Neuropsicología de los asesinos en serie / Neuropsychology of serial killers

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Comunicación basada en el componente P300 de los potenciales relacionados con eventos: propuesta de una matriz con imágenes / Communication based on the p300 component of event-related potentials: a proposal for a matrix with images

Introducción. Desde hace más de dos décadas diversos grupos de investigación han intentado desarrollar un dispositivo denominado ‘interfaz cerebro-computadora’ (BCI), para que puedan utilizarla personas que sufren de alteraciones motrices graves tales como el síndrome de locked in, mediante el uso de su actividad electroencefalográfica registrada mientras son estimulados visualmente. Objetivo. Obtener el componente P300 producido por intensificaciones de imágenes dispuestas en una matriz en un paradigma de tipo oddball, en dos modalidades de selección: dirigida y libre. Sujetos y métodos. Participaron 12 voluntarios sanos que fueron visualmente estimulados con una matriz de 5 × 5 imágenes con fines de comunicación, mientras se registraron sus potenciales relacionados con eventos en tres derivaciones (Fz, Cz y Pz). Se realizaron análisis fuera de línea para obtener el componente P300 producido por las intensificaciones aleatorias por renglón y por columna que contenían las imágenes blanco. Resultados. En ambas modalidades (dirigida y libre), todos los participantes generaron de forma fiable el componente P300. Las selecciones se confirmaron a través de la comparación de los P300 en el renglón y la columna de cada imagen blanco. En la modalidad libre, se observó una mayor activación incluyendo las áreas frontales. En la latencia, no se observaron diferencias significativas. Conclusión. Se identificaron las selecciones de la matriz de 5 × 5 de todos los participantes mediante los P300 producidos. En el presente estudio, el empleo de imágenes en lugar de letras puede incrementar la tasa de comunicación en una BCI basada en el componente P300

Introduction. For more than two decades, several research groups have tried to build a device called ‘brain computer interface’ (BCI) to make it available for people having several disabilities such as the locked in syndrome through the use of the recording of electroencephalography activity while the patients are being visually stimulated. Aim. To obtain a P300 component elicited by intensifications of images arranged in a matrix in an oddball paradigm in two selection modes: assigned and free. Subjects and methods. A 5 × 5 matrix for communication purposes was used to visually stimulate 12 volunteers while their event related potentials were recorded in three leads (Fz, Cz and Pz). Off-line analyses were performed to obtain the P300 component which was elicited by targets images intensified randomly by rows or columns. Results. In both modalities assigned and free, all volunteers generated a reliable P300 component. Confirmation of the selected images was made through a comparison of the P300 when each target, row and column matched. In the free selection mode, higher amplitude and a broader activation including frontal leads was observed. No significant differences in the P300 latency were found. Conclusion. In all volunteers the elicited P300 allows the identification of the selected images in the 5 × 5 matrix. In the present study the use of drawings representing ideas instead of letters might increase the communication rate in a P300-based BCI

[Communication based on the P300 component of event-related potentials: a proposal for a matrix with images]. / Comunicación basada en el componente P300 de los potenciales relacionados con eventos: propuesta de una matriz con imágenes.

INTRODUCTION: For more than two decades, several research groups have tried to build a device called "brain computer interface" (BCI) to make it available for people having several disabilities such as the locked in syndrome through the use of the recording of electroencephalography activity while the patients are being visually stimulated. AIM. To obtain a P300 component elicited by intensifications of images arranged in a matrix in an oddball paradigm in two selection modes: assigned and free. SUBJECTS AND METHODS: A 5 x 5 matrix for communication purposes was used to visually stimulate 12 volunteers while their event related potentials were recorded in three leads (Fz, Cz and Pz). Off-line analyses were performed to obtain the P300 component which was elicited by targets images intensified randomly by rows or columns. RESULTS: In both modalities assigned and free, all volunteers generated a reliable P300 component. Confirmation of the selected images was made through a comparison of the P300 when each target, row and column matched. In the free selection mode, higher amplitude and a broader activation including frontal leads was observed. No significant differences in the P300 latency were found. CONCLUSION: In all volunteers the elicited P300 allows the identification of the selected images in the 5 x 5 matrix. In the present study the use of drawings representing ideas instead of letters might increase the communication rate in a P300-based BCI.

