Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment.

INTRODUCTION: Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE: We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS: We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS: PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS: HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.

Spectral features of resting-state EEG in Parkinson's Disease: A multicenter study using functional data analysis.

OBJECTIVE: This study aims 1) To analyse differences in resting-state electroencephalogram (rs-EEG) spectral features of Parkinson's Disease (PD) and healthy subjects (non-PD) using Functional Data Analysis (FDA) and 2) To explore, in four independent cohorts, the external validity and reproducibility of the findings using both epoch-to-epoch FDA and averaged-epochs approach. METHODS: We included 169 subjects (85 non-PD; 84 PD) from four centres. Rs-EEG signals were preprocessed with a combination of automated pipelines. Sensor-level relative power spectral density (PSD), dominant frequency (DF), and DF variability (DFV) features were extracted. Differences in each feature were compared between PD and non-PD on averaged epochs and using FDA to model the epoch-to-epoch change of each feature. RESULTS: For averaged epochs, significantly higher theta relative PSD in PD was found across all datasets. Also, higher pre-alpha relative PSD was observed in three of four datasets in PD patients. For FDA, similar findings were achieved in theta, but all datasets showed consistently significant posterior pre-alpha differences across multiple epochs. CONCLUSIONS: Increased generalised theta, with posterior pre-alpha relative PSD, was the most reproducible finding in PD. SIGNIFICANCE: Rs-EEG theta and pre-alpha findings are generalisable in PD. FDA constitutes a reliable and powerful tool to analyse epoch-to-epoch the rs-EEG.

Perfil neuropsicológico en pacientes con trauma craneoencefálico atendidos en un hospital de alta complejidad de Medellín, Colombia / Neuropsychological profile of patients with traumatic brain injury evaluated in a high complexity hospital in Medellin, Colombia

RESUMEN INTRODUCCIÓN: El trauma craneoencefálico (TCE) es una de las principales causas de daño cerebral y discapacidad en personas menores de 40 años. Según su severidad, se puede clasificar en leve, moderado o grave, en función de la escala de coma de Glasgow. Muchos pacientes quedan con secuelas neuropsicológicas y comportamentales que pueden afectar en mayor o menor grado su funcionalidad. El objetivo del estudio fue determinar las diferencias en el perfil neuropsicológico, las características clínicas y el compromiso funcional en pacientes con TCE según la clasificación de la severidad. METODOLOGÍA: Se realizó un estudio observacional, analítico, de corte transversal. Se revisaron las historias clínicas y los reportes neuropsicológicos de adultos con TCE evaluados por neuropsicología entre los años 2014 y 2019. Se compararon los resultados de pruebas neuropsicológicas, síndromes neuropsicológicos y funcionalidad según la severidad del TCE. RESULTADOS: Se estudiaron 48 pacientes, 38 de ellos hombres (73 %), con una mediana de edad de 35 años (RI: 25-51). En 14 casos el TCE fue leve, en 18 moderado y en 16 severo. El síndrome neuropsicológico más frente fue el amnésico (100 %), seguido del disejecutivo (79 %) y el compromiso en la atención (77 %). No se encontraron diferencias según severidad del TCE. Cuarenta y un pacientes (85 %) presentaron cambios comportamentales, 14 (29 %) experimentaron alteración en las actividades básicas de la vida diaria y 32 (68 %) en las actividades instrumentales. CONCLUSIONES: Las alteraciones neuropsicológicas, comportamentales y funcionales posteriores a un TCE son frecuentes, sin embargo, no se encontraron diferencias significativas según severidad del trauma.

ABSTRACT INTRODUCTION: Traumatic Brain Injury (TBI) is one of the main causes of brain damage and disability in people under 40 years of age. The severity of TBI can be classified as mild, moderate, or severe based on the Glasgow coma scale. Many patients are left with neuropsychological and behavioral sequelae that can affect functionality to a greater or lesser degree. The objective of the study was to determine the differences in the neuropsychological profile, clinical characteristics and functional impairment in patients with TBI according to severity. METHODOLOGY: An observational, analytical, cross-sectional study was carried out. The clinical records and neuropsychological reports of adults with TBI evaluated between 2014 and 2019 were reviewed. The results of neuropsychological tests, neuropsychological syndromes, and functionality according to severity of TBI were compared. RESULTS: 48 patients were studied, 35 were males (73 %), the median age was 35 years (IR: 25-51). In 14 TBI was mild, in 18 moderate and 16 severe. The most common neuropsychological syndrome was amnesic (100 %) followed by dysexecutive (79 %) and attentional commitment (77 %). No differences were found according to severity of TBI. 41 patients (85 %) presented behavioral changes, 14 (29 %) presented alteration in basic activities of daily life and 32 (68 %) in instrumental activities. CONCLUSIONS: Neuropsychological, behavioral and functional alterations are frequent after TBI; however, no significant differences were found according to the severity of the trauma.

