Autism Spectrum Disorders: Assessment of cognitive abilities using the non-verbal SON-R 6-40 / Transtorno do Espectro Autista: Avaliação de habilidades cognitivas utilizando o teste não-verbal SON-R 6-40

Abstract Cognition in individuals with Autism Spectrum Disorder (ASD) shows large variability. Nonverbal tests can be more suitable for cognitive assessment in this group. We investigated cognitive abilities in ASD using the SON-R 6-40 Nonverbal Intelligence Test. A total of 37 individuals with ASD (AG) aged 6-24 years participated. Cognitive assessment of the AG was done using the SON-R 6-40 and performance compared with the standardized sample which served as the control group (CG). Results showed lower subtest scores in the AG than in the CG. Approximately 84% of the AG had intellectual disability according to IQ scores. Individuals with preserved speech in the AG had higher IQ scores than patients without preserved speech. There was no relationship between intelligence and ASD symptom severity as reported by families.

Resumo A cognição de indivíduos com Transtorno do Espectro Autista (TEA) apresenta grande variabilidade. Testes não-verbais podem ser mais adequados para avaliação cognitiva desta população. Investigou-se as habilidades cognitivas de indivíduos com TEA a partir do desempenho no Teste não verbal de inteligência SON-R 6-40. Participaram 37 indivíduos com TEA (GTEA) entre 6 e 24 anos, cujo desempenho no SON-R 6-40 foi comparado ao da amostra normativa do instrumento (GC). Houve pior desempenho do GTEA em todos os subtestes, com diferença significativa em relação ao GC. Quase 84% do GTEA apresentou QI compatível com deficiência intelectual. Aqueles com fala preservada apresentaram desempenho superior ao grupo não-verbal. Não houve relação entre inteligência e gravidade dos sintomas conforme relato das famílias.

Perfil cognitivo de uma criança com diagnóstico prévio de dislexia do desenvolvimento associada a distúrbio do processamento auditivo central: estudo de caso / Cognitive Profile of a Child with Prior Diagnosis of Developmental Dyslexia Associated with Central Auditory Processing Disorder: Case Study

OBJETIVO: Este estudo fez uma análise comparativa do perfil cognitivo de uma criança com diagnóstico prévio de Dislexia do Desenvolvimento (DD) associada a Distúrbio do Processamento Auditivo Central, com perfis de DD descritos na literatura. MÉTODOS: Os domínios cognitivos da linguagem, memória, habilidades acadêmicas, percepção viso-motora, atenção, velocidade de processamento e funções executivas foram investigados por meio de uma bateria de testes neuropsicológicos. Paralelamente à testagem, foi realizada uma pesquisa bibliográfica sobre os perfis de DD descritos na literatura. RESULTADOS: Os resultados mostraram rebaixamento do Índice de Organização Perceptual em relação aos demais no WISC-IV. Os domínios da linguagem, habilidades acadêmicas e habilidades viso-espaciais mostraram-se deficitários quando comparados a crianças da mesma faixa etária e ao desempenho do próprio sujeito nos domínios da memória, atenção e funções executivas menos complexas. CONCLUSÃO: Em concordância com perfis de DD investigados na literatura, o perfil cognitivo do paciente confirmou: 1. Déficits no processamento fonológico. 2. Desempenho acadêmico com níveis rebaixados. 3. Disfunções executivas de planejamento, automonitoramento e raciocínio abstrato. 4. Dificuldades na formação, articulação e compreensão de conceitos verbais. 5. Erros ortográficos característicos e problemas específicos na leitura. 6. Dificuldades na memória de trabalho fonológica e memória semântica. 7. Memória episódica preservada. Divergindo de outros perfis descritos na literatura, este estudo mostrou: 1. Índice de Memória Operacional no WISC-IV dentro da faixa média. 2. Índice de Organização Perceptual rebaixado, na faixa limítrofe. 3. Comprometimento das habilidades viso-construtivas.

