Validación de la versión breve del “Cociente de empatía” con adolescentes de México / Validation of the short version of the “quotient of empathy” with adolescents from mexico

La empatía es una habilidad que permite la identificación e interpretación de experiencias subjetivas de otros. El objetivo de este estudio fue validar el “Cociente de empatía” (CE) en adolescentes mexicanos a partir de una muestra de 573 estudiantes (350 mujeres y 223 hombres) con una edad media de 14,8 años (DT= 1,96). Se realizó un análisis factorial exploratorio, identificando dos factores, uno con 16 ítems asociados a la dimensión afectiva y otro de 13 ítems con la dimensión cognitiva (índices de bondad de ajuste: GFI= 0,984, RMSEA= 0,034 y RMSR= 0,072). Para evaluar el modelo bifactorial obtenido, se realizó un análisis factorial confirmatorio, presentando adecuados índices de ajuste (RMSEA= 0,020, RMSR= 0,045, CFI= 0,998, GFI= 0,988). En la consistencia interna se encontró un coeficiente de correlación ω de McDonald de 0,941 para la dimensión afectiva y 0,772 para la dimensión cognitiva (p< 0,001). La validación de este instrumento de empatía apoyará su uso como herramienta de evaluación en investigación clínica en adolescentes mexicanos. (AU)

Empathy is a skill that enables the identification with and interpretation of others' subjective experiences. The purpose of this study was to validate the Empathy Quotient (EQ) in adolescents in Mexico. A sample of 573 Mexican adolescent students (350 female and 223 male) with an age range of 12-19 years was employed (Mage= 14.8 years, SD= 1.96). An exploratory factor analysis (EFA) was carried out which identified two factors, one with 16 items associated with the affective dimension and one with 13 items related to the cognitive dimension (model fit indices: GFI= .984, RMSEA= .034, and RMSR= .072). To evaluate the resultant bifactor model, a confirmatory factor analysis (CFA) was performed, showing good fit indexes (RMSEA= .020, RMSR= .045, CFI= .998, GFI= .988). Regarding internal consistency, we found a McDonald's ω correlation coefficient of= .941 for the affective dimension and ω= .772 for the cognitive dimension, with p< .001. The validation of this empathy instrument will support its use as a clinical research assessment tool in Mexican adolescents. (AU)

The Relationship Between Executive Functions and Externalizing and Internalizing Behaviors in Mexican Preschoolers.

Executive functions allow the regulation of behavior and emotions. This study aimed to analyze the association of executive functions with externalizing and internalizing behaviors in 30 Mexican preschoolers with typical development (age M = 53.63 months; SD = 7.83 months; 40% girls) from homes of middle-low socioeconomic status. Behavioral and cognitive measures were used to assess executive functions and analyzed them using robust statistical methods. We found that executive functions are related to externalizing and internalizing behaviors at the behavioral level. Only Forward Digit Span predicts attentional problems. Individual differences in children's cognitive development in a Mexican context were adressed, and they have clinical and educational implications.

Neurological Soft Signs and cognitive processes in Mexican schoolchildren aged 6 to 11 years / Sinais Neurológicos Sutis e processos cognitivos em crianças escolares mexicanas de 6 a 11 anos / Signos Neurológicos Blandos y procesos cognitivos en niños escolares mexicanos de 6-11 años

Abstract Neurological Soft Signs (NSS) are indicative of generalized disruptions in neurological networks of cortico-subcortical areas. Their presence leads to problems in children's cognitive development with future academic repercussions. The presence of NSS was assessed and compared in 144 children aged 6 to 11 years of low-medium socioeconomic status from Mexico City and the metropolitan area through the Infant Neuropsychological Maturity Questionnaire (CUMANIN, for its Spanish acronym) and the School Neuropsychological Maturity Questionnaire (CUMANES, for its Spanish acronym). Results indicate significant differences by sex. Girls showed better performance in word articulation. In groups by age, significant differences were found in leximetric-comprehension, visual perception and executive function-errors. Participants showed the presence of developmental NSS which include: language (articulation disorders, oral and written language disturbances, difficulty finding words), psychomotricity, visual perception and other cognitive functions. There are several factors related to those impairments such as age, socioeconomic context and critical stages in child's development. Identification and early diagnosis can reduce the risk of school failure.

Resumo Os Sinais Neurológico Sutis (SNS) são indicadores de interrupções generalizadas nas redes de trabalho neural de áreas córtico-subcorticais, cuja presença leva a problemas no desenvolvimento neurocognitivo da criança que representam repercussões acadêmicas negativas. Na presente pesquisa, foi avaliada e comparada a presença de SNS com os processos cognitivos de 144 participantes mexicanos de estrato socioeconómico médio-baixo com idades entre 6 e 11 anos, sem antecedentes neurológicos ou psiquiátricos, por meio dos Cuestionarios de Madurez Neuropsicológica (CUMANIN) e Madurez Neuropsicológica Escolar (CUMANES). Os resultados indicaram diferenças significativas por gênero, já que as meninas apresentaram melhor desempenho na articulação de palavras. Nos grupos por idade, as diferenças significativas foram encontradas na velocidade de leitura e compreensão, visuopercepção e função executiva e erros. Em geral, os participantes mostraram presença de SNS de desenvolvimento, que incluem interferências na linguagem (problemas articulatórios, alterações da linguagem oral e escrita, dificuldade para encontrar palavras), psicomotricidade, visuopercepção e outras funções cognitivas. Ao final, conclui-se que a identificação e o diagnóstico precoce dos SNS permite diminuir o risco de fracasso escolar.

