Analysis of functional connectivity using machine learning and deep learning in different data modalities from individuals with schizophrenia.

Objective. Schizophrenia(SCZ) is a severe mental disorder associated with persistent or recurrent psychosis, hallucinations, delusions, and thought disorders that affect approximately 26 million people worldwide, according to the World Health Organization. Several studies encompass machine learning (ML) and deep learning algorithms to automate the diagnosis of this mental disorder. Others study SCZ brain networks to get new insights into the dynamics of information processing in individuals suffering from the condition. In this paper, we offer a rigorous approach with ML and deep learning techniques for evaluating connectivity matrices and measures of complex networks to establish an automated diagnosis and comprehend the topology and dynamics of brain networks in SCZ individuals.Approach.For this purpose, we employed an functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) dataset. In addition, we combined EEG measures, i.e. Hjorth mobility and complexity, with complex network measurements to be analyzed in our model for the first time in the literature.Main results.When comparing the SCZ group to the control group, we found a high positive correlation between the left superior parietal lobe and the left motor cortex and a positive correlation between the left dorsal posterior cingulate cortex and the left primary motor. Regarding complex network measures, the diameter, which corresponds to the longest shortest path length in a network, may be regarded as a biomarker because it is the most crucial measure in different data modalities. Furthermore, the SCZ brain networks exhibit less segregation and a lower distribution of information. As a result, EEG measures outperformed complex networks in capturing the brain alterations associated with SCZ.Significance. Our model achieved an area under receiver operating characteristic curve (AUC) of 100% and an accuracy of 98.5% for the fMRI, an AUC of 95%, and an accuracy of 95.4% for the EEG data set. These are excellent classification results. Furthermore, we investigated the impact of specific brain connections and network measures on these results, which helped us better describe changes in the diseased brain.

Brain instability in dynamic functional connectivity in schizophrenia.

Schizophrenia is a severe psychiatric disorder associated with altered connectivity of brain functional networks (BFNs). Researchers have observed a profound disruption in prefrontal-temporal interactions, damage to hub regions in brain networks and modified topological organization of BFNs in schizophrenia (SCZ) individuals. Assessment of BFNs with dynamic approaches allow the characterization of new functional structures, such as topological stability patterns and temporal connectivity, which are not accessible through static methods. In this perspective, the present study investigated the physiological processes of brain connectivity in SCZ. A resting-state EEG dataset of 14 SCZ individuals and 14 healthy controls (HC) was obtained at a sampling rate of 250 Hz. Dynamic BFNs were constructed using time-varying graphs combined with the motifs' synchronization method and the indexes were evaluated in different scales: global averages, by hemispheres, by regions, and by electrodes for both groups. The SCZ group exhibited lower temporal connectivity, lesser hub probability, and fewer number of edges in right and left temporal lobes over time, besides increased temporal connectivity in the central-parietal region. Neither differences for the full synchronization time of BFNs were observed, nor for intra- and inter-hemispheric connections between groups. These results indicate that SCZ BFNs exhibit a dynamic fluctuation pattern with abrupt increases in connectivity over time for the regions studied. This elucidates an attempted interaction of the temporal area with other regions (frontal, central-parietal, and occipital) that is not sufficient to maintain a connectivity pattern in schizophrenia individuals similar to that of healthy subjects. Our results suggest that changes in interaction of dynamic BFNs connections in SCZ can be better approached by dynamic analyses that enable a thorough glance at brain changes over time.

Brain Asymmetry in Pain Affective Modulation.

OBJECTIVE: The aim of this study was to characterize the dynamic brain networks underlying the affective modulation of pleasant, unpleasant, and neutral image perception due to painful stimulations in healthy subjects. METHODS: Forty volunteers, 20 men and 20 women, participated in this study. Brain activity was recorded by 64-channel electroencephalography. After data cleaning, brain functional networks were built through the use of the motif synchronization method. RESULTS: We found that increased cerebral connectivity in the left hemisphere under the pain condition broke the connection symmetry. Both women and men showed homophilic connections (intrahemispheric), but women were more homophilic than men. The pain condition increased homophily in the left hemisphere, and emotions could modulate pain. The frontal, central, and left temporal regions showed homophilic variation, depending on the emotional stimulus. CONCLUSIONS: Pain and emotions altered brain activity. There was increased connectivity and homophily in the left brain hemisphere for the painful experience. The emotions modulated brain activity in the pain condition. Overall, the brain presented homophilic characteristics; homophily changed, depending on emotion or pain. The left brain hemisphere seems to be related to pain processing.

Isotonic exercises and relaxing techniques in individuals with temporomandibular dysfunction.

Objective: The present study aimed to compare the clinical characteristics of volunteers with temporomandibular dysfunction before and after performing exercises with those of volunteers who only followed self-care guidelines.Methods: A parallel randomized controlled trial was performed. Individuals included underwent the intervention twice a week for one month, while the control group only followed self-care guidelines.Results: Twenty-three volunteers participated; however, during the study, four dropped out. At the end of the study, the degree of depression decreased in the volunteers in the intervention group.Conclusion: The level of pain decreased, but the improvement was not statistically significant and, therefore, could not be attributed to the intervention. It can be concluded that the strategies used to reduce pain in this study were not sufficient for clinical improvement in volunteers with temporomandibular dysfunction.

