Digital Neuropsychology beyond Computerized Cognitive Assessment: Applications of Novel Digital Technologies.

Compared with other health disciplines, there is a stagnation in technological innovation in the field of clinical neuropsychology. Traditional paper-and-pencil tests have a number of shortcomings, such as low-frequency data collection and limitations in ecological validity. While computerized cognitive assessment may help overcome some of these issues, current computerized paradigms do not address the majority of these limitations. In this paper, we review recent literature on the applications of novel digital health approaches, including ecological momentary assessment, smartphone-based assessment and sensors, wearable devices, passive driving sensors, smart homes, voice biomarkers, and electronic health record mining, in neurological populations. We describe how each digital tool may be applied to neurologic care and overcome limitations of traditional neuropsychological assessment. Ethical considerations, limitations of current research, as well as our proposed future of neuropsychological practice are also discussed.

Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments.

This is the second of two narrative reviews on cognitive disorders in epilepsy (companion manuscript: Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations). Its focus is on the clinical targets, indications, and the selection of neuropsychological test instruments. Cognitive assessment has become an essential tool for the diagnosis and outcome control in the clinical management of epilepsy. The diagnostics of basic and higher brain functions can provide valuable information on lateralized and localized brain dysfunctions associated with epilepsy, its underlying pathologies and treatment. In addition to the detection or verification of deficits, neuropsychology reveals the patient's cognitive strengths and, thus, information about the patient reserve capacities for functional restitution and compensation. Neuropsychology is an integral part of diagnostic evaluations mainly in the context of epilepsy surgery to avoid new or additional damage to preexisting neurocognitive impairments. In addition and increasingly, neuropsychology is being used as a tool for monitoring of the disease and its underlying pathologies, and it is suited for the quality and outcome control of pharmacological or other non-invasive medical intervention. This narrative review summarizes the present state of neuropsychological assessments in epilepsy, reveals diagnostic gaps, and shows the great need for education, homogenization, translation and standardization of instruments.

Neuropsychological Outcomes of Exposure to Hurricane Katrina and Relocation.

OBJECTIVE: Survivors of natural disasters are at risk for mental health sequela, including deficits in neurocognitive functioning. This study explores links between hurricane exposure and resulting psychiatric symptoms and deficits in cognitive processing, attention, learning, and memory. METHODS: Relocated Katrina survivors and demographically matched controls completed neurocognitive tests assessing processing speed (Trail Making Test, Part A), mental flexibility (Trail Making Test, Part B), sustained attention (Conner's Continuous Performance Test), and learning and memory (Rey Auditory-Verbal Learning Test). PTSD (Clinician-Administered PTSD Scale) and depressive symptoms (BDI- II) were also measured. RESULTS: Survivors had more PTSD and depression symptoms and weaker performance in cognitive processing, mental flexibility, and sustained attention, but not memory and learning compared to controls. When controlling for depression and PTSD symptoms (analysis of covariances), only CPT-II response time remained significantly different for survivors, so that sustained attention deficits were independent of emotional symptoms. CONCLUSION: Survivors had more psychiatric symptoms and neurocognitive dysfunctions than controls in most assessed measures. Our study had mixed results in identifying cognitive deficits related to psychopathology. Results suggest that disaster survivors, even those without psychopathology, should be assessed for cognitive issues that may affect their ability to process post-disaster instructions and access assistance in recovery efforts.

Neuropsychological Measures in the Arab World: A Systematic Review.

Although Arabic is one of the most widely used languages in the world, little is known on the availability of standardized neuropsychological tests in Arabic. We review the literature published before 2016, using the keywords Arab*, cogniti*, and neuropsycholo*, as well as keywords for each Arab country. PubMed, PsycINFO, Education Source, Academic Search Complete, Education Resources Information Center, Shamaa, and Arabpsynet databases were searched, in addition to a selected number of Arabic medical and educational journals. After excluding case reports, studies conducted on Arab groups residing outside the Arab world or Israel, and studies that employed intelligence scales or cognitive screens without standardization, 384 studies were eventually reviewed. Tests with most extensive use, adaptation, validation and norming were identified. The Raven Matrices, with its variants, was the most normed cognitive test for Arab individuals (normed in 16 countries). The rate of neuropsychology publications from the Arab countries combined, per year, was less than half of that of each American journal (top 10 journals pertaining to cognition). Nonetheless, the rate in Arab countries has increased after 2010. Publications were mostly from Egypt and Saudi Arabia, but the ratio of test adaptation-to-publication was the largest in Jordan and Lebanon. Approximately half of these publications did not employ cognitive tests that were developed, translated, adapted, or standardized according to international guidelines of psychological measurement. We provide recommendations on improving clinical neuropsychology to better serve Arab patients.

