Case Report: Neurodegenerative Diseases After Severe Acute Respiratory Syndrome Coronavirus 2 Infection, a Report of Three Cases: Creutzfeldt-Jakob Disease, Rapidly Progressive Alzheimer's Disease, and Frontotemporal Dementia.

The relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and neurodegenerative diseases is yet to be fully clarified. Rapid worsening and even new-onset cases of those disorders have been reported in association with coronavirus disease 2019 (COVID-19). We describe three cases of neurodegenerative diseases in patients with SARS-CoV-2: a case of Creutzfeldt-Jakob disease during the COVID-19 acute phase, to our knowledge, is the second one described in the literature; a rapidly progressive Alzheimer's Disease; and a patient with frontotemporal dementia, and a quick decline of both cognitive and behavioral domains. This report suggests an association between SARS-CoV-2 infection and a higher probability of developing or accelerating neurodegenerative chronic neurologic conditions. We reinforce the need for a close cognitive follow-up in the aftermath of Sars-Cov2 infection.

The association of post-stroke anhedonia with salivary cortisol levels and stroke lesion in hippocampal/parahippocampal region.

BACKGROUND: Anhedonia constitutes a coherent construct, with neural correlates and negative clinical impact, independent of depression. However, little is known about the neural correlates of anhedonia in stroke patients. In this study, we investigated the association of post-stroke anhedonia with salivary cortisol levels and stroke location and volume. PATIENTS AND METHODS: A psychiatrist administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition to identify anhedonia in 36 inpatients, without previous depression, consecutively admitted in a neurology clinic in the first month after a first-ever ischemic stroke. Salivary cortisol levels were assessed in the morning, evening, and after a dexamethasone suppression test. We used magnetic resonance imaging and a semi-automated brain morphometry method to assess stroke location, and the MRIcro program according to the Brodmann Map to calculate the lesion volume. RESULTS: Patients with anhedonia had significantly larger diurnal variation (P-value =0.017) and higher morning levels of salivary cortisol (1,671.9±604.0 ng/dL versus 1,103.9±821.9 ng/dL; P-value =0.022), and greater stroke lesions in the parahippocampal gyrus (Brodmann area 36) compared to those without anhedonia (10.14 voxels; standard deviation ±17.72 versus 0.86 voxels; standard deviation ±4.64; P-value =0.027). The volume of lesion in the parahippocampal gyrus (Brodmann area 36) was associated with diurnal variation of salivary cortisol levels (rho=0.845; P-value =0.034) only in anhedonic patients. CONCLUSION: Our findings suggest that anhedonia in stroke patients is associated with the volume of stroke lesion in the parahippocampal gyrus and with dysfunction of the hypothalamic-pituitary-adrenal axis.

The influence of depressive symptoms on quality of life after stroke: a prospective study.

BACKGROUND: Poststroke depressive symptoms have prospectively predicted impairment of health-related quality of life (HRQOL). However, it is not known whether such predictive effect is independent of HRQOL at 1 month after stroke. This study aimed to investigate the impact of depressive symptoms at 1 and 3 months after stroke on the 3-month poststroke HRQOL and to investigate the influence of the HRQOL measured at 1 month after stroke on these relationships. METHODS: We prospectively evaluated 67 patients at 1 and 3 months after a first-ever ischemic stroke from 106 eligible patients who have been consecutively admitted to the neurology ward of a teaching hospital. A psychiatrist assessed the presence of depressive symptoms using the 31-item version of the Hamilton Rating Scale for Depression and the HRQOL was assessed with the 36-item Short-Form Health Survey from the Medical Outcomes Study. We used linear regression to measure the impact of depressive symptoms, HRQOL at 1 month, and potential confounders on HRQOL at 3 months. RESULTS: We found an association between depressive symptoms at 1 month and HRQOL at 3 months after the stroke; however, this association was not significant when adjusting for the 1 month poststroke HRQOL. Depressive symptoms at 3 months were associated with HRQOL at 3 months after stroke, independently of the poststroke HRQOL at 1 month and potential confounders. CONCLUSIONS: Current depressive symptoms at 3 months are important for HRQOL at 3 months after stroke; however, regarding the prospective prediction, HRQOL at 1 month is the most relevant factor.