Subjective Cognitive and Communicative Complaints and Health-Related Quality of Life in Parkinson's Disease with and without Mild Cognitive Impairment.

INTRODUCTION: Mild Cognitive Impairment (MCI) is common in Parkinson's Disease (PD). Few studies have compared the Health-Related Quality of Life (HRQoL) in patients with and without MCI due to PD (PD-MCI), and its correlation to patients' subjective cognitive and communicative difficulties has not been explored. OBJECTIVE: We aimed to compare HRQoL in PD-MCI and PD without MCI (PD-nMCI), and explore its possible relationship to subjective cognitive and communicative complaints. METHODS: We included 29 PD-nMCI and 11 PD-MCI patients. The HRQoL was assessed with the Parkinson's Disease Questionnaire-39 (PDQ-39): its Cognition dimension was used as a measure of subjective cognitive complaints, its Communication dimension for subjective communicative complaints, and the summary index (PDQ-39 SI) as an indicator of HRQoL. Non-parametric partial correlations between the Cognition and Communication dimensions, and the adjusted PDQ-39 SI were conducted. RESULTS: PD-MCI patients had greater subjective cognitive and communicative complaints and worse HRQoL than PD-nMCI patients. In the PD-MCI group, both subjective cognitive and communicative complaints exhibited significant direct correlations with the adjusted HRQoL scores. CONCLUSIONS: HRQoL seems to be affected in PD-MCI, and it might be influenced by greater subjective cognitive and communicative complaints. Including patient-reported outcome measures of HRQoL, and providing cognitive and speech rehabilitation, as well as psychotherapeutic strategies to face these deficits can enhance the patient-centred approach in PD.

Resting-state EEG alpha/theta ratio related to neuropsychological test performance in Parkinson's Disease.

OBJECTIVE: To determine possible associations of hemispheric-regional alpha/theta ratio (α/θ) with neuropsychological test performance in Parkinson's Disease (PD) non-demented patients. METHODS: 36 PD were matched to 36 Healthy Controls (HC). The α/θ in eight hemispheric regions was computed from the relative power spectral density of the resting-state quantitative electroencephalogram (qEEG). Correlations between α/θ and performance in several neuropsychological tests were conducted, significant findings were included in a moderation analysis. RESULTS: The α/θ in all regions was lower in PD than in HC, with larger effect sizes in the posterior regions. Right parietal, and right and left occipital α/θ had significant positive correlations with performance in Judgement of Line Orientation Test (JLOT) in PD. Adjusted moderation analysis indicated that right, but not left, occipital α/θ influenced the JLOT performance related to PD. CONCLUSIONS: Reduction of the occipital α/θ, in particular on the right side, was associated with visuospatial performance impairment in PD. SIGNIFICANCE: Visuospatial impairment in PD, which is highly correlated with the subsequent development of dementia, is reflected in α/θ in the right posterior regions. The right occipital α/θ may represent a useful qEEG marker for evaluating the presence of early signs of cognitive decline in PD and the subsequent risk of dementia.

Cannabis, schizophrenia and cognition: the contribution of brain connectivity. / Cannabis, esquizofrenia y cognición, aportes de la conectividad cerebral.

The lack of consensus on the issue of whether the consumption of cannabis favors neurocognition among schizophrenia-diagnosed patients or not, plus methodological problems found in available evidence and the limitations of studies focused on diagnosis and treatment for positive symptoms are sufficient reason for designing new research proposals based on recent brain connectivity models. The objective of this paper is to review available literature databases, selected for neurocognition in cannabis-using schizophrenia patients and to analyze contributions made by functional connectivity studies. Cognitive impairment among schizophrenia patients is found even before the appearance of the first psychotic symptoms. Measuring cognitive function in these patients, techniques such as fMRI and EEG have found brain impairment. Furthermore, regarding schizophrenia-diagnosed patients who use cannabis, some studies have shown less deterioration among cognitive domains, which may apparently be related with one of its components (CBD). Measuring brain connectivity can be useful for clarifying neurophysiological mechanisms of cognition in marihuana-using schizophrenia patients. Cognitive decline is generalized in schizophrenia patients and is considered fundamental for disease physiopathology.

