Executive functions beyond the "Holy Trinity": A scoping review.

OBJECTIVE: Executive functions (EFs) are a multifaceted construct, important for several outcomes throughout life. The most commonly addressed executive components are inhibitory control, working memory, and cognitive flexibility. To map how other executive components are addressed conceptually and methodologically in the literature, a scoping review was carried out. METHOD: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline was used. The database search (2017-2022) was carried out on the APA PsycInfo, Medline, Scopus, LILACS, and SciELO databases. A total of 3,473 articles were identified; 1,302 remained after screening. Given the large number of articles, a sample calculation was performed (95% CI and 5% error), with 297 articles randomly selected for full-text reading and 242 studies included for analysis. RESULTS: There was a predominance of health application studies in adults and older adults and in developed countries. There is relative conceptual consensus that EF are a multidimensional construct; however, there is no explicit identification of the theoretical model used in the studies. A diversity of EF was evidenced, which broadens the understanding of the construct, its assessment, and intervention targets. Furthermore, there was a variety of instruments used to assess these skills, with a predominance of performance tests, often with construct-instrument ambivalence between studies. CONCLUSIONS: The mapping showed a diversity of skills referred to as EF in addition to the core components and identified the instruments used in their assessment. Greater conceptual and structural clarity and greater methodological care are fundamental to support the assessment of EF and their intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Neuropsychological assessment after long-term omeprazole treatment.

Recent studies suggest that Omeprazole, a widely used treatment for gastric acid-related disorders, may have a significant effect on human cognition. However, there is no consensus on the matter. Though some studies suggest the drug is associated with an increased risk of cognitive decline, memory impairment, and dementia, this issue has not been sufficiently studied. Therefore, the goal of this study was to investigate the cognitive impairments associated with long-term Omeprazole treatment, with a focus on memory, attention, and executive functions. Additionally, we sought to verify whether the duration of treatment was associated with the magnitude of the associated cognitive impairments. The sample consisted of 30 participants of both genders treated with Omeprazole (experimental group) and 30 participants who did not use the drug (control group). The cognitive assessment battery: Verbal Fluency, Rey Auditory-Verbal Learning, Attention Assessment Battery, Five Digit Test, Hayling Test, and NEUPSILIN Subtest. The groups were compared using Student's T-tests, and the association between treatment duration and cognitive performance was examined using Pearson's coefficients. The results showed significant group differences in verbal fluency, short-term episodic memory, selective attention, and executive functions. The duration of Omeprazole treatment was also positively associated with the magnitude of cognitive impairment.

Inhibitory control stimulation in elementary school children through digital games: A systematic mapping study.

The inhibitory control is a component of the executive functions that allows the individual to inhibit inadequate behaviors, resist distractions and select a relevant stimulus when executing activities. In the neuropsychology field, evidences of stimulation and improvement of the inhibitory control through school interventions is sought by using computerized software, such as digital games. These research studies constitute an important investigation area within the executive functions in ecological approaches. This paper presents a systematic mapping study on inhibitory control stimulation in elementary school children with the use of digital games. The investigation encompassed an automated database search with further backward snowballing procedure with the final selection for additional publications as research strategy. The automated search considered six databases: SCOPUS, PubMed, IEEE Explore Digital Library, ACM Library, Springer Link, and Scielo. The initial database search found 641 works published between 2014 and 2019. After the exclusion and inclusion criteria were considered, three publications related to digital games or mobile applications were found and selected for analysis, which focused on inhibitory control or correlated processes stimulation in school-based interventions with elementary school children. Results indicated that investigations within the field are incipient, pointing to an emerging research area.

Cognition, oxidative stress and vitamin B12 levels evaluation on patients under long-term omeprazole use.

OBJECTIVES: To evaluate the differences concerning cognitive performance, oxidative stress and vitamin B12 levels in omeprazole users under treatment for longer than six months. METHODS: A case-control study was developed with 44 omeprazole users (OU; 81.8 % female, 66 ± 8.7 years old) and 35 nonusers (NOU; 88.6 % female, 62 ± 8.7 years old). The cognitive ability was assessed through tests approaching attention, memory and executive functions. The vitamin B12 was dosage using a chemiluminescent immunoassay and oxidative stress analysis, based on the evaluation of malondialdehyde, enzymatic activity of extracellular superoxide dismutase, glutathione peroxidase, catalase and the ferric reducing antioxidant power in plasma. KEY FINDINGS: A significant increase of the ferric reducing antioxidant power [omeprazole users (OU) group = 1690 µM ± 441 and nonusers (NOU) group = 1308 ± 616; P value=0.002] and a decrease on glutathione peroxidase levels [OU group = 0.534 (0.27-10.63) and NOU group = 71.86 (14.36-173.1); P value=0.006] were found on omeprazole users group, as well as differences on cognitive performance, with impairments on executive functions, automatic and attentional processing. CONCLUSIONS: Long-term use of omeprazole is suggested to induce an oxidative stress condition, which causes neurotoxicity and cognitive decline.