[Semantic verbal fluency in Spanish-speaking people: a comparative analysis]. / Fluidez verbal semántica en hispanohablantes: un análisis comparativo.

INTRODUCTION: Semantic verbal fluency (SVF) is the most commonly used test in the evaluation of normal and pathological functioning, whether it be clinically or experimentally. Several studies have suggested that the age, schooling and culture of the subject all affect performance in this test. To date no research has been conducted that proves whether there are differences between subjects who speak the same language but who come from different countries. PATIENTS AND METHODS: Data from the 'animals' category of the SVF in adult Spanish-speaking subjects and also the influence exerted by culture, age and schooling on the outcomes in this test were both submitted to analysis. The aforementioned variables were compared with the data reported by five research groups. RESULTS: The SVF test yields similar data from one Spanish-speaking country to another, provided that the subjects' age and schooling are taken into account. The differences found in this study may be due to variations in the way the tests are administered and scored rather than any cultural effect. We propose a standardised method of applying the test, so as to allow these variables to be unified in the future. CONCLUSION: Age and schooling are factors that determine performance in the SVF, although this is not true of culture.

Fluidez verbal semántica en hispanohablantes: un análisis comparativo / Semantic verbal fluency in spanish-speaking people: A comparative analysis

Introduction. Semantic verbal fluency (SVF) is the most commonly used test in the evaluation of normal and pathological functioning, whether it be clinically or experimentally. Several studies have suggested that the age, schooling and culture of the subject all affect performance in this test. To date no research has been conducted that proves whether there are differences between subjects who speak the same language but who come from different countries. Patients and methods. Data from the ‘animals’ category of the SVF in adult Spanish-speaking subjects and also the influence exerted by culture, age and schooling on the outcomes in this test were both submitted to analysis. The aforementioned variables were compared with the data reported by five research groups. Results. The SVF test yields similar data from one Spanish-speaking country to another, provided that the subjects’ age and schooling are taken into account. The differences found in this study may be due to variations in the way the tests are administered and scored rather than any cultural effect. We propose a standardized method of applying the test, so as to allow these variables to be unified in the future. Conclusion. Age and schooling are factors that determine performance in the SVF, although this is not true of culture (AU)

Introducción. La fluidez verbal semántica (FVS) es la prueba de mayor uso en la valoración del funcionamiento normal y patológico, ya sea clínica o experimentalmente. Diversas investigaciones han sugerido que la edad, la educación, y la cultura del sujeto influyen en el desempeño de esta prueba. Hasta el momento carecemos de investigaciones que indiquen si existen diferencias entre sujetos hablantes del mismo idioma pero que proceden de diversos países. Pacientes y métodos. Se analizaron los datos de laFVS en la categoría de ‘animales’ en sujetos hispanohablantes adultos, así como la influencia de la cultura, la edad y la escolaridad en esta prueba. Se compararon con las variables anteriores los datos publicados de cinco grupos de investigación. Resultados. La prueba de FVS arroja datos semejantes entre los países hispanohablantes, siempre y cuando se tome en cuenta la edad y la escolaridad de los sujetos. Las diferencias encontradas en este estudio pueden deberse a la variabilidad en la administración y calificación de las pruebas, más que a un efecto cultural. Se propone un método estandarizado de aplicación de la prueba, de forma que en el futuro se unifiquen estas variables. Conclusión. La edad y la escolaridad son los factores determinantes en la ejecución de la FVS y no la cultura (AU)

[Recent advances in rehabilitation technology: a review of the brain-computer interface]. / Novedades en tecnología de rehabilitación: una revisión acerca de la interfaz cerebro-computadora.

