Evaluación de la versión española del Memory Impairment Screen / Evaluation of the spanish version of the memory impairment screen

Introducción. Los tests de cribado para detectar demenciassuelen ser largos, en ocasiones difíciles de aplicar, y precisancierto instrucción previa. El Memory Impairment Screen (MIS) esun test de cribado de fácil aplicación y rápido (3-4 minutos) queevalúa la memoria verbal a corto plazo. Objetivo. Evaluar la utilidaddel MIS para el cribado de demencia en nuestra población.Sujetos y métodos. Evaluamos a 101 sujetos, divididos en 49 sujetoscon demencia según los criterios DMS-IV y 52 sujetos sin deteriorocognitivo. Se estudiaron variables demográficas (edad, sexo,escolaridad) y los resultados de la escala de deterioro global, eltest minimental (MMSE) de Folstein, el MIS, la fluidez verbalsemántica (FVS) y el test del reloj a la orden (TRO). Análisis estadístico:se compararon variables demográficas y los resultados delos tests entre los grupos con y sin demencia, y se determinaron losparámetros de utilidad diagnóstica y áreas bajo la curva ROC(aROC). Resultados. No hubo diferencias significativas entre lasvariables sociodemográficas excepto una edad media mayor en elgrupo con demencia. El MIS mostró una sensibilidad del 83,7%(IC 95%: 71-97,9), mayor que la FVS y TRO, y una especificidaddel 94,2% (IC 95%: 84,4-98), mayor que el MMSE y la FVS. ElaROC del MIS fue de 0,935 (IC 95%: 0,954-1,006). Conclusión.Estos resultados demuestran que el MIS es un buen test de cribadode demencia, que podría emplearse por su sencillez y aplicaciónrápida en nuestra población

Introduction. Screening tests for detecting dementias are usually long, sometimes difficult to apply, and require acertain amount of instruction prior to using them. The Memory Impairment Screen (MIS) is a fast (3-4 minutes), easy-to-applyscreening test that evaluates short-term verbal memory. Aim. To evaluate the value of the MIS for screening for dementia inour population. Subjects and methods. We evaluated 101 subjects who were divided into two groups, one consisting of 49individuals with dementia according to DMS-IV criteria and the other made up of 52 subjects with no cognitive impairment.Demographic variables (sex, age, schooling) were studied together with the results from the Global Deterioration Scale, theFolstein Mini-Mental State Examination (MMSE), the MIS, the Semantic Verbal Fluency (SVF) and the Command-ConditionClock Test (CCCT). Statistical analysis: demographic variables and the results from the tests for the two groups (with andwithout dementia) were compared, and the parameters for diagnostic usefulness and the areas under the ROC (aROC) weredetermined. Results. No significant differences were found between the sociodemographic variables except for a higher meanage in the group with dementia. The MIS showed a sensitivity of 83.7% (95% CI: 71-97.9), which was higher than the SVF andthe CCCT, and a specificity of 94.2% (95% CI: 84.4-98), which was higher than the MMSE and the SVF. The aROC of the MISwas 0.935 (95% CI: 0.954-1.006). Conclusions. These findings show that the MIS is a good test for screening for dementia,and its simplicity and quick application could make it suitable for use in our population

[Evaluation of the Spanish version of the Memory Impairment Screen]. / Evaluación de la versión española del Memory Impairment Screen.

INTRODUCTION: Screening tests for detecting dementias are usually long, sometimes difficult to apply, and require a certain amount of instruction prior to using them. The Memory Impairment Screen (MIS) is a fast (3-4 minutes), easy-to-apply screening test that evaluates short-term verbal memory. AIM: To evaluate the value of the MIS for screening for dementia in our population. SUBJECTS AND METHODS: We evaluated 101 subjects who were divided into two groups, one consisting of 49 individuals with dementia according to DMS-IV criteria and the other made up of 52 subjects with no cognitive impairment. Demographic variables (sex, age, schooling) were studied together with the results from the Global Deterioration Scale, the Folstein Mini-Mental State Examination (MMSE), the MIS, the Semantic Verbal Fluency (SVF) and the Command-Condition Clock Test (CCCT). STATISTICAL ANALYSIS: demographic variables and the results from the tests for the two groups (with and without dementia) were compared, and the parameters for diagnostic usefulness and the areas under the ROC (aROC) were determined. RESULTS: No significant differences were found between the sociodemographic variables except for a higher mean age in the group with dementia. The MIS showed a sensitivity of 83.7% (95% CI: 71-97.9), which was higher than the SVF and the CCCT, and a specificity of 94.2% (95% CI: 84.4-98), which was higher than the MMSE and the SVF. The aROC of the MIS was 0.935 (95% CI: 0.954-1.006). CONCLUSIONS: These findings show that the MIS is a good test for screening for dementia, and its simplicity and quick application could make it suitable for use in our population.