Behavioural activation and trial-based cognitive therapy may be beneficial to reduce suicidal ideation in major depressive disorder: A post hoc study from a clinical trial.

WHAT IS KNOWN AND OBJECTIVE: The suicidality spectrum is a clinical challenge because of the difficulty of its management and its association with mortality. Few studies have investigated psychotherapies for reducing the components of suicidality. In this study, we compared the effect of behavioural activation (BA), trial-based cognitive therapy (TBCT) - both added to antidepressant (AD) treatment - and treatment as usual (TAU) in mitigating suicidal ideation in patients with major depressive disorder (MDD). METHODS: A post hoc study was conducted with data from a randomized clinical trial. Secondary analyses compared the treatments using scores from the items that evaluated suicidal ideation with the HAM-D (HAM-D-3) and BDI (BDI-9). A composite measurement was constructed by summing the scores from the two items (HAM-D-3 plus BDI-9). RESULTS AND DISCUSSION: Seventy-six patients were analysed (BA + AD = 24; TBCT + AD = 26 and TAU = 26). In HAM-D-3, the BA + AD group showed a statistically greater reduction than the TAU group. In BDI-9, the three groups did not show significant differences. In the HAM-D-3 plus BDI-9, TBCT + AD reduced ideations more than the TAU group. There were no differences among the psychotherapies in any of the measures. Sensitivity analyses showed improvement in suicidal ideation in both psychotherapies compared to TAU. WHAT IS NEW AND CONCLUSION: This is one of the few studies that evaluated the effect of BA and TBCT in lowering suicidal ideation. Adding these therapies to ADs seems to decrease suicidal ideation. We suggest the possible beneficial effects of BA and TBCT in the management of suicidal ideation in patients with recurrent MDD. Our findings need further studies to confirm these results.

Neurophysiological aspects of isotonic exercises in temporomandibular joint dysfunction syndrome.

PURPOSE: The aim of the study was to investigate the electroneurophysiological aspects of volunteers with temporomandibular disorders before and after performing isotonic exercises for pain relief and self-care guidelines. METHODS: The study was a parallel controlled randomized controlled trial under protocol 1,680,920. The inclusion criteria were age between 18 and 60 years, muscle temporomandibular dysfunction with or without limitation of mouth opening and self-reported pain with scores between 4 and 10. The individuals were randomized into experimental group and control. Twenty-three volunteers participated in the study, most of then were female. Control group had 11 and experimental group 12 individuals. Dropouts occurred in both groups, two in the experimental group and three in the control group. Since there were an intergroup imbalance the power density was analysed just in experimental group. Electroencephalographic recording was performed before and after the interventions, using the 32-channel apparatus, with sample frequency of 600 Hz and impedance of 5 kΩ. The data were processed through the MATLAB computer program. The individual records filtered off-line, using bandpass between 0.5 and 50 Hz. Epochs of 1,710 ms were created and the calculation of the absolute power density calculated by means of the fast Fourier transform. The statistical approach was inferential and quantitative. RESULTS: The alpha power density analyzed presented a difference, but not significant, when compared in the two moments. CONCLUSION: According to this study, isotonic exercises performed to reduce pain provided a small increase in alpha power density in the left temporal, parietal and occipital regions.

Zinc supplementation combined with antidepressant drugs for treatment of patients with depression: a systematic review and meta-analysis.

CONTEXT: Zinc is an essential trace mineral required for the function of brain and neural structures. The role of zinc supplementation in the prevention and treatment of depression has been suggested in clinical studies that reported a reduction in depressive symptoms. OBJECTIVE: The aim of this review was to determine whether zinc supplementation vs placebo can prevent or improve depressive symptoms in children, adolescents, or adults. DATA SOURCES: Five electronic databases were searched, and studies published until September 2019 were included without language restriction. STUDY SELECTION: Randomized, controlled, crossover trials that evaluated the effect of zinc supplementation vs a comparator for prevention or improvement of depressive symptoms in children, adolescents, or adults were eligible for inclusion. DATA EXTRACTION: Two authors independently performed data extraction and risk-of-bias assessment. RESULTS: The initial search identified 12 322 studies, 5 of which were eligible for meta-analysis. The standardized mean difference (SMD) showed an average reduction of 0.36 point (95%CI, -0.67 to -0.04) in the intervention group compared with the placebo group. Forstudies in which the mean age of participants was ≥ 40 years, the SMD was reduced by 0.61 point (95%CI, -1.12 to -0.09) in the intervention group vs the placebo group. The meta-analysis by sample size (< 60 individuals and ≥ 60 individuals) did not show an effect of zinc supplementation in reducing depressive symptoms (SMD -0.28; 95%CI, -0.67 to -0.10; and SMD -0.52; 95%CI, -1.10 to 0.06). CONCLUSION: Zinc supplementation may reduce depressive symptoms in individuals treated with antidepressant drugs for clinical depression. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42018081691.