Resumen Los Signos Neurológicos Blandos (SNB) son indicativos de interrupciones generalizadas en las redes de trabajo neuronal de áreas cortico-subcorticales, cuya presencia conlleva a problemas en el desarrollo neurocognitivo del niño que representan repercusiones académicas negativas. En la presente investigación se evaluó y comparó la presencia de SNB con los procesos cognitivos de 144 participantes mexicanos de estrato socioeconómico medio-bajo con edades entre los 6 y 11 años sin antecedentes neurológicos o psiquiátricos por medio de los Cuestionarios de Madurez Neuropsicológica (CUMANIN) y Madurez Neuropsicológica Escolar (CUMANES). Los resultados indicaron diferencias significativas por sexo, ya que las niñas presentaron mejor desempeño en la articulación de palabras. En los grupos por edad, las diferencias significativas se encontraron en leximetría-comprensión, visopercepción y función ejecutiva-errores; y, en general, los participantes mostraron presencia de SNB de desarrollo, que incluyen afectaciones en: lenguaje (problemas articulatorios, alteraciones del lenguaje oral y escrito, dificultad para encontrar palabras), psicomotricidad, visopercepción y otras funciones cognitivas. Al final, se concluye que la identificación y diagnóstico temprano de los SNB permite disminuir el riesgo de fracaso escolar.

Testing whether cognitive reserve as measured by self-rating of stimulating activities moderates the association of polysubstance use and neurocognitive disorder.

Introduction: The objectives were to identify a latent factor of cognitive reserve (CR) assessed by self-rating of cognitively stimulating activities, to analyze the association between this factor and educational attainment, and to test whether CR moderates the association between polysubstance use and neurocognitive disorder (NCD). Methods: Cross-sectional data of 753 participants was collected in Mexico City. A questionnaire for self-rating of stimulating activities (work/education, leisure, physical, social, usual- and current environments) was designed. Confirmatory factor analysis was performed to test unifactoriality. This CR factor was then used within a structural equation model of moderation between recent- and years of substance use and indicators of NCD (Montreal Cognitive Assessment and an interview for subjective cognitive deficits). Results: We found acceptable goodness-of-fit values for the unifactorial model, but no association of this factor with educational attainment, nor with recent- and years of substance use (suggesting independence of CR and severity of neuropathology). We did not find a moderation effect of CR between substance use and indicators of NCD; CR was negatively associated with subjective cognitive deficits only. Conclusions: Moderation effect of self-rated CR should be further tested using direct measures of substance-induced neuropathology. Measurement of self-rated CR may complement self-reported cognitive examination.

Influencia del estatus socioeconómico sobre variables cognitivas y electroencefalográficas en escolares con riesgo de daño cerebral / Influence of socioeconomic status on cognitive and electroencephalographic variables school children at risk

Introducción: el estatus socioeconómico puede impactar sobre la cognición y la actividad eléctrica cerebral de los niños, por la influencia que tiene sobre el desarrollo durante etapas tempranas. Objetivo: evaluar la asociación de variables socioeconómicas, con alteraciones cognitivas y electroencefalográficas, en un grupo de niños escolares con riesgo de daño cerebral. Métodos: se estudiaron 42 niños mexicanos, de 6-7 años de edad. Se realizó un estudio socioeconómico a los padres y los niños fueron evaluados mediante la Evaluación Neuropsicológica Infantil (subpruebas de lectura-escritura y escala de signos neurológicos blandos), la Escala de Inteligencia de Wechsler para Niños, la Escala de Conners para Padres-Revisada y un electroencefalograma en diferentes edades. Resultados: con las variables socioeconómicas y, mediante un análisis de conglomerados, se encontraron 3 grupos que mostraban una adecuada diferenciación académica y económica entre sí. Por el método de clasificación basado en regresiones dispersas, se identificaron las variables que diferenciaban significativamente a los 3 grupos: problemas sociales, cognitivos, síntomas inatento, índice TDAH (Trastorno por Déficit de Atención e Hiperactividad, Escala de Conners para Padres-Revisada), lectura de palabras, comprensión en lectura de oraciones, dictado de sílabas, precisión de lectura en voz alta, lectura de sílabas, dictado de no palabras, movimiento de oposición digital, agarre de lápiz (Evaluación Neuropsicológica Infantil) y primer electroencefalograma normal. Conclusiones: el grupo con más desventajas socioeconómicas tuvo un peor desempeño en la lectoescritura y mayor prevalencia de actividad paroxística no epileptiforme; mientras que, el grupo con mayores ventajas socioeconómicas, mostró mejor desempeño en estas habilidades, mayor proporción de electroencefalogramas normales y una tendencia hacia problemas de atención(AU)