OBJECTIVE: This study had the purpose to do a comparative analysis of the cognitive profile of a child with prior diagnosis of Developmental Dyslexia (DD) associated with Central Auditory Processing Disorder, with the DD's profiles described in the literature. METHODS: The cognitive domains of language, memory, academic abilities, perceptual abilities, attention, speed processing and executive functions were investigated through a battery of neuropsychological tests. Additionally, a literature review about the cognitive profiles of DD was conducted. RESULTS: The results showed low Perceptual Reasoning Index in the WISC-IV. The domains of language, academic abilities and perceptual organization were limited comparing to other children at the same age and to the results of the patient in the domains of attention, memory and non-complex executive functions. CONCLUSION: In accordance with the DD profiles investigated in the literature, the patient's cognitive profile showed: 1. Phonological deficits. 2. Poor school achievement. 3. Executive dysfunctions related to planning, self-monitoring and abstract reasoning. 4. Problems in forming, articulating and understanding verbal concepts. 5. Characteristic reading and misspelling errors. 6. Deficits in the phonological working memory and semantic memory. 7. Episodic memory preserved. Differing from the profiles depicted in the literature, this study showed: 1. Working Memory Index in WISC-IV in normal levels. 2. Lowered Perceptual Reasoning Index. 3. Deficits in visual-perceptual skills.

Variações cariotípicas na Síndrome de Turner: uma análise do fenótipo cognitivo / Karyotypic variations in Turner Syndrome: an analysis of the cognitive phenotype

A Síndrome de Turner é uma condição genética que resulta da deleção do segundo cromossomo sexual (45, X). Todavia, alguns indivíduos apresentam uma mistura de linhagens celulares, que é conhecida como mosaicismo. Nas mulheres com a deleção completa existe uma discrepância cognitiva entre habilidades verbais e não-verbais, sendo estas últimas as mais afetadas. Entretanto, acredita-se que a heterogeneidade genética é uma das responsáveis por variações no fenótipo cognitivo desses indivíduos. Assim, o objetivo do estudo foi investigar diferenças nas habilidades verbais e não-verbais, avaliadas pelas Escalas de Inteligência Wechsler, em 5 mulheres com Síndrome de Turner e diferentes cariótipos. O estudo revelou que a variação cariotípica refletiu em diferenças no perfil cognitivo das participantes. Tais resultados são importantes, uma vez que influenciam diretamente os métodos de avaliação e intervenção de uma população específica, além de indicar como tal variação genética atua sobre a cognição.(AU)

Turner syndrome is a genetic condition that results from deletion of the second sex chromosome (45, X). However some individuals exhibit a mixture of cells, which is known as mosaicism. In women with complete deletion there is a cognitive discrepancy between verbal and non-verbal skills, the latter being the most affected. Nevertheless, it is believed that genetic heterogeneity is one of the points responsible for variations in the individuals' cognitive phenotype. Thus, this study aimed to investigate differences in verbal and non-verbal abilities, evaluated by the Wechsler Intelligence scales, in 5 Turner syndrome women with different karyotypes. The study revealed that karyotype variation reflected in differences in the participants' cognitive profile. Such results are important since they directly influence the methods of assessment and intervention of a specific population, as well as indicating how such genetic variation impacts on cognition.(AU)

Variações cariotípicas na Síndrome de Turner: uma análise do fenótipo cognitivo / Karyotypic variations in Turner Syndrome: an analysis of the cognitive phenotype

A Síndrome de Turner é uma condição genética que resulta da deleção do segundo cromossomo sexual (45, X). Todavia, alguns indivíduos apresentam uma mistura de linhagens celulares, que é conhecida como mosaicismo. Nas mulheres com a deleção completa existe uma discrepância cognitiva entre habilidades verbais e não-verbais, sendo estas últimas as mais afetadas. Entretanto, acredita-se que a heterogeneidade genética é uma das responsáveis por variações no fenótipo cognitivo desses indivíduos. Assim, o objetivo do estudo foi investigar diferenças nas habilidades verbais e não-verbais, avaliadas pelas Escalas de Inteligência Wechsler, em 5 mulheres com Síndrome de Turner e diferentes cariótipos. O estudo revelou que a variação cariotípica refletiu em diferenças no perfil cognitivo das participantes. Tais resultados são importantes, uma vez que influenciam diretamente os métodos de avaliação e intervenção de uma população específica, além de indicar como tal variação genética atua sobre a cognição.

