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1.
Rev. neurol. (Ed. impr.) ; 66(supl.1): S65-S70, 1 mar., 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-171893

RESUMO

Introducción. El trastorno del espectro autista (TEA) es un trastorno del neurodesarrollo asociado con trastornos de la función ejecutiva, el lenguaje, la función emocional y la función social, cuyo sustrato anatomofuncional se relaciona con una desorganización de las conexiones funcionales cerebrales. El objetivo es investigar las conexiones cerebrales en sujetos con TEA mediante análisis de la coherencia interhemisférica (CIH) del electroencefalograma cuantificado y sus cambios tras la terapia asistida con delfines (TAD) frente a la intervención terapéutica sin delfines (ITSD). Pacientes y métodos. Se determinó la CIH en 44 sujetos con TEA antes de asignarse aleatoriamente a dos grupos de tratamiento: TAD (n = 22) e ITSD (n = 22). Los resultados se analizaron estadísticamente mediante el test de la ANOVA multimedida para los factores intrasujeto (tiempo) e intersujeto (TAD frente a ITSD). Resultados. La CIH mostró una reducción significativa (p < 0,05) para ambos grupos en las frecuencias delta, theta, beta y alfa (p < 0,001) en la región frontal anterior (F3-F4). Se halló también una reducción en la frecuencia alfa en la región central (C3-C4) (p < 0,05), y alfa (p < 0,05) y beta (p < 0,001) en la región temporal (T3-T4). En la intersección con el tratamiento específico (TAD), la coherencia en la banda alfa aumentó en Fp1-Fp2 (p < 0,05) y no descendió la delta en F3-F4 (p < 0,05). Conclusión. En niños de 5 años con TEA, la TAD aumenta la CIH en la región frontal anterior y estabiliza la tendencia a la reducción de la banda delta en la región frontal posterior (AU)


Introduction. Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with impairments in executive function, language, emotional function, and social function. Its anatomofunctional substrate is related to a disorganization of the brain’s functional connections. The aim is to investigate the cerebral connections in subjects with ASD through the analysis of the interhemispheric coherence (IHC) of the quantified electroencephalogram and its changes after dolphin assisted therapy (DAT) versus therapeutical intervention without dolphins (TIWD). Patients and methods. The IHC was determined in 44 subjects with ASD before randomly assigning them to two therapeutic groups: DAT (n = 22) and TIWD (n = 22). The results were statistically analyzed through the multi-measure ANOVA test for within-subject (time) and between-subject (DAT vs TIWD) factors. Results. The IHC showed a significant reduction (p < 0.05) for both groups in the delta, theta, beta, and alpha frequencies (p < 0.001) in the anterior frontal region (F3-F4), alpha in the central region (C3-C4) (p < 0.05), and alpha (p < 0.05) and beta (p < 0.001) in the temporal region (T3-T4). In the intersection with the specific treatment (DAT), the coherence in the alpha band increased in Fp1-Fp2 (p < 0.05), and the delta did not decline in F3-F4 (p < 0.05). Conclusion. In 5-year-old children with ASD, DAT increases the IHC in the anterior frontal region and stabilizes the tendency to reduce the delta band in the posterior frontal region (AU)


Assuntos
Humanos , Pré-Escolar , Terapia Assistida por Animais/métodos , Transtorno do Espectro Autista/terapia , Cérebro/fisiopatologia , Perciformes , Resultado do Tratamento , Avaliação de Resultado de Intervenções Terapêuticas , Eletroencefalografia/estatística & dados numéricos , Amostragem Aleatória Simples
2.
Rev. neurol. (Ed. impr.) ; 66(supl.1): S91-S96, 1 mar., 2018.
Artigo em Espanhol | IBECS | ID: ibc-171897

RESUMO

Introducción. La bibliografía actual reconoce un solapamiento de aspectos genéticos, clínicos y neuropsicológicos entre el trastorno del espectro del autismo (TEA) y el trastorno por déficit de atención/hiperactividad (TDAH), sugiriendo que podría existir un patrón común que abarca desde la etiología genética y estructural común hasta patrones sintomatológicos compartidos. Objetivo. Revisar los avances actuales en estos aspectos comunes. Desarrollo. Se han encontrado trabajos que apuntan a dificultades atencionales preescolares en la base de ambos trastornos. Desde la perspectiva genética, se estima que un 50-72% de factores genéticos se solapan entre ambos trastornos. También comparten una disminución del volumen del cuerpo calloso y la sustancia gris frontal izquierda, y alteraciones funcionales como la hipoactivación prefrontal dorsolateral, estriadotalámica y parietal superior. Se encuentran resultados en cuanto al funcionamiento ejecutivo, con perfiles diferenciales para ambas condiciones, y también sobre la relación de los comportamientos repetitivos e impulsivos en las primeras etapas en TEA, con los problemas hiperactivos posteriores. Conclusiones. Esta nueva concepción del continuo TEA-TDAH, con una base neuroevolutiva común y características clínicas asociadas, podría ser de gran utilidad para la práctica clínica y se sugiere considerar la asociación a la hora de plantear el tratamiento (AU)