INTRODUCTION AND AIMS: In this work we review some of the options available in rehabilitation technology that are used to aid people with severe neuromuscular disorders, and which take electrophysiological activity as a source of biological signals with which to design interfaces. DEVELOPMENT: A number of different researchers have generated a novel communication and control system that utilises the electrical activity of the brain as a signal that represents the messages or commands an individual sends to the outside world, without using the normal output pathways of the brain, such as peripheral nerves and muscles; instead, this is achieved through an artificial system that extracts, encodes and applies them, called a brain-computer interface (BCI). The electrophysiological activity for a BCI can be obtained by means of superficial or implanted electrodes, and may therefore be classified as invasive or non-invasive. Five types of brain signals have been explored for use with a BCI: visual evoked potentials, slow cortical potentials, cortical neuronal activity, beta and mu rhythms, and event-related potentials. CONCLUSIONS: Thanks to recent improvements and developments in prototypes, this technology is sure to open up new possibilities of communication and control for the affected population; it also represents a valuable field of multidisciplinary research with numerous interesting applications in areas beyond the sphere of health care.

Novedades en tecnología de la rehabilitación: una revisión acerca de la interfaz cerebro-computadora / Recent advances in rehabilitation technology: a review of the brain-computer interface

Introducción y objetivo. En el presente trabajo se revisan algunas opciones tecnológicas de rehabilitación que se emplean para asistir a personas con graves alteraciones neuromusculares, con base en la actividad electrofisiológica como fuente de señales biológicas para diseñar interfaces. Desarrollo. Diversos investigadores han desarrollado un novedoso sistema de comunicación y control que emplea la actividad eléctrica cerebral como una señal que representa mensajes u órdenes que un individuo envía al mundo externo, pero sin utilizar las rutas normales de salida del cerebro, como los nervios periféricos y los músculos, sino un sistema artificial que las extrae, codifica y aplica, la cual se denomina interfaz cerebro-computadora (BCI). La actividad electrofisiológica para una BCI puede obtenerse mediante electrodos superficiales o implantados, por lo que éstas se pueden clasificar como invasivas y no invasivas. Se han explorado cinco tipos de señales del cerebro para operar una BCI: potenciales visuales evocados, potenciales corticales lentos, actividad neuronal cortical, ritmos ß y µ y potenciales relacionados con eventos. Conclusión. Con el desarrollo y la mejora de prototipos, esta reciente tecnología promete ampliar las posibilidades de comunicación y control de la población afectada; constituye un valioso ámbito de investigación multidisciplinar con múltiples e interesantes aplicaciones en áreas fuera del campo de la salud (AU)

Introduction and aims. In this work we review some of the options available in rehabilitation technology that are used to aid people with severe neuromuscular disorders, and which take electrophysiological activity as a source of biological signals with which to design interfaces. Development. A number of different researchers have generated a novel communication and control system that utilises the electrical activity of the brain as a signal that represents the messages or commands an individual sends to the outside world, without using the normal output pathways of the brain, such as peripheral nerves and muscles; instead, this is achieved through an artificial system that extracts, encodes and applies them, called a brain-computer interface (BCI). The electrophysiological activity for a BCI can be obtained by means of superficial or implanted electrodes, and may therefore be classified as invasive or non-invasive. Five types of brain signals have been explored for use with a BCI: visual evoked potentials, slow cortical potentials, cortical neuronal activity, beta and mu rhythms, and event-related potentials. Conclusions. Thanks to recent improvements and developments in prototypes, this technology is sure to open up new possibilities of communication and control for the affected population; it also represents a valuable field of multidisciplinary research with numerous interesting applications in areas beyond the sphere of health care (AU)

Effects of culture and education on neuropsychological testing: a preliminary study with indigenous and nonindigenous population.

We analyzed the influence of education and of culture on the neuropsychological profile of an indigenous and a nonindigenous population. The sample included 27 individuals divided into four groups: (a) seven illiterate Maya indigenous participants, (b) six illiterate Pame indigenous participants, (c) seven nonindigenous participants with no education, and (d) seven Maya indigenous participants with 1 to 4 years of education . A brief neuropsychological test battery developed and standardized in Mexico was individually administered. Results demonstrated differential effects for both variables. Both groups of indigenous participants (Maya and Pame) obtained higher scores in visuospatial tasks, and the level of education had significant effects on working and verbal memory. Our data suggested that culture dictates what it is important for survival and that education could be considered as a type of subculture that facilitates the development of certain skills.