Turner syndrome is a genetic condition that results from deletion of the second sex chromosome (45, X). However some individuals exhibit a mixture of cells, which is known as mosaicism. In women with complete deletion there is a cognitive discrepancy between verbal and non-verbal skills, the latter being the most affected. Nevertheless, it is believed that genetic heterogeneity is one of the points responsible for variations in the individuals' cognitive phenotype. Thus, this study aimed to investigate differences in verbal and non-verbal abilities, evaluated by the Wechsler Intelligence scales, in 5 Turner syndrome women with different karyotypes. The study revealed that karyotype variation reflected in differences in the participants' cognitive profile. Such results are important since they directly influence the methods of assessment and intervention of a specific population, as well as indicating how such genetic variation impacts on cognition.

Perfil cognitivo dos alunos com dificuldades de aprendizagem na leitura e matemática / Cognitive profile of students with learning difficulties in reading and mathematics / Perfil cognitivo de los alumnos con dificultades de aprendizaje en lectura y matemática

A coocorrência entre as dificuldades na leitura e na matemática é frequente, indicando que as habilidades cognitivas comuns subjacentes a tais dificuldades possam estar deficitárias. A pesquisa aqui descrita analisa as habilidades cognitivas que estão na base das aprendizagens da leitura e da matemática, contribuindo para a prática pedagógica nessas áreas. Trata-se de um estudo transversal de caráter quantitativo em que foram identificadas funções cognitivas de 79 alunos do 3º ao 6º ano do ensino fundamental, divididos em quatro grupos: com dificuldades na leitura, na matemática, nas duas áreas e sem dificuldades. Obtivemos o perfil cognitivo dos grupos com tarefas de processamento fonológico, senso numérico, memória de trabalho e estratégias de contagem e recuperação da memória. Cada grupo apresentou um perfil cognitivo único, indicando necessidades educacionais diversas. Os resultados alertam para a importância da estimulação do processamento fonológico e do senso numérico, habilidades ainda pouco conhecidas pela escola brasileira.

The co-occurrence of difficulties in reading and mathematics is frequent, indicating that common cognitive skills underlying these difficulties may be impaired. The study aims to analyse the cognitive abilities which are in the basis of acquisition of both reading and mathematics skills contributing to the educational practice in these areas. This is a cross-sectional, quantitative study that identified cognitive functions of 79 students from 3rd to 6th grade of elementary school. The students were divided into four groups: difficulties in reading, in mathematics, in both areas and the control group. We assessed the cognitive profile of the students through tasks in volving: phonological processing, number sense, working memory, counting strategies and arithmetic fact retrieval. Each group showed a unique cognitive profile indicating different educational needs. The results urge attention to the importance of the stimulation of phonological processing and number sense, abilities which are still unknown by Brazilian schools.

La co-ocurrencia de dificultades en lectura y matemática son frecuentes, lo que indica que habilidades cognitivas comunes que subyacen a estas dificultades pueden ser deficientes. La investigación descrita aquí examina las habilidades cognitivas que subyacen en el aprendizaje de lectura y matemática, lo que contribuye a la práctica pedagógica en estas áreas. Se trata de un estudio transversal, de carácter cuantitativo, en el que se identificaron las funciones cognitivas de los 79 estudiantes de 3º al 6º año de la escuela primaria, divididos en cuatro grupos: con dificultades en lectura, en matemática, en las dos áreas y sin dificultades. Se ha observado el perfil cognitivo de los grupos con tareas de procesamiento fonológico, sentido numérico, memoria de trabajo y estrategias para contar y recuperación de la memoria. Cada grupo presentó un perfil cognitivo único que indica diversas necesidades educativas. Los resultados ponen de relieve la importancia de la estimulación del procesamiento fonológico y el sentido numérico, habilidades estas aún poco conocidas por la escuela brasileña.