Estilos parentais e a relação com traços de personalidade de crianças em idade escolar / Parenting styles and relationship with personality traits of school children

As relações entre os cuidadores e as crianças têm se mostrado fundamentais para o desenvolvimento infantil. O objetivo deste estudo foi investigar a relação entre estilos parentais (EP) com os traços de personalidade das crianças. Participaram 50 mães e seus filhos de 10 a 12 anos, de três escolas públicas. O questionário sociodemográfico e o Inventário de Estilos Parentais (IEP) foram respondidos pelas mães e o IEP e o Questionário de Personalidade Junior-Eysenck pelas crianças. Foi realizado o teste de normalidade Kolmogorov-Smirnova e após os dados mostrarem seguir distribuição normal, utilizou-se a análise de correlação de Pearson através do Statistical Package for the Social Sciences (SPSS) com um nível de significância p ≤ 0,05. Houve divergência quanto à percepção das crianças em relação ao EP adotado pelas mães e da visão das mães sob seus estilos EP frente aos filhos. Associações significativas demonstraram a existência da relação entre os EP das mães e os traços de personalidade de seus filhos. A punição, disciplina relaxada, monitoria negativa, negligência e abuso se correlacionaram de forma positiva, com intensidade de fraca a moderada, principalmente com os traços de personalidade psicoticismo e neuroticismo.

Relationships between caregivers and children have been fundamental to child development. The aim of the study was to investigate the relationship between these parenting styles (EP) with the children's personality traits. Fifty mothers and their children aged 10 to 12 years, from three public schools participated. The sociodemographic questionnaire and the Parenting Styles Inventory (IEP) were answered by the mothers and the IEP and the Junior-Eysenck Personality Questionnaire by the children. The Kolmogorov-Smirnova normality test was performed and after the data showed to follow normal distribution, using a Pearson correlation analysis using the Statistical Package for the Social Sciences (SPSS) with a significance level p ≤ 0.05. There was disagreement regarding the children's perception of the EP adopted by the mothers and the mothers' view under their EP styles in relation to their children. Relevant associations demonstrated the existence of a relationship between the mothers' EPs and their children's personality traits. Punishment, relaxed discipline, negative monitoring, neglect and abuse were positively correlated, with weak to moderate intensity, mainly with personality traits, psychoticism and neuroticism.

Program for the Neuropsychological Stimulation of Cognition in Students: Impact, Effectiveness, and Transfer Effects on Student Cognitive Performance.

Despite the crucial role played by the executive functions (EF) to cognitive, emotional, and social development of children before and during school years, little attention has been given to construct and analyze the efficacy of programs that intend to develop them. The program of neuropsychological stimulation of cognition in students: emphasis on EF, or PENcE (an acronym from its original name in Portuguese, Programa de Estimulação Neuropsicológica da Cognição em Escolares: ênfase nas Funções Executivas), is an early and preventive intervention program for school-aged children, and implemented at school three times a week for 5 months. The PENcE was structured in four modules, each focusing on a different executive component: organization and planning, inhibitory control, working memory, and cognitive flexibility. The objectives of this study were to verify the effectiveness of the PENcE among elementary school children and to investigate whether there are transfer effects to other executive, cognitive, and academic abilities. The sample consisted of 113 children attending 3rd or 4th grade at two public elementary schools. Eight classes participated in the study, divided into two groups: an experimental group (EG) (four classes; n = 64), which received the intervention, and a control group (CG) (four classes; n = 49), which continued their regular school activities. The EF and academic skills of both participant groups were evaluated before and after the intervention. The EG showed significantly greater improvements in inhibitory control, working memory, and abstract planning relative to the CG, with a small to medium effect size. There were transfer effects to other cognitive and academic abilities. These findings suggest the PENcE may be a useful method of improving EF and could benefit both school-aged children and education professionals.

Neuropsychological stimulation of executive functions in children with typical development: A systematic review.

This systematic review aimed to characterize empirical studies on neuropsychological interventions to stimulate executive functions in children with typical development. Searches were conducted according to the PRISMA method. Nineteen (19) studies on the analysis to evaluate the effectiveness of intervention programs in pre-school and school children were obtained. There was a predominance of studies that used computerized cognitive training, most of them involving the stimulation of working memory. Others used pen and paper forms, or hybrid tasks, and some programs used a school curriculum approach aiming to improve self-regulation. Results provide preliminary evidence on the effectiveness of such on the executive performance in children with typical development. Each executive component, as well as each type of intervention has its peculiarities. Computerized trainings and pen and paper tasks tend to improve the targeted executive functions, but transfer effects are still inconsistent. Regarding the effects of programs using school curriculum approach, they seem to be more generalizable, with functionality gains accomplishing mainly socio-emotional regulation. Multimodal approaches may be even more effective. Follow-up studies should be targeted in order to track the maintenance of direct and transfer effects regarding mainly cognitive and social development associated to school achievement.

Bells Test: Are there differences in performance between adult groups aged 40-59 and 60-75?