Introduction: the socioeconomic status can impact on the cognition and electrical brain activity of children due to the influence it has on the development during early stages. Objective: to evaluate the association of socioeconomic variables with cognitive and electroencephalographic alterations, in a group of school children at risk of brain damage. Methods: 42 Mexican children in the ages from 6 to 7 years old were studied. A socioeconomic study was conducted on the parents, and the children were evaluated through the Child Neuropsychological Assessment (reading-writing subtests and the scale of neurological soft signs), the Wechsler´s Intelligence Scale for Children, the Conners´ Scale for Parents-Revised and an electroencephalogram in different ages. Results: with the socioeconomic variables and by means of an analysis of conglomerate, 3 groups were found that showed an adequate academic and economic differentiation among themselves. By the classification method based on scattered regressions were identified variables that significantly differentiated the 3 groups: social and cognitive problems, inattentive symptoms, ADHD (Attention Deficit and Hyperactivity Disorder, Conners Scale for Parents-Revised), reading of words, comprehension in reading of sentences, dictation of syllables, accuracy of reading aloud, reading of syllables, dictation of non words, movement of digital opposition, pencil´s grip (Neuropsychological Evaluation of Children) and first normal electroencephalogram. Conclusions: the group with more socioeconomic disadvantages had a worse performance in reading and writing and a higher prevalence of non-epileptiform paroxysmal activity; whereas, the group with the greatest socioeconomic advantages showed a better performance in these skills, a greater proportion of normal electroencephalograms and a tendency towards attention problems(AU)

Influencia del estatus socioeconómico sobre variables cognitivas y electroencefalográficas en escolares con riesgo de daño cerebral / Influence of socioeconomic status on cognitive and electroencephalographic variables school children at risk

Introducción: el estatus socioeconómico puede impactar sobre la cognición y la actividad eléctrica cerebral de los niños, por la influencia que tiene sobre el desarrollo durante etapas tempranas. Objetivo: evaluar la asociación de variables socioeconómicas, con alteraciones cognitivas y electroencefalográficas, en un grupo de niños escolares con riesgo de daño cerebral. Métodos: se estudiaron 42 niños mexicanos, de 6-7 años de edad. Se realizó un estudio socioeconómico a los padres y los niños fueron evaluados mediante la Evaluación Neuropsicológica Infantil (subpruebas de lectura-escritura y escala de signos neurológicos blandos), la Escala de Inteligencia de Wechsler para Niños, la Escala de Conners para Padres-Revisada y un electroencefalograma en diferentes edades. Resultados: con las variables socioeconómicas y, mediante un análisis de conglomerados, se encontraron 3 grupos que mostraban una adecuada diferenciación académica y económica entre sí. Por el método de clasificación basado en regresiones dispersas, se identificaron las variables que diferenciaban significativamente a los 3 grupos: problemas sociales, cognitivos, síntomas inatento, índice TDAH (Trastorno por Déficit de Atención e Hiperactividad, Escala de Conners para Padres-Revisada), lectura de palabras, comprensión en lectura de oraciones, dictado de sílabas, precisión de lectura en voz alta, lectura de sílabas, dictado de no palabras, movimiento de oposición digital, agarre de lápiz (Evaluación Neuropsicológica Infantil) y primer electroencefalograma normal. Conclusiones: el grupo con más desventajas socioeconómicas tuvo un peor desempeño en la lectoescritura y mayor prevalencia de actividad paroxística no epileptiforme; mientras que, el grupo con mayores ventajas socioeconómicas, mostró mejor desempeño en estas habilidades, mayor proporción de electroencefalogramas normales y una tendencia hacia problemas de atención(AU)

Introduction: the socioeconomic status can impact on the cognition and electrical brain activity of children due to the influence it has on the development during early stages. Objective: to evaluate the association of socioeconomic variables with cognitive and electroencephalographic alterations, in a group of school children at risk of brain damage. Methods: 42 Mexican children in the ages from 6 to 7 years old were studied. A socioeconomic study was conducted on the parents, and the children were evaluated through the Child Neuropsychological Assessment (reading-writing subtests and the scale of neurological soft signs), the Wechsler´s Intelligence Scale for Children, the Conners´ Scale for Parents-Revised and an electroencephalogram in different ages. Results: with the socioeconomic variables and by means of an analysis of conglomerate, 3 groups were found that showed an adequate academic and economic differentiation among themselves. By the classification method based on scattered regressions were identified variables that significantly differentiated the 3 groups: social and cognitive problems, inattentive symptoms, ADHD (Attention Deficit and Hyperactivity Disorder, Conners Scale for Parents-Revised), reading of words, comprehension in reading of sentences, dictation of syllables, accuracy of reading aloud, reading of syllables, dictation of non words, movement of digital opposition, pencil´s grip (Neuropsychological Evaluation of Children) and first normal electroencephalogram. Conclusions: the group with more socioeconomic disadvantages had a worse performance in reading and writing and a higher prevalence of non-epileptiform paroxysmal activity; whereas, the group with the greatest socioeconomic advantages showed a better performance in these skills, a greater proportion of normal electroencephalograms and a tendency towards attention problems(AU)