Cognitive impairment and antiretroviral treatment in a Peruvian population of patients with human immunodeficiency virus.

BACKGROUND: HIV-associated cognitive impairment occurs even in the early stages of infection. Short-term memory, psychomotor speed, attention, and executive functioning are the main capacities affected. Controversy exists regarding whether highly active antiretroviral therapy (HAART) is helpful in combating this process. The objective of the present study is to determine the association between cognitive impairment and HAART in HIV-infected patients from Hospital Regional de Huacho. METHODS: Prospective study of HIV patients meeting criteria to start HAART. Twenty-one HIV-positive patients were recruited between April and July 2011. Researchers administered a standardised neuropsychological test battery before and 4 weeks after onset of HAART. Psychomotor speed, executive function, short term memory (visual and verbal), attention, and visuospatial performance were evaluated. RESULTS: Nineteen patients completed the study (14 males and 5 females). In the pre-HAART evaluation, most patients scored below average on the executive function and psychomotor speed subtests. Psychomotor speed and immediate visual memory improved significantly after four months of treatment with HAART. CONCLUSIONS: Some degree of cognitive decline may present even in the early and asymptomatic stages of HIV infection. The benefits of antiretroviral treatment for cognitive performance can be detected after only a few weeks of follow-up.

Perfil cognitivo en pacientes con infección por el virus de inmunodeficiencia humana neurológicamente asintomáticos / Cognitive profile in human immunodeficiency virus-infected neurologically asymptomatic patients

Introducción: Diversos estudios han comunicado la presencia de deterioro cognitivo asociado al virus de inmunodeficiencia humana (VIH) tipo 1, aún en estadios tempranos de la infección. Las principales funciones comprometidas son la memoria a corto plazo, velocidad psicomotriz, atención y función ejecutiva. Objetivos: Describir el perfil cognitivo en pacientes con VIH neurológicamente asintomáticos, antes de iniciar terapia antirretroviral de gran actividad (TARGA), y determinar posibles factores asociados. Diseño: Estudio transversal-analítico. Lugar: Hospital Regional de Huacho. Participantes: Pacientes con VIH y con criterios para ingresar a TARGA. Intervenciones: Veintiún pacientes con VIH, que fueron atendidos desde de abril a julio de 2011, fueron evaluados clínicamente y se les administró una batería neuropsicológica estandarizada. Principales medidas de resultados: Puntajes alcanzados en las pruebas de velocidad psicomotriz, función ejecutiva, memoria inmediata, atención y habilidades visuoespaciales. Resultados: El 47,6% de pacientes presentó un deterioro cognitivo significativo. Los pacientes fallaron principalmente en las pruebas de velocidad psicomotriz y función ejecutiva. Con excepción de un paciente, todos fracasaron en al menos un test. La edad, tiempo de enfermedad, grado de instrucción y depresión no influyeron significativamente sobre el perfil cognitivo. Conclusiones: Estos hallazgos sugieren que el compromiso cognitivo en algún grado puede presentarse desde las fases tempranas y asintomáticas de la infección por el VIH; estos hallazgos coinciden con la literatura.

Background: Several studies have reported cognitive impairment in HIV-1 infected individuals even at early stages of the infection. Short-term memory, psychomotor speed, attention and executive functions are mainly affected. Objectives: To determine the cognitive profile in neurologically asymptomatic HIV-infected patients before starting highly active antiretroviral therapy (HAART), and possible associated factors. Design: Analytic and cross-sectional study. Setting: Hospital Regional de Huacho, Peru. Participants: HIV patients with criteria to start HAART. Interventions: Twenty-one asymptomatic HIV patients attended from April to July 2011 had a detailed clinical history and a battery of standardized neuropsychological tests. Main outcomes measures: Scores in psychomotor speed, executive function, immediate memory, attention, and visuospatial performance evaluations. Results: Significant cognitive impairment was determined in 47.6% of patients. Patients performed worse in psychomotor speed and executive function tests. All but one patient failed at least in one test. Age, level of instruction, time of disease, and depression were not statistically associated. Conclusions: In accordance with the literature, these findings suggest cognitive decline may occur in early asymptomatic stages of HIV infection.

