La sustancia blanca en los trastornos del desarrollo / White matter in developmental disorders

La sustancia blanca supone el principal conector entre distintas regiones cerebrales, ayudando a que trabajen de forma unificada y concertada. En su estudio, las imágenes con tensor de difusión son una técnica idónea para detectar el grado de integridad de estas fibras. Actualmente, se les otorga un papel relevante en el desarrollo y patofisiología de diferentes trastornos del desarrollo, y éste ha sido el objetivo del presente trabajo. En la revisión de trastornos como el autismo, la dislexia o el trastorno por déficit de atención/hiperactividad, se ha encontrado una afectación clara de ciertas fibras, sobre todo en el fascículo longitudinal superior arqueado y la red temporoparietal (relacionados con la regulación de la conducta motora y atencional), el cuerpo calloso (que garantiza el intercambio eficaz y rápido de información entre los hemisferios cerebrales) y regiones del cíngulo (que guardarían relación con la cognición social y la autoconciencia (AU)

The white matter is the main connection between different regions of the brain and helps them to work in a unified, coordinated way. Diffusion tensor imaging is an ideal technique with which to study it in order to detect the degree of integrity of these fibres. Nowadays, they are considered to play a significant role in the development and pathophysiology of different developmental disorders, and the aim of this study was to examine this role. On reviewing disorders such as autism, dyslexia or attention deficit hyperactivity disorder, certain fibres were found to be clearly involved. This was especially the case of the (arcuate) superior longitudinal fasciculus and the temporal-parietal network (related with the regulation of motor and attentional behaviour), the corpus callosum (which ensures the efficient and swift exchange of information between the hemispheres of the brain) and cingulate regions (which would be related with social cognition and self-consciousness (AU)

Evaluación de la memoria en el daño cerebral adquirido: comparación entre la escala de memoria de Wechsler y el test conductual de memoria de Rivermead / Evaluation of memory in acquired brain injury: a comparison between the wechsler memory scale and the rivermead behaviour memory test

Introducción. La afectación de los procesos de aprendizaje y memoria en el daño cerebral adquirido (DCA) es muy frecuente, a la par que heterogénea, generadora de déficit en otras capacidades cognitivas y de limitaciones funcionales significativas. Una buena evaluación neuropsicológica de la memoria pretende estudiar no sólo el tipo, intensidad y naturaleza de los problemas, sino su manifestación en la vida diaria. Pacientes y métodos. Este estudio examina la correlación entre un test de memoria tradicional, la escala de memoria de Wechsler-III (WMS-III), y un test de memoria considerado funcional, el test conductual de memoria de Rivermead (RBMT), en una muestra de 60 pacientes con DCA. Resultados. Todas las correlaciones obtenidas fueron moderadas. Entre los subtest de memoria verbal se encontraron mayores correlaciones que entre los de memoria visual. Un número importante de sujetos con puntuaciones escalares por debajo de la normalidad en la WMS-III realizaron correctamente (de forma total o parcial) la prueba correspondiente en el RBMT. Conclusiones. El uso combinado en la evaluación de la WMS-III y RBMT puede aportar un análisis más comprensivo de los déficit de memoria y su rehabilitación. La ejecución inferior en la WMS-III que en el RBMT indica una mayor sensibilidad del primero, aunque son necesarios estudios futuros que comparen los rendimientos en los test con las limitaciones funcionales valoradas subjetivamente por el paciente y su entorno, para determinar cuál de ambas pruebas posee un mejor equilibrio entre sensibilidad y especificidad, y un mayor valor predictivo (AU)

Introduction. Learning processes and memory are frequently compromised in acquired brain injury (ABI), while at the same time such involvement is often heterogeneous and a source of deficits in other cognitive capacities and significant functional limitations. A good neuropsychological evaluation of memory is designed to study not only the type, intensity and nature of the problems, but also the way they manifest in daily life. Patients and methods. This study examines the correlation between a traditional memory test, the Wechsler Memory Scale-III (WMS-III), and a memory test that is considered to be functional, the Rivermead Behavioural Memory Test (RBMT), in a sample of 60 patients with ABI. Results. All the correlations that were observed were moderate. Greater correlations were found among the verbal memory subtests than among the visual memory tests. An important number of subjects with below-normal scalar scores on the WMS-III correctly performed (either fully or partially) the corresponding test in the RBMT. Conclusions. The joint use of the WMS-III and RBMT in evaluation can provide a more comprehensive analysis of the memory deficits and their rehabilitation. The lower scores obtained in the WMSIII compared to those of the RBMT indicate greater sensitivity of the former. Nevertheless, further testing needs to be carried out in the future to compare the performance in the tests after the patients and those around them have subjectively assessed their functional limitations. This would make it possible to determine which of the two tests offers the best balance between sensitivity and specificity, as well as a higher predictive value (AU)

[Evaluation of memory in acquired brain injury: a comparison between the Wechsler Memory Scale and the Rivermead Behaviour Memory Test]. / Evaluación de la memoria en el daño cerebral adquirido: comparación entre la escala de memoria de Wechsler y el test conductual de memoria de Rivermead.

INTRODUCTION: Learning processes and memory are frequently compromised in acquired brain injury (ABI), while at the same time such involvement is often heterogeneous and a source of deficits in other cognitive capacities and significant functional limitations. A good neuropsychological evaluation of memory is designed to study not only the type, intensity and nature of the problems, but also the way they manifest in daily life. PATIENTS AND METHODS: This study examines the correlation between a traditional memory test, the Wechsler Memory Scale-III (WMS-III), and a memory test that is considered to be functional, the Rivermead Behavioural Memory Test (RBMT), in a sample of 60 patients with ABI. RESULTS: All the correlations that were observed were moderate. Greater correlations were found among the verbal memory subtests than among the visual memory tests. An important number of subjects with below-normal scalar scores on the WMS-III correctly performed (either fully or partially) the corresponding test in the RBMT. CONCLUSIONS: The joint use of the WMS-III and RBMT in evaluation can provide a more comprehensive analysis of the memory deficits and their rehabilitation. The lower scores obtained in the WMS-III compared to those of the RBMT indicate greater sensitivity of the former. Nevertheless, further testing needs to be carried out in the future to compare the performance in the tests after the patients and those around them have subjectively assessed their functional limitations. This would make it possible to determine which of the two tests offers the best balance between sensitivity and specificity, as well as a higher predictive value.