Right inferior frontal gyrus activation is associated with memory improvement in patients with left frontal low-grade glioma resection.

Patients with low-grade glioma (LGG) have been studied as a model of functional brain reorganization due to their slow-growing nature. However, there is no information regarding which brain areas are involved during verbal memory encoding after extensive left frontal LGG resection. In addition, it remains unknown whether these patients can improve their memory performance after instructions to apply efficient strategies. The neural correlates of verbal memory encoding were investigated in patients who had undergone extensive left frontal lobe (LFL) LGG resections and healthy controls using fMRI both before and after directed instructions were given for semantic organizational strategies. Participants were scanned during the encoding of word lists under three different conditions before and after a brief period of practice. The conditions included semantically unrelated (UR), related-non-structured (RNS), and related-structured words (RS), allowing for different levels of semantic organization. All participants improved on memory recall and semantic strategy application after the instructions for the RNS condition. Healthy subjects showed increased activation in the left inferior frontal gyrus (IFG) and middle frontal gyrus (MFG) during encoding for the RNS condition after the instructions. Patients with LFL excisions demonstrated increased activation in the right IFG for the RNS condition after instructions were given for the semantic strategies. Despite extensive damage in relevant areas that support verbal memory encoding and semantic strategy applications, patients that had undergone resections for LFL tumor could recruit the right-sided contralateral homologous areas after instructions were given and semantic strategies were practiced. These results provide insights into changes in brain activation areas typically implicated in verbal memory encoding and semantic processing.

Velocidade de processamento da informação em adolescentes de escolas públicas e privadas / Speed of Information processing in adolescents from public and private schools / Velocidad de Tratamiento de la información en los adolescentes de escuelas públicas y privadas

A velocidade de processamento da informação se refere à atividade mental por certo período de tempo. O objetivo do estudo foi investigar esta velocidade de processamento em adolescentes de 14 anos de escolas públicas e privadas. Foram selecionadas 14 adolescentes (sexo feminino) que cursavam o 9º ano do Ensino Fundamental ou o 1º ano do Ensino Médio. Foram avaliadas por meio do IVP (Código, Procurar símbolos e Cancelamento) da WISC-IV e do Teste de Trilhas Coloridas Infantil (TTCI). O teste qui-quadrado apontou maior número de quase erros no TTCI em meninas que frequentavam escola privada. Nenhuma diferença foi encontrada entre os grupos no IVP. Embora o tipo de escola não pareça produzir diferenças entre os grupos no IVP, o número de quase erros, indicativo de distração, mostrou-se mais sensível para identificar essas diferenças. Sugere-se que o número de quase erros possa indicar diferenças mais sutis entre os grupos...

The speed of information processing refers to attainment of mental activity in a certain period of time. The aim of this study was investigate the speed of information processing in 14 years old girls, who attended public and private schools. We selected 14 girls who were in the 9th grade of elementary school or 1st year of high school. Half of them attended public school and the other half attended private school. They were evaluated by: Processing Speed Index - PSI (Coding, Symbol Search and Cancellation) of the WISC - IV and the Trail Making Test Colored Children (TTCI). The chi-square test showed a higher number of near-misses in CCTT in girls attending private school compared to girls attending public school. No difference was found between the two groups in the PSI. Although the type of school does not seem to produce significant differences between the groups in the PVI, the number of nearmisses showed a more sensitive measure to identify these differences. It is suggested that the number of near-misses may indicate subtle differences between groups...

La velocidad de procesamiento de información se refiere a la realización de actividad mental en un determinado período de tiempo. El objetivo de este estudio fue investigar la velocidad de procesamiento de información en adolescentes de 14 años que asisten a escuelas públicas y privadas. Fueron seleccionado 14 adolescentes, de sexo femenino que curzaban 9 º o 10º grado. La mitad asistia a la escuela pública y la otra mitad a la escuela privada. Fueron evaluadas utilizando las siguientes pruebas: IVP (Código, búsqueda y cancelación de símbolos) de la bacteria WISC-IV y test infantil de sequencias coloreadas (TISC). El t-test mostro un mayor número de casi errores en TISC en las niñas que asisten a las escuelas privadas. No se encontraron diferencias entre los dos grupos en las otro pruebas. Se sugiere que la medición de la cantidad de casi errores revelan una mayor sensibilidad en TTCI...

