[Translation into Spanish and a preliminary analysis of the psychometric properties of the Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) questionnaire for rating the quality of life among post-stroke patients]. / Traduccion al castellano y analisis preliminar de las propiedades psicometricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus.

INTRODUCTION: The Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) is one of the few specific questionnaires for evaluating the quality of life among patients who have suffered an ischaemic or haemorrhagic stroke. AIMS: To translate and adapt this questionnaire into Spanish and to evaluate its reliability and acceptability. PATIENTS AND METHODS: The original version of the NEWSQOL questionnaire was translated into Spanish. The translation was agreed upon by a team of experts, and was then back-translated into English and sent to the author, who gave her approval of the rendering. This version was later administered to a group of patients in order to evaluate its reliability, acceptability, floor effect and ceiling effect. RESULTS: The process of linguistic adaptation allowed semantic, conceptual and content equivalence to be achieved in the Spanish version of the NEWSQOL. The results obtained in the preliminary analysis show excellent acceptability, an internal consistency index of 0.9 for the whole questionnaire and a good or excellent test-retest agreement for all the domains. No ceiling effect was detected, but a floor effect was observed in the case of the vision and cognition domains. CONCLUSION: The Spanish version of the NEWSQOL questionnaire is reliable for evaluating the quality of life in post-stroke patients, as well as being well accepted. The questionnaire must be used in more broader samples in order to evaluate its validity and sensitivity.

TITLE: Traduccion al castellano y analisis preliminar de las propiedades psicometricas del cuestionario Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) para valorar la calidad de vida en pacientes postictus.Introduccion. El Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL) es uno de los pocos cuestionarios especificos para valorar la calidad de vida en pacientes que han sufrido ictus isquemico u hemorragico. Objetivo. Traducir y adaptar dicho cuestionario al castellano y evaluar su fiabilidad y aceptabilidad. Pacientes y metodos. Se tradujo al castellano la version original del cuestionario NEWSQOL, traduccion que fue consensuada por un equipo de expertos, y a partir de la cual se hizo una retrotraduccion al ingles que se envio a la autora, quien mostro su conformidad. Posteriormente esa version se administro a un grupo de pacientes para valorar su fiabilidad, aceptabilidad, efecto suelo y efecto techo. Resultados. El proceso de adaptacion linguistica permitio obtener la equivalencia semantica, conceptual y de contenido de la version española de NEWSQOL. Los resultados obtenidos en el analisis preliminar reflejan una excelente aceptabilidad, un indice de consistencia interna de 0,9 para la totalidad del cuestionario y una concordancia test-retest buena o excelente para todos los dominios. No se detecto efecto techo, pero si efecto suelo para los dominios de vision y cognicion. Conclusion. La version española del cuestionario NEWSQOL es fiable para valorar la calidad de vida en pacientes postictus, ademas de aceptarse bien. Es necesario utilizar el cuestionario en muestras mas amplias para evaluar su validez y sensibilidad.

[Visuoperceptual processing in Parkinson's disease: from the retina to the frontal cortex]. / Proceso visuoperceptivo en la enfermedad de Parkinson: de la retina a la corteza frontal.

INTRODUCTION: The growing interest in the cognitive impairment shown by patients with Parkinson's disease has led to a wealth of research in this line over recent years. In this paper we review the visuospatial alterations in these patients, which are usually linked to other disorders such as those affecting planning, sequencing, attention or mnemonic processes. DEVELOPMENT: We report the most relevant findings, which suggest that the existence of these visuospatial disorders shown by patients with Parkinson's disease are not always secondary to other frontal-type cognitive impairments, as has been claimed in recent years. Instead, they may be due to disorders in other anterior points of the perceptive process (as a result of dopaminergic deficits in basal-thalamic-cortical circuits). Thus, visuoperceptual disorders are classified according to their location in the brain: from the retina to the lateral geniculate nucleus, the visual cortex and the extrastriate cortex and, finally, the frontal and prefrontal cortex. CONCLUSIONS: We propose this classification of the disorders according to their location to aid in achieving an objective selection of the sample and of the neuropsychological tests used in studies. In this regard, we consider that there should be a higher degree of agreement among researchers when it comes to designing research projects that deal with visuospatial disorders in patients with Parkinson's disease.

