The relationship between motor function, cognition, independence and quality of life in myelomeningocele patients.

Motor function, cognition, functional independence and quality of life have been described in myelomeningocele patients, but no study has investigated their relationships. We aimed to investigate the relationships between motor function, cognition, functional independence, quality of life, age, and lesion level in myelomeningocele patients, and investigate the influence of hydrocephalus on these variables. We assessed 47 patients with the Gross Motor Function Measure (motor function), Raven's Colored Progressive Matrices (cognition), Pediatric Evaluation of Disability Inventory (functional independence) and the Autoquestionnaire Qualité de vie Enfant Imagé (quality of life). Spearman's correlation tests determined relationships between the variables. The Friedman ANOVAs determined the influence of hydrocephalus. Motor function was strongly related to mobility and lesion level, and moderately related to cognition, self-care and social function. Cognition and quality of life were moderately related to functional independence. Age correlated moderately with functional independence and quality of life. Hydrocephalus resulted in poorer motor/cognitive outcomes and lower functional independence.

The relationship between motor function, cognition, independence and quality of life in myelomeningocele patients / Relação entre função motora, cognição, independência funcional e qualidade de vida em pacientes com mielomeningocele

ABSTRACT Motor function, cognition, functional independence and quality of life have been described in myelomeningocele patients, but no study has investigated their relationships. We aimed to investigate the relationships between motor function, cognition, functional independence, quality of life, age, and lesion level in myelomeningocele patients, and investigate the influence of hydrocephalus on these variables. We assessed 47 patients with the Gross Motor Function Measure (motor function), Raven's Colored Progressive Matrices (cognition), Pediatric Evaluation of Disability Inventory (functional independence) and the Autoquestionnaire Qualité de vie Enfant Imagé (quality of life). Spearman's correlation tests determined relationships between the variables. The Friedman ANOVAs determined the influence of hydrocephalus. Motor function was strongly related to mobility and lesion level, and moderately related to cognition, self-care and social function. Cognition and quality of life were moderately related to functional independence. Age correlated moderately with functional independence and quality of life. Hydrocephalus resulted in poorer motor/cognitive outcomes and lower functional independence.

RESUMO Função motora, cognição, independência funcional e qualidade de vida foram descritos em pacientes com mielomeningocele (MMC), mas sua correlação não foi investigada. Esse estudo investigou correlações entre função motora, cognição, independência funcional, qualidade de vida, idade, nível de lesão em pacientes com MMC e a influência da hidrocefalia nessas variáveis. Quarenta e sete pacientes foram avaliados com a Medida de Função Motora Grossa, Matrizes Progressivas de Raven, Inventário de Avaliação Pediátrica de Incapacidade e Autoquestionnaire Qualité de vie Enfant Imagé. Testes de Spearman investigaram as correlações. ANOVAS de Friedman investigaram a influência da hidrocefalia. A função motora correlacionou-se fortemente com mobilidade e nível de lesão e moderadamente com cognição, auto-cuidado e função social. Cognição e qualidade de vida correlacionaram-se moderadamante com independência funcional. Idade correlacionou moderadamente com independência funcional e qualidade de vida. Hidrocefalia associou-se a piores desfechos motores/cognitivos e menor independência funcional.

Association between language development and auditory processing disorders.

INTRODUCTION: It is crucial to understand the complex processing of acoustic stimuli along the auditory pathway; comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AIM: To investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). MATERIAL AND METHODS: Prospective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. RESULTS: The effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. CONCLUSION: This study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders.