Introduction. The current literature acknowledges an overlap of genetic, clinical and neuropsychological aspects between autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), suggesting that there may be a common pattern that covers features ranging from the common genetic and structural aetiology to shared patterns of symptoms. Aim. To review the current advances in these common aspects. Development. Several studies have pointed out preschool attentional difficulties as the basis of both disorders. From the genetic perspective, it is estimated that 50-72% of the genetic factors overlap between the two disorders. They also share a decrease in the volume of the corpus callosum and left frontal grey matter, as well as functional alterations such as dorsolateral prefrontal, striato-thalamic and superior parietal hypoactivation. Results are also found regarding executive functioning, with differential profiles for the two conditions, and also concerning the relationship between the repetitive and impulsive behaviours in the early stages of ASD and ensuing problems of hyperactivity. Conclusions. This new conception of the ASD-ADHD continuum, with a common neurodevelopmental basis and associated clinical features, could be of great use in clinical practice. It is suggested that this association should be taken into account when it comes to deciding on the treatment (AU)


Assuntos
Humanos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Espectro Autista/complicações , Comorbidade , Diagnóstico Precoce , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Transtornos de Aprendizagem/diagnóstico , Função Executiva , Transtornos Cognitivos/diagnóstico
3.
Rev Neurol ; 60 Suppl 1: S13-8, 2015 Feb 25.
Artigo em Espanhol | MEDLINE | ID: mdl-25726817

RESUMO

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a disorder of a biological origin affecting the neurodevelopment of the brain. It is estimated that 3-7% of school-age children present ADHD. The most commonly used pharmacological treatments are amphetamines and methylphenidate (MPH). Although response rates to MPH are high, full remission rates reach only 56%. The 25% of patients who do not respond to MPH would show a response to other stimulants and vice-versa. AIMS. To clinically evaluate patients by detecting inadequate responses and the efficacy of a change to lisdexamfetamine dimesylate (LDX). PATIENTS AND METHODS: The study was prospective and observation-based. Inadequate responses were considered to be those that presented non-coverage or no effect. The Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV) and Clinical Global Impression-Severity (CGI-S) assessment scales were used for the clinical assessment, together with the Weiss Functional Impairment Rating Scale (WFIRS) and the Child Health and Illness Profile (CHIP-AE). Data regarding adverse side effects were also collected. RESULTS: Forty-one patients met criteria for inadequate response to treatment: 13.6 ± 3.4 years, 54.6 ± 13.2 kg, 158.5 ± 17.2 cm and body mass index of 20.9 ± 3.5 kg/m2. Reasons for change (non-exclusive): non-coverage (76%), lack of intensity of effect (68%) and presence of adverse side effects with the previous medication (16%). The mean score both at baseline and at nine months, on the ADHD-RS, was 24.54 ± 6.3 versus 12.01 ± 3.2 (p < 0.01), respectively, and for the CGI-S values were 5.09 ± 0.5 versus 2.91 ± 0.8 (p < 0.01), respectively. The safety profile coincided with that of other stimulant-based treatments for ADHD. CONCLUSIONS: When the response to MPH presents non-coverage or lack of effect, changing to LDX has proved to be effective, with an improvement in 86.7% of cases, which is similar to that of other studies. It is therefore a good therapeutic option in these patients.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Dimesilato de Lisdexanfetamina/uso terapêutico , Adolescente , Criança , Feminino , Humanos , Masculino , Estudos Prospectivos , Falha de Tratamento
4.
Rev Neurol ; 60 Suppl 1: S69-74, 2015 Feb 25.
Artigo em Espanhol | MEDLINE | ID: mdl-25726827

RESUMO

INTRODUCTION: The difficulties that patients with attention deficit hyperactivity disorder (ADHD) have when it comes to emotional regulation have aroused a great deal of interest in recent years and there is a line of research working on the identification of the neurophysiological correlates. AIMS: To analyse measures of emotional functioning and their correlation with the P300 component in a sample of children with ADHD with and without treatment. PATIENTS AND METHODS: The sample was made up of 71 children with ADHD, almost half of whom were taking some form of medication. The auditory potential P300 was analysed. The parents filled in a scale to assess executive behaviour at home, the Behavior Rating Inventory of Executive Function (BRIEF), which the emotional self-regulation index and the emotional expression scale were taken from. RESULTS: Significant correlations were found between the amplitude of the P300 and the emotional self-regulation index from the version of the BRIEF for preschoolers, and a relation was observed between P300 latency and the severity of the symptoms. CONCLUSIONS: The results highlight the usefulness of evoked potentials for the study of executive correlates and associated conditions in the day-to-day functioning of children with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Emoções , Potencial Evocado P300 , Autocontrole , Criança , Feminino , Humanos , Masculino
5.
Rev. neurol. (Ed. impr.) ; 60(supl.1): s13-s18, mar. 2015. graf
Artigo em Espanhol | IBECS | ID: ibc-134366

