RESUMO
La neuropsicología se ha posicionado como un recurso esencial para la mayoría de las unidades de neurología, neurocirugía, psiquiatría y neurorrehabilitación, que atienden tanto a niños, adultos y adultos mayores, que padecen alteraciones del sistema nervioso central. El desafío de la neuropsicología es contribuir al proceso diagnóstico y al manejo de estos pacientes a partir de la evaluación de procesos cognitivos como atención, memoria, percepción, funciones ejecutivas, considerando sus manifestaciones conductuales y emocionales, toda vez que para la mayoría de las alteraciones neuropsiquiátricas no se cuenta con marcadores biológicos u otras técnicas que precisen el diagnóstico. Las alteraciones neuropsicológicas son manifestaciones comunes y, en algunos casos, centrales en varias de las patologías más prevalentes en neurología y psiquiatría. Este artículo presenta la definición, ámbito, objetivos y herramientas de la neuropsicología, y entrega una breve caracterización de algunos de los trastornos neuropsiquiátricos más relevantes, desde esta perspectiva.
Neuropsychology has positioned itself as an essential resource for most modern centers of neurology, neurosurgery, psychiatry and neurorehabilitation for children, adults and seniors suffering from central nervous system disorders. Its challenge is to help in the diagnosis and management of these patients through the evaluation of cognitive processes, such as: Attention, memory, perception, executive functions; taking into account behavioral and emotional expressions - since most neuropsychiatric disorders have no biological markers; and we have no other techniques that provide accurate diagnoses. Neuropsychological disturbances are common, and in some cases, the main clinical manifestation in these disorders. This paper discusses the definition, scope, objectives, and tools of neuropsychology. It also provides a brief description of some relevant neuropsychiatric disorders through this perspective.
Assuntos
Humanos , Criança , Adulto , Idoso , Transtornos Mentais/diagnóstico , Neuropsicologia/métodos , Desempenho Psicomotor/fisiologia , Cognição/fisiologia , Transtornos Neurocognitivos , Demência , Transtornos da Memória , Doenças do Sistema Nervoso/diagnóstico , Testes NeuropsicológicosRESUMO
Attention Deficit/Hyperactivity Disorder (ADHD) is a clinical syndrome characterized by an onset in early life. More than 65% of patients persist with manifestations of ADHD in adulthood. These symptoms may interfere in activities of daily-living, interpersonal relationships and professional and academic achievement. Nevertheless, the observation of an important group of adults with ADHD who do not show significant difficulties in the areas mentioned before puts into evidence the prognostic heterogeneity of this disorder. One of the current, most accepted explanations is the Double-Pathway Model: two double-dissociated deficits (Executive Disorders and Delayed-Reward Processing impairments) are involved in the genesis of ADHD, which explains the existence of different behavioral phenotypes. Moreover, personality traits like tenacity or perseverance are associated with higher levels of achievement in adults. On these grounds, we propose the hypothesis that the neurobiological correlate of tenacity/perseverance is a preserved Delayed-Reward Processing capacity, although further studies are needed to verify this idea.
Assuntos
Logro , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Função Executiva/fisiologia , Adulto , Humanos , PrognósticoRESUMO
Attention Deficit/Hyperactivity Disorder (ADHD) is a clinical syndrome characterized by an onset in early life. More than 65% of patients persist with manifestations of ADHD in adulthood. These symptoms may interfere in activities of daily-living, interpersonal relationships and professional and academic achievement. Nevertheless, the observation of an important group of adults with ADHD who do not show significant difficulties in the areas mentioned before puts into evidence the prognostic heterogeneity of this disorder. One of the current, most accepted explanations is the Double-Pathway Model: two double-dissociated deficits (Executive Disorders and Delayed-Reward Processing impairments) are involved in the genesis of ADHD, which explains the existence of different behavioral phenotypes. Moreover, personality traits like tenacity or perseverance are associated with higher levels of achievement in adults. On these grounds, we propose the hypothesis that the neurobiological correlate of tenacity/perseverance is a preserved Delayed-Reward Processing capacity, although further studies are needed to verify this idea.
Assuntos
Adulto , Humanos , Logro , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Função Executiva/fisiologia , PrognósticoRESUMO
Jonathan Swift is one of the most celebrated satirist writers in literature. His well-known "Gulliver's Travels", apart from being a serious human being criticism, contains many interesting ana unrecognized comments about medical and other scientific facts. Swift made what seems to be the first account of a dementing illness in the elderly; his description fits well with what we now know as Alzheimer's disease. He also described a condition now called synaesthesia, a very interesting phenomenon that may contribute to creativity. In this paper, we review aspects of his life and reveal these amazing descriptions as samples of Swift's extraordinary power of observation.