Association between language development and auditory processing disorders / Associação entre transtornos no desenvolvimento de linguagem e processamento auditivo

INTRODUCTION: It is crucial to understand the complex processing of acoustic stimuli along the auditory pathway ;comprehension of this complex processing can facilitate our understanding of the processes that underlie normal and altered human communication. AIM: To investigate the performance and lateralization effects on auditory processing assessment in children with specific language impairment (SLI), relating these findings to those obtained in children with auditory processing disorder (APD) and typical development (TD). MATERIAL AND METHODS: Prospective study. Seventy-five children, aged 6-12 years, were separated in three groups: 25 children with SLI, 25 children with APD, and 25 children with TD. All went through the following tests: speech-in-noise test, Dichotic Digit test and Pitch Pattern Sequencing test. RESULTS: The effects of lateralization were observed only in the SLI group, with the left ear presenting much lower scores than those presented to the right ear. The inter-group analysis has shown that in all tests children from APD and SLI groups had significantly poorer performance compared to TD group. Moreover, SLI group presented worse results than APD group. CONCLUSION: This study has shown, in children with SLI, an inefficient processing of essential sound components and an effect of lateralization. These findings may indicate that neural processes (required for auditory processing) are different between auditory processing and speech disorders. .

INTRODUÇÃO: Entender como os estímulos acústicos são processados ao longo da via auditiva é fundamental para compreender os processos que subjazem à comunicação humana normal e alterada. OBJETIVO: Investigar o desempenho e efeitos de lateralidade na avaliação do processamento auditivo em crianças com distúrbio específico de linguagem (DEL), comparando os resultados obtidos aos encontrados em crianças com transtorno de processamento auditivo (TPA) e desenvolvimento típico (DT). MATERIAL E MÉTODO: Estudo Prospectivo. 75 crianças (6-12 anos), divididas em três grupos (25 crianças com DEL, 25 crianças com TPA e 25 crianças em DT), foram submetidas aos seguintes testes: Teste de Figura com Ruído, Teste Dicótico de Dígitos e Teste de Padrão de Frequência. RESULTADO: Os efeitos de lateralidade foram observados apenas no grupo DEL, sendo o desempenho na orelha esquerda inferior ao apresentado na orelha direita. Na comparação intergrupos, o desempenho dos grupos TPA e DEL foi significativamente inferior ao observado no grupo DT para todos os testes. Além disso, observamos nas crianças do grupo DEL um desempenho inferior às do grupo TPA. CONCLUSÃO: Este estudo constatou o processamento ineficiente de componentes cruciais de sons e o efeito de lateralidade em crianças com DEL. Esses achados evidenciam que os processos neurais que subjazem ao processamento auditivo são diferentes entre alterações de processamento auditivo e alterações de fala. .

Relação entre funções cognitivas e perdas adquiridas na visão de cores de pacientes com esclerose múltipla tipo remitente recorrente / Relationship between cognitive functions and acquired color vision loss in patients with relapsing-remitting type of multiple sclerosis

A Esclerose Múltipla (EM) é uma doença inflamatória autoimune caracterizada por desmielinização e degeneração do sistema nervoso central (SNC) duas a três vezes mais frequente em mulheres. A etiologia da EM é dividida em dois subtipos principais: o tipo remitente-recorrente (EMRR) mais comum, caracterizado por dois ou mais episódios de agravamento dos sintomas que envolvem diferentes locais do SNC, separados por pelo menos 1 mês e remisão dos sintomas e o tipo progressivo é a forma menos comum, caracterizada por um contínuo agravamento dos sintomas desde o início geralmente sem recaídas claras ou remissões. A presente pesquisa teve por objetivo avaliar o comprometimento da visão de cores e de sua relação com perdas de atenção, memória visual imediata, memória visual tardia, memória operacional e funções executivas dos portadores de esclerose múltipla tipo remitente recorrente. Método: participaram 41 pacientes com esclerose múltipla de idades entre 20 e 58 anos (35,4±12,2) e 37 controles com idade (34,7±12,1) e escolaridade semelhante. A discriminação de cores foi avaliada com o Cambridge Colour Test (CCT) e a avaliação de funções neuropsicológicas foram utilizados subtestes da bateria Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task e Rapid Information Processing; Escalas de Depressão e Ansiedade de Beck e Escala de Determinação Funcional da Qualidade de vida (DEFU).(AU)