RESUMO

Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) es un trastorno del neurodesarrollo cerebral de origen biológico. Se estima que el 3-7% de los niños en edad escolar presentan TDAH. Dentro del tratamiento farmacológico, las anfetaminas y el metilfenidato (MPH) son los más utilizados. Aunque las tasas de respuesta al MPH son altas, las tasas de remisión completa llegan sólo al 56%. Un 25% de los pacientes que no responden al MPH sí lo haría a otros estimulantes, y viceversa. Objetivo. Valorar clínicamente a los pacientes con detección de respuestas inadecuadas y la eficacia de un cambio a lisdexanfetamina dimesilato (LDX). Pacientes y métodos. Estudio observacional prospectivo. Se consideró respuesta inadecuada al MPH aquella que presentaba falta de cobertura o de efecto. Se utilizaron las escalas de evaluación Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV) y Clinical Global Impression-Severity (CGI-S) para la valoración clínica, así como la escala de evaluación del deterioro funcional de Weiss (WFIRS) y el perfil de salud infantil (CHIP-AE). También se recogieron los efectos adversos. Resultados. Cumplieron criterios de respuesta inadecuada al tratamiento 41 pacientes: 13,6 ± 3,4 años, 54,6 ± 13,2 kg, 158,5 ± 17,2 cm e índice de masa corporal de 20,9 ± 3,5 kg/m2. Motivos del cambio (no excluyentes): falta de cobertura (76%), falta de intensidad del efecto (68%) y presencia de efectos adversos con la medicación anterior (16%). La puntuación media basal y a los nueve meses, en la ADHD-RS, fue de 24,54 ± 6,3 frente a 12,01 ± 3,2 (p < 0,01), respectivamente, y para la CGI-S, de 5,09 ± 0,5 frente a 2,91 ± 0,8 (p < 0,01), respectivamente. El perfil de seguridad coincidió con el de otros tratamientos estimulantes para el TDAH. Conclusión. Cuando la respuesta al MPH presenta falta de cobertura o falta de efecto, el cambio a LDX se ha mostradoeficaz, con una mejoría en el 86,7% de los casos, similar a la de otros estudios, por lo que resulta una buena opción terapéutica en estos pacientes (AU)


Introduction. Attention deficit hyperactivity disorder (ADHD) is a disorder of a biological origin affecting the neurodevelopment of the brain. It is estimated that 3-7% of school-age children present ADHD. The most commonly used pharmacological treatments are amphetamines and methylphenidate (MPH). Although response rates to MPH are high, full remission rates reach only 56%. The 25% of patients who do not respond to MPH would show a response to other stimulants and vice-versa. Aims. To clinically evaluate patients by detecting inadequate responses and the efficacy of a change to lisdexamfetamine dimesylate (LDX). Patients and methods. The study was prospective and observation-based. Inadequate responses were considered to be hose that presented non-coverage or no effect. The Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV) and Clinical Global Impression-Severity (CGI-S) assessment scales were used for the clinical assessment, together with the Weiss Functional Impairment Rating Scale (WFIRS) and the Child Health and Illness Profile (CHIP-AE). Data regarding adverse side effects were also collected. Results. Forty-one patients met criteria for inadequate response to treatment: 13.6 ± 3.4 years, 54.6 ± 13.2 kg, 158.5 ± 17.2 cm and body mass index of 20.9 ± 3.5 kg/m2. Reasons for change (non-exclusive): non-coverage (76%), lack of intensity of effect (68%) and presence of adverse side effects with the previous medication (16%). The mean score both at baseline and at nine months, on the ADHD-RS, was 24.54 ± 6.3 versus 12.01 ± 3.2 (p < 0.01), respectively, and for the CGI-S values were 5.09 ± 0.5 versus 2.91 ± 0.8 (p < 0.01), respectively. The safety profile coincided with that of other stimulant-based treatments for ADHD. Conclusions. When the response to MPH presents non-coverage or lack of effect, changing to LDX has proved to be effective, with an improvement in 86.7% of cases, which is similar to that of other studies. It is therefore a good therapeutic option in these patients (AU)


Assuntos
Humanos , Masculino , Feminino , Terapêutica/instrumentação , Terapêutica/métodos , Tratamento Farmacológico/métodos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Pacientes Desistentes do Tratamento/educação , Estudos Observacionais como Assunto/métodos , Terapêutica/psicologia , Terapêutica , Tratamento Farmacológico/instrumentação , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Pacientes Desistentes do Tratamento/psicologia , Estudos Observacionais como Assunto/instrumentação , Estudos Prospectivos
6.
Rev. neurol. (Ed. impr.) ; 60(supl.1): s69-s74, mar. 2015. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-134375

RESUMO

Introduction. The difficulties that patients with attention deficit hyperactivity disorder (ADHD) have when it comes to emotional regulation have aroused a great deal of interest in recent years and there is a line of research working on the identification of the neurophysiological correlates. Aims. To analyse measures of emotional functioning and their correlation with the P300 component in a sample of children with ADHD with and without treatment. Patients and methods. The sample was made up of 71 children with ADHD, almost half of whom were taking some form of medication. The auditory potential P300 was analysed. The parents filled in a scale to assess executive behaviour at home, the Behaviour Rating Inventory of Executive Function (BRIEF), which the emotional self-regulation index and the emotional expression scale were taken from. Results. Significant correlations were found between the amplitude of the P300 and the emotional self-regulation index from the version of the BRIEF for preschoolers, and a relation was observed between P300 latency and the severity of the symptoms. Conclusions. The results highlight the usefulness of evoked potentials for the study of executive correlates and associated conditions in the day-to-day functioning of children with ADHD (AU)