OBJECTIVE: To verify whether differences exist between groups of Brazilian adults aged 40-59 and 60-75 in respective performance on the Bells Test, given the dearth of literature investigating the relationship between focused visual attention and the age factor. METHODS: Eighty-four neurologically healthy adults (half aged 40-59 and half 60-75) with high educational level (40-59 years group: M=17.75 years' education; SD=4.00; 60-75 years group: M=15.85 years education; SD=3.19) were assessed using the Bells Test. Data on accuracy and processing speed were compared between groups by ANCOVA, controlled for the covariates education and frequency of reading and writing habits. RESULTS: There were no significant differences between the age groups. CONCLUSION: It is suggested that aging influences sustained and focused attention and speed processing after 75 years of age on visual cancellation paradigms, when executive and attentional changes tend to be more marked. Further studies should investigate healthy older and oldest-old adults, as well as groups with low and intermediate educational backgrounds. In addition, Brazilian clinical populations should also be characterized, particularly those with neurological disorders that might have visual hemineglect.

OBJETIVO: Verificar se existem diferenças entre grupos de adultos brasileiros de 40 a 59 e 60 a 75 anos de idade na performance no Teste dos Sinos, uma vez que há uma literatura reduzida que aborda as relações entre a atenção visual focalizada e o fator de idade. MÉTODOS: Foram avaliados 80 adultos (metade deles com idade entre 40 e 59 e outra metade com idade entre 60 e 75) com alto nível educacional (40-59 anos de idade: M=17,75, DP=4,00; 60-75 anos de idade: M=15,85, DP=3,19) e saudáveis neurologicamente, por meio do Teste dos Sinos. Os dados de precisão e velocidade de processamento foram comparados entre os grupos por uma análise ANCOVA, controlando as covariáveis educação e frequência de hábitos de leitura e escrita. RESULTADOS: Não houve diferenças significativas entre os grupos etários. CONCLUSÃO: Sugere-se que a influência do envelhecimento na atenção sustentada e focalizada e velocidade de processamento após os 75 anos de idade em paradigmas de cancelamento visual, quando as mudanças executivas e atencionais tendem a ser mais notáveis. Estudos futuros devem investigar adultos saudáveis mais velhos e longevos, bem como, adultos com níveis educacionais baixos e intermediários. Ademais, populações clínicas brasileiras também devem ser caracterizadas, principalmente com transtornos neurológicos que podem apresentar heminegligência visual.

Program of neuropsychological stimulation of cognition in students: Emphasis on executive functions - development and evidence of content validity.

OBJECTIVE: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF) in Elementary School children within the school environment. METHODS: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI) was calculated. RESULTS: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process. CONCLUSION: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.

OBJETIVO: O objetivo desse estudo foi descrever o processo de construção e evidências de validade de conteúdo de um programa de intervenção precoce-preventiva para estimular as FE em crianças do Ensino Fundamental no ambiente escolar. MÉTODOS: O processo seguiu as etapas recomendadas para construção de instrumentos neuropsicológicos, são elas: fase interna de organização do programa, com pesquisa bibliográfica e análise dos materiais disponíveis em sala de aula; construção do programa; análise de juízes especialistas; integração dos dados e finalização do programa. Para determinar o nível de concordância entre os juízes, foi calculado o Índice de Validade de Conteúdo. RESULTADOS: Verificou-se concordância entre os especialistas tanto para o programa de forma geral, bem como em cada atividade, o que permitiu obter evidências de validade de conteúdo. Considera-se que todas as etapas foram essenciais e necessárias, pois contribuíram para identificar os pontos positivos e as possíveis falhas, assim como adequar os estímulos e aprimorar as tarefas e atividades do programa. CONCLUSÃO: Ao descrever os procedimentos metodológicos adotados nesse estudo, entende-se que outros também podem se basear para construir ou adaptar programas de estimulação e reabilitação neuropsicológica. Além disso, possibilita ao leitor uma compreensão detalhada de todo cuidado e rigor teórico e científico adotado na elaboração desse programa.

Brazilian norms and effects of age and education on the Hayling and Trail Making Tests.

OBJECTIVES: To describe normative data for the Hayling Test and the Trail Making Test (TMT) in a sample of Brazilian adults, and to investigate the effects of age and education on test performance. METHOD: A total of 313 (TMT) and 364 (Hayling) individuals with age ranges of 19-39, 40-59, and 60-75 years, and with at least 5 years of formal education, participated in this study. The tests were administered as part of a large battery of a normative project. Individuals were evaluated individually in silent, ventilated rooms at a university clinic. Instrument protocols were scored by trained research assistants and double-checked to ensure data reliability. RESULTS: There were major effects of age on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Errors B/15, B/45), and major effects of education on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Time A, Errors B/15, B/45). Interaction effects were found in Time B and B-A for the Hayling Test and in Time A for the TMT. CONCLUSIONS: Age and education were critical for performance on both verbal and non-verbal executive functions.