La falta de consenso sobre si el consumo de cannabis favorece la neurocognición en pacientes con diagnóstico de esquizofrenia consumidores de esta sustancia, más los problemas metodológicos encontrados en la evidencia disponible y las limitaciones de los estudios, los cuales se centran en el diagnóstico y tratamiento de los síntomas positivos, son elementos suficientes para diseñar nuevas propuestas de investigación desde los modelos recientes de conectividad cerebral. El objetivo de este trabajo es revisar la literatura disponible en las bases de datos seleccionadas sobre la neurocognición en pacientes con diagnóstico de esquizofrenia consumidores de cannabis y los aportes de los estudios de conectividad funcional. Alteraciones cognitivas en los pacientes con esquizofrenia, se evidencian incluso antes de la aparición de los primeros síntomas psicóticos; técnicas como RMFI y EEG han encontrado alteraciones en los cerebros de los pacientes con esquizofrenia. En los pacientes con esquizofrenia consumidores de cannabis, algunos estudios evidencian menores deterioros en los diferentes dominios cognitivos, que al parecer podian estar relacionados con uno de sus componentes, el CBD. La medición de la conectividad cerebral, puede ser útil para aclarar los mecanismos neurofisiológicos de la cognición en los pacientes con diagnóstico de esquizofrenia consumidores de cannabis.

Executive Functions and High Intellectual Capacity in School-Age: Completely Overlap?

OBJECTIVE: To analyze the relationship between the dimensions of the executive function and intellectual capacity in children with high academic performance. METHOD: an analytical, observational, prospective study with a non-random sample of 104 children between 7 and 11 years of age, belonging to educational institutions in Medellín, Colombia, divided into groups according to the measure of Total Intellectual Capacity (TIC): 1. Those with an average TIC of between 85-115. 2. Children with higher IC or those with scores ranging from 116-129 and 3. Children with TIC of > 130, known as exceptional talents. They are provided executive function tests that are in compliance with bioethical conditions. RESULTS AND CONCLUSIONS: The Intellectual Capacity is not a concept analogous or synonymous to executive function. This study demonstrates that the common element among all participants is high academic performance and an absence of alteration of the executive function. Finally, an adequate executive functioning makes high academic performance possible.

Objetivo: Analizar la relación entre las dimensiones de la función ejecutiva y capacidad intelectual en niños escolarizados con alto rendimiento académico. Método: investigación de tipo analítica, observacional, prospectiva, con muestra no aleatoria de 104 niños entre los 7 y 11 años de edad pertenecientes a instituciones educativas de Medellín-Colombia, dividida en tres grupos de acuerdo con la medida de Capacidad Intelectual Total (CIT). 1. Aquellos con CIT promedio entre 85-115. 2. Niños con CI superior; puntuaciones entre 116-129 y 3. Niños con un CIT > 130; talentos excepcionales. Se les suministro pruebas de función ejecutiva con cumplimiento de condiciones bioéticas. Resultados y conclusiones: La Capacidad Intelectual no es concepto análogo ni sinónimo de función ejecutiva. Este estudio demostró que el elemento común entre todos los participantes es un alto rendimiento académico y una ausencia de alteración de la función ejecutiva. Finalmente, un adecuado funcionamiento ejecutivo posibilita un alto rendimiento académico.

Trastorno específico del desarrollo del lenguaje en una población infantil colombiana / Specific language impairment in a colombian children sample

En el Grupo de Neurociencias de Antioquia fueron evaluados 204 niños entre los 6-16 años de edad con problemas del habla y del lenguaje. 51 cumplieron los criterios de trastorno específico en el desarrollo del lenguaje (TEDL). Al grupo TEDL, se le realizó una evaluación neuropsicológica y lingüística y se compararon con un grupo control de niños asintomáticos. Al comparar con el grupo control, el grupo con TEDL presentó diferencias significativas en: pruebas de comprensión, en especial para estructuras morfosintácticas complejas y frases elaboradas; pruebas de expresión verbal sobre todo en la formulación de oraciones; pruebas de repetición de palabras sin sentido, errores en la denominación y marcadas desventajas en pruebas de lectura y escritura.

The Neuroscience Group of Antioquia evaluated two hundred and fourchildren from 6 to 16 years old with speech and language problems and 51of them meet the inclusion and exclusion criteria for Specific LanguageImpairment (SLI). The SLI group underwent a neuropsychological andlinguistic test to compare their cognitive and linguistic skills with a control group of asymptomatic children. When compared to the control group,SLI children showed significant differences in comprehension tests, particularly in complex morphosyntactic structures and elaborated sentences; in verbal expression, especially formulated sentences; repetition test ofnon-sense words; naming errors and marked disadvantages in readingwritingsub-tests.