Síndrome de Williams: características clínicas de tres casos / Williams syndrome: clinical characteristics of three cases

El Síndrome de Williams (SW) es un síndrome genético generado por la deleción del gen de la Elastina y genes contiguos del cromosoma 7q11.23. Tiene una incidencia de 1:7500-20.000 recién nacidos vivos. Se caracteriza por un conjunto de síntomas y signos con compromiso multiorgánico y un fenotipo conductual distintivo. Objetivo: Describir la clínica del SW en relación a tres casos clínicos. Método: Estudio descriptivo retrospectivo de fichas clínicas de pacientes estudiados y tratados entre el 2006 y 2012. Resultados: Tres varones con rango de edad entre 4 y 6 años. Todos presentaron dismorfias características y se asociaron a cardiopatía congénita: estenosis aórtica supravalvular. En los rasgos de personalidad destacaron alta sociabilidad y habilidades en lenguaje expresivo, RM leve a moderado y mala coordinación motora. Conclusión: Todos nuestros pacientes presentaron características concordantes con las descritas para SW. Existen alteraciones funcionales cerebrales en pacientes con SW que tienen relación con el perfil cognitivo observado.

Williams Syndrome (WS) is a genetic disorder caused by deletion of elastine gene and contiguous genes of chromosome 7q11.2. It has an incidence of 1:7.500-20.000 newly born. It is characterized by a group of symptoms and signs with multiorganic involvement and a distinctive behavioural phenotype. Objective: To describe the clinical manifestations of WS in relation to three case reports. Method: review of clinical reports of patients diagnosed and treated between 2006 and 2012. Results: Three boys aged 5-9 years, all of them presented distinctive appearance, associated to congenital heart disease: aortic supravalvular stenosis. Behavioral features included high sociability and expressive language skills, mental retardation and poor motor coordination. Conclusions: All of our patients had clinical characteristics corresponding to the ones described for WS in the literature. The peculiar cognitive profile is presumed to be related to functional brain alterations described in WS.

Perfil cognitivo de la dependencia emocional en estudiantes universitarios en Medellín, Colombia / Cognitive profile of emotional dependence in University Students from Medellín, Colombia

El objetivo de este estudio fue la identificación del perfil cognitivo de los estudiantes universitarios con dependencia emocional. Ésta se plantea como un patrón orientado al otro como fuente de satisfacción y seguridad personal, donde el perfil cognitivo les llevaría a interpretar los hechos de manera diferente, basándose en cubrir sus necesidades emocionales insatisfechas. Se tomó una muestra aleatoria estratificada de 569 estudiantes universitarios. Los resultados arrojaron un modelo que explica el 89.3 % de la variabilidad, con alta capacidad predictiva (sensibilidad 91.4 %, especificidad 97.7 %), conformado por el esquema de desconfianza/abuso, creencias centrales del trastorno de la personalidad paranoide y dependiente, distorsión cognitiva de falacia de cambio y estrategia hipodesarrollada de afrontamiento de autonomía.

The objective of this study was to identify the cognitive profile of university students with emotional dependency. This is considered as a pattern oriented to another person as a source of satisfaction and personal safety, where the cognitive profile will make them to interpret the facts in a different way in order to cover their unsatisfied emotional needs. We use a random sample of 569 university students. The results showed a characteristic profile which explains 89.3% of the variability and a high predictive model capacity (sensitivity 91.4% and specificity 97.7%), formed by the schema of mistrust/abuse, the cores beliefs of paranoid and dependent personality disorders, fallacy of change as cognitive distortion and underdeveloped autonomy as a coping skill.