Velocidade de processamento da informação em adolescentes de escolas públicas e privadas / Speed of Information processing in adolescents from public and private schools / Velocidad de Tratamiento de la información en los adolescentes de escuelas públicas y privadas

A velocidade de processamento da informação se refere à atividade mental por certo período de tempo. O objetivo do estudo foi investigar esta velocidade de processamento em adolescentes de 14 anos de escolas públicas e privadas. Foram selecionadas 14 adolescentes (sexo feminino) que cursavam o 9º ano do Ensino Fundamental ou o 1º ano do Ensino Médio. Foram avaliadas por meio do IVP (Código, Procurar símbolos e Cancelamento) da WISC-IV e do Teste de Trilhas Coloridas Infantil (TTCI). O teste qui-quadrado apontou maior número de quase erros no TTCI em meninas que frequentavam escola privada. Nenhuma diferença foi encontrada entre os grupos no IVP. Embora o tipo de escola não pareça produzir diferenças entre os grupos no IVP, o número de quase erros, indicativo de distração, mostrou-se mais sensível para identificar essas diferenças. Sugere-se que o número de quase erros possa indicar diferenças mais sutis entre os grupos.(AU)

The speed of information processing refers to attainment of mental activity in a certain period of time. The aim of this study was investigate the speed of information processing in 14 years old girls, who attended public and private schools. We selected 14 girls who were in the 9th grade of elementary school or 1st year of high school. Half of them attended public school and the other half attended private school. They were evaluated by: Processing Speed Index - PSI (Coding, Symbol Search and Cancellation) of the WISC - IV and the Trail Making Test Colored Children (TTCI). The chi-square test showed a higher number of near-misses in CCTT in girls attending private school compared to girls attending public school. No difference was found between the two groups in the PSI. Although the type of school does not seem to produce significant differences between the groups in the PVI, the number of nearmisses showed a more sensitive measure to identify these differences. It is suggested that the number of near-misses may indicate subtle differences between groups.(AU)

La velocidad de procesamiento de información se refiere a la realización de actividad mental en un determinado período de tiempo. El objetivo de este estudio fue investigar la velocidad de procesamiento de información en adolescentes de 14 años que asisten a escuelas públicas y privadas. Fueron seleccionado 14 adolescentes, de sexo femenino que curzaban 9 º o 10º grado. La mitad asistia a la escuela pública y la otra mitad a la escuela privada. Fueron evaluadas utilizando las siguientes pruebas: IVP (Código, búsqueda y cancelación de símbolos) de la bacteria WISC-IV y test infantil de sequencias coloreadas (TISC). El t-test mostro un mayor número de casi errores en TISC en las niñas que asisten a las escuelas privadas. No se encontraron diferencias entre los dos grupos en las otro pruebas. Se sugiere que la medición de la cantidad de casi errores revelan una mayor sensibilidad en TTCI.(AU)

Executive function and depressive symptoms of retardation in nonelderly stroke patients.

The depression-executive dysfunction syndrome, a late-onset depression of vascular origin with executive dysfunction and psychomotor retardation, has also been described after stroke. We verified whether this syndrome also occurs in nonelderly stroke patients by investigating the association between domains of depressive symptoms with executive functions in 87 first-ever ischemic stroke patients. The retardation domain of the 31-item Hamilton Rating Scale for Depression was associated with decreased performance on verbal fluency (assessed with FAS). The association was maintained for younger patients (aged <60 years) after adjusting for confounders. This result supports the clinical presentation of depression-executive dysfunction syndrome in younger stroke patients. Confirmation of this finding, its neural correlates, and clinical implication deserve further investigation.