Brazilian norms and effects of age and education on the Hayling and Trail Making Tests / Normas brasileiras e efeitos de idade e escolaridade no Teste Hayling e no Teste de Trilhas

Abstract Objectives To describe normative data for the Hayling Test and the Trail Making Test (TMT) in a sample of Brazilian adults, and to investigate the effects of age and education on test performance. Method A total of 313 (TMT) and 364 (Hayling) individuals with age ranges of 19-39, 40-59, and 60-75 years, and with at least 5 years of formal education, participated in this study. The tests were administered as part of a large battery of a normative project. Individuals were evaluated individually in silent, ventilated rooms at a university clinic. Instrument protocols were scored by trained research assistants and double-checked to ensure data reliability. Results There were major effects of age on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Errors B/15, B/45), and major effects of education on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Time A, Errors B/15, B/45). Interaction effects were found in Time B and B-A for the Hayling Test and in Time A for the TMT. Conclusions Age and education were critical for performance on both verbal and non-verbal executive functions.

Resumo Objetivos Descrever dados normativos do Teste Hayling e do Teste de Trilhas em uma amostra de adultos brasileiros e investigar os efeitos de idade e escolaridade no desempenho das tarefas. Método Participaram deste estudo um total de 313 (TMT) e 364 (Hayling) indivíduos com idades nos intervalos de 19-39, 40-59 e 60-75 anos e com pelo menos 5 anos de escolaridade formal. Os testes foram administrados como parte de uma bateria maior de um projeto de normatização. Os indivíduos foram avaliados individualmente em salas silenciosas e ventiladas em uma clínica universitária. As pontuações dos protocolos foram realizadas por assistentes de pesquisa treinados e foram checadas duplamente para garantir a fidedignidade dos dados. Resultados Foram encontrados efeitos principais de idade no TMT (Tempo B, Erros B e Tempo B-A) e no Teste Hayling (Erros B/15 e B/45), e efeitos principais de educação no TMT (Tempo B, Erros B e Tempo B-A) e no Teste Hayling (Tempo A, Erros B/15 e B/45). Foram encontrados efeitos de interação entre variáveis nos Tempos B e B-A do Teste Hayling e no Tempo A do TMT. Conclusões Idade e escolaridade foram fatores críticos para o desempenho em ambos os testes verbal e não-verbal de avaliação das funções executivas.

Bells Test: Are there differences in performance between adult groups aged 40-59 and 60-75? / Teste dos sinos: Há diferenças no desempenho entre grupos de adultos de 40 a 59 anos e 60 a 70 anos?

ABSTRACT Objective: To verify whether differences exist between groups of Brazilian adults aged 40-59 and 60-75 in respective performance on the Bells Test, given the dearth of literature investigating the relationship between focused visual attention and the age factor. Methods: Eighty-four neurologically healthy adults (half aged 40-59 and half 60-75) with high educational level (40-59 years group: M=17.75 years' education; SD=4.00; 60-75 years group: M=15.85 years education; SD=3.19) were assessed using the Bells Test. Data on accuracy and processing speed were compared between groups by ANCOVA, controlled for the covariates education and frequency of reading and writing habits. Results: There were no significant differences between the age groups. Conclusion: It is suggested that aging influences sustained and focused attention and speed processing after 75 years of age on visual cancellation paradigms, when executive and attentional changes tend to be more marked. Further studies should investigate healthy older and oldest-old adults, as well as groups with low and intermediate educational backgrounds. In addition, Brazilian clinical populations should also be characterized, particularly those with neurological disorders that might have visual hemineglect.

RESUMO Objetivo: Verificar se existem diferenças entre grupos de adultos brasileiros de 40 a 59 e 60 a 75 anos de idade na performance no Teste dos Sinos, uma vez que há uma literatura reduzida que aborda as relações entre a atenção visual focalizada e o fator de idade. Métodos: Foram avaliados 80 adultos (metade deles com idade entre 40 e 59 e outra metade com idade entre 60 e 75) com alto nível educacional (40-59 anos de idade: M=17,75, DP=4,00; 60-75 anos de idade: M=15,85, DP=3,19) e saudáveis neurologicamente, por meio do Teste dos Sinos. Os dados de precisão e velocidade de processamento foram comparados entre os grupos por uma análise ANCOVA, controlando as covariáveis educação e frequência de hábitos de leitura e escrita. Resultados: Não houve diferenças significativas entre os grupos etários. Conclusão: Sugere-se que a influência do envelhecimento na atenção sustentada e focalizada e velocidade de processamento após os 75 anos de idade em paradigmas de cancelamento visual, quando as mudanças executivas e atencionais tendem a ser mais notáveis. Estudos futuros devem investigar adultos saudáveis mais velhos e longevos, bem como, adultos com níveis educacionais baixos e intermediários. Ademais, populações clínicas brasileiras também devem ser caracterizadas, principalmente com transtornos neurológicos que podem apresentar heminegligência visual.

Program of neuropsychological stimulation of cognition in students: Emphasis on executive functions - development and evidence of content validity / Programa de estimulação neuropsicológica da cognição em escolares: Ênfase nas funções executivas - desenvolvimento e evidências de validade de conteúdo

ABSTRACT Objective: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF) in Elementary School children within the school environment. Methods: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI) was calculated. Results: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process Conclusion: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program.