Lóbulos frontales y funciones ejecutivas en transexuales / Frontal Lobes and Executive Functions in Transsexuals

Una persona transexual se define como aquella que presenta una incongruencia entre el fenotipo físico y la identidad de género. Existen transexuales nacidos hombres pero con identidad de género de mujer. Se ha propuesto que uno de los orígenes de esta condición radica en los efectos que las hormonas esteroides sexuales tienen sobre el desarrollo cerebral a nivel prenatal y es posible que afecten las funciones cognitivas como las funciones ejecutivas. El objetivo fue evaluar funciones ejecutivas en transexuales hombre a mujer. Con la batería de lóbulos Frontales y Funciones Ejecutivas, se encontró que las Transexuales tuvieron una menor ejecución comparadas con los hombres en los puntajes totales de funciones ejecutivas y en los totales de corteza prefrontal orbitomedial. En las subpruebas de inhibición (Stroop) y Toma de decisiones (Juego de cartas del IOWA) las transexuales obtuvieron menores puntajes que los hombres y las mujeres. Estos resultados apoyan las evidencias que indican que las TH-M presentan una ejecución cognitiva lejana a su sexo de nacimiento y se propone un perfil cognitivo en las TH-M diferente al de los hombres y las mujeres.

Transsexualism is characterized by the development of a gender identity that is at variance with morphology of genitals and secondary sex characteristics. The origin of the transsexualism is not very clear, although some biological indicators as the prenatal androgenization seems to be one of the causes that predispose to the development of the sexual identity, as well as the cerebral anatomical differences between transsexuals and non transsexuals. Mental functions including executive functions are susceptible to be affected by sexual steroids hormones during development. The aim was to evaluate the cognitive profile in male to female transsexuals (M-FT) in absence of hormonal treatment with estrogens. With the battery of Frontal lobes and Executive Functions, transsexuals had a smaller execution compared with the men in the totals of executive functions and the totals of orbitomedial prefrontal cortex. In the sub-tests of inhibition (Stroop) and Decision making (letter Game of the IOWA) group transsexual had minor's scores than men and women. These results support the evidences that they indicate that the transsexuals display a distant mental execution to their sex of birth. We propose a cognitive profile in our transsexual group different from men and the women sets out.

Tumores cerebrales infratentoriales y supratentoriales: comparación de perfil cognitivo y su impacto en la calidad de vida en niños en edad escolar / Infra- and supratentorial brain tumors: comparison of the cognitive profile and its impact on quality of life in school-age children

INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.

INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.

Tumores cerebrales infratentoriales y supratentoriales: comparación de perfil cognitivo y su impacto en la calidad de vida en niños en edad escolar / Infra- and supratentorial brain tumors: comparison of the cognitive profile and its impact on quality of life in school-age children

INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.

INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.

Different cognitive profiles of Brazilian patients with relapsing-remitting and primary progressive multiple sclerosis / Diferentes perfis cognitivos de pacientes brasileiros com esclerose múltipla remitente-recorrente e progressiva primária

Cognitive impairment is a symptom of multiple sclerosis (MS). Different clinical forms of multiple sclerosis have different cognitive profiles, according to findings of previous studies which used extensive batteries of neuropsychological tests. OBJECTIVE: To investigate cognitive profiles of Brazilian patients with relapsing-remitting multiple sclerosis (RRMS) and primary progressive multiple sclerosis (PPMS) by using a brief battery of neuropsychological tests. METHOD: Sixty-six patients, within 18-65 of age and 3-18 years of education, were paired with healthy control subjects, regarding gender, age, and education level. RESULTS: On Symbol Digit Modalities Test and Hooper Visual Organization Test, cognition was affected in 50 percent in RRMS and 69 percent in PPMS. Fluency of "F" was impaired in 24 percent of RRMS and 81 percent of PPMS. Immediate recall was affected in 32 percent of RRMS and in 63 percent of PPMS; whereas late recall, in 46 percent of relapsing-remitting and in 69 percent of primary progressive. CONCLUSION: Cognitive profiles of relapsing-remitting and primary progressive patients are different.