Avaliação da velocidade de processamento em uma amostra de crianças de 7 a 10 anos com e sem hipótese diagnóstica de TDAH / Processing speed assessment in a sample of 7- 10 year-olds children

Comparamos o desempenho de crianças com hipótese diagnóstica de TDAH ao de crianças saudáveis nos testes de velocidade de processamento da Escala de Inteligência Wechsler para crianças, 4ª edição (WISC-IV). Foram selecionadas dezesseis crianças, sendo 8 com hipótese diagnóstica de TDAH (Grupo TDAH) e 8 saudáveis (Grupo controle), de ambos os sexos, com idade entre 7 a 10 anos, provenientes do ensino público da cidade de Itatiba/SP. A velocidade de processamento foi avaliada pelos seguintes testes: Código, Procurar Símbolos e Cancelamento. Os resultados mostraram que não houve diferença significativa entre os grupos. Concluímos que os resultados examinados por meio da escala SNAP-IV não apresentaram diferença estatística entre os grupos. Futuros estudos poderiam ampliar o número de participantes de modo a equilibrar o número de participantes por faixa etária(AU)

We compared the performance of children with diagnosis of ADHD to the healthy children on tests of the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV) Processing Speed. We selected sixteen children, 8 with diagnosis of ADHD (ADHD group) and 8 healthy subjects (control group), of both sexes, aged 7-10 years, from the public schools of the city of Itatiba / SP. Processing speed was assessed by the following tests: Coding Browse Symbols and Cancellation. The results showed no significant difference between the groups we conclude that the results examined by SNAP-IV scale, no statistically significant difference between groups. Future studies could expand the number of participants in order to balance the number of participants of age(AU)

Correlação entre velocidade de processamento e atenção alternada em crianças saudáveis de seis anos / Correlation between processing speed and attention switching in healthy children aged six years

O presente estudo investigou a correlação entre a velocidade de processamento (VP) e a atenção alternada em crianças saudáveis de 06 anos de idade, por meio da aplicação de testes psicométricos específicos. Foram avaliadas 28 crianças em curso do 1º Ano do Ensino Fundamental, tanto de escola pública quanto privada e igualmente divididas entre os gêneros. Utilizou-se o teste Matrizes Progressivas Coloridas de Raven; os subtestes do Índice de Velocidade de Processamento (IVP): Código A, Procurar Símbolos A, Cancelamento da escala WISC-IV; e o Teste de Trilhas Coloridas Infantil - forma 2 (TCC2). Os resultados evidenciaram correlação moderada negativa entre o IVP e o TCC2, não havendo diferença significativa entre os gêneros. Diante dos resultados, observou-se que a rapidez de execução em tarefas que avaliam VP se relaciona com redução moderada do desempenho em tarefas de atenção alternada(AU)

This study investigated the correlation between processing speed (PS) and attention switching in healthy children 06 years old, through the application of specific psychometric tests. We evaluated 28 children in the course of the 1st year of elementary school, both private and public schools as equally divided between genders. We used the test of Raven Colored Progressive Matrices; subtest of Processing Speed Index (PSI): Code A, Symbol Search A, Cancellation of WISC-IV; and the Children´s Color Trails Test - form 2 (CTT2). The results showed moderate negative correlation between PSI and CTT2, with no significant difference between genders. Considering the results, it was observed that the speed of execution into tasks that assess PS relates to moderate reduction of performance in attention switching tasks(AU)

Magnetic fields in noninvasive brain stimulation.

The idea that magnetic fields could be used therapeutically arose 2000 years ago. These therapeutic possibilities were expanded after the discovery of electromagnetic induction by the Englishman Michael Faraday and the American Joseph Henry. In 1896, Arsène d'Arsonval reported his experience with noninvasive brain magnetic stimulation to the scientific French community. In the second half of the 20th century, changing magnetic fields emerged as a noninvasive tool to study the nervous system and to modulate neural function. In 1985, Barker, Jalinous, and Freeston presented transcranial magnetic stimulation, a relatively focal and painless technique. Transcranial magnetic stimulation has been proposed as a clinical neurophysiology tool and as a potential adjuvant treatment for psychiatric and neurologic conditions. This article aims to contextualize the progress of use of magnetic fields in the history of neuroscience and medical sciences, until 1985.