Proceso visuoperceptivo en la enfermedad de Parkinson: de la retina a la corteza frontal / Visuoperceptual processing in Parkinson’s disease: from the retina to the frontal cortex

Introducción. El creciente interés por los déficit cognitivos que presentan los pacientes con enfermedad de Parkinson ha dado lugar a la proliferación de trabajos sobre este tema durante los últimos años. En el presente artículo se revisa la alteración visuoespacial en dichos pacientes, que habitualmente se relaciona con otros trastornos como los que afectan a la planificación, la secuenciación, la atención o los procesos de la memoria. Desarrollo. Se exponen los hallazgos más relevantes que apuntan a que la existencia de esas alteraciones visuoespaciales que muestran los pacientes con enfermedad de Parkinson no son siempre secundarias a otros déficit cognitivos de tipo frontal, como se ha afirmado en los últimos años, sino que pueden deberse a trastornos en otros puntos anteriores del proceso perceptivo (como consecuencia de la deficiencia dopaminérgica en el circuito basal-talámico-cortical). Para ello, se clasifican los trastornos visuoperceptivos en función de su localización cerebral: desde la retina hasta el núcleo geniculado lateral, la corteza visual y la corteza extraestriada, y, finalmente, la corteza frontal y prefrontal. Conclusiones. Se propone la presente clasificación de los trastornos según la localización de los mismos en aras de una selección objetiva de la muestra y de las pruebas neuropsicológicas utilizadas en los estudios. Es deseable, a este respecto, un mayor consenso entre los investigadores a la hora de diseñar las investigaciones que versen sobre alteraciones visuoespaciales en los pacientes con enfermedad de Parkinson

Introduction. The growing interest in the cognitive impairment shown by patients with Parkinson’s disease has led to a wealth of research in this line over recent years. In this paper we review the visuospatial alterations in these patients, which are usually linked to other disorders such as those affecting planning, sequencing, attention or mnemonic processes. Development. We report the most relevant findings, which suggest that the existence of these visuospatial disorders shown by patients with Parkinson’s disease are not always secondary to other frontal-type cognitive impairments, as has been claimed in recent years. Instead, they may be due to disorders in other anterior points of the perceptive process (as a result of dopaminergic deficits in basal-thalamic-cortical circuits). Thus, visuoperceptual disorders are classified according to their location in the brain: from the retina to the lateral geniculate nucleus, the visual cortex and the extrastriate cortex and, finally, the frontal and prefrontal cortex. Conclusions. We propose this classification of the disorders according to their location to aid in achieving an objective selection of the sample and of the neuropsychological tests used in studies. In this regard, we consider that there should be a higher degree of agreement among researchers when it comes to designing research projects that deal with visuospatial disorders in patients with Parkinson’s disease

[Evaluating the simulation of memory problems within the legal and forensic fields]. / Evaluacion de la simulacion de problemas de memoria dentro del ambito legal y forense.

The present article is a theoretic review of the techniques used to assess the malingering of memory problems in the forensic and legal context. The necessity of instruments to facilitate the detection of malingerers is confirmed. This phenomenon is more relevant in the memory pathology context because their exaggeration or false performance is very common. The reason of this preference is the ease of the simulation of these very well known symptoms. The consequences, economics primarily, of the confirmation of brain damage sequels have produced that malingerers are well informed about the characteristics of this syndrome. This review is focus on, both tests assessing different components of memory, such as the Wechsler Memory Scale III and the California Verbal Learning Test, and tests designed specifically to detect malingering. We also differentiate tests assessing explicit and implicit memory. Likewise, future lines of research are proposed in this important legal context.

[Elderly and brain-damaged drivers in Spain]. / Conductores mayores y con daño cerebral en España.

AIM: The number of drivers and vehicles crossing our roads increases every year. Driving a car requires cognitive, psychomotor and psychological aptitudes and abilities that they should be assessed when the driving license is getting. DEVELOPMENT: The current expectancy of life implies the increasing number of elderly people as drivers. The survival of brain injured people has increased because of scientific and technological improvements. The cognitive, emotional and behavioral sequelae of brain injury could influence in the ability to drive. However, the measures of this driving ability are not yet well established. CONCLUSION: Having in mind the legal dispositions, we would like to analyse the psychometric tests administering to get the driving licence and their sensitivity to assess brain injured people. It is also important to know how to manage cognitive deterioration drivers.