Frequência Alfa na meditação Gurdjieff / Alpha Frequency in Gurdjieff Meditation

Introdução: a meditação é uma prática que visa regular o estado mental e as emoções, podendo induzir a estados alterados de consciência. Dentre inúmeras técnicas de meditação, o trabalho proposto por George I. Gurdjieff, inclui práticas voltadas para o recolhimento da atenção e o equilíbrio entre a atividade do corpo, da mente e do sentimento. Estudos realizados com eletroencefalografia (EEG), avaliando o estado meditativo em geral, demonstraram um padrão cerebral caracterizado pelo aumento da amplitude dos ritmos eletroencefalográficos alfa e teta, bem como diferenças na atividade alfa entre a meditação e o relaxamento. Entretanto, isto não está caracterizado em meditadores da linha de G.I. Gurdjieff, que praticam, além de meditações sentadas, exercícios corporais acompanhados de uma música própria e exercícios de atenção durante a vida diária. Objetivo: comparar a atividade cerebral da frequência alfa durante os estágios de meditação e relaxamento e avaliar as diferenças entre as regiões frontal, central e occipital nesses dois estados, em meditadores experientes do grupo Gurdjieff, de Salvador-Bahia-Brasil. Metodologia: a coleta da atividade cerebral dos 8 voluntários foi realizada através do EEG. O protocolo de coleta adotado foi de 6 minutos de relaxamento e 12 minutos de meditação. Resultados: foi encontrado aumento significativo da potência alfa durante a meditação, quando comparada ao relaxamento. As regiões frontal e central não apresentaram diferenças entre si para a potência alfa, enquanto a região occipital apresentou aumento da potência alfa em comparação com as regiões frontal e central. Existe um aumento da densidade de alfa durante a meditação em todas as regiões cerebrais testadas, com maior densidade na região occipital. Conclusão: A frequência alfa comporta-se de forma diferente durante a meditação, comparada ao relaxamento, com um aumento da densidade de potência durante o estado meditativo em todas as regiões avaliadas, sendo a região occipital a que apresentou maior potência.

Introduction: meditation is a practice that aims to regulate the mental state and emotions, and can induce altered states of consciousness. Among numerous meditation techniques, the work proposed by George I. Gurdjieff, includes an attempt to balance activities from the body, the mind and the feelings. Studies conducted with electroencephalography (EEG), evaluating the meditative tate, demonstrated a brain pattern characterized by increased alpha and theta amplitude, as well as differences in alpha activity between meditation and relaxation. However, this is not characterized in Gurdjieff meditators, which practice beyond sitted meditations, body exercises with music, and attentional exercises during everyday life. Objective: comparing the brain activity of the alpha power during the meditation and relaxation stages and evaluate the differences between the frontal, central and occipital regions in these two states, in experienced meditators from the Gurdjieff group, in Salvador-Bahia-Brazil. Methodology: the data collection of the brain activity from 8 volunteers was performed by EEG. The collection protocol adopted was 6 minutes of relaxation and 12 minutes of meditation. Results: a significant increase in alpha power was found during meditation, when compared to relaxation. The frontal and central regions showed no differences between them for alpha power, while the occipital region showed an increase in alpha power compared to the frontal and central regions. Conclusion: the alpha frequency behaves differently during meditation, compared to relaxation, with an increase in alpha density during the meditative state in all evaluated regions, with the occipital region being the most potent.

Qualidade de vida em adultos com Transtorno de Déficit de Atenção com Hiperatividade / Quality of life in adults with Attention Deficit Hyperactivity Disorder

Introdução: mais de 50% das crianças com transtorno de déficit de atenção com hiperatividade (TDAH) continuam apresentando sintomas na vida adulta, com impactos no desenvolvimento psicossocial, profissional, acadêmico e emocional e, consequentemente, na qualidade de vida (QV). Objetivo: descrever características e escores da QV de dados da linha de base de uma amostra clínica de indivíduos adultos, participantes de ensaio clínico randomizado controlado do uso de estimulação transcraniana por corrente contínua no TDAH. Metodologia: sessenta indivíduos foram selecionados e submetidos à avaliação da QV com a escala de autorrelato de adultos (ASRS) e a escala da qualidade de vida em adultos com TDAH (AAQoL). Características demográficas e clínicas dos indivíduos foram descritas como frequências e porcentagens para variáveis categóricas. Resultados: a média (DP) do escore total de AAQoL foi de 43,0 (14,1). Os escores médios (DP) das subescalas foram 37,4 (15,8) para Produtividade na Vida, 38,4 (23,0) para Saúde Psicológica, 53,7 (15,5) para Perspectiva de Vida e 45,9 (22,2) para Relacionamentos. Conclusão: os resultados obtidos com o AAQoL demonstraram que os sujeitos da amostra caracterizaram o perfil do adulto portador de TDAH, onde diversas esferas da vida são comprometidas, em especial os "Relacionamentos", em que apresentou o maior comprometimento identificado, além da "Produtividade". Foi identificado também o consumo de bebida alcoólica e a hereditariedade com familiares também portadores, como confirma a literatura.