Exploración de las propiedades psicométricas de la Batería Montreal de Evaluación de Amusia en una muestra de sujetos con epilepsia de lóbulo temporal / Exploration of the psychometric properties of the Montreal Battery of Evaluation of Amusia in a sample with temporal lobe epilepsy

ANTECEDENTES: La Batería Montreal de Evaluación de Amusia (MBEA) es un instrumento de reciente creación, utilizado para evaluar percepción y memoria musical asociadas al funcionamiento de lóbulos temporales. La epilepsia de lóbulo temporal no sintomática (ELTns) es una condición de alta prevalencia en México; esto proporciona una oportunidad para evaluar la MBEA, considerando que las crisis epilépticas pueden producir alteraciones neuropsicológicas específicas según la localización lobular y la lateralización de foco epileptogénico (LFE). OBJETIVO: Explorar las propiedades psicométricas y diagnósticas de la MBEA. MÉTODO: Dos muestras no probabilística de 31 controles y 22 casos de epilepsia ELTns fueron evaluados con la MBEA. Se utilizaron asimismo los datos estandarizados originales de la MBEA para comparación de controles. RESULTADOS: El análisis con prueba t mostró desempeños significativamente menores de los casos en comparación con los controles y significativamente menores entre controles y la norma. No se encontraron diferencias significativas en los puntajes según LFE. El análisis por Curvas ROC mostró propiedades cuestionables de sensibilidad y especificidad en la MBEA utilizando la ELTns como variable de estado. DISCUSIÓN Y CONCLUSIÓN: Se hallaron alteraciones en funciones de percepción musical en los casos; sin embargo, se detectaron inconsistencias teóricas con respecto a la relación de funciones afectadas. Las diferencias entre el grupo control y la norma apuntan a continuar evaluando la MBEA en población mexicana. La MBEA parece ser una medida poco precisa en términos de sensibilidad y especificidad para las alteraciones amúsicas en la ELTns, y su utilidad como medida de apoyo en la determinación de LFE permanece incierta.

BACKGROUND: The Montreal Battery of Evaluation of Amusia (MBEA) is a newly developed instrument to assess music perception and memory, associated to temporal lobe functioning. The non-symptomatic temporal lobe epilepsy is a prevalent condition in Mexico, and it gives an opportunity to test the MBEA, considering the fact that epileptic seizures can cause neuropsychological impairment according to lobar localization and hemispherical lateralization of the epileptogenic foci. OBJECTIVE: To explore the psychometric and diagnostic properties of the MBEA. METHOD: Two non-probabilistic samples of 31 control subjects and 22 cases with non-symptomatic temporal lobe epilepsy were assessed with the MBEA. Data from the original validation were used to compare with the control group. RESULTS: Analysis with t test showed significantly lower performances in the case group relative to controls, and a general lower performance of controls compared to the norm. There was no significant difference in performance between cases with left epileptogenic foci and cases with right epileptogenic foci. ROC curve analysis showed questionable properties of sensitivity and specificity in the MBEA. DISCUSSION AND CONCLUSION: Impairments in music perception were found in cases, although theoretical inconsistences with respect to relation between impaired functions were also detected. The performance of the control group relative to the norm aims to the continuation of the validation process, considering cultural differences. The MBEA seems to be a poor measure in terms of sensibility and specificity for the detection of amusic impairments in subjects with non-symptomatic temporal lobe epilepsy, and its utility for determining hemispheric lateralization of epileptogenic foci remains uncertain.

Positive impact of speech therapy in progressive non-fluent aphasia / Impacto positivo de la terapia del lenguaje en afasia progresiva no fluente / Impacto positivo da terapia da linguagem em afasia progressiva não fluente

The aim of this paper is to analyze the effects of intensive speech therapy intervention in a case of progressive non-fluent aphasia (PNFA). This is a dementia syndrome characterized by a progressive deficit in expressive language fluency and syntactic analysis, and by agrammatism and phonemic paraphasias. Although in the early stages there are no alterations in memory, comprehension, or visual processing, personality changes can slightly occur. To analyze the effects of speech therapy in this syndrome, a single case design with pre- and post-test was used. The participant was a male patient of 84 years with PNFA, who for twelve months received weekly speech therapy to stimulate the phonological, lexical and syntactic processing. He underwent neuropsychological assessment in three stages: six months before the onset of therapy, six months after therapy started and after completing 12 months of intervention. Assessment involved linguistic processing, general cognition, neuropsychiatric symptoms, quality of life (QOL) and activities of daily living (ADL). As a result of therapy, the patient showed a slight improvement in language prosody, fluency, and content of spontaneous speech, and a significant improvement in repetition, reading aloud, and oral-phonatory praxis. Other aspects of cognitive functioning (orientation, verbal naming, praxis, and memory) remained stable; ADLs and QOL improved. It is concluded that prolonged speech therapy can improve language processing and have a positive impact on other cognitive and socio-emotional processes in PNFA. This 12-month therapeutic stimulation not only slowed cognitive decline, but allowed to see maintenance of achievements and improvement of symptoms, which can be regarded as a success in PNFA treatment, considering the rapid progression of the disease.

