Teoría de la Mente en pacientes Traumatizados Craneoencefálico

Antecedentes: Uno de los impedimentos más importantes en los traumatismos craneoencefálicos (TEC), revistan en las dificultades de interacción social, la Teoría de la Mente (ToM) es un factor fundamental de la cognición social, que permite una interacción satisfactoria del sujeto. Objetivo: Observar la capacidad de ToM en pacientes TEC moderado o severo, y su relación con dominios neurocognitivos. Método: Pacientes diagnosticados con TEC moderado o severo, evaluados neuropsicológicamente, edad 16 y 45 años, se aplicaron Test de la Mirada (TdlM) e Historias Extrañas (HT). Resultados: Se encontraron correlaciones entre TdlM y HT con memoria y funciones ejecutivas. Pacientes lesionados izquierdos, rinden significativamenie menos en HT. Conclusiones: Pacientes con TEC moderado o grave tienen una disminución de la capacidad de ToM. Existe una relación entre memoria episódica y ToM, podría deberse a que esta última requiere información a experiencias pasadas. Durante la infancia la ToM depende de la memoria episódica, pero cuando ambas se desarrollan adecuadamente, son independientes. Existe una relación entre funciones ejecutivas y ToM. Ambos constructos están vinculados en la infancia, pero luego comienzan a ser más independientes. Sin embargo, la ToM igualmente va a requerir de las funciones ejecutivas.

Background: One of the most important impediments in traumatic brain injuries (TBI), are the difficulties of social and family interaction. The Theory of Mind (ToM) is a fundamental factor of social cognition, which allows a satisfactory interaction of the individual with his environment. Objetive: To observe the ability of ToM in moderate or severe TBI patients, and its relationship with neurocognitive domains. Methods: Outpatients with diagnosis of moderate or severe TBI, evaluated neuropsychologically, age between 16 and 45 years, were applied Eyes Test (ET) and the Hinting task (HT). Results: Correlations were found between ET and HT with memory and executive functions. Injured left, perform significantly less in HT Patients with moderate or severe TBI have a decrease in ToM capacity. Conclusions: There is a relationship between episodic memory and ToM, which could be due to the latter 's need to request information from past experiences through episodic memory. During childhood ToM depends on episodic memory, but when both are achieved and developed properly, they are independent. There is a relationship between executive functions and ToM. Both constructs are linked in childhood, but then they begin to be more independent. However, ToM tasks will also require executive functions.

Working Group Recommendations for the Practice of Teleneuropsychology in Latin America.

OBJECTIVE: Teleneuropsychology (teleNP) could potentially expand access to services for patients who are confined, have limited personal access to healthcare, or live in remote areas. The emergence of the COVID-19 pandemic has significantly increased the use of teleNP for cognitive assessments. The main objective of these recommendations is to identify which procedures can be potentially best adapted to the practice of teleNP in Latin America, and thereby facilitate professional decision-making in the region. METHOD: Steps taken to develop these recommendations included (1) formation of an international working group with representatives from 12 Latin American countries; (2) assessment of rationale, scope, and objectives; (3) formulation of clinical questions; (4) evidence search and selection; (5) evaluation of existing evidence and summary; and (6) formulation of recommendations. Levels of evidence were graded following the Oxford Centre for Evidence-Based Medicine system. Databases examined included PubMed, WHO-IRIS, WHO and PAHO-IRIS, Índice Bibliográfico Español en Ciencias de la Salud (IBCS), and LILACS. RESULTS: Working group members reviewed 18,400 titles and 422 abstracts and identified 19 articles meeting the criteria for level of evidence, categorization, and elaboration of recommendations. The vast majority of the literature included teleNP tests in the English language. The working group proposed a series of recommendations that can be potentially best adapted to the practice of teleNP in Latin America. CONCLUSIONS: There is currently sufficient evidence to support the use of videoconferencing technology for remote neuropsychological assessments. These recommendations will likely contribute to the advancement of teleNP research and practice in the region.

[Practice recommendations for the detection and diagnosis of patients with Alzheimer's disease dementia in the City of Buenos Aires]. / Recomendaciones para la detección y diagnóstico de pacientes con demencia debida a Enfermedad de Alzheimer en la Ciudad de Buenos Aires.

Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epi- demic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer's Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations propose a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.