Multiple sclerosis (MS) is an autoimmune inflammatory disease characterized by demyelination and central nervous system (CNS) degeneration. It is two times more frequent in women. It can be presented in two subtypes: the relapsing-remitting (RR), most common type, characterized by two or more episodes of focal disorders in different sites of the CNS, and remission of the symptoms; and the progressive subtype, less common, characterized by a continuous worsening of the symptoms, since the beginning, usually with no remissions. The present research evaluated color vision impairment and its relationship to attention loss, short-term memory, long-term memory, working memory and executive function in patients with the relapsing-remitting MS type. Methods: 41 patients with multiple sclerosis (20 to 58 years, 35.4 ± 12.2 in average) and 37 controls matched to age (34.7 ± 12.1 in average) and years of education participated of the study. Color vision was tested using the Cambridge Colour Test (CCT) and the neuropsychological assessment was performed using tests of the Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task, Rapid Information Processing the Beck Depression and Anxiety Inventories and the Functional Assessment of Multiple Sclerosis quality of life instrument.(AU)

Memory span measured by the spatial span tests of the Cambridge neuropsychological test automated battery in a group of Brazilian children and adolescents / Capacidade de memória medida por testes de retenção espacial da bateria neuropspicologica computadorizada de Cambridge em um grupo de crianças e adolescentes brasileiros

The neuropsychological tests of spatial span are designed to measure attention and working memory. The version of the spatial span test in the Cambridge Neuropsychological Test Automated Battery (CANTAB) evaluates these functions through the recall of sequences of spatial locations presented to the subject. Objective: The present study investigated how age, gender and educational level might affect the performance of the non-verbal system. Methods: A total of 60 children and adolescents aged 6 to 18 years were assessed (25 males and 35 females). Results: The results showed no gender differences in test performance. Children with six or more years of education showed better performance than children with less than three years of education. Older children had more schooling and thus were able to recall a greater number of items. Span length values proved similar to a previous large normative study which also employed the CANTAB Spatial Span (De Luca et al., 2003). Conclusion: The similarity in performance of the Brazilian children and adolescents studied and the group of Australian participants examined by the cited authors, despite the socio-cultural and economical differences, points to the suitability of the task for the assessment of attention and working memory in Brazilian children.

Testes neuropsicológicos de span visuoespacial são construídos para avaliar amplitude atencional e memória de trabalho. Na versão do teste de span visuoespacial da Cambridge Neuropsychological Test Automated Battery (CANTAB) essa avaliação é feita através de sequências de localização espacial. Objetivo: O presente estudo investiga como a idade, o sexo e a escolaridade podem afetar o desempenho nesse sistema não-verbal. Métodos: Foram avaliadas 60 crianças e adolescentes com idades entre 6 e 18 anos (25 meninos; 35 meninas). Resultados: Os resultados não mostraram diferenças no desempenho do teste entre os sexos. O grupo de crianças com seis ou mais anos de escolaridade foi melhor do que a de crianças menores de três anos de estudo. Nossos resultados sugerem que as crianças mais velhas e, portanto, com maior tempo de escolaridade conseguem se lembrar de um número maior de itens. Os valores de amplitude foram similares aos obtidos em um experimento normativo prévio amplo no qual foi utilizado o teste Spatial Span do CANTAB (De Luca et al., 2003). Conclusão: Estas concordâncias de desempenhos entre crianças e adolescentes brasileiros e o grupo de participantes australianos examinados pelos autores citados nos mostram que apesar das diferenças sócio-culturais e econômicas existentes, a tarefa é adequada para avaliação de atenção e memória de trabalho em crianças brasileiras.

Memory span measured by the spatial span tests of the Cambridge Neuropsychological Test Automated Battery in a group of Brazilian children and adolescents.