El objetivo de este artículo es analizar los efectos de una intervención intensiva de terapia del lenguaje en un caso de afasia progresiva no fluente (APNF). Este es un síndrome demencial caracterizado por un déficit progresivo en la fluidez del lenguaje expresivo y el análisis sintáctico, y por agramatismo y parafasias fonémicas. Aunque en las primeras etapas no presenta alteraciones en la memoria, la comprensión o el procesamiento visual, sí pueden presentarse ligeros cambios en la personalidad. Para analizar los efectos de la terapia del lenguaje en este síndrome, se utilizó un diseño de caso único con pre y post prueba. El participante fue un paciente masculino de 84 años con APNF, quien durante doce meses recibió una terapia de lenguaje semanal para estimular el procesamiento fonológico, léxico y sintáctico. Se le realizó una evaluación neuropsicológica en tres etapas: seis meses antes del inicio de la terapia, después de seis meses de intervención, y al completar 12 meses de esta. Específicamente se evaluó el procesamiento lingüístico, la cognición general, los síntomas neuropsiquiátricos, la calidad de vida (CdV) y las actividades de la vida diaria (AVD). Como resultado de la terapia, el paciente mostró ligeras mejorías en la prosodia, la fluidez y el contenido del lenguaje espontáneo, y una mejoría significativa en la repetición, la lectura en voz alta y las praxias orofonatorias. Otros aspectos cognitivos (orientación, denominación verbal, praxias y memoria) se mantuvieron estables; las AVD y la CDV mejoraron. Se concluye que la terapia del lenguaje prolongada puede mejorar el procesamiento lingüístico y también tener un impacto positivo en otros procesos cognitivos y socio-emocionales en la APNF. La intervención no solo disminuyó la velocidad del deterioro cognitivo, sino que permitió ver el mantenimiento de los logros y la mejoría de los síntomas, lo cual es un éxito en el tratamiento de la APNF, debido a su rápida progresión.

O objetivo deste artigo é analisar os efeitos de uma intervenção intensiva de terapia da linguagem em um caso de afasia progressiva não fluente (APNF). Esta é uma síndrome demencial caracterizada por um déficit progressivo na fluência da linguagem expressiva e da análise sintática, e por agramatismo e parafasias fonêmicas. Ainda que nas primeiras etapas não presenta alterações na memória, na compreensão ou no processamento visual, podem aparecer pequenas mudanças na personalidade. Para analisar os efeitos da terapia da linguagem nesta síndrome, utilizou-se um desenho de caso único com testes antes e depois. O participante foi um paciente masculino de 84 anos com APNF, que durante doze meses recebeu uma terapia de linguagem semanal para estimular o processamento fonológico, léxico e sintático. Realizou-se uma avaliação neuropsicológica em três etapas: seis meses antes do início da terapia, depois de seis meses de intervenção, e ao completar 12 meses desta. Avaliou-se especificamente o processamento linguístico, a cognição geral, os sintomas neuropsiquiátricos, a qualidade de vida (QdV) e as atividades da vida diária (AVD). Como resultado da terapia, o paciente mostrou pequenas melhorias na prosódia, na fluência e no conteúdo da linguagem espontânea, e uma melhoria significativa na repetição, na leitura em voz alta e nas praxias orofonatórias. Outros aspectos cognitivos (orientação, denominação verbal, praxias e memória) mantiveram-se estáveis; as AVD e a QdV melhoraram. Conclui-se que a terapia da linguagem prolongada pode melhorar o processamento linguístico e também ter um impacto positivo em outros processos cognitivos e sócio emocionais na APNF. A intervenção diminuiu não somente a velocidade da deterioração cognitiva, senão que permitiu ver a manutenção dos êxitos e a melhoria dos sintomas, o que representa um sucesso no tratamento da APNF, devido a sua rápida progressão.

Executive functioning and adaptive coping in healthy adults.

Middle-aged individuals encounter multiple environmental demands to which they must develop efficient solutions, thus making the study of executive functions and coping strategies within this age group important. This study evaluated the relationship between the planning and flexible organization of executive function with adaptive coping strategies (ACS) in adults aged 43 to 52 years old. The study included 104 participants, including 52 men and 52 women, with no history of neurological or psychiatric illnesses, diabetes, or hypertension. The participants engaged in the Tower of London(DX) (TOL(DX)) test, the Wisconsin Card-Sorting Test (WCST), and the Coping Strategies Inventory. A relationship was observed between the percentage of errors and conceptual-level responses (WCST) and the Problem Solving ACS. In a separate analysis performed on the men, a negative relationship was discovered between the WCST and the Emotional Expression ACS. In the female group, the dimensions of the WCST and the TOL(DX) were associated with the ACS Emotional Expression and Problem-Solving subscales and the maladaptive coping strategy Social Withdrawal subscale. The relationship between executive functioning and the ACS is multidimensional, complex, and different between men and women. This study adds a neuropsychological characterization of the relationship between executive functions and ACS with ecological validity. The study confirms a relationship between the flexible organization of executive function and the Problem-Solving ACS.