Efectos del Maltrato en la Neurocognición. Un Estudio en Niños Maltratados Institucionalizados y no Institucionalizados / Effects of mistreatment on neurocognition: A study on institutionalized and noninstitutionalized children who have suffered mistreatment / Efeitos do Maltrato na Neurocognição. Um estudo em crianças maltratadas institucionalizadas e não institucionalizadas

Resumen (analítico): Los objetivos del presente estudio fueron: (i) analizar las diferencias en el desempeño de un protocolo neurocognitivo en niños y niñas que experimentaron maltrato en comparación con niños y niñas que no lo sufrieron; y (ii) examinar si existen diferencias entre niños y niñas víctimas de maltrato, institucionalizados y no institucionalizados. Evaluamos a 30 niños y niñas con trauma temprano (11 institucionalizados y 19 no institucionalizados) y 24 controles de 7 a 12 años de edad. Empleamos el WISC IV, el Tomal, el Test de la Mirada, el Test de Metidas de Pata y la Escala Scared. Encontramos diferencias significativas entre los niños y niñas maltratados y no maltratados en todos los dominios analizados. Además, los niños y niñas maltratados institucionalizados obtuvieron un rendimiento inferior en CI respecto de sus pares maltratados no institucionalizados. La experiencia de estrés vivida en forma temprana, facilitaría un neurodesarrollo caracterizado por deficiencias en aspectos cognitivos y emocionales.

Abstract (analytical): The purpose of this study is: (i) to analyze the differences in the application of a neurocognitive protocol for children that have suffered maltreatment compared to children who have not suffered abuse; and (ii) to examine if there are any differences between institutionalized and non-institutionalized children who have suffered mistreatment. A total of 30 seven- to twelveyear-old children who suffered mistreatment during early childhood (11 institutionalized and 19 noninstitutionalized) and 24 children in a control group were assessed. The WISC IV, the TOMAL, Eyes Test and Faux Pas Recognition Test and the SCARED scale were employed. Significant differences were found between abused and non-abused children in every aspect that was analyzed. Furthermore, abused institutionalized children have shown a dramatically lower performance in their IQ tests compared to non-institutionalized children who were abused. Early stress experiences seem to produce a neurodevelopment characterized by deficiencies in terms of cognitive and emotional aspects.

Resumo (analítico): Os objetivos do presente estudo foram (i) analisar as diferenças no desempenho de um protocolo neurocognitivo em crianças que experimentaram maltrato em comparação com crianças que não apresentaram e (ii) examinar se existem diferenças entre crianças maltratadas de forma institucionalizadas e não institucionalizadas. Avaliaram-se 30 crianças com traumas nos primeiros anos de vida (11 institucionalizadas e 19 não institucionalizadas) e 24 com controles de 7 a 12 anos de idade. Foi utilizado o WISC IV, o TOMAL, o Teste do Olhar, o Teste de "metidas de pata" e a Escala SCARED. Encontraram-se diferenças significativas entre as crianças maltratadas e não maltratadas em todos os dominios analisados. Ademais, as crianças maltratadas de forma institucionalizada obtiveram um rendimento inferior em CI em relação ao seus pares maltrados de forma não institucionalizada. A experiencia de stress vivida desde cedo facilitaria o desenvolvimento neurológico caracterizado por deficiências em aspectos cognitivos e emocionais.

José Ingenieros y las amusias, sobre los orígenes de la neuropsicología argentina / José Ingenieros and the amusias: the beginning of the neuropsychology in Argentina

La escuela neuropsicológica argentina nace de la mano de la escuela europea y forma parte del inicio de la psicología experimental. En 1896, Horacio Pinero crea la primera cátedra de psicología de la Universidad de Buenos Aires, y en 1898 se anexa el primer laboratorio de psicología experimental. José Ingenieros, psiquiatra, neurólogo, político y, sobre todo, sociólogo publica en Francia su trabajo sobre afasias musicales, el primer estudio neuropsicológico argentino con trascendencia internacional. En él redime a Charcot y no a Knoblauch como el primero en describir la amusia, habla de una inteligencia y no de un lenguaje musical, y propone una clasificación y una metodología de evaluación con una perspectiva integradora neurológica-psiquiátrica. Este artículo dio origen a su libro en francés sobre el lenguaje musical y sus alteraciones histéricas, premiado por la Academia de Medicina de París