RESUMO Objetivo: O objetivo desse estudo foi descrever o processo de construção e evidências de validade de conteúdo de um programa de intervenção precoce-preventiva para estimular as FE em crianças do Ensino Fundamental no ambiente escolar. Métodos: O processo seguiu as etapas recomendadas para construção de instrumentos neuropsicológicos, são elas: fase interna de organização do programa, com pesquisa bibliográfica e análise dos materiais disponíveis em sala de aula; construção do programa; análise de juízes especialistas; integração dos dados e finalização do programa. Para determinar o nível de concordância entre os juízes, foi calculado o Índice de Validade de Conteúdo. Resultados: Verificou-se concordância entre os especialistas tanto para o programa de forma geral, bem como em cada atividade, o que permitiu obter evidências de validade de conteúdo. Considera-se que todas as etapas foram essenciais e necessárias, pois contribuíram para identificar os pontos positivos e as possíveis falhas, assim como adequar os estímulos e aprimorar as tarefas e atividades do programa. Conclusão: Ao descrever os procedimentos metodológicos adotados nesse estudo, entende-se que outros também podem se basear para construir ou adaptar programas de estimulação e reabilitação neuropsicológica. Além disso, possibilita ao leitor uma compreensão detalhada de todo cuidado e rigor teórico e científico adotado na elaboração desse programa.

Brazilian adaptation of the Hotel Task: a tool for the ecological assessment of executive functions / Adaptação brasileira da tarefa do hotel: uma ferramenta para a avaliação ecológica das funções executivas

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility. OBJECTIVE: The goal of this study was to adapt the Hotel Task for use in the Brazilian population. METHODS: The sample comprised 27 participants (three translators, six expert judges, seven healthy adults, ten patients with traumatic brain injuries and one hotel manager). The adaptation process consisted of five steps, which were repeated until a satisfactory version of the task was produced. The steps were as follows: (1) Translation; (2) Development of new stimuli and brainstorming among the authors; (3) Analysis by expert judges; (4) Pilot studies; (5) Assessment by an expert in business administration and hotel management. RESULTS: The adapted version proved adequate and valid for the assessment of executive functions. However, further research must be conducted to obtain evidence of the reliability, as well as the construct and criterion validity, sensitivity and specificity, of the Hotel Task. CONCLUSION: Many neurological and/or psychiatric populations may benefit from the adapted task, since it may make significant contributions to the assessment of dysexecutive syndromes and their impact on patient functioning. .

A busca por validade ecológica dos instrumentos neuropsicológicos vem recebendo uma atenção especial nos últimos anos, especialmente daquelas ferramentas que avaliam funções executivas. A Tarefa do Hotel é uma das tarefas ecológicas de exame executivo mais reconhecida internacionalmente, por examinar planejamento, organização, automonitoramento e flexibilidade cognitiva. OBJETIVO: O objetivo deste estudo é apresentar o processo de adaptação da Tarefa do Hotel para uma versão brasileira. MÉTODO: A amostra constitui-se de 27 indivíduos (três tradutores, seis juízes especialistas, sete adultos saudáveis, dez pacientes pós traumatismocranioencefálico e um gerente de hotel). Cinco etapas foram conduzidas, replicadas ao longo do processo: (1) tradução, (2) desenvolvimento de novos estímulos e brainstorming entre os autores, (3) análise de juízes especialistas em neuropsicologia, (4) estudos pilotos e (5) julgamento de expert em administração e hotelaria. RESULTADO: A versão adaptada mostrou-se adequada e válida para avaliar componentes executivos, sendo necessários estudos futuros em busca de evidências de fidedignidade, validades de construto e de critério, sensibilidade e especificidade, considerando-se as particularidades de uma ferramenta ecológica. CONCLUSÃO: Muitas populações clínicas neurológicas e/ou psiquiátricas poderão se beneficiar do exame com a Tarefa do Hotel, por esta auxiliar no diagnóstico de síndrome disexecutiva relacionada à demanda de componentes executivos no cotidiano. .

Brazilian preliminary norms and investigation of age and education effects on the Modified Wisconsin Card Sorting Test, Stroop Color and Word test and Digit Span test in adults / Normas brasileiras preliminares e a investigação dos efeitos de idade e escolaridade no desempenho dos testes Wisconsin de Classificação de Cartas modificado, Stroop de Cores e Palavras e Dígitos em adultos

Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary. OBJECTIVE: To present normative data for adults (19-75 year-olds; with five years of education or more) on the Modified Wisconsin Card Sorting Test (MWCST), Stroop color and word test and Digit Span test. Age and education effects were investigated. METHODS: Three samples were formed after inclusion criteria and data analysis: MWCST (n=124); Digit Span (n=123), and Stroop test (n=158). Groups were divided into young (19-39), middle-aged (40-59) and older (60-75) participants with five to eight years of education and nine years of education or more. Two-way ANOVA and ANCOVA analyses were used. RESULTS: Education effects were found in most variables of the three tasks. An age effect was only found on color naming and color-word naming speed from the Stroop test. No interactions were detected. CONCLUSION: In countries with heterogeneous educational backgrounds, the use of stratified norms by education to assess at least some components of executive functions is essential for an ethical and accurate cognitive diagnosis. .