O comprometimento cognitivo é um sintoma da esclerose múltipla (EM). Formas clínicas diferentes da EM apresentam diferentes perfis cognitivos, de acordo com resultados de estudos anteriores que usaram bateria extensa de testes neuropsicológicos. OBJETIVO: Investigar o perfil cognitivo de pacientes com esclerose múltipla remitente-recorrente (EMRR) e esclerose múltipla progressiva primária (EMPP) utilizando uma bateria neuropsicológica breve. MÉTODO: 66 pacientes com idade de 18 a 65 anos, escolaridade 3 a 18 anos, foram pareados a controles por sexo, idade e escolaridade; e avaliados. RESULTADO: No Symbol Digit Modalitie Test e Hooper Visual Organization Test 50 por cento com EMRR e 69 por cento com EMPP apresentaram desempenho comprometido. Na fluência da letra "F" o comprometimento foi de 24 por cento daqueles com EMRR e 81 por cento com EMPP. Na evocação imediata o comprometimento foi de 32 por cento na EMRR e 63 por cento na EMPP e, evocação tardia em 46 por cento na remitente-recorrente e 69 por cento com progressiva primária. CONCLUSÃO: Os perfis cognitivos dos pacientes com esclerose múltipla remitente-recorrente e progressiva primária são diferentes.

Processos atencionais em idosos saudáveis com alta escolaridade da comunidade da cidade de São Paulo / Attentional function in healthy aging with more than 12 years of education from São Paulo's community

Muitos estudos apontam para que mais de um terço dos sujeitos de 60 anos ou mais apresente prejuízo na atenção, apesar de não haver um padrão do efeito da idade sobre esta. O objetivo deste estudo foi avaliar o perfil de sujeitos idosos saudáveis de alta escolaridade no desempenho em medidas de atenção. Para isso, 14 sujeitos entre 60 e 89 anos de idade e entre 12 e 17 anos de escolaridade foram avaliados por meio de subtestes do WAIS-III, do Trail Making Test e do Stroop Test, após serem incluídos por critérios pré-determinados. Todos os sujeitos mostraram desempenho satisfatório em medidas de atenção, exceto para atenção seletiva (cartão 1 do teste Stroop). Houve correlação positiva entre as variáveis de desempenho nos testes de atenção sustentada e seletiva. Esse resultado corrobora achados anteriores que mostram um efeito positivo da alta escolaridade sobre o funcionamento atencional de sujeitos idosos saudáveis(AU)

Several studies have shown that more than a third of the aging people would have attention impairment, regardless of there is no commun effect of age in this process. The aim of this study was to evaluate the attentional performance of healthy elderly subjects with hight level of education. For this, 14 subjects between 60 and 89 years old and between 12 and 17 years of education were assessed through WAIS-III´s subtests, Trail Making Test and Stroop Test, after been included for pré-determined criterious. All subjects had a sactisfatory performance in attencional tests, except for the selective attention (card 1 of Stroop). There was a positive correlation between two variables (sustained and selective). This result is in agreement with previous findings showing a positive effect of hight schooling on attentional performance in healthy elderly(AU)

Relación entre esquemas maladaptativos tempranos y características de ansiedad y depresión en estudiantes universitarios / Relation between early maladaptive schemes and anxiety and depression features in university students

La ansiedad y la depresión constituyen importantes problemas de salud, dadas las altas tasas de prevalencia tanto en población normal como en población clínica. El presente estudio no experimental pretende identificar el perfil cognitivo mediante el modelo de los esquemas maladaptativos tempranos presentes en estudiantes de la Universidad Pontificia Bolivariana Bucaramanga-UPB, relacionados con las puntuaciones obtenidas en ansiedad y depresión; todo con el fin de aportar a la identificación de características cognitivas que puedan ayudar en la prevención de estos trastornos. Se evaluaron 259 estudiantes de psicología de primero a séptimo semestre de la UPB mediante los cuestionarios BDI, ST/DEP, STAI y YSQ-L2. Los resultados no indican la presencia de esquemas diferenciales en función de la presencia de depresión Estado/Rasgo y de ansiedad Estado/Rasgo, lo cual podría sugerir, desde el paradigma dimensional, la presencia de cierto patrón cognitivo para un trastorno mixto de ansiedad y depresión. No obstante se sugiere realizar nuevos estudios con otras muestras, incluida población clínica.