The neuropsychological tests of spatial span are designed to measure attention and working memory. The version of the spatial span test in the Cambridge Neuropsychological Test Automated Battery (CANTAB) evaluates these functions through the recall of sequences of spatial locations presented to the subject. OBJECTIVE: The present study investigated how age, gender and educational level might affect the performance of the non-verbal system. METHODS: A total of 60 children and adolescents aged 6 to 18 years were assessed (25 males and 35 females). RESULTS: The results showed no gender differences in test performance. Children with six or more years of education showed better performance than children with less than three years of education. Older children had more schooling and thus were able to recall a greater number of items. Span length values proved similar to a previous large normative study which also employed the CANTAB Spatial Span (De Luca et al., 2003). CONCLUSION: The similarity in performance of the Brazilian children and adolescents studied and the group of Australian participants examined by the cited authors, despite the socio-cultural and economical differences, points to the suitability of the task for the assessment of attention and working memory in Brazilian children.

Testes neuropsicológicos de span visuoespacial são construídos para avaliar amplitude atencional e memória de trabalho. Na versão do teste de span visuoespacial da Cambridge Neuropsychological Test Automated Battery (CANTAB) essa avaliação é feita através de sequências de localização espacial. OBJETIVO: O presente estudo investiga como a idade, o sexo e a escolaridade podem afetar o desempenho nesse sistema não-verbal. MÉTODOS: Foram avaliadas 60 crianças e adolescentes com idades entre 6 e 18 anos (25 meninos; 35 meninas). RESULTADOS: Os resultados não mostraram diferenças no desempenho do teste entre os sexos. O grupo de crianças com seis ou mais anos de escolaridade foi melhor do que a de crianças menores de três anos de estudo. Nossos resultados sugerem que as crianças mais velhas e, portanto, com maior tempo de escolaridade conseguem se lembrar de um número maior de itens. Os valores de amplitude foram similares aos obtidos em um experimento normativo prévio amplo no qual foi utilizado o teste Spatial Span do CANTAB (De Luca et al., 2003). CONCLUSÃO: Estas concordâncias de desempenhos entre crianças e adolescentes brasileiros e o grupo de participantes australianos examinados pelos autores citados nos mostram que apesar das diferenças sócio-culturais e econômicas existentes, a tarefa é adequada para avaliação de atenção e memória de trabalho em crianças brasileiras.

The use of the Cambridge Neuropsychological Test Automated Battery (CANTAB) in neuropsychological assessment: application in Brazilian research with control children and adults with neurological disorders

Computerized neuropsychological tests can be effective and have many benefits. This paper addresses these issues using the computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess Brazilian children and adults. Preliminary normative data for Brazilian children obtained in a series of CANTAB subtests are presented together with data from adults (controls) and samples of patients with multiple sclerosis and Duchenne muscular dystrophy. The results obtained in children confirmed the normative values reported for American children (Luciana & Nelson, 2002), indicating high applicability of the CANTAB battery for children in the evaluation of visual memory, working memory, planning, and set shifting. For multiple sclerosis patients, CANTAB revealed differences between the control and multiple sclerosis groups for all subtests employed, including visual memory, working memory, spatial memory, decision making, inhibitory control, and sustained attention. In children with Duchenne muscular dystrophy, the CANTAB tests revealed specific detriments in attention and memory. These results of the application of CANTAB in different patient groups indicate that the battery is appropriate for assessing several central nervous system diseases.(AU)

The use of the Cambridge Neuropsychological Test Automated Battery (CANTAB) in neuropsychological assessment: application in Brazilian research with control children and adults with neurological disorders

Computerized neuropsychological tests can be effective and have many benefits. This paper addresses these issues using the computer-based Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess Brazilian children and adults. Preliminary normative data for Brazilian children obtained in a series of CANTAB subtests are presented together with data from adults (controls) and samples of patients with multiple sclerosis and Duchenne muscular dystrophy. The results obtained in children confirmed the normative values reported for American children (Luciana & Nelson, 2002), indicating high applicability of the CANTAB battery for children in the evaluation of visual memory, working memory, planning, and set shifting. For multiple sclerosis patients, CANTAB revealed differences between the control and multiple sclerosis groups for all subtests employed, including visual memory, working memory, spatial memory, decision making, inhibitory control, and sustained attention. In children with Duchenne muscular dystrophy, the CANTAB tests revealed specific detriments in attention and memory. These results of the application of CANTAB in different patient groups indicate that the battery is appropriate for assessing several central nervous system diseases.