The Technology Crisis in Neuropsychology.

Neuropsychology has fallen reliant on outdated and labor intensive methods of data collection that are slow, highly inefficient, and expensive, and provide relatively data-poor estimates of human behavior despite rapid technological advance in most other fields of medicine. Here we present a brief historical overview of current testing practices in an effort to frame the current crisis, followed by an overview of different settings in which technology can and should be integrated. Potential benefits of laboratory based assessments, remote assessments, as well as passive and high-frequency data collection tools rooted in technology are discussed, along with several relevant examples and how these technologies might be deployed. Broader issues of data security and privacy are discussed, as well as additional considerations to be addressed within each setting. Some of the historical barriers to adoption of technology are also presented, along with a brief discussion of the remaining uncertainties. While by no means intended as a comprehensive review or prescriptive roadmap, our goal is to show that there are a tremendous number of advantages to technologically driven data collection methods, and that technology should be embraced by the field. Our predictions are that the comprehensive assessments of the future will likely entail a combination of lab-based assessments, remote assessments, and passive data capture, and leading the development of these efforts will cement the role of neuropsychology at the forefront of cognitive and behavioral science.

Combination treatment in the rehabilitación of visuospatial neglect / Tratamiento combinado en la rehabilitación de la negligencia visuo-espacial

BACKGROUND: Visuo-spatial neglect predicts longer hospitalization, poorer recovery of motor skills and greater functional limitation. The aim of the present study was to analyze whether the combined administration of computerized cognitive rehabilitation with right hemifield eye-patching in patients with left spatial neglect following a right hemisphere stroke is more effective than computerized cognitive rehabilitation applied in isolation. METHOD: Randomized clinical trial conducted in 28 patients. These were grouped into two experimental groups: single treatment group (ST) (n= 15) and combined treatment group (CT) (n= 13). All received an average of 15 one-hour sessions of computerized cognitive rehabilitation using the Guttmann, NeuroPersonalTrainer® telerehabilitation platform. Those patients in the TC group performed the sessions wearing a visual device with which the right hemifield of each eye was occluded. RESULTS: Following treatment, both the ST and the TC group showed improvements in neuropsychological examination protocol although there were no differences pre- and post-treatment on the functional scale in either group. Likewise, no statistically significant differences were observed in intergroup comparison. CONCLUSIONS: The results from this study indicate that combination treatment is not more effective than rehabilitation applied in isolation

ANTECEDENTES: la negligencia visuo-espacial predice mayor tiempo de hospitalización, peor recuperación de las habilidades motoras y limitaciones funcionales. El objetivo fue analizar si la administración combinada de rehabilitación cognitiva informatizada junto con el right hemifield eye patching, en participantes que presentan negligencia espacial izquierda como consecuencia de un ictus hemisférico derecho, es más eficaz que la rehabilitación cognitiva informatizada aplicada de forma aislada. MÉTODO: ensayo clínico aleatorizado realizado con 28 participantes. Dos grupos experimentales: grupo tratamiento único (TU) (n= 15) y grupo tratamiento combinado (TC) (n= 13). Todos ellos recibieron una media de 15 sesiones de rehabilitación cognitiva informatizada de una hora de duración mediante la plataforma de telerehabilitación Guttmann, NeuroPersonalTrainer®. Los participantes del grupo TC las ejecutaron con un dispositivo visual que llevaba el hemicampo derecho de cada ojo ocluido. RESULTADOS: tras el tratamiento, tanto el grupo TU como el TC mostraron mejoras en el protocolo de exploración neuropsicológica aunque no hubo diferencias pre- y post-tratamiento en la escala funcional en ninguno de los dos grupos. Asimismo, no se observaron diferencias estadísticamente significativas en la comparación intergrupal. CONCLUSIONES: los resultados derivados de este estudio indican que el tratamiento combinado no es más eficaz que la rehabilitación aplicada de forma aislada