Introducción. Las dificultades de regulación emocional en los pacientes con trastorno por déficit de atención/hiperactividad (TDAH) han despertado un interés marcado en los últimos años, y existe una línea de trabajo en la identificación de correlatos neurofisiológicos. Objetivo. Analizar, en una muestra de niños con TDAH con y sin tratamiento, medidas de funcionamiento emocional y su correlación con el componente P300. Pacientes y métodos. La muestra constaba de 71 niños con TDAH, de los que casi la mitad tomaba medicación. Se analizó el potencial P300 auditivo. Los padres cumplimentaron una escala de comportamiento ejecutivo en el hogar –Behavior Rating Inventory of Executive Function (BRIEF)-, de la que se tomó el índice de autorregulación emocional, y la escala de expresión emocional. Resultados. Se hallaron correlaciones significativas entre la amplitud del P300 y el índice de autorregulación emocional de la versión para preescolares del BRIEF, y se encontró relación entre la latencia del P300 y la gravedad de los síntomas. Conclusión. Los resultados enfatizan la utilidad de los potenciales evocados para el estudio de correlatos ejecutivos y condiciones asociadas en el funcionamiento diario de los niños con TDAH (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Sintomas Afetivos/diagnóstico , Sintomas Afetivos/psicologia , Neurotransmissores/administração & dosagem , Neurotransmissores/farmacologia , Transtornos do Desenvolvimento da Linguagem/genética , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Sintomas Afetivos/classificação , Sintomas Afetivos/terapia , Neurotransmissores/metabolismo , Neurotransmissores/provisão & distribução , Transtornos do Desenvolvimento da Linguagem/terapia , Epidemiologia Descritiva
7.
Rev Neurol ; 58 Suppl 1: S43-9, 2014 Feb 24.
Artigo em Espanhol | MEDLINE | ID: mdl-25252667

RESUMO

INTRODUCTION: The prevalence of attention deficit hyperactivity disorder (ADHD) in patients with epilepsy stands at around 30-40%, especially the inattentive subtype, while other studies on children diagnosed with ADHD show figures that vary from 6.1% to 30% which present alterations in the electroencephalogram and epilepsy problems. Although clinical practice guidelines advise against treatment with psychostimulants in ADHD that is comorbid with epilepsy, especially when the latter is not considered active, some researchers and practitioners recommend caution as regards beginning this pharmacological therapy, while less research has been conducted on the use of non-psychostimulants. AIM: To review the patient records of children with epilepsy and ADHD who received pharmacological treatment with psychostimulants and non-psychostimulants for an attention disorder. PATIENTS AND METHODS: The study involved a sample of 23 patients aged 5-16 years. The type of epilepsy and the clinical course and electroencephalogram were analysed at both one and two years after beginning pharmacological treatment of ADHD. RESULTS: At two years, one patient presented a crisis and two patients continued to display paroxysmal activity in the electroencephalogram. CONCLUSIONS: The data presented show that pharmacological treatment of ADHD does not exacerbate the epilepsy in well-controlled patients, although it is advisable to take into account factors such as the type of antiepileptic drug, the type of drug for ADHD and the cognitive profile, in order to favour a satisfactory development. In epileptic children with learning difficulties, it is necessary to evaluate the mechanisms involved in attentional processes, since they may well be compromised and in need of a more specific treatment.


Assuntos
Cloridrato de Atomoxetina/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Epilepsia/complicações , Metilfenidato/uso terapêutico , Adolescente , Cloridrato de Atomoxetina/efeitos adversos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Estimulantes do Sistema Nervoso Central/efeitos adversos , Criança , Pré-Escolar , Gerenciamento Clínico , Eletroencefalografia/efeitos dos fármacos , Feminino , Seguimentos , Humanos , Masculino , Metilfenidato/efeitos adversos , Estudos Retrospectivos
8.
Rev Neurol ; 58 Suppl 1: S51-6, 2014 Feb 24.
Artigo em Espanhol | MEDLINE | ID: mdl-25252668

RESUMO

INTRODUCTION: Deficit in the executive functions has been widely studied in attention deficit hyperactivity disorder (ADHD). The interest in its neurophysiological correlates has led to an improvement in the identification of the symptoms, the characteristics and the treatment of the disorder. AIMS: The objective of this study was to analyse the correlation between latency and amplitude of the P300 component and an ecological measure of working memory in a sample of adolescents. PATIENTS AND METHODS: The sample consisted of 24 boys and 7 girls aged between 12 and 18 years. P300 cognitive evoked potentials in auditory mode at Cz were registered and analysed. Furthermore, the parents filled in an executive behaviour home rating scale (BRIEF), which the working memory index was extracted from. RESULTS: Significant correlations were found between the P300 amplitude and the working memory index of the BRIEF-P. CONCLUSIONS: Results underline the usefulness of the P300 component for the study of its executive correlates, as well as the need to conduct further studies involving larger samples and greater complexity.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Potencial Evocado P300/fisiologia , Transtornos da Memória/fisiopatologia , Memória de Curto Prazo/fisiologia , Estimulação Acústica , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Transtornos da Memória/etiologia , Tempo de Reação , Índice de Gravidade de Doença
9.
Rev. neurol. (Ed. impr.) ; 58(supl.1): 43-49, 24 feb., 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-119461

RESUMO

Introducción. La prevalencia del trastorno por déficit de atención/hiperactividad (TDAH) en pacientes con epilepsia se sitúa en torno al 30-40%, especialmente del subtipo inatento, mientras que, a su vez, distintos estudios sobre niños diagnosticados de TDAH muestran cifras variables del 6,1-30% que presentan alteraciones en el electroencefalograma y problemas de epilepsia. Aunque las guías de práctica clínica no desaconsejan el tratamiento con psicoestimulantes en el TDAH comórbido con epilepsia, en especial si ésta no se considera activa, algunos investigadores y clínicos recomiendan ser cautos en el inicio de esta terapia farmacológica, mientras que el uso de no psicoestimulantes está menos estudiado. Objetivo. Revisar las historias clínicas de niños con epilepsia y TDAH que recibieron tratamiento farmacológico con psicoestimulantes y no psicoestimulantes para el trastorno de atención. Pacientes y métodos. Muestra de 23 pacientes de 5-16 años. Se analizó el tipo de epilepsia y la evolución clínica y lectroencefalográfica al año y a los dos años tras el inicio del tratamiento farmacológico del TDAH. Resultados. A los dos años, un paciente presentó una crisis y dos pacientes continuaban mostrando actividad paroxística en el electroencefalograma. Conclusión. Los datos presentados muestran que el tratamiento farmacológico del TDAH no empeora la epilepsia en pacientes bien controlados, aunque se recomienda tener en cuenta factores como el tipo de fármaco antiepiléptico, el tipo de fármaco para el TDAH, así como el perfil cognitivo, para favorecer un desarrollo adecuado. En los niños epilépticos con dificultades del aprendizaje, deben valorarse los mecanismos de los procesos atencionales que puedan estar alterados y que precisen un tratamiento específico (AU)