Introduction: more than 50% of children with attention deficit / hyperactivity disorder (ADHD) continue to show symptoms in adulthood, with impacts on psychosocial, professional, academic, and emotional development and, consequently, on quality of life (QoL). Objective: to describe characteristics and QoL scores of baseline data from a clinical sample of adult subjects participating in randomized controlled clinical trial of the use of transcranial by continuous stimulation in ADHD. Methodology: sixty individuals were selected and submitted to QoL assessment using the adult self-report scale (ASRS) and the quality of life scale in adults with ADHD (AAQoL). Demographic and clinical characteristics of individuals were described as frequencies and percentages for categorical variables. Results: the mean (SD) of the total AAQoL score was 43.0 (14.1). The mean scores (SD) of the subscales were 37.4 (15.8) for Productivity in Life, 38.4 (23.0) for Psychological Health, 53.7 (15.5) for Life Perspective and 45.9 (22.2) for Relationships. Conclusion: the results obtained with the AAQoL demonstrated that the subjects of the sample characterized the profile of the adult with ADHD where different spheres of life are compromised, especially the "Relationships" in which he presented the greatest impairment identified, in addition to "Productivity". The consumption of alcoholic beverages and heredity with family members also had been identified, as confirmed by the literature.

Acompanhamento audiológico de lactente com risco para sífilis congênita: relato de caso / Audiological follow up of an infant affected by congenital syphilis: case report

Objetivo: descrever o acompanhamento audiológico de uma criança com exame sorológico positivo para sífilis. Caso Clínico: E.G.M.L, com sorologia positiva para sífilis, com dois dias de vida, obteve resultado "falha" na Triagem Auditiva Neonatal, com Emissões Otoacústicas Evocadas Transientes. Encaminada para o ambulatório da Clínica Escola de Fonoaudiologia, da Universidade Estadual da Bahia, retornou com quatro meses, quando realizou reteste das Emissões Otoacústicas Evocadas Transientes, que permaneceram ausentes; também se submeteu à imitanciometria, onde foram obtidas curvas timpanométricas "pico único". A avaliação da condução nervosa com Potencial Evocado Auditivo do Tronco Encefálico do Tronco Encefálico mostrou-se normal na orelha esquerda, com limiares eletrofisiológicos presentes até a intensidade de 50 dB. Porém, houve despertar do sono e não foi possível avaliar a orelha direita. Em nova reavaliação, aos oito meses, a condução nervosa pelo mesmo processo apresentou normalidade na orelha direita. As condições nutricionais de E.G.M.L. eram então críticas, com desnutrição acentuada. O atendimento no âmbito audiológico foi temporariamente suspenso e houve encaminhamento para o setor de fisioterapia e nutrição da Universidade do Estado da Bahia. Discussão: o levantamento de questões audiológicas, em grupos de risco para alterações auditivas, visa à reabilitação e à garantia das condições ideais de comunicação. Neonatos com detecção precoce de alterações auditivas são candidatos ideais à amplificação e reabilitação. Conclusão: crianças com risco para sífilis congênita precisam ser avaliadas na Triagem Auditiva e acompanhadas no seguimento. Entretanto, algumas vezes torna-se difícil conscientizar a família. Essa continuidade é importante para assegurar a integridade dos sentidos e, no caso da audição, para favorecer o desenvolvimento adequado da criança.

Objective: to describe the audiologic follow-up of a child testing positive in the serological test for syphilis. Case: E.G.M.L. has positive syphilis serology and within two days of life presented a Newborn Hearing Screening result considered fail and Transient-evoked Otoacoustic Emissions (TEOAE). She was referred to the outpatient clinic of the Clinical School of Speech-Language Therapy of State University of Bahia (UNEB) to where she returned after four months to submit to a retest of TEOAE which remained absent and an immittance test that presented a single-peaked tympanometric shape. The evaluation of nerve conduction related to Auditory Brainstem Response (ABR) was normal in the left ear presenting thresholds up to 50 dB. However, as she awakened, it was not possible to assess the right ear. However, in a new reassessment, which only occurred when she was at eight months of age, the nerve conduction related to ABR was normal in the right ear. The nutritional status of E.G.M.L at eight months of age was critical, she was severely undernourished. The hearing care service was temporarily suspended, then she was referred to the UNEB physiotherapy and nutrition sector. Discussion: the purpose of the survey on audiological issues among infectious risk groups is to make an early diagnosis of hearing disorders in order to promote rehabilitation and improve communication functions. Neonates with hearing loss at such a young age are the best candidates for amplification and rehabilitation. Conclusion: Children at risk for congenital syphilis need to be evaluated in terms of Hearing Screening and to be monitored, even though it sometimes becomes difficult to convince the family about that. It is important to keep this process in order to assure the integrity of the senses, especially in terms of the audiologic system, and to promote the adequate development of the child.

A systematic review of transcranial direct current stimulation effects in attention-deficit/hyperactivity disorder.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) stands out as the most prevalent neurodevelopmental disorder of childhood, with global prevalence ranging from 3.4% to 7•2%. Its cognitive symptoms result from the combination of complex etiological processes encompassing genetic and environmental components. Available therapeutic approaches are associated with significant challenges such as modest efficacy or side effects. Transcranial direct current stimulation (tDCS) is a promising tool for enhancing cognitive performance in neuropsychiatric disorders. Trials investigating its applicability in ADHD have showed propitious, however, still preliminary findings. METHODS: We performed a systemic review by searching on Medline, Cochrane Library, Web of Science, ScienceDirect and Embase using the descriptors: "attention-deficit/hyperactivity disorder" or "ADHD"; and "transcranial direct current stimulation" or "tDCS"; following PRISMA guidelines. RESULTS: A total of 383 articles were identified. After removing duplicates, 45 studies were assessed for eligibility, and after careful review, 11 manuscripts applying tDCS in ADHD were included. Significant improvements in attention, inhibitory control and working memory were reported, in addition to increased brain connectivity following use of active tDCS. LIMITATIONS: The main limitation was the small number of trials investigating use of tDCS in ADHD. Study methods and outcome measures were quite variable, and generally did not include long-term follow-up. CONCLUSIONS: Although the extent literature indicates promising findings, the available data remains highly preliminary. Further trials evaluating the efficacy of tDCS for ADHD, with longer follow-up, are necessary. These studies will be needed to determine the optimal protocol for clinical efficacy.