Preliminary findings on the effects of occupational exposure to mercury vapor below safety levels on visual and neuropsychological functions.

OBJECTIVE: To evaluate whether there are visual and neuropsychological decrements in workers with low exposure to Hg vapor. METHODS: Visual fields, contrast sensitivity, color vision, and neuropsychological functions were measured in 10 workers (32.5 +/- 8.5 years) chronically exposed to Hg vapor (4.3 +/- 2.8 years; urinary Hg concentration 22.3 +/- 9.3 microg/g creatinine). RESULTS: For the worst eyes, we found altered visual field thresholds, lower contrast sensitivity, and color discrimination compared with controls (P <0.05). There were no significant differences between Hg-exposed subjects and controls on neuropsychological tests. Nevertheless, duration of exposure was statistically correlated to verbal memory and depression scores. CONCLUSIONS: Chronic exposure to Hg vapor at currently accepted safety levels was found to be associated with visual losses but not with neuropsychological dysfunctions in the sample of workers studied.

Chromatic discrimination losses in multiple sclerosis patients with and without optic neuritis using the Cambridge Colour Test.

We assessed chromatic discrimination in multiple sclerosis (MS) patients both with (ON) and without (no ON) a history of optic neuritis using the Cambridge color test (CCT). Our goal was to determine the magnitude and chromatic axes of any color vision losses in both patient groups, and to evaluate age-related changes in chromatic discrimination in both patient groups compared to normals. Using the CCT, we measured chromatic discrimination along the protan, deutan and tritan axes in 35 patients with MS (17 ON eyes) and 74 age matched controls. Color thresholds for both patient groups were significantly higher than controls' along the protan and tritan axes (p < 0.001). In addition, the ON and no-ON groups differed significantly along all three-color axes (p < 0.001). MS patients presented a progressive color discrimination impairment with age (along the deutan and tritan axes) that was almost two times faster than controls, even in the absence of ON. These findings suggest that demyelinating diseases reduce sensitivity to color vision in both red-green and blue-yellow axes, implying impairment in both parvocellular and koniocellular visual pathways. The CCT is a useful tool to help characterize vision losses in MS, and the relationship between these losses and degree of optic nerve involvement.

Estudo da visão de cores, percepção de formas e espaço em pacientes com esclerose múltipla / Study of color vision, perception of shapes and space in patients with multiple sclerosis

A presente dissertação objetiva avaliar a visão de cores dos pacientes com EM (com e sem queixas visuais), através de teste psicofísicos e a percepção de formas e espaço, através de testes neuropsicológicos, além de investigar a existência de correlação entre essas funções. Participaram da pesquisa um total de 35 pacientes (9 M e 27 F) com o diagnóstico de EM, com idades entre 18 e 60 anos (média 36,84±10,49), e nível de educação variado, e 36 controles com faixa etária e nível escolar equivalente. Os pacientes possuíam acuidade visual 20/20, ou melhor e foram divididos em dois grupos: um com neurite óptica (NO n=52) outro sem NO (n=17). Foram utilizados os testes: Cambridge Color Test (CCT) fase trivector e elipse, Judgment of line orientation (JLO), visual form discrination (VFD), Bateria de percepção visual de objeto e espaço (VOSP), e as Escalas de depressão e ansiedade de Beck. Os resultados mostram diferenças entre grupos (anova OneWay), nos três eixos analisados (protan, deutan e tritan) e nas áreas das elipses em todos os grupos, (p0,005) indicando que a visão de cores está prejudicada em ambos os sistemas de oponência, sendo que a ocorrência de NO está associada a maior prejuízo, mas há perda da visão de cores mesmo na ausência de NO. Dos olhos sem No 52 possui áreas das elipses normais (27/52), 27 (...)