Atividade física, envelhecimento e o desempenho no teste de fluência verbal categoria animais / Physical activity, aging and performance on verbal fluency testing in the animals category

A cognição em idosos é caracterizada por um declínio natural e gradual nas suas diversas funções cognitivas. Diversos estudos têm mostrado que a atividade física regular pode contribuir retardando essa perda. O objetivo deste estudo foi avaliar o desempenho de sujeitos idosos saudáveis engajados em atividade física regular em medida de função executiva – teste de fluência verbal categoria animais. Para isso, 14 sujeitos com idade entre 60 e 85 e 1 a 4 anos de escolaridade foram avaliados através de uma bateria de testes de rastreio – MEEM, HAD, um teste de cognição geral – WAIS-III, uma entrevista semidirigida e o teste de fluência verbal. Sujeitos engajados em atividade física mostraram desempenho melhor na medida de função executiva em comparação com normas propostas para nossa população. Esse resultado está de acordo com outros achados que mostram um efeito positivo da atividade física sobre o funcionamento cognitivo de sujeitos idosos saudáveis(AU)

Cognition in the elderly is characterized by a natural and gradual decline in its various functions. Several studies have shown that regular physical activity can help to slow the loss. The objective of this study has been to evaluate the performance of healthy, elderly subjects engaged in regular physical activity as a measure of executive function through verbal fluency testing, category of animals. To this end, 14 subjects between the ages of 60 and 85, and having 1 to 4 years of schooling, were assessed by a battery of screening tests, i.e., MMSE, HAD, a test of general cognition - WAIS-III, a semi-directed interview and testing verbal fluency. Subjects engaged in physical activity showed the best performance measure of executive function compared with the proposed standards for our population. This result is consistent with other findings that show a positive effect of physical activity on cognitive functioning in healthy elderly subjects(AU)

Avaliação do desempenho da memória de curto prazo em crianças de escola pública e particular / Performance evaluation of short-term memory in children from public and private schools

Nesta pesquisa buscamos observar as diferenças existentes no desempenho da memória operacional entre crianças de escola pública e particular de diferentes cidades brasileiras. Os dados foram obtidos através da análise do desempenho da memória de curto prazo em crianças de sete anos, avaliadas através de dois subtestes da Escala Wechsler de Inteligência para Crianças (WISC) e pela Escala Matrizes Progressivas Coloridas de Raven – Escala Especial. Participaram deste estudo cinquenta e seis crianças, entre sete anos e sete anos e onze meses de idade, sendo vinte e oito estudantes de escolas públicas e a outra metade de escolas particulares, das cidades de Campinas – SP, Pouso Alegre – MG, Recife – PE e Florianópolis – SC. Os resultados, a partir dos instrumentos utilizados, sugerem que a diferença encontrada entre esses tipos de ensino é pouco significativa(AU)

In this study we sought to observe the differences in working memory performance among children in public and private schools in different cities. Data were obtained through analysis of the performance of short-term memory in seven-year old children, as evaluated by two subtests, i.e., the Wechsler Intelligence Scale for Children (WISC), and the Scale Raven Colored Progressive Matrices - Special Scale. There were fifty-six children that participated in the study, between the ages of seven years, and seven years and eleven months old. Twenty-eight students were from public schools and the other half from private schools; encompassing the cities of Campinas - SP, Pouso Alegre - MG, Recife - PE , and Florianopolis - SC. The results from the instruments suggest that the difference found between these types of education is insignificant(AU)

Transcranial magnetic stimulation in mild to severe hemiparesis early after stroke: a proof of principle and novel approach to improve motor function.

Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the unaffected hemisphere can enhance function of the paretic hand in patients with mild motor impairment. Effects of low-frequency rTMS to the contralesional motor cortex at an early stage of mild to severe hemiparesis after stroke are unknown. In this pilot, randomized, double-blind clinical trial we compared the effects of low-frequency rTMS or sham rTMS as add-on therapies to outpatient customary rehabilitation, in 30 patients within 5-45 days after ischemic stroke, and mild to severe hand paresis. The primary feasibility outcome was compliance with the interventions. The primary safety outcome was the proportion of intervention-related adverse events. Performance of the paretic hand in the Jebsen-Taylor test and pinch strength were secondary outcomes. Outcomes were assessed at baseline, after ten sessions of treatment administered over 2 weeks and at 1 month after end of treatment. Baseline clinical features were comparable across groups. For the primary feasibility outcome, compliance with treatment was 100% in the active group and 94% in the sham group. There were no serious intervention-related adverse events. There were significant improvements in performance in the Jebsen-Taylor test (mean, 12.3% 1 month after treatment) and pinch force (mean, 0.5 Newtons) in the active group, but not in the sham group. Low-frequency rTMS to the contralesional motor cortex early after stroke is feasible, safe and potentially effective to improve function of the paretic hand, in patients with mild to severe hemiparesis. These promising results will be valuable to design larger randomized clinical trials.

Abnormal sensory integration affects balance control in hemiparetic patients within the first year after stroke.

OBJECTIVE: Impairments in balance can be a consequence of changes in the motor, sensory, and integrative aspects of motor control. Abnormal sensory reweighting, i.e., the ability to select the most appropriate sensory information to achieve postural stability, may contribute to balance impairment. The Sensory Organization Test is a component of Computerized Dynamic Posturography that evaluates the impact of visual, vestibular, and somatosensory inputs, as well as sensory reweighting, under conditions of sensory conflict. The aim of this study is to compare balance control in hemiparetic patients during the first year post-stroke and in age-matched neurologically normal subjects using the Berg Balance Scale and Computerized Dynamic Posturography. METHODS: We compared the Berg Balance Scale and Sensory Organization Test scores in 21 patients with hemiparesis after first-ever ischemic stroke and in 21 age-matched, neurologically normal subjects. An equilibrium score was defined for each Sensory Organization Test condition. RESULTS: Berg Balance Scale scores were significantly lower in the patients than in the neurologically normal subjects. Equilibrium scores were significantly lower in the patients than in the neurologically normal subjects for those Sensory Organization Test conditions that did not provide appropriate somatosensory information and under conditions of sensory conflict. A history of falls was more frequent in patients with lower equilibrium scores. CONCLUSION: During the first year after a stroke, defective sensory reweighting significantly impacts balance control in hemiparetic patients. These results are important for the planning of effective rehabilitation interventions.

Cognitive impairments in patients with low grade gliomas and high grade gliomas.

OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19) and high-grade glioma (G2, n=8) patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

Neuroinfection survey at a neurological ward in a Brazilian tertiary teaching hospital.

OBJECTIVES: This study was undertaken to characterize the neuroinfection profile in a tertiary neurological ward. INTRODUCTION: Neuroinfection is a worldwide concern and bacterial meningitis, tetanus and cerebral malaria have been reported as the commonest causes in developing countries. METHODS: From 1999 to 2007, all patients admitted to the Neurology Ward of Hospital das Clínicas, São Paulo University School of Medicine because of neuroinfection had their medical records reviewed. Age, gender, immunological status, neurological syndrome at presentation, infectious agent and clinical outcome were recorded. RESULTS: Three hundred and seventy four cases of neuroinfectious diseases accounted for 4.2% of ward admissions and the identification of infectious agent was successful in 81% of cases. Mean age was 40.5 + 13.4 years, 63.8% were male, 19.7% were immunocompromised patients and meningoencephalitis was the most common clinical presentation despite infectious agent. Viruses and bacteria were equally responsible for 29.4% of neuroinfectious diseases; parasitic, fungal and prion infections accounted for 28%, 9.6% and 3.5% respectively. Human immunodeficiency virus (HIV), herpes simplex virus 1 (HSV1), Mycobacterium tuberculosis, Treponema pallidum, Taenia solium, Schistosoma mansoni, Cryptococcus neoformans and Histoplasma capsulatum were the more common infectious pathogens in the patients. Infection mortality rate was 14.2%, of which 62.3% occurred in immunocompetent patients. CONCLUSION: Our institution appeared to share some results with developed and developing countries. Comparison with literature may be considered as quality control to health assistance.