Análise comparativa do vocabulário expressivo de crianças nascidas pré-termo e a termo / Comparative analysis of the expressive vocabulary of preterm and full-term children

RESUMO Objetivo Comparar o desempenho de crianças nascidas pré-termo e a termo na avaliação do vocabulário expressivo. Métodos A avaliação do vocabulário foi realizada por meio do ABFW - Teste de Linguagem Infantil, em 40 crianças, na faixa etária de 2 a 4 anos, sendo 20 nascidas pré-termo e 20 nascidas a termo, pareadas conforme idade e sexo. Foram aplicados os testes estatísticos pertinentes, adotando-se o nível de significância menor que 5%. Resultados Observou-se diferença estatística entre o grupo pré-termo e a termo nas designações por vocábulos usuais nos campos conceituais: vestuário, móveis e utensílios e profissões; nas não designações, nos campos: profissões e locais e nos processos de substituição nos campos vestuário, profissões, locais, formas e cores. Conclusão Sugere-se uma possível relação entre o nascimento prematuro e dificuldades no desenvolvimento do vocabulário. Destaca-se a importância da intervenção precoce nesses casos, a fim de evitar ou minimizar repercussões no desenvolvimento da linguagem e na fase escolar.

ABSTRACT Purpose To compare the performance of preterm and full-term children in the expressive vocabulary assessment. Methods The vocabulary was assessed through the ABFW - Child Language Test in 40 two- to four-year-old children - 20 preterm and 20 full-term, matched for age and gender. The proper statistical tests were used, adopting the significance level lower than 5%. Results A statistical difference between the preterm and full-term groups was observed in the usual word designations (in the conceptual fields of clothing, furniture and appliances, and professions), in the no designations (in professions and places), and in the substitution processes (in clothing, professions, places, and shapes and colors). Conclusion A possible relationship between premature birth and difficulties in vocabulary development is suggested. The importance of early intervention in these cases is highlighted, to avoid or minimize consequences to language development and school achievements.

Análise das habilidades pragmáticas de crianças nascidas pré-termo / Analysis of the pragmatic skills in preterm children

RESUMO Objetivo Caracterizar as habilidades pragmáticas de crianças nascidas pré-termo e investigar se existe correlação com a idade gestacional, o gênero e a faixa etária. Métodos Foram avaliadas 42 crianças nascidas pré-termo, com baixo peso ao nascer, de ambos os gêneros, na faixa etária de 2 a 4 anos. A análise do perfil comunicativo foi realizada por meio do Protocolo de Pragmática do ABFW - Teste de Linguagem Infantil nas Áreas de Fonologia, Vocabulário, Fluência e Pragmática. Resultados Quanto à iniciativa na comunicação, houve melhor desempenho das crianças pré-termo moderadas e tardias. Em relação aos atos comunicativos, as crianças não alcançaram os valores de referência propostos pelo teste. Os meios verbais foram mais utilizados, apesar de haver grande ocorrência dos meios gestuais. As funções comunicativas mais observadas foram comentário, narrativa, jogo e pedido de objeto. Conclusão As crianças pré-termo apresentaram desvios nas habilidades pragmáticas, na faixa etária investigada. As variáveis linguísticas descritas neste estudo não apresentaram correlação com idade e gênero.

ABSTRACT Purpose To characterize the pragmatic skills of preterm children and investigate whether it is correlated with gestational age, gender and age group. Methods 42 low-birth-weight preterm infants of both genders, aged 2 to 4 years, were evaluated. The analysis of the communication profile was performed through the Pragmatics Protocol of the ABFW - child language test in the fields of phonology, vocabulary, fluency and pragmatics. Results regarding the communication initiative, there was a better performance of moderate and late preterm children. Regarding the communicative acts, the children did not reach the reference values proposed by the test. The verbal means were the most used, although there was a high occurrence of the gestural means. The most observed communicative functions were commenting, narrative, game and object request. Conclusion The preterm children had deviations in pragmatic skills in the age group investigated. The linguistic variables described in this study were not correlated with age and gender.