As funções executivas estão envolvidas em uma série de distúrbios neurológicos e psiquiátricos humanos. Por esta razão, instrumentos de avaliação adequados com normas estratificadas por idade e escolaridade são necessárias para diagnóstico dos sintomas. OBJETIVO: Apresentar dados normativos para adultos (19 a 75 anos de idade; a partir de cinco anos de educação) no Wisconsin Card Sorting Test Modificado (MWCST), teste Stroop de cores e palavras e no teste de Dígitos. Os efeitos de idade e escolaridade foram investigados. MÉTODOS: Três amostras foram formadas após a análise dos critérios de inclusão e dos dados: MWCST (n=124); Dígitos (n=123) e teste Stroop (n=158). Os grupos foram divididos em jovens (19-39), de meia-idade (40-59) e idosos (60-75) de cinco a oito anos de ensino e nove anos de escolaridade ou mais. Foram utilizados os testes Two-way ANOVA e ANCOVA. RESULTADOS: Efeitos de educação foram encontrados na maioria das variáveis das três tarefas. O efeito idade foi encontrado somente na velocidade de nomeação de cores e nomeação de cor-palavra do teste Stroop. Não foram detectadas interações. CONCLUSÃO: Em países com cenários educacionais heterogêneos, o uso de normas estratificadas por educação para avaliar, pelo menos alguns componentes, das funções executivas é essencial para um diagnóstico cognitivo ético e preciso. .

Brazilian preliminary norms and investigation of age and education effects on the Modified Wisconsin Card Sorting Test, Stroop Color and Word test and Digit Span test in adults.

Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary. OBJECTIVE: To present normative data for adults (19-75 year-olds; with five years of education or more) on the Modified Wisconsin Card Sorting Test (MWCST), Stroop color and word test and Digit Span test. Age and education effects were investigated. METHODS: Three samples were formed after inclusion criteria and data analysis: MWCST (n=124); Digit Span (n=123), and Stroop test (n=158). Groups were divided into young (19-39), middle-aged (40-59) and older (60-75) participants with five to eight years of education and nine years of education or more. Two-way ANOVA and ANCOVA analyses were used. RESULTS: Education effects were found in most variables of the three tasks. An age effect was only found on color naming and color-word naming speed from the Stroop test. No interactions were detected. CONCLUSION: In countries with heterogeneous educational backgrounds, the use of stratified norms by education to assess at least some components of executive functions is essential for an ethical and accurate cognitive diagnosis.

As funções executivas estão envolvidas em uma série de distúrbios neurológicos e psiquiátricos humanos. Por esta razão, instrumentos de avaliação adequados com normas estratificadas por idade e escolaridade são necessárias para diagnóstico dos sintomas. OBJETIVO: Apresentar dados normativos para adultos (19 a 75 anos de idade; a partir de cinco anos de educação) no Wisconsin Card Sorting Test Modificado (MWCST), teste Stroop de cores e palavras e no teste de Dígitos. Os efeitos de idade e escolaridade foram investigados. MÉTODOS: Três amostras foram formadas após a análise dos critérios de inclusão e dos dados: MWCST (n=124); Dígitos (n=123) e teste Stroop (n=158). Os grupos foram divididos em jovens (19-39), de meia-idade (40-59) e idosos (60-75) de cinco a oito anos de ensino e nove anos de escolaridade ou mais. Foram utilizados os testes Two-way ANOVA e ANCOVA. RESULTADOS: Efeitos de educação foram encontrados na maioria das variáveis das três tarefas. O efeito idade foi encontrado somente na velocidade de nomeação de cores e nomeação de cor-palavra do teste Stroop. Não foram detectadas interações. CONCLUSÃO: Em países com cenários educacionais heterogêneos, o uso de normas estratificadas por educação para avaliar, pelo menos alguns componentes, das funções executivas é essencial para um diagnóstico cognitivo ético e preciso.

Brazilian adaptation of the Hotel Task: A tool for the ecological assessment of executive functions.

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility. OBJECTIVE: The goal of this study was to adapt the Hotel Task for use in the Brazilian population. METHODS: The sample comprised 27 participants (three translators, six expert judges, seven healthy adults, ten patients with traumatic brain injuries and one hotel manager). The adaptation process consisted of five steps, which were repeated until a satisfactory version of the task was produced. The steps were as follows:(1) Translation;(2) Development of new stimuli and brainstorming among the authors;(3) Analysis by expert judges;(4) Pilot studies;(5) Assessment by an expert in business administration and hotel management. RESULTS: The adapted version proved adequate and valid for the assessment of executive functions. However, further research must be conducted to obtain evidence of the reliability, as well as the construct and criterion validity, sensitivity and specificity, of the Hotel Task. CONCLUSION: Many neurological and/or psychiatric populations may benefit from the adapted task, since it may make significant contributions to the assessment of dysexecutive syndromes and their impact on patient functioning.