Assuntos
Doença de Alzheimer/história , Pessoas Famosas , Literatura Moderna/história , Medicina na Literatura , História do Século XVII , História do Século XVIII , IrlandaRESUMO
Jonathan Swift is one of the most celebrated satirist writers in literature. His well-known "Gulliver's Travels", apartfrom being a serious human being criticism, contains many interesting ana unrecognized comments about medical and other scientific facts. Swift made what seems to be thefirst account of a dementing illness in the elderly; his description fits well with what we now know as Alzheimer's disease. He also described a condition now called synaesthesia, a very interestingphenomenon that may contribute to creativity. In thispaper, we review aspects ofhis Ufe and reveal these amazing descriptions as samples of Swift's extraordinary power of observation.
Assuntos
História do Século XVII , História do Século XVIII , Doença de Alzheimer/história , Pessoas Famosas , Literatura Moderna/história , Medicina na Literatura , IrlandaRESUMO
Robert Walser (1878-1956) is an important but unknown European writer of the twentieth century. He was also a mysterious and solitary man who lived at the margins of society. After the questionable diagnosis of schizophrenia, he nearly stopped writing and spent almost three decades in two Swiss psychiatric hospitals. The originality of his work, undoubtedly conditioned by his mental disorder, renders interesting a review of his life and a discussion of the possible differential diagnosis of his disease.
Assuntos
Pessoas Famosas , Literatura/história , Esquizofrenia/história , História do Século XX , Humanos , SuíçaRESUMO
Robert Walser (1878-1956) is an important but unknown European writer of the twentieth century. He was also a mysterious and solitary man who lived at the margins of society. After the questionable diagnosis of schizophrenia, he nearly stopped writing and spent almost three decades in two Swiss psychiatric hospitals. The originality of his work, undoubtedly conditioned by his mental disorder, renders interesting a review of his life and a discussion of the possible differential diagnosis of his disease.
Assuntos
História do Século XX , Humanos , Pessoas Famosas , Literatura/história , Esquizofrenia/história , SuíçaRESUMO
Los médicos habitualmente no evaluamos el olfato por no considerarlo útil o relevante para el diagnóstico y por el desconocimiento de la existencia de test específicos para identificar sus alteraciones. Sin embargo, existe evidencia clínica de que la presencia de hiposmia o anosmia precede con mucha frecuencia, incluso por décadas, la aparición de enfermedades neurodegenerativas paradigmáticas como la enfermedad de Parkinson y Alzheimer. Presentamos un práctico test para identificar defectos olfatorios, validándolo en controles sanos y destacando las alteraciones en un grupo de pacientes parkinsonianos idiopáticos con respecto a otras causas de parkinsonismo. Disponer de un método para identificar defectos olfatorios es de gran utilidad en el diagnóstico diferencial de la enfermedad de Parkinson.
Assuntos
Humanos , Doença de Parkinson/diagnóstico , Odorantes , Olfato , Diagnóstico Diferencial , Transtornos do OlfatoRESUMO
Los trastornos del córtex prefrontal (CPF) permiten explicar la sintomatología de importantes cuadros neurológicos y psiquiátricos, tales como las secuelas de traumatismos encéfalo-craneanos y las esquizofrenias. Sin embargo, y a pesar de la gran importancia de sus funciones, su estudio se ha visto dificultado por razones teóricas, experimentales y clínicas. Recientemente han surgido dos nuevos modelos que intentan explicar los mecanismos a la base del funcionamiento del CPF. Presentamos una revisión de las principales manifestaciones clínicas ante su disfunción, los modelos explicativos postulados tradicionalmente, además de las dos propuestas recientes de Koechlin y Mesulam, para finalizar con una revisión de los instrumentos más utilizados en el ámbito clínico para la evaluación de las funciones propias de esta región, denominadas funciones ejecutivas y de autorregulación del comportamiento.
Dysfunction of prefrontal cortex explains the symptoms of many neurological and psychiatric disorders, such as the consequences of cerebral trauma and schizophrenia. Although the importance of frontal lobe functions in complex cognition has long been recognized, systematic research efforts to specify the nature, organization and roles of these functions have been difficult for theoretical, experimental and clinical reasons. Recently, two new theoretical frameworks have been proposed to explain the role of prefrontal cortex. In this paper, we present a revision of the main clinical manifestations secondary to prefrontal dysfunction, the frameworks proposed by Mesulam and Koechlin to explain the role of prefrontal cortex in behavior and the principal instruments available to evaluate executive and strategic self-regulation functions.