Alteraciones neuropsicológicas asociadas en pacientes con infarto lacunar / Neuropsychological disorders associated with patients with lacunar infarct / Alterações neuropsicológicas associadas em pacientes com enfarte lacunar

Existe poca evidencia del deterioro cognoscitivo que defina el perfil del paciente con Infarto Lacunar (IL). El propósito de este estudio fue identificar las alteraciones neuropsicológicas en este tipo de pacientes. La muestra estuvo compuesta por 16 pacientes con IL y 16 participantes sanos con una edad promedio de 63 ± 9.41 y 64.75 ± 9.06 años y una escolaridad de 7.55 ± 4.34 y 7.94 ± 3.51, respectivamente. Se valoró la función cognoscitiva mediante un instrumento de tamizaje y una batería neuropsicológica. El análisis estadístico se llevó a cabo a través de la prueba Kruskal-Wallis y la U de Man-Whitney. Los pacientes con IL se caracterizan por la alteración de dominios como planeación, fluidez verbal, cambio atencional, habilidad visoconstructiva y velocidad de procesamiento de la información (p < 0.050). El IL se relaciona con el deterioro del funcionamiento ejecutivo y de velocidad de procesamiento, debido a la interrupción de circuitos frontocortico-subcorticales asociados con su correcto desempeño.

There is little evidence of cognitive impairment to define the profile of patients with Lacunar Infarction (IL). The purpose of this study was to identify the neuropsychological disorders in these patients. The sample consisted of 16 patients with IL and 16 healthy control participants with an average age of 63 ± 9.41 and 64.75 ± 9.06 years, and average schooling of 7.55 ± 4.34 and 7.94 ± 3.51, respectively. Cognitive function was assessed using a screening tool and a neuropsychological battery. Statistical analysis was carried out by the Kruskal-Wallis and Mann-Whitney U tests. Patients with IL are characterized by the alteration of domains such as planning, verbal fluency, attention switching, visoconstructive skill and information processing speed (p <0.050). The IL is related to the impairment of executive functioning and processing speed, due to the interruption of frontocortico-subcortical circuits associated with their proper performance.

Existe pouca evidência da deterioração cognoscitiva que defina o perfil do paciente com Enfarte Lacunar (IL). O propósito deste estudo foi identificar as alterações neuropsicológicas neste tipo de pacientes. A mostra foi composta por 16 pacientes com IL e 16 participantes sãos com uma idade média de 63 ± 9.41 e 64.75 ± 9.06 anos e uma escolaridade de 7.55 ± 4.34 e 7.94 ± 3.51, respectivamente. Avaliou-se a função cognoscitiva mediante um instrumento de tamizagem e uma bateria neuropsicológica. A análise estadística foi feita através do teste Kruskal-Wallis e a U de Man-Whitney. Os pacientes com IL se caracterizan pela alteração de dominios como planejamento, fluêcia verbal, mudança atencional, habilidade visoconstructiva e velocidade de processamento da informação (p < 0.050). O IL se relaciona com a deterioração do funcionamento executivo e da velocidade de processamento, devido à interrupção de circuitos frontocortico-subcorticais associados com seu correto desempenho.

Análisis del desempeño cognitivo de los enfermos con Parkinson: Importancia del nivel educativo / Analysis of cognitive performance in patients with Parkinson disease: The importance of educational level

Introducción. Las experiencias vitales, entre ellas la educación, capacitan a las personas para tolerar los efectos de una patología. En la enfermedad de Parkinson (EP) esta reserva cognitiva podría estar beneficiando el rendimiento cognitivo de los pacientes y actuando con un atenuador de los síntomas derivados de una posible demencia asociada. El objetivo de este trabajo es el de estudiar el efecto del nivel de educación sobre el rendimiento cognitivo en una muestra de pacientes con EP, e investigar si existe relación entre el nivel de educación adquirido, el deterioro cognitivo y el inicio de la enfermedad. Pacientes y método: La muestra estuvo compuesta por 30 pacientes con diagnóstico de Parkinson sin demencia, que fueron distribuidos en tres grupos dependiendo de su nivel de escolaridad (básica, media y superior), y a los que se les aplicó el MiniMental Parkinson (MMP) como medida de rendimiento cognitivo, y la escala autoaplicada para la evaluación de la depresión con el Inventario de Depresión de Beck (BDI), con el fin de descartar trastornos depresivos. Resultados: Se obtuvieron diferencias significativas entre el nivel de educación básico y los niveles medio y superior (p= 0,016, p= 0,003, respectivamente). No se encontraron efectos significativos con la edad de inicio de la EP entre los tres grupos analizados. El análisis de las subpruebas del MMP no arrojó diferencias significativas; sin embargo, se obtuvo una correlación moderada entre la subprueba de memoria y los años de escolaridad (r= 0,407, p< 0,005). Conclusiones: El nivel de educación puede estar afectando al rendimiento cognitivo en la vejez y funcionar como un atenuador de los síntomas, mejorando la habilidad adquirida del cerebro a través de la experiencia (e.g., educación), para tolerar los efectos de una patología (AU)