Evaluación de la simulación de problemas de memoria dentro del ámbito legal y forense / Evaluating the simulation of memory problems within the legal and forensic fields

Objetivo. Este artículo es una revisión teórica de las técnicas existentes para evaluar la simulación de problemas de memoria dentro del ámbito legal y forense. Desarrollo. Se ha constatado la necesidad de dotar al neuropsicólogo forense de instrumentos que le faciliten la detección de posibles simuladores. En especial, este fenómeno cobra mayor importancia en el ámbito de la patología de la memoria, al ser éste un campo frecuentemente elegido para la exageración o la producción falsa de sintomatología psicopatológica. El motivo de esta preferencia se encuentra en la mayor facilidad que existe para simular síntomas característicos del síndrome mnésico que son bien conocidos popularmente. Las consecuencias, principalmente económicas, de la comprobación de la existencia de un daño cerebral y sus secuelas, han provocado que cada vez los simuladores se informen más y mejor de las características de los síndromes objeto de su simulación. Conclusiones. Esta revisión se centrará tanto en pruebas generales de valoración de los diferentes componentes de la memoria, como la escala de memoria de Wechsler-III o el test de aprendizaje verbal de California, como en los tests diseñados específicamente para detectar la posible simulación, y diferenciar los que miden memoria explícita de los que valoran memoria implícita. Asimismo, se señalan posibles pautas para investigaciones futuras sobre un tema que cobra cada vez más importancia en el ámbito legal (AU)

The present article is a theoretic review of the techniques used to assess the malingering of memory problems in the forensic and legal context. The necessity of instruments to facilitate the detection of malingerers is confirmed. This phenomenon is more relevant in the memory pathology context because their exaggeration or false performance is very common. The reason of this preference is the ease of the simulation of these very well known symptoms. The consequences, economics primarily, of the confirmation of brain damage sequels have produced that malingerers are well informed about the characteristics of this syndrome. This review is focus on, both tests assessing different components of memory, such as the Wechsler Memory Scale-III and the California Verbal Learning Test, and tests designed specifically to detect malingering. We also differentiate tests assessing explicit and implicit memory. Likewise, future lines of research are proposed in this important legal context (AU)

Conductores ancianos y con daño cerebral en España / Elderly drivers with brain damage in spain

Objetivo. El número de vehículos con motor que circulan por nuestras carreteras aumenta cada año, así como el de conductores. Conducir un vehículo requiere una serie de aptitudes y capacidades cognitivas, psicomotoras y psicológicas que deben evaluarse bien en el momento de conseguir el permiso de conducción. Desarrollo. La actual expectativa de vida conlleva el aumento de conductores mayores de 65 años y los avances científicos y tecnológicos han hecho que sobrevivan un número importante de personas con algún tipo de lesión cerebral. En estos casos, es posible que la afectación de las capacidades cognitivas (p. ej., atención, habilidades visuoperceptivas, aumento de los tiempos de reacción, etc.) y las alteraciones emocionales y conductuales pudieran influir en la habilidad para la conducción. Sin embargo, no se conocen bien ni se han desarrollado las medidas que determinen la aptitud o no de estas personas para volver a conducir. Conclusiones. Teniendo en cuenta el marco legal existente, queremos analizar las pruebas psicotécnicas que se aplican actualmente para conceder los permisos de circulación y ver si serían adecuadas para valorar los pacientes con daño cerebral. También es importante saber cómo es aconsejable actuar en caso de estar frente a un conductor con deterioro cognitivo (AU)

Aim. The number of drivers and vehicles crossing our roads increases every year. Driving a car requires cognitive, psychomotor and psychological aptitudes and abilities that they should be assessed when the driving license is getting. Development. The current expectancy of life implies the increasing number of elderly people as drivers. The survival of brain injured people has increased because of scientific and technological improvements. The cognitive, emotional and behavioral sequelae of brain injury could influence in the ability to drive. However, the measures of this driving ability are not yet well established. Conclusion. Having in mind the legal dispositions, we would like to analyse the psychometric tests administering to get the driving licence and their sensitivity to assess brain injured people. It is also important to know how to manage cognitive deterioration drivers (AU)

[Neuropsychological deficits in alcoholics: some implications for road safety]. / Déficit neuropsicológicos en alcohólicos: implicaciones para la seguridad vial.