Cognitive impairments in patients with low grade gliomas and high grade gliomas / Comprometimentos cognitivos em pacientes com gliomas de baixo grau e gliomas de alto grau

OBJECTIVE: The relationship between brain tumors and cognitive deficits is well established in the literature. However, studies investigating the cognitive status in low and high-grade gliomas patients are scarce, particularly in patients with average or lower educational level. This study aimed at investigating the cognitive functioning in a sample of patients with low and high-grade gliomas before surgical intervention. METHOD: The low-grade (G1, n=19) and high-grade glioma (G2, n=8) patients underwent a detailed neuropsychological assessment of memory, executive functions, visuo-perceptive and visuo-spatial abilities, intellectual level and language. RESULTS: There was a significant impairment on verbal and visual episodic memory, executive functions including mental flexibility, nominal and categorical verbal fluency and speed of information processing in G2. G1 showed only specific deficits on verbal and visual memory recall, mental flexibility and processing speed. CONCLUSION: These findings demonstrated different levels of impairments in the executive and memory domains in patients with low and high grade gliomas.

OBJETIVO: A associação entre tumores cerebrais e déficits cognitivos é bem estabelecida na literatura. No entanto, estudos sobre a cognição de pacientes com gliomas de baixo e alto grau são escassos, especialmente, em sujeitos com baixa escolaridade. Este estudo investigou o funcionamento cognitivo de uma amostra de pacientes com gliomas de baixo e alto grau antes da intervenção cirúrgica. MÉTODO: Os pacientes com glioma de baixo grau (G1, n=19) e alto grau (G2, n=8) foram avaliados quanto à memória, funções executivas, habilidades visuo-perceptivas e visuo-espaciais, nível intelectual e linguagem. RESULTADOS: Houve prejuízo significativo em G2 na memória episódica verbal e visual, funções executivas incluindo flexibilidade mental, fluência verbal nominal e categórica e velocidade de processamento de informações. G1 demonstrou apenas déficits específicos de evocação verbal e visual, flexibilidade mental e velocidade de processamento. CONCLUSÃO: Estes achados demonstraram níveis diferenciados de comprometimento nos domínios executivos e mnésticos de pacientes com gliomas de baixo e alto grau.

Processos atencionais em idosos saudáveis com alta escolaridade da comunidade da cidade de São Paulo / Attentional function in healthy aging with more than 12 years of education from São Paulo's community

Muitos estudos apontam para que mais de um terço dos sujeitos de 60 anos ou mais apresente prejuízo na atenção, apesar de não haver um padrão do efeito da idade sobre esta. O objetivo deste estudo foi avaliar o perfil de sujeitos idosos saudáveis de alta escolaridade no desempenho em medidas de atenção. Para isso, 14 sujeitos entre 60 e 89 anos de idade e entre 12 e 17 anos de escolaridade foram avaliados por meio de subtestes do WAIS-III, do Trail Making Test e do Stroop Test, após serem incluídos por critérios pré-determinados. Todos os sujeitos mostraram desempenho satisfatório em medidas de atenção, exceto para atenção seletiva (cartão 1 do teste Stroop). Houve correlação positiva entre as variáveis de desempenho nos testes de atenção sustentada e seletiva. Esse resultado corrobora achados anteriores que mostram um efeito positivo da alta escolaridade sobre o funcionamento atencional de sujeitos idosos saudáveis(AU)

Several studies have shown that more than a third of the aging people would have attention impairment, regardless of there is no commun effect of age in this process. The aim of this study was to evaluate the attentional performance of healthy elderly subjects with hight level of education. For this, 14 subjects between 60 and 89 years old and between 12 and 17 years of education were assessed through WAIS-III´s subtests, Trail Making Test and Stroop Test, after been included for pré-determined criterious. All subjects had a sactisfatory performance in attencional tests, except for the selective attention (card 1 of Stroop). There was a positive correlation between two variables (sustained and selective). This result is in agreement with previous findings showing a positive effect of hight schooling on attentional performance in healthy elderly(AU)