[The development of attention, memory and the inhibitory processes: the chronological relation with the maturation of brain structure and functioning]. / Desarrollo de la atención, la memoria y los procesos inhibitorios: relación temporal con la maduración de la estructura y función cerebral.

Development during childhood and adolescence is characterized by greater efficiency in performing cognitive tasks. The correlations between cognitive and brain development are not altogether clear and have not been studied in depth. The aim of this study is to survey the research carried out into the development of cognitive functioning in children, adolescents and adults, and its chronological relation with brain development. Anatomofunctional and cognitive-behavioural studies are presented. Anatomical studies have shown that the white matter increases linearly throughout childhood and adolescence, whereas cortical and subcortical grey matter increases in the pre-adolescent period and later diminishes in the post adolescent stage. It has been claimed that these changes are regional and that the prefrontal cortex (PFC) is one of the last areas to mature. Functional research has studied cognitive processes attributed to the functioning of the PFC, such as attention, working memory and the inhibition of irrelevant responses. The findings from these studies have shown a behavioural and physiological development of these three processes during childhood and adolescence. Behavioural results have evidenced greater efficiency in capacities such as discriminating between relevant and irrelevant information, storing and handling information in the memory and the inhibition of unsuitable responses during the performance of a task. The physiological results have presented changes in the magnitude, spread and integration of the regions activated during task performance. Cognitive and behavioural maturation is consecutive to structural and physiological maturing and this is produced in a chronologically and qualitatively different way in the distinct regions of the brain.

Desarrollo de la atención, la memoria y los procesos inhibitorios: relación temporal con la maduración de la estructura y función cerebral / The development of attention, memory and the inhibitory processes: the chronological relation with the maturation of brain structure and functioning

El desarrollo durante la niñez y la adolescencia se caracteriza por una mayor eficiencia en la realización de tareas cognitivas. Las correlaciones entre el desarrollo cognitivo y el cerebral no son claras y no se han estudiado profundamente. El objetivo de este trabajo es revisar las investigaciones sobre el desarrollo del funcionamiento cognitivo en niños, adolescentes y adultos, así como su relación temporal con el desarrollo cerebral. Se presentan estudios anatomofuncionales y cognitivocomportamentales. Los estudios anatómicos han mostrado que la sustancia blanca aumenta linealmente durante la niñez y la adolescencia, mientras que la sustancia gris cortical y subcortical tienen un incremento en la etapa preadolescente, seguido por una disminución en la etapa postadolescente. Se ha comunicado que estos cambios son regionales y que la corteza prefrontal (CPF) es una de las últimas zonas en madurar. Las investigaciones funcionales han estudiado procesos cognitivos atribuidos al funcionamiento de la CPF, tales como la atención, la memoria de trabajo y la inhibición de respuestas irrelevantes. Los resultados de estos estudios han mostrado un desarrollo conductual y fisiológico de estos tres procesos durante la niñez y la adolescencia. Los resultados conductuales han objetivado una mayor eficiencia de capacidades como la discriminación entre información relevante e irrelevante, el almacenamiento y manipulación de información en la memoria y la inhibición de respuestas inadecuadas durante la ejecución de una tarea. Los resultados fisiológicos han presentado cambios en la magnitud, dispersión e integración de las regiones activadas durante la ejecución de tareas. La maduración cognitiva y conductual es consecutiva a la estructural y fisiológica y ésta se produce de manera diferente, tanto cronológica como cualitativamente, en las distintas regiones cerebrales (AU)