AIM: There are various published studies showing that chronic alcoholics present cognitive deficit. In this conference we would like to review the most actual studies focusing on the neuropsychological alterations as consequences of the long and abusive alcohol intake. We also will analyse the involvement of these deficit in a complex task as driving. DEVELOPMENT: The long and abusive alcohol intake produces an affectation of the central nervous system. We could observe its consequences both in short and long term. Attention and memory deficit and a slowness of information processing are very common. However, complete neuropsychological assessment and rehabilitation programs are convenient. This is an important topic if we consider the high number of traffic accidents in which alcohol intake is one of the possible causes. Therefore, it is necessary to pay attention to the persons working daily with a car, such as taxi or bus drivers, especially those of them who are alcoholics in abstinence, chronic alcoholics and people who suffer from alcohol abuse. CONCLUSION: The control of this situation and the publicity about neuropsychological sequels of alcoholism could contribute in an efficient way towards safety in road.

Déficit neuropsicológicos en alcohólicos: implicaciones para la seguridad vial / Neuropsychological deficits in alcoholics: some implications for road safety

Objetivo. Diferentes estudios publicados muestran que los alcohólicos crónicos presentan algunos déficit cognitivos. Se pretenden revisar los estudios más actuales centrados en las alteraciones neuropsicológicas que aparecen como consecuencia del consumo abusivo y prolongado de alcohol, y analizar cómo estas alteraciones podrían afectar a una tarea tan compleja como es la conducción. Desarrollo. El consumo prolongado y en grandes cantidades de alcohol conlleva una afectación del sistema nervioso central. Las consecuencias de ello se observan tanto a corto como a largo plazo. Son frecuentes los déficit de atención, memoria y una mayor lentitud en el procesamiento de la información. A pesar de ello, no se llevan a cabo programas integrales de valoración y rehabilitación neuropsicológica. Este es un tema de gran interés, si tenemos en cuenta el elevado número de accidentes de tráfico en los que una de las posibles causas es el consumo de alcohol. En este sentido, también es importante llamar la atención de las personas que diariamente trabajan con el automóvil, como repartidores, conductores de autobuses, taxi, etc., especialmente aquellos que son alcohólicos en abstinencia, alcohólicos crónicos o personas que abusan del alcohol. Conclusiones. El control de esta situación y la publicidad sobre las secuelas neuropsicológicas del alcoholismo pueden contribuir de manera eficaz en la política de seguridad vial (AU)

Aim. There are various published studies showing that chronic alcoholics present cognitive deficit. In this conference we would like to review the most actual studies focusing on the neuropsychological alterations as consequences of the long and abusive alcohol intake. We also will analyse the involvement of these deficit in a complex task as driving. Development. The long and abusive alcohol intake produces an affectation of the central nervous system. We could observe its consequences both in short and long term. Attention and memory deficit and a slowness of information processing are very common. However, complete neuropsychological assessment and rehabilitation programs are convenient. This is an important topic if we consider the high number of traffic accidents in which alcohol intake is one of the possible causes. Therefore, it is necessary to pay attention to the persons working daily with a car, such as taxi or bus drivers, especially those of them who are alcoholics in abstinence, chronic alcoholics and people who suffer from alcohol abuse. Conclusion. The control of this situation and the publicity about neuropsychological sequels of alcoholism could contribute in an efficient way towards safety in road (AU)

Programa de rehabilitación de las capacidades atencionales en pacientes con demencia tipo Alzheimer y enfermedades cerebrovasculares / Program for the rehabilitation of attentional processes in patients with Alzheimer's disease and stroke

En los últimos años, el incremento de la esperanza de vida y el aumento del número de personas que padecen algún tipo de demencia o enfermedad cerebrovascular han hecho patente la necesidad de desarrollar métodos de intervención neuropsicológica. El objetivo principal de esta investigación es la búsqueda de un método de rehabilitación de las capacidades atencionales que se muestre efectivo en pacientes con enfermedad de Alzheimer en estadios iniciales así como en personas que hayan sufrido un accidente cerebrovascular. Para ello se ha diseñado un programa de rehabilitación neuropsicológica que ha sido aplicado a dos muestras: una formada por veintidós personas diagnosticadas de demencia tipo Alzheimer y otra constituida por diez sujetos que habían sufrido un accidente cerebrovascular en los últimos seis meses (AU)

[Strategies to follow in the design of neuropsychological rehabilitation programs for brain injured people]. / Estrategias a seguir en el diseño de los programas de rehabilitación neuropsicológica para personas con daño cerebral.