A busca por validade ecológica dos instrumentos neuropsicológicos vem recebendo uma atenção especial nos últimos anos, especialmente daquelas ferramentas que avaliam funções executivas. A Tarefa do Hotel é uma das tarefas ecológicas de exame executivo mais reconhecida internacionalmente, por examinar planejamento, organização, automonitoramento e flexibilidade cognitiva. OBJETIVO: O objetivo deste estudo é apresentar o processo de adaptação da Tarefa do Hotel para uma versão brasileira. MÉTODO: A amostra constitui-se de 27 indivíduos (três tradutores, seis juízes especialistas, sete adultos saudáveis, dez pacientes pós traumatismocranioencefálico e um gerente de hotel). Cinco etapas foram conduzidas, replicadas ao longo do processo:(1) tradução,(2) desenvolvimento de novos estímulos e brainstorming entre os autores,(3) análise de juízes especialistas em neuropsicologia,(4) estudos pilotos e(5) julgamento de expert em administração e hotelaria. RESULTADO: A versão adaptada mostrou-se adequada e válida para avaliar componentes executivos, sendo necessários estudos futuros em busca de evidências de fidedignidade, validades de construto e de critério, sensibilidade e especificidade, considerando-se as particularidades de uma ferramenta ecológica. CONCLUSÃO: Muitas populações clínicas neurológicas e/ou psiquiátricas poderão se beneficiar do exame com a Tarefa do Hotel, por esta auxiliar no diagnóstico de síndrome disexecutiva relacionada à demanda de componentes executivos no cotidiano.

Contributions of the ecological approach to the neuropsychology of executive functions / Contribuições da abordagem ecológica na neuropsicologia das funções executivas / Aportes del enfoque ecológico a la neuropsicología de las funciones ejecutivas

Neurocognitive assessment involves several different types of processes, techniques and instruments. Traditionally, clinical and/or standardized methods have been the most extensively used in neuropsychological research and clinical practice. Ecological instruments are characterized by the standardized administration of tasks with similar cognitive demands to those observed in everyday situations. Although executive functions are often required in daily living tasks, the lack of a consensus as to their theoretical definition has posed several hurdles to their assessment and rehabilitation. The aim of this paper was to present the contributions of an ecological neuropsychological approach to assessment, rehabilitation, and neuroimaging, while discussing the theoretical implications of these processes on the neuropsychology of executive functions. This was achieved through a non-systematic review of classical and contemporary literature on ecological assessment tools. The use of an ecological approach has contributed to the understanding and assessment of functional impairment, as well as to the development of rehabilitation programs focusing on practical daily living activities, allowing for a clearer understanding of the neural correlates of complex environmental and individual factors, and for a more thorough reassessment of the validity of theoretical models of executive functions.(AU).

A avaliação neurocognitiva é composta por diferentes tipos de processos, técnicas e instrumentos. Tradicionalmente, recursos clínicos e/ou padronizados têm sido os de maior eleição na clínica e pesquisa neuropsicológica. Os instrumentos ecológicos são caracterizados pela forma padronizada de aplicação associada a tarefas que simulam situações diárias de demanda cognitiva. As funções executivas são amplamente requeridas nas tarefas cotidianas complexas. Além disso, a falta de consenso teórico sobre seus modelos traz um conjunto de problemáticas ao trabalhar com essas funções. O objetivo do presente artigo é apresentar as contribuições da abordagem ecológica para as áreas de avaliação, reabilitação, neuroimagem e, subjacente a todas essas, algumas reflexões teóricas da neuropsicologia das funções executivas. Trata-se de uma revisão não sistemática da literatura baseada na consulta em artigos clássicos e contemporâneos que utilizaram ferramentas de abordagem ecológica. As contribuições dessa abordagem são a busca por uma melhor compreensão de déficits funcionais (avaliação); por uma reabilitação com foco em objetivos práticos da vida diária; a possibilidade de compreensão dos correlatos neurais em settings complexos dependentes de fatores pessoais e ambientais; e a necessidade de reavaliação da validade de modelos teóricos das funções executivas a partir dessas evidências.(AU).

La evaluación neurocognitiva es compuesta por diferentes tipos de procesos, técnicas y instrumentos. Tradicionalmente, recursos clínicos y/o estandarizados son los de mayor elección en la clínica y la pesquisa neuropsicológica. Los instrumentos ecológicos son caracterizados por una manera estandarizada de aplicación asociada a las tareas que simulan situaciones del cotidiano de demanda cognitiva. Las funciones ejecutivas son en general requeridas en las tareas cotidianas complejas. Además, la falta de consenso teórico sobre suyos modelos tiene un conjunto de problemáticas al trabajar con estas funciones. El objetivo del presente artigo es presentar las contribuciones de la enfoque ecológico para las áreas de evaluación, rehabilitación, neuroimagen e, subyacente a todas esas, algunas reflexiones teóricas de la neuropsicología de las funciones ejecutivas. Es una revisión no sistemática de la literatura basada en la consulta en artículos clásicos y contemporáneos que utilizaron las herramientas del enfoque ecológico. Las contribuciones de esa abordaje son la busca por una mejor comprensión de déficits funcionales (evolución); por una rehabilitación con foco en objetivos prácticos de la vida cotidiana; la posibilidad de comprensión de los correlatos neuronales en settings complejos dependientes de factores personales y ambientales; y la necesidad de re-valuación de la validad de los modelos teóricos de las funciones ejecutivas de esas evidencias.(AU).