Introduction: Vital experiences, among them education, enable people to tolerate the effects of pathology. In Parkinson disease (PD) this cognitive reserve could benefit the patient’s cognitive performance and could act as an attenuator of derived symptoms from a possible associated dementia. The purpose of this study is to determine the effect of educational level on the cognitive performance in a sample of patients with PD and to investigate if there is any type of relation between acquired educational level, cognitive deterioration and the beginning of the disease. Patients and method: the sample consisted of 30 patients diagnosed with Parkinson disease without dementia, that were distributed in three groups according to their educational level (basic, middle and high), they were assessed with the Mini Mental Parkinson (MMP) test as a measurement method for the cognitive performance, and the self applied Beck’s Depression Inventory (BDI) scale to discard depressive disorders. Results: We obtained significant differences between the basic, the middle and the superior educational levels (p= 0,016, p= 0,003, respectively). We didn’t find significant effects differences involving the age of beginning of PD among the three groups analyzed. The analysis made to the subtests of the MMP didn’t show significant differences either. However , we obtained a moderate correlation between the memory subtest and the educational levels (r= 0,407, p< 0,005). Conclusions: The academic level may be affecting at some degree the cognitive performance in old age and act as an attenuator for the neurological pathology symptoms, improving the acquired brain abilities through experience (e.g. education). These results are interpreted in favor for the cognitive reserve hypothesis (AU)

Synthesis and new contributions in the study of obesity / Síntesis y nuevas aportaciones para el estudio de la obesidad

Obesity is a medical condition that affects millions of people around the world whose neurochemical, cognitive and environmental/social factors should be treated together for its better understanding. This review aims to analyse the latest research in order to understand the etiology and development of obesity with a focus on the most important aspects for treatment that extend beyond diet and exercise such as: a) the physiological mechanisms underlying energy homeostasis, b) cognitive deficits in executive functions, memory, attention and learning; c) emotional processing and stress d) environmental/social factors and e) body perception of obese individuals. It is necessary to integrate all these factors together with improvements in differential diagnosis and the clarification of role played by genetic and environmental factors in its etiology.

La obesidad es una condición clínica que afecta a millones de personas en todo el mundo y cuyos componentes neuroquímicos, cognitivos y ambientales/sociales deberían ser tratados de manera conjunta para su mejor comprensión. Esta revisión tiene por objetivo analizar las investigaciones más recientes, con el fin de comprender la etiología y desarrollo de la obesidad, centrando la atención en los aspectos más importantes para su tratamiento, y que van más allá del control de la dieta y el ejercicio físico, como son: a) los mecanismos fisiológicos que subyacen a la homeostasis energética; b) los déficit cognitivos en las funciones ejecutivas, la memoria, la atención y el aprendizaje; c) el procesamiento emocional y el estrés; d) los factores ambientales/sociales y, e) la percepción que la persona obesa tiene de su propio cuerpo. Resulta necesario integrar todos estos factores, junto a una mejora en el diagnóstico diferencial, y la clarificación del papel que juegan los factores genéticos y ambientales en su etiología.

[Emotion and recognition memory: the discrimination of negative information as an adaptive process]. / Emoción y memoria de reconocimiento: la discriminación de la información negativa como un proceso adaptativo.

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A´) and response bias (B´´D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive.

Estandarización de la Figura de Taylor en población mexicana / Taylor's Figure Standardization on Mexican population

In order to perform a neuropsychologycal evaluation, the clinician may use several instruments; nevertheless, most of them have been designed for use on populations with very different social and cultural backgrounds from that of Mexico. This makes the research on the standardization of methods of evaluation for Mexican population a very important task for both clinical and research settings. Normative data obtained from Mexican population is necessary because it provides the clinician that works with Mexican patients with a reference framework that allows him or her to correctly classify a particular behavior of an individual as normal or abnormal and thus make specific evaluations and cooperate in diagnostic. Researchers interested on cognitive functioning also require qualitative and quantitative equivalent instruments that may allow them to objectively evaluate the efficacy of short-time interventions as in a pre- and post-treatment experimental designs; and it is precisely for this reason that Taylor's figure was developed. Taylor's figure (TF) was originally designed as an alternative to Rey-Osterrieth's complex figure (ROCF), in order to use it in test-retest situations. Similar to ROCF, Taylor's figure has two modalities: copy and memory. The former evaluates constructional praxia, while the latter measures immediate recalling. Parallel tests, that is, different tests that evaluate the same variables, are useful because they reduce the measurement error involved in applying the task twice to the same person (i.e. learning), thus increasing the validity of follow up evaluations of cognitive functioning. <