INTRODUCTION: Before initiating the planning of the neuropsychological rehabilitation program for a brain injured patient, it is necessary to make and comprehensive neuropsychological evaluation. This evaluation has to be oriented, not only to the scores obtained, but how cognitive processes are deteriorated. In this sense, it is very important to pay attention to the strategies used by the subject to carry out each one of the tasks that we present to him, and the emotional factors that can influence in the success of the rehabilitation program like, for example, awareness of the deficits or familiar and social pressures. DEVELOPMENT: The neuropsychological rehabilitation program must take care of several fundamental issues: 1. The treatment of the altered cognitive functions (cognitive rehabilitation): the use of different principles like the restoration, the compensation or the substitution will be determined. 2. The modification of the dysadaptative behaviors (irritability, aggressiveness, etc.) by means of different operating techniques. 3. The professional readaptation or reintegration: one of the final objectives of the rehabilitation is the reintegration of the brain injured person in the work or studies that did before or in those for which is enabled. 4. The psychosocial support: it is impo0rtant to work with the relatives and the social surroundings, specially the paper of the associations and the support groups. The design of the rehabilitation program must be focused to the specific necessities of each individual patient. It is also advisable to combine the individual and group treatment sessions.

[Nosologic aspects of personality change due to head trauma]. / Consideraciones nosológicas del cambio de personalidad postraumático.

INTRODUCTION: Personality change due to head injury is one of the most prevalent neuropsychiatric posttraumatic disorders and causes significant impairment in familial, social or occupational functioning. OBJECTIVES: To study the prevalence and clinical characteristics of personality changes secondary to severe closed head injuries, according to DSM-IV criteria. PATIENTS AND METHODS: Fifty-five patients (aged 15-65 years) with severe head trauma were studied during the chronic stage (11-3 months) with the following instruments: the Revised Iowa Collateral Head Injury Interview for the assessment of posttraumatic frontal symptoms, the Standardized Polyvalent Psychiatric Interview of Lobo et al, assessment of premorbid personality and its exacerbation, and the Scale of Aggressiveness of Yudofsky. RESULTS: Thirty-three patients (60% of the sample) fulfilled DSM-IV criteria for personality change due to head injury; two thirds of them were combined or mixed type, which consists in the association of two or more types specified in the DSM-IV. The most prevalent types were apathic, unstable, disinhibited, aggressive, which are related with lesions in prefrontal cortex. There were nine patients with 'unspecified' symptoms, such as 'inappropriate euphoria' and 'poor insight', and other symptoms related to executive dysfunction. CONCLUSIONS: One third of cases of personality changes were related to premorbid features; this fact argues against the exclusion of the criterium 'excerbation of premorbid personality traits' in DSM-IV. Only one third of posttraumatic personality changes can be classified according to DSM-IV and ICD-10 criteria. The high prevalence of symptoms related to deficit in self-awareness and executive dysfunction suggest the need of further investigations about nosology in this field.

[Forensic neuropsychology in the aging and the dementias]. / Aspectos de la Neuropsicología Forense en el envejecimiento y en las demencias.

INTRODUCTION. Forensic Neuropsychology establishes an expert valuation of the brain-injured patient (or supposed), or of the law offender people (or supposed) requiring law protection due to their illness. This discipline has a fundamental role in the study of cerebral organic syndromes, particularly in the dementias. DEVELOPMENT. The demential syndrome is common to a group of diseases as degenerative or cardiovascular disorders, brain tumors, syphilis, alcoholism or toxic factors, etc. When speaking of dementia we refer to a syndrome characterized by a progressive and global deterioration of the cognitive functions (memory, language, attention, space-temporal orientation, praxis, thinking, etc.) with preservation of the level of conscience (DSM-IV). This symptomatology affects the personality of the individual as reasonable being , as well as to his behavior and social adaptation. The decrease or loss of the intellectual and volitives abilities of the affected person of a demential syndrome, if it is permanent, also implies a change in its legal situation, since its legal capacity is altered. Therefore, it will be necessary to adopt protective measures for his person and his patrimony. Even if it is necessary, to promote a process of disability, whose sentence will be emitted by a judge, who will indicate: the degree of the mentioned disability, the trusteeship regime and who is designated as a legal tutor.

[Forensic neuropsychology: principal issues and applications]. / La neuropsicología forense: consideraciones básicas y campos de aplicación.