... possui deficiência difusa (14/52), 13 no eixo tritan (7/52), 6 no eixo protan (3/52) e 2 no deutan (1/52), indicando que a incidência de prejuízo difuso é maior entre estes pacientes

To assess color vision, form and space perception in patients with clinical diagnosis of multiple sclerosis, with or without history of optic neuritis. Methods: We evaluated 35 patients (27F; 9M; mean age = 36.84±10.49 years) with diagnosis of multiple sclerosis. All patients had visual acuity between 0 and 0.1 logMAR and presented no alterations in a complete ophthalmologic exam. We compared the results with 36 control subjects, matched in age and school level. Color discrimination was performed with Cambridge Colour Test (CCT) along the protan, deutan and tritan cone isolation axes. All patients were evaluated monocularly in both eyes. In neuropsychological evaluation, for space and form perception, we used Judgment of Line Orientation (JLO), Visual Form Discrimination (VFD), Visual Object and Space Perception Test (VOSP), and the depression and anxiety of Beck Scales. Results: Color discrimination measured in both groups differed significantly from the control group in all Trivector axes and in the ellipses areas (p < 0.005). Eyes with history of optic neuritis were associated whit larger damage. MS patients presented a progressive color discrimination impairment with age (along the deutan and tritan axes) that was almost two times faster than controls, even in the absence of ON. In neuropsychological evaluation, MS group presented statistical differences from control group in VOSP silhouettes, objects and cubs tests (p0,005). Conclusions: Most of the central visual functions were impaired in patients with ME, who had no impairment in visual acuity. Episodes of optic neuritis are a factor that increases the chance of reduction in color discrimination. Correlations between color vision and neuropsychological evaluation suggest that losses in chromatic discrimination leads to damage in neuropsychological tests performance. These findings suggest that demyelinating ...(AU)

A aplicação da neuropsicologia na pesquisa experimental: o exemplo da intoxicação por vapor de mercúrio / Neuropsychology in experimental research: mercury intoxication as an example of application

O desenvolvimento da neuropsicologia acompanhou a evolução do estudo do cérebro desde os registros mais antigos. A ciência neuropsicológica faz uso de medidas quantitativas de desempenho e tecnologias para produção de neuroimagem que, em conjunto, permitem a observação das relações cérebro-comportamento. No âmbito experimental, a neuropsicologia tem revelado novos conhecimentos na investigação de alterações cognitivas, psicomotoras ou comportamentais associadas a patologias congênitas ou adquiridas. No presente artigo são abordados aspectos históricos da neuropsicologia experimental e apresentados os principais resultados de um estudo referente às alterações neuropsicológicas de pacientes com histórico de intoxicação por vapor de mercúrio, presentes anos após o período de exposição ao metal (AU)

A aplicação da neuropsicologia na pesquisa experimental: o exemplo da intoxicação por vapor de mercúrio / Neuropsychology in experimental research: mercury intoxication as an example of application

O desenvolvimento da neuropsicologia acompanhou a evolução do estudo do cérebro desde os registros mais antigos. A ciência neuropsicológica faz uso de medidas quantitativas de desempenho e tecnologias para produção de neuroimagem que, em conjunto, permitem a observação das relações cérebro-comportamento. No âmbito experimental, a neuropsicologia tem revelado novos conhecimentos na investigação de alterações cognitivas, psicomotoras ou comportamentais associadas a patologias congênitas ou adquiridas. No presente artigo são abordados aspectos históricos da neuropsicologia experimental e apresentados os principais resultados de um estudo referente às alterações neuropsicológicas de pacientes com histórico de intoxicação por vapor de mercúrio, presentes anos após o período de exposição ao metal