Development during childhood and adolescence is characterized by greater efficiency in performing cognitive tasks. The correlations between cognitive and brain development are not altogether clear and have not been studied in depth. The aim of this study is to survey the research carried out into the development of cognitive functioning in children, adolescents and adults, and its chronological relation with brain development. Anatomofunctional and cognitive-behavioural studies are presented. Anatomical studies have shown that the white matter increases linearly throughout childhood and adolescence, whereas cortical and subcortical grey matter increases in the pre-adolescent period and later diminishes in the post-adolescent stage. It has been claimed that these changes are regional and that the prefrontal cortex (PFC) is one of the last areas to mature. Functional research has studied cognitive processes attributed to the functioning of the PFC, such as attention, working memory and the inhibition of irrelevant responses. The findings from these studies have shown a behavioural and physiological development of these three processes during childhood and adolescence. Behavioural results have evidenced greater efficiency in capacities such as discriminating between relevant and irrelevant information, storing and handling information in the memory and the inhibition of unsuitable responses during the performance of a task. The physiological results have presented changes in the magnitude, spread and integration of the regions activated during task performance. Cognitive and behavioural maturation is consecutive to structural and physiological maturing and this is produced in a chronologically and qualitatively different way in the distinct regions of the brain (AU)

[The neurobiology of developmental dyslexia: a survey]. / Neurobiología de la dislexia del desarrollo: una revisión.

One of the most common disorders affecting the ability to read is developmental dyslexia, which, unlike the alexia related to a loss of the capacity to read associated with brain damage, refers to a specific disorder in the acquisition of reading skills and becomes apparent in reiterated persistent difficulties in learning to read. A number of studies have attempted to detect structural and functional abnormalities that might be the origin of problems in learning to read. The use of functional neuroimaging techniques such as positron emission tomography (PET), spectroscopic magnetic resonance imaging (SMRI) and functional magnetic resonance imaging (fMRI) enables us to measure changes in the metabolic activity associated with alterations in the neuronal networks involved in the reading process. In this review, different studies are analysed in an attempt to identify alterations in the cortico subcortical regions which could be the origin of the developmental dyslexia. Results show that in dyslexics there is a temporoparietooccipital disconnection, and a disconnection with the left frontal cortex as regards the demands for fast auditory processing, as well as abnormalities in the connections between the temporoparietal cortex and the cerebellum with other regions of the brain. Such findings suggest that the altered areas of the brain do not only show a characteristic pattern of hypoactivation, but also that these alterations could be the cause of this malady. We highlight the importance of these findings in the diagnosis and rehabilitation of this population.

Neuropsychological profile of patients with primary systemic hypertension.

Arterial hypertension represents a risk factor for cerebrovascular disease. It has been hypothesized that chronic hypertension may eventually result in small subcortical infarcts associated with some cognitive impairments. One hundred fourteen patients with primary systemic hypertension (PSH) and 114 matched subjects were selected. PSH patients were further divided in four groups depending upon the hypertension severity. In addition to the medical and laboratory exams, a neuropsychological evaluation was administered. The NEUROPSI neuropsychological test battery was used. An association between level of hypertension and cognitive impairment was observed. Most significant differences were observed in the following domains: Reading, executive functioning, constructional, and memory-recall. No differences were observed in orientation, memory-recognition, and language. Some neuropsychological functions appeared impaired even in the PSH group with the least risk factors. Cognitive evaluation may be important in cases of PSH not only to determine early subtle cognitive changes, but also for follow-up purposes, and to assess the efficacy of different therapeutic procedures.

Learning to read is much more than learning to read: a neuropsychologically based reading program.

Departing from the observation that illiterates significantly underscore in some neuropsychological tests, a learning-to-read method named NEUROALFA was developed. NEUROALFA is directed to reinforce these underscored abilities during the learning-to-read process. It was administered to a sample of 21 adult illiterates in Colima (Mexico). Results were compared with 2 control groups using more traditional procedures in learning to read. The NEUROPSI neuropsychological test battery was administered to all the participants before and after completing the learning-to-read training program. All 3 groups presented some improvement in the test scores. Gains, however, were significantly higher in the experimental group in Orientation in Time, Digits Backward, Visual Detection, Verbal Memory, Copy of a Semi-Complex Figure, Language Comprehension, Phonological Verbal Fluency, Similarities, Calculation Abilities, Sequences, and all the recall subtests, excluding Recognition. Performance in standard reading tests was also significantly higher in the experimental group. Correlations between pretest NEUROPSI scores and reading ability were low. However, correlations between posttest NEUROPSI scores and reading scores were higher and significant for several subtests. Results are interpreting as supporting the assumption that reinforcement of those abilities in which illiterates significantly underscore results in a significant improvement in neuropsychological test scores and strongly facilitates the learning-to-read process. The NEUROALFA method of teaching reading to adult illiterates is beginning to be used extensively in Mexico. To our knowledge, this is the first attempt to apply neuropsychological principles to social problems.