INTRODUCTION: The term Forensic Neuropsychology refers to the application of the knowledge of the field of Neuropsychology to the legal matters. The field of Clinical Neuropsychology has experienced a great development, thanks to the investigations and publications that have been made both in the basic and applied fields. Nevertheless, only in the last years, clinical neuropsychologists have participated actively in the courts. DEVELOPMENT: The testimony as experts of neuropsychologists is more and more common. They inform to the judge on the behavioral, emotional and cognitive sequels following lesions to the human brain, as well as the importance of psychosocial variables in modulating brain function and dysfunction. The relationship between Neuropsychology and Law has been influenced by the confluence of a series of related factors that have contributed to the professionalization of this discipline. Among these, we can emphasize the study of brain-behavior relationships by means of quantitative methods, the interpretative strategies to infer the presence, location and type of neuropathology; the decision making on legal subjects like the determination of disability; the description of the characteristic cognitive-behavioral profiles of neurological disorders; the implication of the psychosocial variables and the decision on the most appropriate interventions. Some of the most important objectives of this new discipline are: the identification of the sequels of mild traumatic brain injury as the posconmocional syndrome , the determination of premorbid intellectual functioning and the valoration of cognitive loss. There is no doubt that in the next years this field of application of Clinical Neuropsychology is going to experience an important growth in our country, thanks partly, to the norms that are followed to establish the degree of disability and the compensations of the insurance agencies, that consider these neuropsychological sequelae.

[Differential diagnosis of post-concussive syndrome]. / Diagnóstico diferencial del síndrome posconmocional.

INTRODUCTION: Posconcussional syndrome is characterized by a heterogeneous group of somatic, cognitive and psychosocial symptoms, which occur in patients with head trauma, generally of mild severity. It is the neuropsychiatric postraumatic disorder more prevalent in the field of forensic medicine. DEVELOPMENT: Classical authors (Lishamn and Barraquer, for example) focused on controversial aspects of this syndrome, such as conceptual problems and etiology (organic versus functional). The objective of this report is to review the posconcussional literature in search of relevant aspects in forensic neuropsychology: conceptual aspects, epidemiology, etiology, clinical features, methodology for assessment, and its differential diagnosis with other postraumatic disorders, such as postraumatic stress disorder, adjustment disorder, anxiety disorder, mood disorders (major depressive disorder), substancerelated disorders, dementia due to head trauma, amnesic disorder, somatoform disorders, factitious disorder, malingering, chronic pain and chronic whiplash syndrome.

Diagnóstico diferencial del síndrome posconmocional / Differential diagnosis of posconcussional syndrome

Introducción. El síndrome posconmocional hace referencia a la aparición de un grupo heterogéneo de síntomas: somáticos, cognitivos y psicológicos, que pueden aparecer y persistir de forma variable después de un traumatismo craneoencefálico, en general, de leve intensidad. Desarrollo. Destacados autores como Lishman o Barraquer han puesto de relieve los problemas conceptuales relacionados con este trastorno y la controversia existente respecto a su etiología (orgánica frente a funcional). Estas dificultades enfatizan la importancia de este síndrome, que es el trastorno neuropsiquiátrico más frecuente dentro de las enfermedades postraumáticas, en el campo de la Medicina Legal. El objetivo de este estudio es realizar una revisión de la bibliografía sobre las siguientes áreas que pueden ser de interés dentro del campo de la Neuropsicología Forense: aspectos conceptuales, epidemiología, etiopatogenia, clínica, metodología para su evaluación y, por último, hacer hincapié en el diagnóstico diferencial neuropsicológico entre este síndrome y los siguientes trastornos neuropsiquiátricos postraumáticos: trastorno por estrés postraumático, trastornos adaptativos, trastornos de ansiedad, trastornos afectivos (depresión mayor), abuso o dependencia de sustancias, demencia debida a traumatismo craneal, trastorno amnésico, trastorno de somatización, trastorno facticio, simulación, dolor crónico y síndrome de `latigazo cervical' (whiplash injury) (AU)

[The nature, diagnosis and treatment of post-concussion syndrome]. / Sobre la naturaleza, diagnóstico y tratamiento del síndrome posconmocional.

INTRODUCTION: The relationship between brief loss of consciousness, subsequent cognitive and emotional complaints, and impact on daily functioning continues to be hotly debated. DEVELOPMENT: In this paper the strong variability about prevalence of the postconcussional syndrome found in several studies is outstanding and the main issues of this disagreement are suggested. Recent neuroimaging techniques are discussed and some neuropsychological measures are suggested. CONCLUSIONS: Currents models (organic/psychogenic) of postconcussional symptoms are reviewed, and a multifactorial model which integrates biological factors with the relevance of neuropsychological deficits--attention, memory, speed of information processing--and coping process is proposed. Finally, according with this model, we conclude with some suggestions to improve neuropsychological intervention and medical treatment of these patients.