Asimetrías neuroquímicas en las alteraciones psiquiátricas / Neurochemical asymmetries in psychiatric disorders

La asimetría cerebral se podría definir como la existencia de una diferencia anatómica, funcional o bioquímica entre ambos hemisferios cerebrales. Más que estático se trata de un concepto dinámico en el que diversos factores endógenos y ambientales actúan como moduladores. Además, el desarrollo y el envejecimiento modifican la asimetría cerebral y algunas alteraciones neuropsiquiátricas ­como, por ejemplo, la esquizofrenia, la depresión, el autismo infantil o la enfermedad de Alzheimer­ se caracterizan en parte por un desequilibrio en determinadas asimetrías cerebrales. Sin embargo, no está claro si estos cambios son causa o consecuencia de tales alteraciones. Aunque la asimetría cerebral es un fenómeno ampliamente estudiado, su significado funcional y las bases neuroquímicas que subyacen a las asimetrías anatómicas y/o funcionales aún no han sido del todo dilucidados. En el presente trabajo se revisa la bibliografía más significativa referente a la asimetría cerebral en el ser humano, así como las alteraciones psiquiátricas más destacadas en las que se han descrito desequilibrios en la asimetría cerebral, incidiendo especialmente en los aspectos neuroquímicos de ésta

Brain asymmetry can be defined as an anatomical, functional or neurochemical difference between the two hemispheres. It is not a static but is rather a dynamic phenomenon in which both environmental and endogenous factors act as modulators. Moreover, aging modifies brain asymmetry, and an imbalance in specific asymmetries characterizes some brain disorders such as schizophrenia, depression, infantile autism and Alzheimer's disease. However, it is not clear whether these changes are a cause or a consequence of these disorders. Although this phenomenon has been extensively studied, its functional significance is not yet clear, and the neurochemical bases underlying anatomical or functional asymmetries in the brain are still poorly understood. In the present article the most important literature on human brain asymmetry, as well as the most significant psychiatric disorders in which imbalances in brain asymmetry have been described are reviewed, with special emphasis on its neurochemical component

Pineal modulation of the rat caudate-putamen spontaneous neuronal activity: roles of melatonin and vasotocin.

The effects of microiontophoretic application of melatonin and melatonin plus vasotocin on spontaneously active neurons of caudate-putamen in sham-operated and pinealectomized rats were studied. Extracellular unit recordings showed that in sham-pinealectomized rats, melatonin ejection primarily produced inhibition of the responsive neurons (74.1%), whereas only 24.9% of the neurons were excited. Iontophoretic ejection of vasotocin or melatonin+vasotocin produced, in both cases, an inhibition of 100% of the responsive neurons. In pinealectomized rats, iontophoretic melatonin ejection produced a similar percentage of inhibition (46.1%) and excitation (53.8%) of the responsive neurons. The simultaneous ejection of melatonin+vasotocin further increased the percentage of inhibition (88.8%) compared with the melatonin only treated group. Moreover, iontophoretic ejection of vasotocin inhibited 100% of the responsive neurons in pinealectomized rats. The actions of melatonin and vasotocin seem to be specific, because their effects are dependent on the amount of these compounds ejected, i.e., the intensity of the ejection current. These results indicate that the pineal compounds melatonin and vasotocin are neuromodulators of spontaneous neuronal activity of the rat caudate-putamen.

Paradoxical effects of melatonin on spontaneous neuronal activity in the striatum of sham-operated and pinealectomized rats.

The acute effects of intravenous melatonin on spontaneously active striatal neurons in sham-operated and pinealectomized rats were studied. Extracellular recordings in a total of 76 neurons showed that only 19 did not modify their spontaneous activity after melatonin injection. In sham-pinealectomized rats, neural firing decreased in most cells (80% of neurons), and increased in only 5.7% of the neurons after indole administration (100 ng/kg body weight). However, in the group of rats pinealectomized 7 days earlier, the injection of melatonin (at the same dose as above) significantly increased the excitatory response (44%), while the number of cells showing inhibitory response decreased (17%). Moreover, a small percentage (4.9%) of neurons in pinealectomized rats displayed a biphasic response (initial decrease followed by an increased firing). These results demonstrate that aMT can modulate the activity of striatal neurons, and suggest that other compounds of pineal origin (e.g., vasotocin) may change effects of aMT on basal ganglia neurons.