Contributions of the ecological approach to the neuropsychology of executive functions / Contribuições da abordagem ecológica na neuropsicologia das funções executivas / Aportes del enfoque ecológico a la neuropsicología de las funciones ejecutivas

Neurocognitive assessment involves several different types of processes, techniques and instruments. Traditionally, clinical and/or standardized methods have been the most extensively used in neuropsychological research and clinical practice. Ecological instruments are characterized by the standardized administration of tasks with similar cognitive demands to those observed in everyday situations. Although executive functions are often required in daily living tasks, the lack of a consensus as to their theoretical definition has posed several hurdles to their assessment and rehabilitation. The aim of this paper was to present the contributions of an ecological neuropsychological approach to assessment, rehabilitation, and neuroimaging, while discussing the theoretical implications of these processes on the neuropsychology of executive functions. This was achieved through a non-systematic review of classical and contemporary literature on ecological assessment tools. The use of an ecological approach has contributed to the understanding and assessment of functional impairment, as well as to the development of rehabilitation programs focusing on practical daily living activities, allowing for a clearer understanding of the neural correlates of complex environmental and individual factors, and for a more thorough reassessment of the validity of theoretical models of executive functions.

A avaliação neurocognitiva é composta por diferentes tipos de processos, técnicas e instrumentos. Tradicionalmente, recursos clínicos e/ou padronizados têm sido os de maior eleição na clínica e pesquisa neuropsicológica. Os instrumentos ecológicos são caracterizados pela forma padronizada de aplicação associada a tarefas que simulam situações diárias de demanda cognitiva. As funções executivas são amplamente requeridas nas tarefas cotidianas complexas. Além disso, a falta de consenso teórico sobre seus modelos traz um conjunto de problemáticas ao trabalhar com essas funções. O objetivo do presente artigo é apresentar as contribuições da abordagem ecológica para as áreas de avaliação, reabilitação, neuroimagem e, subjacente a todas essas, algumas reflexões teóricas da neuropsicologia das funções executivas. Trata-se de uma revisão não sistemática da literatura baseada na consulta em artigos clássicos e contemporâneos que utilizaram ferramentas de abordagem ecológica. As contribuições dessa abordagem são a busca por uma melhor compreensão de déficits funcionais (avaliação); por uma reabilitação com foco em objetivos práticos da vida diária; a possibilidade de compreensão dos correlatos neurais em settings complexos dependentes de fatores pessoais e ambientais; e a necessidade de reavaliação da validade de modelos teóricos das funções executivas a partir dessas evidências.

La evaluación neurocognitiva es compuesta por diferentes tipos de procesos, técnicas y instrumentos. Tradicionalmente, recursos clínicos y/o estandarizados son los de mayor elección en la clínica y la pesquisa neuropsicológica. Los instrumentos ecológicos son caracterizados por una manera estandarizada de aplicación asociada a las tareas que simulan situaciones del cotidiano de demanda cognitiva. Las funciones ejecutivas son en general requeridas en las tareas cotidianas complejas. Además, la falta de consenso teórico sobre suyos modelos tiene un conjunto de problemáticas al trabajar con estas funciones. El objetivo del presente artigo es presentar las contribuciones de la enfoque ecológico para las áreas de evaluación, rehabilitación, neuroimagen e, subyacente a todas esas, algunas reflexiones teóricas de la neuropsicología de las funciones ejecutivas. Es una revisión no sistemática de la literatura basada en la consulta en artículos clásicos y contemporáneos que utilizaron las herramientas del enfoque ecológico. Las contribuciones de esa abordaje son la busca por una mejor comprensión de déficits funcionales (evolución); por una rehabilitación con foco en objetivos prácticos de la vida cotidiana; la posibilidad de comprensión de los correlatos neuronales en settings complejos dependientes de factores personales y ambientales; y la necesidad de re-valuación de la validad de los modelos teóricos de las funciones ejecutivas de esas evidencias.

The impact of frontal and cerebellar lesions on decision making: evidence from the Iowa Gambling Task.

Although the frontal lobes have traditionally been considered the neural substrates of executive functioning (EF), recent studies have suggested that other structures, such as the cerebellum, may be associated with these abilities. The role of the cerebellum has only been sparsely investigated in connection with decision making (DM), an important component of EF, and the few results obtained on this front have been inconclusive. The current study sought to investigate the role of the cerebellum in DM by comparing the performance of patients with cerebellar strokes, frontal-damaged patients, and a healthy control group on the Iowa Gambling Task (IGT). A total of nine cerebellar-damaged adults participated in the study, as well as nine individuals with frontal strokes and 18 control individuals. Patients were administered a version of the IGT adapted to the population of Southern Brazil. There was a marginal difference in mean IGT net scores between the two clinical groups, although both displayed impaired performance as compared to the control group. Overall, the DM ability of patients with cerebellar damage proved to be more preserved than that of individuals with frontal lobe strokes, but less preserved than that of the control group. These data suggested that, while the frontal lobes may be the most important brain structures for DM, the cerebellum might also play an active role in this cognitive function. Future studies assessing participants with lesions in different cerebellar regions and hemispheres will prove invaluable for the understanding of the neural structures involved in DM, and make significant contributions to the globalist-localizationist debate in DM neuroscience.