Description of the linguistic and neurological findings of twins born preterm at two years of age / Descrição dos achados linguísticos e neurológicos de gemelares nascidos pré-termo aos dois anos de idade

INTRODUCTION: Prematurity, low birth weight and multiple births are risk factors for structural changes in the brain, as well as for motor, cognitive, social and language developmental disorders OBJECTIVE: Describe the linguistic findings and investigate the presence of neurological alterations in preterm twins at two years of age METHODS: This is a cross-sectional study based on data analysis of the medical records of six pairs of low birth weight preterm twins of both sexes, at two years of age, attended at the State Center for the Prevention and Rehabilitation of People with Disabilities - CEPRED, in Salvador-Bahia-Brazil. To this end, information regarding birth; the clinical history; the imaging exams; and the speech, neurological and interdisciplinary assessments were collected RESULTS: Preterm twins had atypical language development and neurological changes that may compromise oral language development. From the neurological point of view, abnormalities common to the premature newborn, such as peri-intraventricular hemorrhage, were observed CONCLUSION: Multiple births associated with prematurity and low birth weight may pose risks to children's language acquisition

INTRODUÇÃO: A prematuridade, o baixo peso ao nascer e os nascimentos múltiplos são fatores de risco para alterações estruturais no cérebro, assim como para desvios no desenvolvimento motor, cognitivo, social e de linguagem OBJETIVO: Descrever os achados linguísticos e investigar a presença de alterações neurológicas em gemelares nascidos pré-termo, aos dois anos de idade MÉTODO: Trata-se de um estudo do tipo corte transversal, realizado por meio da análise de dados dos prontuários de seis pares de gêmeos nascidos pré-termo, com baixo peso ao nascer, de ambos os sexos, aos dois anos de idade, atendidos no Centro Estadual de Prevenção e Reabilitação da Pessoa com Deficiência - CEPRED, em Salvador-Bahia-Brasil. Para tanto, foram coletadas as informações referentes ao nascimento; a história clínica; os exames de imagem; e as avaliações fonoaudiológica, neurológica e interdisciplinar RESULTADOS: Os gemelares nascidos pré-termo apresentaram desenvolvimento linguístico atípico e alterações neurológicas que podem comprometer o desenvolvimento da linguagem oral. Do ponto de vista neurológico, foram observadas anormalidades comuns ao recém-nascido prematuro, como a hemorragia peri-intraventricular CONCLUSÃO: Os nascimentos múltiplos associados à prematuridade e ao baixo peso ao nascer podem oferecer riscos à aquisição da linguagem da criança

Avaliação de assimetria hemisférica funcional em pacientes com doença de Alzheimer / Evaluation of functional hemispheric asymmetry in Alzheimer's disease patients

Introdução: as assimetrias cerebrais constituem aspectos fundamentais para a organização funcional e o processamento cognitivo. Estudos prévios têm reportado que alterações no padrão de assimetria hemisférica existentes em algumas patologias reduzem a eficiência no processamento de informação. Objetivos: avaliar a assimetria hemisférica funcional a partir de padrões de homofilia e heterofilia; analisar a assimetria da conectividade funcional de redes dinâmicas em portadores de Alzheimer. Metodologia: foram construídas redes funcionais dinâmicas do córtex cerebral de pacientes com diferentes níveis de Alzheimer (muito leve, leve e moderado a grave) e do grupo de controle a partir de EEG (19 eletrodos, Sistema 10-20). Tais redes foram geradas a partir do método de associação sincronização por motifs e representadas através de grafos variantes no tempo e de redes estáticas agregadas. Essas redes foram avaliadas por meio de índices de assimetria e conectividade. Resultados: os resultados mostram uma tendência à redução da homofilia com a progressão da enfermidade, quando se compara ao controle, além de um leve aumento do índice para o último estágio, se comparado aos estágios iniciais da doença. A assimetria para a conectividade funcional, por sua vez, mostrou uma propensão a maior conectividade para o hemisfério direito, salvo para o estágio moderado a grave. Conclusão: embora os resultados não tenham apresentado diferenças significativas, eles indicam tendências de alteração no padrão de homofilia e na assimetria da conectividade funcional em redes funcionais dinâmicas de pacientes com Alzheimer.

Introduction: brain asymmetries are fundamental aspects for functional organization and cognitive processing. Previous studies have reported that changes in the hemispheric asymmetry pattern of some pathologies reduce the efficiency of information processing. Objectives: to evaluate functional hemispheric asymmetry based on homophilia and heterophilia patterns; to analyze the asymmetry of functional connectivity of dynamic networks in Alzheimer patients. Methodology: dynamic functional networks of the cerebral cortex were constructed from patients with different levels of Alzheimer's (very mild, mild and moderate to severe) and the control group from EEG (19 electrodes, System 10-20). Such networks were generated from the motif synchronization association method and represented by time-varying graphs and aggregate static networks. These networks were evaluated using asymmetry and connectivity indices. Results: the results show a tendency towards a reduction in homophilia with disease progression, when compared to the control, besides a slight increase in the index for the last stage, compared to the initial stages of the disease. Asymmetry for functional connectivity, in turn, showed a propensity for greater connectivity to the right hemisphere, except for the moderate to severe stage. Conclusion: although results did not show significant differences, they indicate trends of change in homophily pattern and functional connectivity asymmetry in dynamic functional networks of patients with Alzheimer's.