Anxiety and depression are important health problems, because of the high prevalence rates in normal population and in clinical population. Thisnon-experimental study intends to identify the cognitive profile, throughthe early maladaptive schemes in students from the Universidad PontificiaBolivariana Bucaramanga, related with depression and anxiety scores. Thegoal is to contribute to the identification of cognitive characteristics thatcould help in the prevention of these disorders. 259 psychology students of the first seven semesters were evaluated by means from the followingquestionnaires: BDI, ST/DEP, STAI and YSQ-L2. The results don’t show the presence of specific schemes as a function of the presence of State/Trait depression or State/Trait anxiety, which might suggest, through thedimensional paradigm, the presence of a cognitive pattern for an anxiety and depression mix disorder. It is suggested that further research should be carried out with other samples, including clinical population.

Construcción y validación del cuestionario de dependencia emocional en población colombiana / Design and validation of the emotional dependence questionnaire in Colombian population

El propósito de esta investigación fue construir y validar un instrumento para evaluar Dependencia emocional. La muestra estuvo conformada por 815 participantes del Área Metropolitana de Medellín Colombia, 506 (62.1%) mujeres y 309 (37.9%) hombres, con edades entre los 16 y los 55 años. De los 66 ítems iniciales que contenía la prueba, fueron excluidos a través del análisis factorial 43 de ellos por no cumplir con los criterios para la selección. El cuestionario final quedó conformado por 23 ítems y seis factores. El Alfa de Cronbach de la escala total fue de 0,927, con una explicación de la varianza del 64.7%. Factor 1: Ansiedad de separación (7 ítems, α = 0.87), Factor 2: Expresión afectiva de la pareja (4 ítems, α = 0.84) , Factor 3: Modificación de planes (4 ítems, α = 0.75), Factor 4: Miedo a la soledad (3 ítems, α = 0.8), Factor 5: Expresión límite (3 ítems, α = 0.62) y Factor 6: Búsqueda de atención (2 ítems, α = 0.7.8). Se encontraron diferencias significativas con relación al sexo en las diferentes subescalas; las puntuaciones de las mujeres en Expresión afectiva de la pareja y Miedo a la soledad fueron mayores, mientras que los hombres reportaron puntuaciones superiores en Búsqueda de atención. Con relación a la edad se encontró que las subescalas Modificación de planes y Expresión límite puntuaban más alto en adolescentes y adultos jóvenes.

The purpose of this research project was to construct and validate an instrument to assess Emotional Dependency. The population sample was taken from the Metropolitan Area of Medellín (Colombia) and consisted of 815 participants, of which 506 (62.1%) were women and 309 (37.9%) were men, between the ages of 16 and 55 years old. The original questionnaire contained 66 items, and by means of a factor analysis test,43 of them were excluded for not complying with the selection criteria. Thus, the final questionnaire consisted of 23 items and six factors. The Cronbach Alpha score for the total scale was 0.927, which explained 65% of the variance, whereas for each specific factor the Alpha Scores obtained were the following: Factor 1: Separation Anxiety (7 items, α = 0.87); Factor 2: Couple’s Affective Expression (4 items, α = 0.84); Factor 3: Change of Plans (4 items, α = 0.75); Factor 4: Fear of Loneliness (3 items, α = 0.8); Factor 5: Borderline Expression (3 items, α = 0.62), and Factor 6: Attention seeking (2 items, α = 0.7.8). Significant differences related to gender were found in the different subscales. The highest scores for the female population were obtained in Factors 2 and 4, Couple’s Affective Expression and Fear of Loneliness, whereas men reported higher scores in Factor 6: Attention Seeking. With respect to age, it was found that the highest scores corresponded to the subscales Change of Plans and Borderline Expression in the Adolescent and Young Adult Population.