[Neuropsychological characteristics of Parkinson's disease]. / Características neuropsicológicas de la enfermedad de Parkinson.

INTRODUCTION: Form part of the clinical symptoms of Parkinson's disease. These disorders may present in varying degrees: whilst in some patients a clinical picture of dementia is seen, in others there are only specific symptoms. DEVELOPMENT: In this article we consider three of the most controversial aspects currently dominating study of the neuropsychology of Parkinson's disease. The first relates to the pathophysiological basis and neurotransmitters involved. The second deals with the distinction between subcortical-type and Alzheimer-type dementia, and the third with the pathophysiological basis underlying the cognitive profile of the subgroups of patients with Parkinson's disease who do not present dementia. CONCLUSION: The relation between the factors causing the disease, neuropathology, individual variables and the presence of these subgroups requires precise systematic investigation of the neuropsychology shown by patients with Parkinson's disease.

Syntactic comprehension, verbal memory, and calculation abilities in Spanish-English bilinguals.

This article analyzes the interfering effect of the second language (L2) on the first language (L1) in native Spanish speakers living in the United States. We examined 3 linguistic aspects: (a) syntactic comprehension, (b) verbal memory, and (c) calculation abilities. We carried out 2 different studies. In the 1st study, we studied syntactic understanding in 50 Spanish-English bilinguals. For all participants, L1 was Spanish and L2 was English, and all learned English early in life and had attended English schools. Results for the Spanish Syntactic Comprehension Test (Marcos & Ostrosky, 1995) were compared with the normative results obtained with 40 Spanish monolingual participants. We observed that the closer to the English syntax the sentences were, the easier it was for the participants to understand them. Participants who had been exposed to English between the ages of 5 and 12 outperformed participants exposed to English before 5 years of age. Language preference correlated with syntactic comprehension. Women outperformed men. In the 2nd study, verbal memory and calculation abilities were examined in L1 and L2 in a group of 85 Spanish-English bilinguals. Parallel versions of the different tests were administered in Spanish and English. The results indicated some significant differences between the 2 languages in several verbal learning and calculation ability subtests. Most of the verbal memory subtests were better performed in L1. Scores on tasks measuring speed and calculation accuracy were higher in the participant's native language. Best spoken language proved to be a significant variable in some verbal memory subtests performed in English but not in Spanish. We analyze implications of bilingualism in neuropsychological testing. We also present some suggestions to minimize the bilingualism effect.

Verbal fluency and repetition skills in healthy older Spanish-English bilinguals.

The influence of bilingualism on cognitive test performance in older adults has received limited attention in the neuropsychology literature. The aim of this study was to examine the impact of bilingualism on verbal fluency and repetition tests in older Hispanic bilinguals. Eighty-two right-handed participants (28 men and 54 women) with a mean age of 61.76 years (SD = 9.30; range = 50-84) and a mean educational level of 14.8 years (SD = 3.6; range 2-23) were selected. Forty-five of the participants were English monolinguals, 18 were Spanish monolinguals, and 19 were Spanish-English bilinguals. Verbal fluency was tested by electing a verbal description of a picture and by asking participants to generate words within phonemic and semantic categories. Repetition was tested using a sentence-repetition test. The bilinguals' test scores were compared to English monolinguals' and Spanish monolinguals' test scores. Results demonstrated equal performance of bilingual and monolingual participants in all tests except that of semantic verbal fluency. Bilinguals who learned English before age 12 performed significantly better on the English repetition test and produced a higher number of words in the description of a picture than the bilinguals who learned English after age 12. Variables such as task demands, language interference, linguistic mode, and level of bilingualism are addressed in the Discussion section.

Sensitivity and specificity of the Mini-Mental State Examination in a Spanish-speaking population.