Alfa no estado alterado de consciência: meditação Raja Yoga / Alpha density in altered state of consciousness: Raja Yoga meditation

Introdução: a meditação é uma técnica ancestral praticada por tradições religiosas e não religiosas, para alcançar benefícios espirituais e na saúde. É considerada um dos estados alterados de consciência. Estudos com ressonância magnética funcional e eletroencefalografia revelaram que existe diminuição da atividade cerebral no lóbulo parietal superior, durante a meditação. Na meditação, a frequência alfa aumenta no córtex cerebral quando comparada ao relaxamento e é caracterizada por ondas rítmicas associadas ao relaxamento e à diminuição de processo cognitivo. Objetivo: descrever e comparar a distribuição de potência da frequência cerebral alfa, nos estágios de MD e RL, nas regiões cerebrais frontal, central e occipital e, comparar as diferenças entre as regiões, de meditadores experientes da casa Brahma Kumaris, praticantes da meditação Raja Yoga, de Salvador ­ BA-Brasil. Metodologia: participaram 14 voluntários neste experimento. A coleta de dados foi realizada com EEG (21 eletrodos). O protocolo utilizado envolveu 6 minutos de relaxamento e 12 minutos de meditação. Os voluntários precisavam ter tido uma noite de sono adaptada à sua rotina e não terem ingerido bebidas estimulantes antes da coleta de dados. Resultados: encontrou-se aumento da densidade alfa na região occipital, na meditação para a média (µV2 / Hz), quando comparada às regiões frontal e central. Obteve-se um tamanho de efeito médio para alfa em relação às comparações entre as regiões frontal e central e um tamanho de efeito pequeno para alfa, entre as regiões central e occipital, durante o processo meditativo. Para as outras regiões, nenhum tamanho de efeito significativo para alfa foi encontrado. Conclusão: não foram encontradas diferenças significativas para alfa, entre os estados de meditação e relaxamento, porém a densidade de potência alfa foi maior na região occipital, quando comparada com as regiões frontal e central; entretanto, essa diferença não apresentou um tamanho de efeito do d de Cohen de relevante magnitude.

Introduction: meditation is an ancient technique practiced by religious and non-religious traditions to achieve spiritual and health benefits. It is considered one of the altered states of consciousness and studies with fMRI and EEG revealed that there is decreased brain activity in the upper parietal lobe during meditation. In meditation, alpha frequency increases in the cerebral cortex when compared to relaxation and is characterized by rhythmic waves associated with relaxation and decreased cognitive process. Objective: to describe and compare the EEG alpha power density distribution during the stages of meditation and relaxation in the frontal, central and occipital regions of experienced Brahma Kumaris Rajayoga meditators. Methodology: volunteers in number of 14 participated in this experiment. Data collection was performed with EEG (21 electrodes). The protocol used involved six minutes of relaxation and 12 minutes of meditation. Volunteers needed to have had a night's sleep suited to their routine and had not inhaled stimulant drinks prior to data collection. Results: we found an increase in alpha density in the occipital region in meditation for the general mean (µV2 / Hz), when compared to the frontal and central regions. A mean effect size for alpha was obtained relative to the comparisons between the frontal and central regions and a small effect size for alpha between the central and occipital regions during meditative process. For the other regions, no significant effect size for alpha was found. Conclusion: no significant differences were found for alpha between the states of meditation and relaxation, but the alpha potency density was higher in the occipital region, when compared with the frontal and central regions; however, this difference did not present a Cohen's d effect size of relevant magnitude

The influence of prematurity on the development of phonological skills / A influência da prematuridade no desenvolvimento das habilidades fonológicas

ABSTRACT Purpose: to check the use of phonological processes in preterm infants. Methods: phonological evaluation was performed through the ABFW Child Language Test in 40 children, aged two to four years, i.e., 20 preterm and 20 full-term children, matched according to age, gender and socioeconomic level. Preterm children were evaluated at the State Center for Prevention and Rehabilitation of People with Disabilities - CEPRED; full-term children were selected and evaluated in a municipal nursery in the city of Salvador, BA, Brazil. The pertinent statistical tests were applied adopting the level of significance lower than 0.05%. Results: in the phonology test, the number of productive phonological processes not expected for the chronological age was statistically significant in the preterm group, especially syllable reduction, consonantal harmony, velar backing and liquid reduction. The high prevalence of cluster reduction and final consonant deletion, though still compatible with chronological age, shows the need to follow up the language acquisition of these children, after the age of four. Conclusion: the results evidenced the difficulty found by preterm infants in the development of phonological skills, emphasizing the importance of early diagnosis and speech-language monitoring in language acquisition.

RESUMO Objetivo: verificar o uso dos processos fonológicos em crianças nascidas pré-termo. Métodos: a avaliação da Fonologia foi realizada por meio do ABFW - Teste de Linguagem Infantil, em 40 crianças, na faixa etária de dois a quatro anos, sendo 20 crianças nascidas pré-termo e 20 crianças nascidas a termo, pareadas conforme idade, sexo e nível socioeconômico. As crianças nascidas pré-termo foram avaliadas no Centro Estadual de Prevenção e Reabilitação da Pessoa com Deficiência - CEPRED; as crianças nascidas a termo foram selecionadas e avaliadas em uma creche municipal, na cidade de Salvador-BA. Foram aplicados os testes estatísticos pertinentes adotando o nível de significância menor que 0,05%. Resultados: na prova de Fonologia, o número de processos fonológicos produtivos não esperados para a idade cronológica foi estatisticamente significante no grupo pré-termo, destacando-se os processos de redução de sílaba, harmonia consonantal, posteriorização para velar e simplificação de líquida. A alta prevalência da simplificação de encontro consonantal e da simplificação de consoante final, apesar de ainda compatíveis com a idade cronológica, alerta para a necessidade do acompanhamento da aquisição da linguagem dessas crianças, após os quatro anos de idade. Conclusão: os resultados evidenciam a dificuldade encontrada pelas crianças nascidas pré-termo no desenvolvimento das habilidades fonológicas, ressaltando a importância do diagnóstico precoce e do monitoramento fonoaudiológico na aquisição da linguagem.