Introduction. The prevalence of attention deficit hyperactivity disorder (ADHD) in patients with epilepsy stands at around 30-40%, especially the inattentive subtype, while other studies on children diagnosed with ADHD show figures that vary from 6.1% to 30% which present alterations in the electroencephalogram and epilepsy problems. Although clinical practice guidelines advise against treatment with psychostimulants in ADHD that is comorbid with epilepsy, especially when the latter is not considered active, some researchers and practitioners recommend caution as regards beginning this pharmacological therapy, while less research has been conducted on the use of non- sychostimulants. Aim. To review the patient records of children with epilepsy and ADHD who received pharmacological treatment with psychostimulants and non-psychostimulants for an attention disorder. Patients and methods. The study involved a sample of 23 patients aged 5-16 years. The type of epilepsy and the clinical course and electroencephalogram were analysed at both one and two years after beginning pharmacological treatment of ADHD. Results. At two years, one patient presented a crisis and two patients continued to display paroxysmal activity in the electroencephalogram. Conclusions. The data presented show that pharmacological treatment of ADHD does not exacerbate the epilepsy in well-controlled patients, although it is advisable to take into account factors such as the type of antiepileptic drug, the type of drug for ADHD and the cognitive profile, in order to favour a satisfactory development. In epileptic children with learning difficulties, it is necessary to evaluate the mechanisms involved in attentional processes, since they may well be compromised and in need of a more specific treatment (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Metilfenidato/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Epilepsia/tratamento farmacológico , Anticonvulsivantes/uso terapêutico , Cognição , Segurança do Paciente
10.
Rev. neurol. (Ed. impr.) ; 58(supl.1): 51-56, 24 feb., 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-119462

RESUMO

Introducción. El déficit en funciones ejecutivas ha sido ampliamente estudiado en el trastorno por déficit de atención/hiperactividad (TDAH). El interés por sus correlatos neurofisiológicos apunta a una mejora en la identificación de los síntomas, las características y los tratamientos para el trastorno. Objetivo. Analizar, en una muestra de adolescentes con TDAH, la correlación entre la latencia y amplitud del componente P300 y una medida ecológica de memoria de trabajo. Pacientes y métodos. La muestra estuvo compuesta por 24 chicos y 7 chicas de 12 a 18 años. Se realizó un registro y análisis de potenciales evocados cognitivos P300 en modalidad auditiva en Cz. Además, los padres cumplimentaron una escala de comportamiento ejecutivo en el hogar (BRIEF), de la que se extrajo el índice de memoria de trabajo. Resultados. Se hallaron correlaciones significativas entre la amplitud del P300 y el índice de memoria de trabajo del BRIEF-P. Conclusión. Los resultados enfatizan la utilidad del componente P300 para el estudio de sus correlatos ejecutivos, y la necesidad de ampliar con estudios que aporten mayores muestras y mayor complejidad (AU)


Introduction. Deficit in the executive functions has been widely studied in attention deficit hyperactivity disorder (ADHD). The interest in its neurophysiological correlates has led to an improvement in the identification of the symptoms, the characteristics and the treatment of the disorder. Aims. The objective of this study was to analyse the correlation between latency and amplitude of the P300 component and an ecological measure of working memory in a sample of adolescents. Patients and methods. The sample consisted of 24 boys and 7 girls aged between 12 and 18 years. P300 cognitive evoked potentials in auditory mode at Cz were registered and analysed. Furthermore, the parents filled in an executive behavior home rating scale (BRIEF), which the working memory index was extracted from. Results. Significant correlations were found between the P300 amplitude and the working memory index of the BRIEF-P. Conclusions. Results underline the usefulness of the P300 component for the study of its executive correlates, as well as the need to conduct further studies involving larger samples and greater complexity (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Proteína p300 Associada a E1A/análise , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Memória de Curto Prazo/fisiologia , Potenciais Evocados , Cognição/fisiologia , Função Executiva
11.
Rev Neurol ; 56 Suppl 1: S107-18, 2013 Feb 22.
Artigo em Espanhol | MEDLINE | ID: mdl-23446712

RESUMO

INTRODUCTION: Evoked potentials P300 and the analysis of executive functions have shown their utility in the monitoring of patients with symptoms of attention deficit hyperactivity disorder (ADHD). PATIENTS AND METHODS: Neuropsychological profiles and evoked potentials P300 have been analysed for two groups of children with an ADHD treatment with atomoxetine and methylphenidate respectively. Correlations between P300 and the selected neuropsychological parameters are studied, and the differences between basal values and 1 year follow-up are analysed. Two groups were performed: a group of 22 children ADHD in the atomoxetine condition, and a group of 24 children ADHD in the methylphenidate condition. RESULTS: The results show a global improvement of all the parameters, in terms of executive function and P300 values in both, the atomoxetine and the methylphenidate group. CONCLUSION: Executive functions and evoked potentials P300 reflect an underlying processing and they are very useful in the clinical practice. This exploratory study shows the importance of designing personalized objective variables-based treatments.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Potencial Evocado P300 , Função Executiva , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Criança , Feminino , Humanos , Masculino
12.
Rev. neurol. (Ed. impr.) ; 56(supl.1): S107-S118, 22 feb., 2013. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-111690