The Mini-Mental State Examination (MMSE; Folstein, Folstein, & McHugh, 1975) was given to a total of 430 normal participants divided into 3 age ranges (16-50, 51-65, and 66-89) and 4 educational ranges (0, 1-4, 5-9, and > or = 10 years). The educational level effect was notoriously stronger than the age effect. Normal illiterate participants obtained scores that would correspond to severe cognitive alterations (M = 17.67); low education participants (1-4 years) would be classified with moderate cognitive alterations (M = 20.61). Sensitivity and specificity of the MMSE were established. Low sensitivity and specificity were found for both the participants with 0 and 1 to 4 years of schooling, 50% and 72.73%, respectively. In participants with more than 5 years of schooling, the specificity (86.36%) and sensitivity (86.36%) indexes were higher. We concluded that the MMSE is an instrument with little diagnostic utility among participants with a low level of education.

Características neuropsicológicas de la enfermedad de Parkinson / Neuropsychological characteristics of parkinson´s disease

Introduction. form part of the clinical symptoms of Parkinson’s disease. These disorders may present in varying degrees: whilst in some patients a clinical picture of dementia is seen, in others there are only specific symptoms. Development. In this article we consider three of the most controversial aspects currently dominating study of the neuropsychology of Parkinson’s disease. The first relates to the pathophysiological basis and neurotransmitters involved. The second deals with the distinction between subcortical-type and Alzheimer-type dementia, and the third with the pathophysiological basis underlying the cognitive profile of the subgroups of patients with Parkinson’s disease who do not present dementia. Conclusion. The relation between the factors causing the disease, neuropathology, individual variables and the presence of these subgroups requires precise systematic investigation of the neuropsychology shown by patients with Parkinson’s disease (AU)

Introducción. Los trastornos cognitivos forman parte de la sintomatología clínica de la enfermedad de Parkinson. Estos trastornos pueden presentarse en grado variable: mientras que en algunos pacientes se observa la presencia de un cuadro demencial, en otros sólo se observa la presencia de una sintomatología específica. Desarrollo. En el presente artículo se abordan tres de los aspectos más controvertidos que predominan actualmente en el estudio de la neuropsicología de la enfermedad de Parkinson. El primero se relaciona con las bases fisiopatológicas y los neurotransmisores involucrados. El segundo, con la distinción entre la demencia de tipo subcortical y la demencia de tipo Alzheimer, y el tercero sobre las bases fisiopatológicas que subyacen al perfil cognitivo de los subrupos de pacientes con enfermedad de Parkinson que no presentan demencia. Conclusión. La relación entre los factores causales de la enfermedad, así como la neuropatología, las variables individuales y la presencia de estos subgrupos requieren de una investigación sistemática y precisa de la sintomatología neuropsicológica que manifiestan los pacientes con enfermedad de Parkinson (AU)

Age-related cognitive decline during normal aging: the complex effect of education.

The purpose of this study was to further analyze the effects of education on cognitive decline during normal aging. An 806-subject sample was taken from five different Mexican regions. Participants ranged in age from 16 to 85 years. Subjects were grouped into four educational levels: illiterate, 1-4, 5-9, and 10 or more years of education, and four age ranges: 16-30, 31-50, 51-65, and 66-85 years. A brief neuropsychological test battery (NEUROPSI), standardized and normalized in Spanish, was administered. The NEUROPSI test battery includes assessment of orientation, attention, memory, language, visuoperceptual abilities, motor skills, and executive functions. In general, test scores were strongly associated with level of educational, and differences among age groups were smaller than differences among education groups. However, there was an interaction between age and education such as that among illiterate individuals scores of participants 31-50 years old were higher than scores of participants 16-30 years old for over 50% of the tests. Different patterns of interaction among educational groups were distinguished. It was concluded that: (a) The course of life-span changes in cognition are affected by education. Among individuals with a low level of education, best neuropsychological test performance is observed at an older age than among higher-educated subjects; and (b) there is not a single relationship between age-related cognitive decline and education, but different patterns may be found, depending upon the specific cognitive domain.