The Argentine neuropsychological school is born of the hand of the European school and is part of the beginning of the Experimental Psychology. In 1896 Horacio Pinero creates the first Department of Psychology at the University of Buenos Aires and in 1898 the first laboratory of Experimental Psychology is annexed. José Ingeniero, psychiatrist, neurologist, politician and above all sociologist publishes in France his work about the musical aphasia, the first neuropsychological work with international significance. In the same redeems to Charcot instead of to Knoblauch like the first one to describe the amusias, it speaks of an intelligence instead of a musical language and proposes a new classification and a methodology of assessment with a neurological-psychiatric integrative perspective. This article gave rise to this book in French on the musical language and its hysterical alterations awarded by the Academy of Medicine of Paris

Validation of the Argentine version of the Memory Binding Test (MBT) for Early Detection of Mild Cognitive Impairment / Validação da versão argentina do Memory Binding Test (MBT) para a detecção precoce do transtorno cognitivo leve

ABSTRACT. Background: "Forgetfulness" is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2=14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI.

RESUMO. "Esquecimento" é queixa frequente no envelhecimento normal e também ocorre nos primeiros estágios de síndromes demenciais. Testes de memória episódica são fundamentais para detectar comprometimento cognitivo amnéstico (CCL). O teste de Memória Associativa (Memory Binding Test-MBT) é um teste fácil e breve para detectar a fase inicial de perda de memória episódica. Objetivo: Validar a versão argentina do MBT e estimar a sua acurácia como instrumento diagnóstico para a detecção precoce do CCL. Métodos: 88 indivíduos (46 controles saudáveis ​​e 42 pacientes com CCL amnéstico), emparelhados por idade e nível educacional, foram avaliados com extensa bateria neuropsicológica e o MBT. Resultados: Um desempenho significativamente melhor foi detectada no grupo controle; todas as escalas do MBT foram preditivas do diagnóstico de CCL (p<0,01). O MBT apresentou alta sensibilidade (69%) e alta especificidade (88%), com valor preditivo (VP) positivo de 93% e e VP negativo de 55% para a recordação dos itens associados (associative paired recall). Diferença estatisticamente significativa (c2=14,164, p<0,001) foi obtida quando foram comparadas as áreas sob as curvas (AUC) do MBT (0,88) e o Mini-Exame do Estado Mental (MEEM) (0,70). Conclusão: A versão argentina do MBT correlacionou-se significativamente com o MEEM e com a bateria de memória e é uma ferramenta útil na detecção de CCL. As características operacionais do MBT são bem adequadas, superando outros testes usualmente utilizados para a detecção de CCL.

Validation of the Argentine version of the Memory Binding Test (MBT) for Early Detection of Mild Cognitive Impairment.

BACKGROUND: "Forgetfulness" is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. OBJECTIVE: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. METHODS: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. RESULTS: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2=14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). CONCLUSION: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI.

"Esquecimento" é queixa frequente no envelhecimento normal e também ocorre nos primeiros estágios de síndromes demenciais. Testes de memória episódica são fundamentais para detectar comprometimento cognitivo amnéstico (CCL). O teste de Memória Associativa (Memory Binding Test-MBT) é um teste fácil e breve para detectar a fase inicial de perda de memória episódica. OBJETIVO: Validar a versão argentina do MBT e estimar a sua acurácia como instrumento diagnóstico para a detecção precoce do CCL. MÉTODOS: 88 indivíduos (46 controles saudáveis ​​e 42 pacientes com CCL amnéstico), emparelhados por idade e nível educacional, foram avaliados com extensa bateria neuropsicológica e o MBT. RESULTADOS: Um desempenho significativamente melhor foi detectada no grupo controle; todas as escalas do MBT foram preditivas do diagnóstico de CCL (p<0,01). O MBT apresentou alta sensibilidade (69%) e alta especificidade (88%), com valor preditivo (VP) positivo de 93% e e VP negativo de 55% para a recordação dos itens associados (associative paired recall). Diferença estatisticamente significativa (c2=14,164, p<0,001) foi obtida quando foram comparadas as áreas sob as curvas (AUC) do MBT (0,88) e o Mini-Exame do Estado Mental (MEEM) (0,70). CONCLUSÃO: A versão argentina do MBT correlacionou-se significativamente com o MEEM e com a bateria de memória e é uma ferramenta útil na detecção de CCL. As características operacionais do MBT são bem adequadas, superando outros testes usualmente utilizados para a detecção de CCL.