Conciencia fonológica y comportamiento verbal en niños con dificultades de aprendizaje / Phonological consciousness and verbal behavior in children with learning difficulties

Antecedente: se ha informado que el trastorno de la conciencia fonológica es la alteración básica en los niños con dificultades del aprendizaje (DA). Objetivo: Analizar las características de la conciencia fonológica y el comportamiento verbal en una muestra de niños de 7 a 10 años que presentan DA, comparados con un grupo control. Material y métodos: se seleccionó una muestra no aleatoria de 64 niños de ambos géneros de 7 a 10 años, escolarizados, de la ciudad de Medellín (Colombia). La muestra fue clasificada en dos grupos de igual tamaño: 1) DA y 2) un grupo control sin DA. Se utilizó un cuestionario estandarizado para maestros (Cuestionario de dificultades de aprendizaje ? CEPA) como criterio para la clasificación de los grupos, usando como punto de corte para los casos una puntuación T= 60, y para los controles T= 55. Los grupos fueron comparados en seis tareas de conciencia fonológica y cinco pruebas de comportamiento verbal. Resultados: el grupo con DA tuvo una ejecución significativamente más baja en la prueba de segmentación fonológica al compararse con los controles sin dificultades de aprendizaje (p = 0.032); y, a nivel del comportamiento verbal, el grupo DA tuvo una ejecución significativamente más pobre en la tarea de comprensión verbal (token test), en el número de ideas y en las inferencias totales en la prueba de narración (p = 0.000). Conclusión: Los niños con DA presentan alteraciones en la segmentación fonológica, en la comprensión verbal y en las habilidades narrativas.

Introduction: Phonological awareness has been suggested as the basic problem in learning disabilities (LD). Objective: Toanalyze the characteristics of the phonological awareness and the verbal skills in a sample of children aged 7 to 10 years with LD compared with a control group without LD. Material and methods: A nonrandom sample of sixty four - 7-to-10-year-old - children of both genders, which were studying in Medellín city (Colombia), was selected. The sample wasclassified in 2 equal size groups: 1) LD and 2) a control group without LD. A questionnaire of LD for teachers (Spanishabbreviation: CEPA) was used as grouping classification. The cut-off point for the cases was a T-score = 60, and for thecontrols T= 55. The groups were compared in six tasks of phonological awareness and 5 tests of verbal skills. Results: The LD group had a statistically significant lower performance on phonological segmentation than the control group (p = 0,032); and significant lower scores on the verbal skills tests of comprehension (Token Test), narratives and inferences (p = 0.000). Conclusion: LD children presented lower performances on tasks of phonological segmentation,verbal comprehension and narratives.

Taxometría de conglomerados del trastorno por déficit de atención/hiperactividad con análisis de clases latentes y de correspondencias / Cluster taxometry of attention deficit/hyperactivity disorder with latent class and correspondence analysis

El trastorno por déficit de atención/hiperactivad (TDA/H) presenta síntomas heterogéneos y con diversos grados de intensidad. El análisis de conglomerados de clases latentes (ACCL) puede clasificar a los niños a partir de los datos directos provenientes de cualquier instrumento que muestre estos síntomas, sin un diagnóstico de patrón de oro previo. Se utilizó un instrumento tipo lista de chequeo para los síntomas de TDA/H y otro para las comorbilidades del TDA/H. ACCLs fueron aplicados para los datos de cada instrumento en una muestra aleatoria y representativa de 540 niños y adolescentes escolarizados de 4 a 17 años, de la ciudad de Manizales. Un análisis de correspondencias simples (ACS) fue usado para determinar la relación o concordancia de los grupos derivados de los ACCLs. Se encontraron seis clases para la lista de chequeo de síntomas de TDA/H y cinco para el instrumento de las comorbilidades de TDA/H. El ACS mostró cuatro grupos independientes, derivados de las concordancias entre las clases obtenidas de los dos instrumentos. Estos hallazgos sugieren que el ACCL y el ACS pueden ser usados como procedimientos taxométricos precisos para la clasificación de las psicopatologías por externalización.

Attention deficit/hyperactivity disorder (ADHD) has heterogeneous symptoms with diverse grades of severity. Latentclass cluster analysis (LCCA) can be used to classify children, using direct data from any instrument that reports these symptoms, without previous gold standard diagnosis. One ADHD symptoms checklist, and one ADHD comorbidities questionnaire were used. LCCAs were developed for each instrument, which were administered to a sample of 540 children and adolescents, aged 4-17 years, from the regular school of Manizales-Colombia. A simple correspondence analysis (SCA) was done to determine the relationships between the groups classified from both LCCAs. Six clusters were obtained from ADHD checklist and five from the ADHD comorbidities questionnaire. SCA found four independent groups, derived from the concordances between the 11 clusters obtained by the LCCAs from both instruments. These findings suggest that LCCA and SCA can be use as accurate taxometric procedures to classify externalizing psychopathologies.