RESUMO

Introducción. Los potenciales evocados P300 y el análisis de funciones ejecutivas han demostrado ser una herramienta de gran utilidad en el seguimiento de los pacientes con trastorno por déficit de atención/hiperactividad (TDAH). Pacientes y métodos. Se analizan los perfiles neuropsicológicos y potenciales P300 de dos grupos de niños con clínica de TDAH que han sido tratados con atomoxetina y metilfenidato, respectivamente. Se estudia la correlación entre el P300 y los parámetros neuropsicológicos seleccionados, y se analizan las diferencias antes y después de un año de tratamiento. Resultados. Los resultados muestran una mejoría significativa global de los parámetros evaluados, en términos de funcionamiento ejecutivo, y también la valoración de potenciales evocados P300, tanto en el grupo tratado con atomoxetina como en el grupo tratado con metilfenidato. Conclusión. El estudio de las funciones ejecutivas y potenciales evocados P300 constituye un reflejo del procesamiento subyacente, de gran utilidad para la práctica clínica. Este estudio exploratorio muestra la relevancia de diseñar tratamientos personalizados y basados en variables objetivas (AU)


Introduction. Evoked potentials P300 and the analysis of executive functions have shown their utility in the monitoring of patients with symptoms of attention deficit hyperactivity disorder (ADHD). Patients and methods. Neuropsychological profiles and evoked potentials P300 have been analysed for two groups of children with an ADHD treatment with atomoxetine and methylphenidate respectively. Correlations between P300 and the selected neuropsychological parameters are studied, and the differences between basal values and 1 year follow-up are analysed. Two groups were performed: a group of 22 children ADHD in the atomoxetine condition, and a group of 24 children ADHD in the methylphenidate condition. Results. The results show a global improvement of all the parameters, in terms of executive function and P300 values in both, the atomoxetine and the methylphenidate group. Conclusion. Executive functions and evoked potentials P300 reflect an underlying processing and they are very useful in the clinical practice. This exploratory study shows the importance of designing personalized objective variables-based treatments (AU)


Assuntos
Humanos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Potencial Evocado P300 , Função Executiva , Metilfenidato/farmacocinética , Testes Neuropsicológicos , Potenciais Evocados
13.
Rev Neurol ; 54 Suppl 3: S41-53, 2012 May 21.
Artigo em Espanhol | MEDLINE | ID: mdl-22605631

RESUMO

INTRODUCTION. Attention deficit hyperactivity disorder (ADHD) is the most frequent neurodevelopmental problem in childhood, with significant repercussions that continue into adulthood. This means that an appropriate therapeutic intervention is vital to improve its prognosis. AIMS. To identify the ideal pharmacological options according to the characteristics of the patient and to report on the new drugs. DEVELOPMENT. The work analyses how therapeutic interventions can be conditioned by the anatomical substrate of the brain, the biochemical bases, genetics, neurophysiological examinations, neuropsychological studies and the clinical symptoms and subtypes. A significant amount of importance is granted to neuropsychological studies, especially those dealing with the executive functions, including evaluation of attention, impulse control, and interference and cognitive flexibility. Taking into consideration the signal-to-noise characteristics can be useful when it comes to choosing the drug. CONCLUSIONS. The development of the pharmacological therapeutic options in ADHD opens up expectations concerning applicability and greater specificity in daily practice to fit the characteristics of each patient. Psychoeducation must always be included and a thorough study of each particular child is recommended. This should involve analysing the neuropsychological features of his or her brain function in order to be able to reflect on the ideal pharmacological option that allows more favourable progress.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Psicotrópicos/uso terapêutico , Transtorno do Deficit de Atenção com Hiperatividade/classificação , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/genética , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Encéfalo/patologia , Encéfalo/fisiopatologia , Mapeamento Encefálico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/farmacocinética , Estimulantes do Sistema Nervoso Central/uso terapêutico , Criança , Pré-Escolar , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/etiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/fisiopatologia , Drogas em Investigação/uso terapêutico , Diagnóstico Precoce , Eletroencefalografia , Potenciais Evocados , Função Executiva/efeitos dos fármacos , Estudos de Associação Genética , Predisposição Genética para Doença , Humanos , Modelos Biológicos , Neuroimagem/métodos , Testes Neuropsicológicos , Neurotransmissores/metabolismo , Prognóstico
14.
Rev. neurol. (Ed. impr.) ; 54(supl.3): s41-s53, 21 mayo, 2012. ilus
Artigo em Espanhol | IBECS | ID: ibc-100106