Perfil de internações psiquiátricas em unidade hospitalar de Salvador, Bahia / Profile of psychiatric internment in hospital units in Salvador, Bahia

Introdução: os transtornos mentais e comportamentais caracterizam-se por uma série de alterações psíquicas que afetam ideias, emoções, comportamentos e relacionamentos interpessoais. Essas perturbações acometem milhares de pessoas no mundo e requerem uma atenção à saúde que atendam os princípios da universalidade, igualdade e integralidade defendidos pelo Sistema Único de Saúde (SUS). Objetivo: avaliar e descrever o perfil das internações psiquiátricas em unidades públicas hospitalares de Salvador (BA), no período de 2010 a 2016. Metodologia: trata-se de um estudo epidemiológico realizado por meio de consulta ao Departamento de Informática do SUS (DATASUS), sendo verificados os dados referentes ao período de 2010 a 2016. Os dados obtidos foram organizados em planilhas do software Microsoft Excel® e passaram por tratamento estatístico descritivo, sendo calculadas as frequências das internações hospitalares. Resultados: o município de Salvador é responsável por 39,58% das internações psiquiátricas da Bahia, no período especificado. A frequência de hospitalizações foi maior em indivíduos do sexo masculino, pardos e na faixa etária de 30 a 34 anos. Os hospitais especializados são responsáveis pela maior parte das hospitalizações por transtornos mentais e comportamentais, internando 63,01% dos pacientes em Salvador. A esquizofrenia, os transtornos esquizotípicos e delirantes são responsáveis por 45,63% de toda demanda Conclusões: a assistência integral a saúde mental deve ser garantida aos portadores de transtornos mentais e comportamentais. O fortalecimento dos três níveis de atenção à saúde é de suma importância devido aos diversos estados clínicos das doenças, no intuito de assegurar um cuidado de qualidade.

Introduction: and behavioral disorders are characterized by a series of psychic changes that affect ideas, emotions, behaviors, and interpersonal relationships. These disorders afflict thousands of people in the world and require health care that meet the principles of universality, equality and integrality defended by Brazilian National Health System (SUS). Objective: To evaluate and describe the profile of psychiatric hospitalizations in public hospitals in Salvador (BA), as observed from 2010 to 2016. Methodology: this is an epidemiological study carried out by consulting DATASUS, and the data for the period from 2010 to 2016 were verified. Data obtained were organized in Microsoft Excel® spreadsheets and underwent descriptive statistical treatment, by calculating the frequencies of hospitalizations. Results: the municipality of Salvador is responsible for about 39.58% of the psychiatric hospitalizations of Bahia in the specified period. The frequency of hospitalizations was greater in males, mulattos and the age group of 30 to 34 years. Specialized hospitals accounted for 63.01% of hospitalizations due to mental and behavioral disorders in Salvador. Schizophrenia, schizotypal and delusional disorders account for 45.63% of all demand. Conclusions: comprehensive mental health care must be guaranteed to those with mental and behavioral disorders. Strengthening the three levels of health care is of paramount importance to ensure humanized and quality care and guarantee universal, equal and integral care as recommended by the Unified Health System (SUS).

Comprehensive neuropsychological evaluation of children and adolescents with sickle cell anemia: a hospital-based sample.

BACKGROUND: Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. METHODS: The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. RESULTS: Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. CONCLUSION: As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.

Comprehensive neuropsychological evaluation of children and adolescents with sickle cell anemia: a hospital-based sample

Abstract Background: Individuals with sickle cell anemia may suffer symptomatic or silent cerebral infarcts leading to neurocognitive complications. This study investigated the cognitive and intellectual performance of children and adolescents with sickle cell anemia. Methods: The socioeconomic status, clinical aspects and behavioral profile of 15 young individuals with sickle cell anemia were evaluated. The Wechsler Intelligence Scale for Children, the Developmental Neuropsychological Assessment Test, and the Child Behavior Checklist were applied. Results: Participants with a history of stroke had lower intelligence quotient (IQ) scores. Alterations were found in attention and executive functioning, language, verbal and visual memory, visuospatial processing and sensorimotor skills. These alterations were found both in the children and adolescents who had had a cerebral infarction and in those who apparently had not. In the majority of cases, there were learning difficulties, a history of repeating school years and a need for specialist educational support. The most common additional diagnoses in accordance with the Diagnostic and Statistical Manual of Mental Disorders IV were depressive disorder, anxiety disorder and somatic disorder, as well as conditions associated with physical and psychosocial repercussions of sickle cell anemia. Conclusion: As sickle cell anemia is considered a progressive cerebral vasculopathy, it is a potential risk factor for neurocognitive and psychosocial development. Therefore, periodic neuropsychological and behavioral evaluations of children and adolescents with sickle cell anemia may represent a useful measure to reduce long-term biopsychosocial repercussions.