describe the absence of the arcuate fasciculi in 2 cases of congenital bilateral perisylvian syndrome (CBPS). DESIGN: Case series. SETTING: Pediatric referral hospital-based study. PATIENTS: Two patients with CBPS, referred to our institution as candidates for surgical treatment of epilepsy. Intervention Diffusion tensor imaging (1.5-T scanner; 15 encoding directions; b = 800 s/mm(2)) and deterministic tractography of the main projection and association tracts. MAIN OUTCOME MEASURES: Neuropsychology evaluation; fractional anisotropy, apparent diffusion coefficients, and anatomical aspect of the tracts. RESULTS: Absence of the arcuate fasciculus was observed in both subjects. Ancillary findings were complete absence of the superior longitudinal fasciculi in 1 case and underdevelopment in the other. Low fractional anisotropy of the left inferior occipitofrontal fasciculus was found in both cases. The same tract was maloriented in 1 of the cases. CONCLUSION: Agenesis of the arcuate fasciculus may accompany CBPS.

Atypical propositional language organization in prenatal and early-acquired temporal lobe lesions.

This study investigated differences in propositional language organization in children with developmental and acquired brain lesions. We evaluated 30 right-handed subjects with intractable epilepsy due to either focal cortical dysplasia or hippocampal sclerosis with neuropsychological testing and functional MRI prior to epilepsy surgery. Atypical activations were seen in both prenatal and early postnatal lesions, but the contribution of specific histopathological substrate was minimal. Atypical organization of both temporal and frontal language areas also correlated inversely with receptive vocabulary scores. The data demonstrated a greater propensity toward atypical activation patterns for receptive than expressive networks, particularly when lesions were located in the dominant temporal lobe. Atypical language organization was not correlated with seizure-related factors such as age at onset or duration of epilepsy. The patterns of atypical language activation support prior studies implicating proximity of pathology to eloquent cortex in the dominant hemisphere as the primary determinant of functional reorganization.

Validação da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN) / Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN)

A fobia social (também conhecida como transtorno de ansiedade social) é um grave transtorno mental que traz sofrimento e incapacitação. O objetivo deste estudo foi validar para a língua portuguesa o Mini-Inventário de Fobia Social (Mini-SPIN) em uma amostra da população. Foi realizado um estudo da validade discriminativa do Mini-SPIN em uma amostra de 644 pessoas (grupo positivo para o Mini-SPIN: n = 218 e grupo controle/negativo: n = 426) de um estudo de prevalência de transtornos de ansiedade na cidade de Santo André (SP). A versão em português do Mini-SPIN (com escore de 6 pontos, sugerido na versão original em inglês) demonstrou uma sensibilidade de 95,0 por cento, especificidade de 80,3 por cento, valor preditivo positivo de 52,8 por cento, valor preditivo negativo de 98,6 por cento e taxa de classificação incorreta de 16,9 por cento. Com escores de 7 pontos, foi observado um aumento na especificidade e no valor preditivo positivo (88,6 por cento e 62,7 por cento), sendo que a sensibilidade e o valor preditivo negativo (84,8 por cento e 96,2 por cento) mantiveram-se altos. A versão em português do Mini-SPIN apresentou qualidades psicométricas satisfatórias em termos de validade discriminativa. Neste estudo, o ponto de corte igual a 7 mostrou-se mais adequado para a identificação da fobia social generalizada.

Social phobia (also known as social anxiety disorder) is a severe mental disorder that brings distress and disability. The aim of this study was validate to the Portuguese language the Mini-Social Phobia Inventory (Mini-SPIN) in a populational sample. We performed a discriminative validity study of the Mini-SPIN in a sample of 644 subjects (Mini-SPIN positive group: n = 218 and control/negative group: n = 426) of a study of anxiety disorders' prevalence in the city of Santo André-SP. The Portuguese version of the Mini-SPIN (with score of 6 points, suggested in the original English version) demonstrated a sensitivity of 95.0 percent, specificity of 80.3 percent, positive predictive value of 52.8 percent, negative predictive value of 98.6 percent and incorrect classification rate of 16.9 percent. With score of 7 points, was observed an increase in the specificity and positive predictive value (88.6 percent and 62.7 percent), while the sensitivity and negative predictive value (84.8 percent and 96.2 percent) remained high. The Portuguese version of the Mini-SPIN showed satisfactory psychometric qualities in terms of discriminative validity. In this study, the cut-off of 7, was considered to be the most suitable to screening of the generalized social phobia.

[Validation of the portuguese version of the Mini-Social Phobia Inventory (Mini-SPIN)]. / Validação da versão em português do Mini-Inventário de Fobia Social (Mini-SPIN).

Social phobia (also known as social anxiety disorder) is a severe mental disorder that brings distress and disability. The aim of this study was validate to the Portuguese language the Mini-Social Phobia Inventory (Mini-SPIN) in a populational sample. We performed a discriminative validity study of the Mini-SPIN in a sample of 644 subjects (Mini-SPIN positive group: n = 218 and control/negative group: n = 426) of a study of anxiety disorders' prevalence in the city of Santo André-SP. The Portuguese version of the Mini-SPIN (with score of 6 points, suggested in the original English version) demonstrated a sensitivity of 95.0%, specificity of 80.3%, positive predictive value of 52.8%, negative predictive value of 98.6% and incorrect classification rate of 16.9%. With score of 7 points, was observed an increase in the specificity and positive predictive value (88.6% and 62.7%), while the sensitivity and negative predictive value (84.8% and 96.2%) remained high. The Portuguese version of the Mini-SPIN showed satisfactory psychometric qualities in terms of discriminative validity. In this study, the cut-off of 7, was considered to be the most suitable to screening of the generalized social phobia.