RESUMO

Introducción. El trastorno por déficit de atención/hiperactividad (TDAH) es la problemática más frecuente del neurodesarrollo infantil con repercusiones significativas que se prolongan hasta la edad adulta, por lo que una adecuada intervención terapéutica es decisiva para su mejor pronóstico. Objetivos. Identificar las opciones farmacológicas idóneas en función de las características del paciente y describir los nuevos fármacos. Desarrollo. Se analiza cómo las intervenciones terapéuticas pueden estar condicionadas por el sustrato anatómico cerebral, las bases bioquímicas, la genética, las exploraciones neurofisiológicas, los estudios neuropsicológicos, y los síntomas y subtipos clínicos. Se da importancia relevante a los estudios neuropsicológicos, especialmente de las funciones ejecutivas, incluyendo la valoración de la atención, controles de impulsos, e interferencia y flexibilidad cognitiva. Las consideraciones sobre las características señal-ruido pueden ser útiles para la elección del fármaco. Conclusiones. El desarrollo de las opciones terapéuticas farmacológicas en el TDAH abre expectativas de aplicabilidad y mayor especificidad en la práctica diaria en función de las características propias del paciente. La psicoeducación siempre debe incluirse y es recomendable un estudio riguroso de cada niño en particular, analizando las características propias neuropsicológicas de su función cerebral para razonar sobre la opción farmacológica idónea que posibilite una evolución más favorable (AU)


Introduction. Attention deficit hyperactivity disorder (ADHD) is the most frequent neurodevelopmental problem in childhood, with significant repercussions that continue into adulthood. This means that an appropriate therapeutic intervention is vital to improve its prognosis. ims. To identify the ideal pharmacological options according to the characteristics of the patient and to report on the new drugs. Development. The work analyses how therapeutic interventions can be conditioned by the anatomical substrate of the brain, the biochemical bases, genetics, neurophysiological examinations, neuropsychological studies and the clinical symptoms and subtypes. A significant amount of importance is granted to neuropsychological studies, especially those dealing with the executive functions, including evaluation of attention, impulse control, and interference and cognitive flexibility. Taking into consideration the signal-to-noise characteristics can be useful when it comes to choosing the drug. Conclusions. The development of the pharmacological therapeutic options in ADHD opens up expectations concerning applicability and greater specificity in daily practice to fit the characteristics of each patient. Psychoeducation must always be included and a thorough study of each particular child is recommended. This should involve analysing the neuropsychological features of his or her brain function in order to be able to reflect on the ideal pharmacological option that allows more favourable progress (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/farmacocinética , Eletroencefalografia , Testes Neuropsicológicos , Potenciais Evocados , Giro do Cíngulo/fisiopatologia , Clonidina/farmacocinética
15.
Rev Neurol ; 54 Suppl 1: S131-5, 2012 Feb 29.
Artigo em Espanhol | MEDLINE | ID: mdl-22374765

RESUMO

INTRODUCTION AND AIMS: . In this work we analyse the syntax used by children diagnosed with attention deficit hyperactivity disorder (ADHD) when writing texts with a narrative and argumentative superstructure. The basic data analysed are the ratio of syntactic complexity and the relative distribution of verb tenses, assuming that in fusional languages like Spanish the TAM system (tense, aspect, mode) is the direct linguistic correlate of the executive functions related with the management of temporality. SUBJECTS AND METHODS: Children between 8 and 13 years of age were asked to write narrative and argumentative texts; data were obtained in clinical contexts. The use of complex syntactic structures and verb conjugation were analysed both quantitatively and qualitatively. RESULTS AND CONCLUSIONS: The children with ADHD displayed lower values in terms of levels of syntactic complexity and used fewer subordinate clauses than the children in the control group in both types of texts. As far as verb tenses are concerned, they used a higher proportion of prototypical tenses, that is to say, the present simple in argumentation and the imperfect indicative in narrative texts.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Transtornos da Linguagem/etiologia , Linguística , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Criança , Linguagem Infantil , Função Executiva , Humanos , Narração , Testes Neuropsicológicos , Comunicação Persuasiva , Tempo , Vocabulário , Redação
16.
Rev Neurol ; 54 Suppl 1: S95-103, 2012 Feb 29.
Artigo em Espanhol | MEDLINE | ID: mdl-22374778

RESUMO

INTRODUCTION: Cognitive evoked potentials (P300) have been core of interest in attention deficit hyperactivity disorder (ADHD) research. The identification of its relationship with the most ecological aspects of executive dysfunction involves a link between neurophysiological and functional frames for a better treatment approach and monitoring of the evolution of the disorder. AIMS: To explore the differences in latency and amplitude of P300 component in Cz, Fz and Pz, between ADHD and no-ADHD children, and to analyze the correlations between variables of P300 and indexes of a measurement of executive functioning at home. SUBJECTS AND METHODS: Two groups were performed: an ADHD group of 16 children with a diagnosis of combined ADHD; and a group of 8 children without ADHD. Cognitive event-related potentials (P300) were registered and analyzed in an auditory and a visual modality. In addition, fathers fulfilled an executive behavior scale -Behavior Rating Inventory for Executive Function (BRIEF)-. RESULTS. The differences between the ADHD and the control group were significant, in visual and auditory latencies and in visual amplitudes. Significant correlations were found between some variables of P300 component and the BRIEF subscales. CONCLUSION: These results remark the utility of cognitive evoked potentials for the executive dysfunction in ADHD research, and emphasize the necessity of keeping the clinical assessment in diagnosis and monitoring of these children.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Potencial Evocado P300 , Função Executiva , Estimulação Acústica , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Comportamento Infantil , Potencial Evocado P300/fisiologia , Potenciais Evocados Auditivos/fisiologia , Potenciais Evocados Visuais/fisiologia , Feminino , Humanos , Entrevista Psicológica , Masculino , Testes Neuropsicológicos , Pais/psicologia , Inventário de Personalidade , Estimulação Luminosa , Tempo de Reação
17.
Rev. neurol. (Ed. impr.) ; 54(supl.1): s95-s103, 29 feb., 2012. tab
Artigo em Espanhol | IBECS | ID: ibc-99621