Dentro del ámbito neuropsicológico existe una serie de instrumentos de evaluación que en su mayoría han sido diseñados en un contexto sociocultural diferente al nuestro, por lo que es importante contar con pruebas neuropsicológicas estandarizadas en sujetos mexicanos. Desde esta perspectiva, los datos de una población normativa nos permiten tener un marco de referencia para comparar y establecer diagnósticos diferenciales dentro de la práctica clínica. Asimismo, dentro del ámbito de la investigación se requieren instrumentos que en teoría sean equivalentes en cuanto a la función que evalúan para llevar un seguimiento sobre el funcionamiento cognoscitivo de una población en particular a lo largo del tiempo. La Figura de Taylor se diseñó como una alternativa a la Figura Compleja de Rey-Osterrieth para aplicarla en situaciones de test-retest. Consta de dos modalidades: una de copia que evalúa la praxia de construcción y otra de memoria inmediata. El término <

Emoción y memoria de reconocimiento: la discriminación de la información negativa como un proceso adaptativo / Emotion and recognition memory: The discrimination of negative information as an adaptive process

Se estudió el efecto de la emoción generada a través de fotografías del IAPS (International Affective Picture System) sobre el reconocimiento incidental de dichas fotografías con períodos de retención cortos (15 min). Se utilizaron tareas distractoras de memorización y tiempo de reacción, junto a tiempos de exposición breves (2 segundos por fotografía), con el fin de evitar que la elevada tasa de reconocimiento presente en este tipo de trabajos impida comprobar el efecto de la emoción sobre los parámetros de discriminación (A´) y sesgo de respuesta (B´´D) (efecto techo). Para este fin se utilizaron 80 fotografías representativas de los niveles medio y alto del espacio afectivo bidimensional. Los resultados informan de una mayor discriminación y un estilo de respuesta más conservador para las fotografías desagradables y las de arousal medio. Para este tipo de fotografías se obtuvo una mayor confianza y menores tiempos de respuesta en la fase de reconocimiento. Los resultados pueden explicarse por los efectos que el contenido negativo y el nivel de activación de las fotografías tienen sobre el procesamiento atencional y la memoria, e interpretarse como un fenómeno que resulta adaptativo evolutivamente (AU)

We studied the effect of emotion generated by IAPS (International Affective Picture System) pictures on incidental recognition of these pictures for short retention periods (15 min). Memorization distraction tasks and reaction time tasks were used together with short exposure times (2 seconds per picture) in order to prevent a high recognition rate that would impede testing for the effect of emotion on discrimination parameters (A´) and response bias (B´´D) (ceiling effect). We used 80 pictures representing the medium and high levels of two-dimensional emotional space. The results showed greater discrimination and a more conservative response style to unpleasant and medium arousal level pictures. These pictures produced higher confidence and lower response times in the recognition phase. The results can be explained by the negative content of the pictures and activation level effects on attentional processing and memory, and can be interpreted as a phenomenon that is evolutionarily adaptive (AU)

Visoconstructive deficits and risk of developing eating disorders.

In order to explore if neuropsychological deficits on visual constructional ability could be related to risk eating behaviors, a total of 102 women were evaluated, 51 of the participants had been formally diagnosed with eating disorders and 51 did not. All participants were given the Eating Attitude Test (EAT-40), The Rey-Osterrieth Complex Figure and The Tower of London Task. Results revealed the existence of a deficit on visual integration similar to those observed in other studies with diagnosed patients. The group at risk showed a comparatively reduced ability on the tasks and the control participants' execution was on the average. Findings revealed the need for designing studies to evaluate neuropsychological processes as possible risk factors which predict eating disorders.

Visoconstructive Deficits and Risk of Developing Eating Disorders

In order to explore if neuropsychological deficits on visual constructional ability could be related to risk eating behaviors, a total of 102 women were evaluated, 51 of the participants had been formally diagnosed with eating disorders and 51 did not. All participants were given the Eating Attitude Test (EAT-40), The Rey-Osterrieth ComplexFigure and The Tower of London Task. Results revealed the existence of a deficit on visual integration similar to those observed in other studies with diagnosed patients. The group at risk showed a comparatively reduced ability on the tasks and the control participants’ execution was on the average. Findings revealed the need for designing studies to evaluate neuropsychological processes as possible risk factors which predict eating disorders (AU)

A fin de explorar si las deficiencias neuropsicológicas en el proceso visoconstructivo están relacionadas con conductas alimentarias de riesgo, se evaluó un total de 102 mujeres, 51 presentaban conductas de riesgo y 51 no las presentaban. A todas las participantes se les aplicó el Cuestionario de Actitudes hacia la Alimentación (EAT-40); la Figura Compleja de Rey-Osterrieth y la Torre de Londres. Los resultados revelaron la existencia de un déficit en la integración visual similar al observado en otros estudios realizados con pacientes diagnosticadas. El grupo con riesgo mostró una reducción en tales habilidades en comparación con el desempeño de los participantes sin riesgo, mismo que estuvo dentro del promedio. Los hallazgos revelan la necesidad de diseñar estudios que evalúen los procesos neuropsicológicos como posibles factores predictores de los trastornos de la conducta alimentaria (AU)