RESUMO

Introducción. Los potenciales evocados cognitivos (P300) han sido centro de interés en el estudio del trastorno por déficit de atención/hiperactividad (TDAH). Identificar su relación con los aspectos más ecológicos del déficit ejecutivo supone una conexión entre el ámbito neurofisiológico y funcional para un mejor abordaje del tratamiento y seguimiento de la evolución del trastorno. Objetivos. Explorar las diferencias en latencia y amplitud del componente P300 entre un grupo de niños con TDAH y un grupo de controles sin TDAH, y examinar las correlaciones entre las variables del P300 y los índices de una medida de funcionamiento ejecutivo en el hogar. Sujetos y métodos. Participaron dos grupos: un grupo experimental (TDAH), formado por 16 niños y niñas con diagnóstico de TDAH subtipo combinado, y un grupo control (sin TDAH), formado por 8 niños y niñas. Se realizó un registro y análisis de potenciales evocados cognitivos P300 en las modalidades auditiva y visual Cz. Además, los padres cumplimentaron una escala de comportamiento ejecutivo en el hogar –Behavior Rating Inventory for Executive Function (BRIEF)–. Resultados. Las diferencias resultaron significativas entre el grupo con TDAH y el grupo control, en las latencias visual y auditiva y en la amplitud visual del P300. Se hallaron correlaciones significativas entre algunas variables del P300 y los índices del BRIEF. Conclusión. Estos resultados ponen de manifiesto la utilidad de los potenciales evocados cognitivos para el estudio de la disfunción ejecutiva en el TDAH, y se enfatiza la necesidad de mantener la valoración clínica en el diagnóstico y seguimiento de estos niños (AU)


Introduction. Cognitive evoked potentials (P300) have been core of interest in attention deficit hyperactivity disorder (ADHD) research. The identification of its relationship with the most ecological aspects of executive dysfunction involves a link between neurophysiological and functional frames for a better treatment approach and monitoring of the evolution of the disorder. Aims. To explore the differences in latency and amplitude of P300 component in Cz, Fz and Pz, between ADHD and no-ADHD children, and to analyze the correlations between variables of P300 and indexes of a measurement of executive functioning at home. Subjects and methods. Two groups were performed: an ADHD group of 16 children with a diagnosis of combined ADHD;and a group of 8 children without ADHD. Cognitive event-related potentials (P300) were registered and analyzed in an auditory and a visual modality. In addition, fathers fulfilled an executive behavior scale –Behavior Rating Inventory for Executive Function (BRIEF)–. Results. The differences between the ADHD and the control group were significant, in visual and auditory latencies and in visual amplitudes. Significant correlations were found between some variables of P300 component and the BRIEF subscales. Conclusion. These results remark the utility of cognitive evoked potentials for the executive dysfunction in ADHD research, and emphasize the necessity of keeping the clinical assessment in diagnosis and monitoring of these children (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Potenciais Evocados , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Função Executiva/fisiologia , Análise e Desempenho de Tarefas
18.
Rev. neurol. (Ed. impr.) ; 54(supl.1): s131-s135, 29 feb., 2012. graf
Artigo em Espanhol | IBECS | ID: ibc-99625

RESUMO

Introducción y objetivos. En este trabajo se analiza la sintaxis utilizada por niños con diagnóstico de trastorno por déficit de atención/hiperactividad (TDAH) en la redacción de textos de superestructura narrativa y argumentativa. Los datos básicos analizados son la ratio de complejidad sintáctica y la distribución relativa de los tiempos verbales, asumiendo que en las lenguas fusionantes como el español el sistema TAM (tiempo, aspecto, modo) es el correlato lingüístico directo de las funciones ejecutivas relacionadas con la gestión de la temporalidad. Sujetos y métodos. Se solicitó a niños de entre 8 y 13 años la elaboración de textos narrativos y argumentativos escritos; los datos se obtuvieron en contextos clínicos. Se analizó cualitativa y cuantitativamente la utilización de estructuras sintácticas complejas y de la conjugación verbal. Resultados y conclusiones. Los niños con TDAH desarrollan valores menores en los niveles de complejidad sintáctica y utilizan menos subordinadas que los niños del grupo control en ambos tipos de texto; por lo que se refiere a los tiempos verbales, emplean en mayor proporción los tiempos prototípicos, es decir, presente de indicativo en la argumentación e imperfecto de indicativo en la narración (AU)


Introduction and aims. In this work we analyse the syntax used by children diagnosed with attention deficit hyperactivity disorder (ADHD) when writing texts with a narrative and argumentative superstructure. The basic data analysed are the ratio of syntactic complexity and the relative distribution of verb tenses, assuming that in fusional languages like Spanish the TAM system (tense, aspect, mode) is the direct linguistic correlate of the executive functions related with the management of temporality. Subjects and methods. Children between 8 and 13 years of age were asked to write narrative and argumentative texts; data were obtained in clinical contexts. The use of complex syntactic structures and verb conjugation were analysed both quantitatively and qualitatively. Results and conclusions. The children with ADHD displayed lower values in terms of levels of syntactic complexity and used fewer subordinate clauses than the children in the control group in both types of texts. As far as verb tenses are concerned, they used a higher proportion of prototypical tenses, that is to say, the present simple in argumentation and the imperfect indicative in narrative texts (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Leitura , Dislexia/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Compreensão
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