Aportaciones de la neuropsicología a la encefalitis por anticuerpos antirreceptoContributions of neuropsychology to anti-NMDA receptor antibody encephalitis: a literature reviewr de NMDA: revisión de la bibliografía / Contributions of neuropsychology to anti-NMDA receptor antibody encephalitis: a literature review

La encefalitis límbica generada por anticuerpos antirreceptor de N-metil-D-aspartato (NMDA) es una entidad neurológica aguda y grave, más prevalente en las mujeres jóvenes y asociada a un tumor subyacente. El curso con déficit cognitivo grave hace necesario reflexionar sobre las aportaciones de la neuropsicología al diagnóstico, evolución y tratamiento de la enfermedad, poco estudiadas hasta el momento. Se revisa la bibliografía precedente, criticando la medición de los síntomas cognitivos (predominantemente mnésicos y ejecutivos) asociados a esta enfermedad. Se proponen instrumentos neuropsicológicos válidos y fiables, y se plantea que las medidas neuropsicológicas pueden servir como pará- metros de seguimiento de estos pacientes que ayuden a monitorizar su funcionalidad en la vida diaria una vez recuperados de la fase aguda, así como convertirse en una base sobre la que articular programas de rehabilitación que favorezcan el logro de la autonomía personal y la reinserción comunitaria de los pacientes. Con todo, se subraya la necesidad de incluir a neuropsicólogos y neuropsiquiatras no sólo en la detección, sino en el tratamiento de los pacientes, en pro de alcanzar la recuperación de la independencia personal y la readaptación a sus entornos naturales (AU)

Limbic encephalitis generated by anti-N-methyl-D-aspartate (NMDA) receptor antibodies is an acute and severe neurological entity, which is more prevalent in young females and is associated to an underlying tumour. Since it leads to severe cognitive impairment, thought needs to be given to the contributions of neuropsychology to the diagnosis, development and treatment of the disease, which have received little attention from researchers to date. A review is conducted of the prior literature, evaluating the measurement of the cognitive symptoms (predominantly mnemonic and executive) associated to this disease. Valid, reliable neuropsychological instruments are proposed, and it is suggested that neuropsychological measures may be used as parameters to follow up these patients which help monitor their functionality in daily living once they have recovered from the acute phase. Similarly they can become a basis on which to assemble rehabilitation programmes that favour the accomplishment of personal autonomy and the patients’ reintegration in the community. Nevertheless, we stress the need to include neuropsychologists and neuropsychiatrists in not only the detection but also the treatment of these patients so as to enable them to recover their personal independence and readapt to their natural settings (AU)

Actualización de la depresión postictus: nuevos retos en pacientes con ictus minor o ataque isquémico transitorio / Update on post-stroke depression: posing new challenges in patients with a minor stroke or transient ischaemic attack

Introducción. El ictus es una de las principales causas de discapacidad en la población adulta. El desarrollo de síntomas depresivos es la complicación afectiva más frecuente. Hasta ahora, en la mayoría de los estudios sobre depresión postictus se ha excluido a los pacientes que han sufrido un ictus minor o un ataque isquémico transitorio (AIT), si bien es un subgrupo igualmente vulnerable a esta enfermedad. Objetivo. Revisar los estudios publicados de depresión postictus para dilucidar los aspectos que ya se han demostrado ampliamente y los que necesitan mayor evidencia. Desarrollo. La depresión postictus es frecuente tanto en los pacientes con ictus establecido como en los pacientes con ictus minor o AIT. Aunque existen discrepancias en la definición utilizada, aproximadamente uno de cada tres pacientes desarrollará esta complicación. Se han identificado factores de riesgo de depresión postictus con un amplio respaldo científico (sexo femenino, antecedentes de depresión u otros trastornos psiquiátricos, gravedad del ictus y afectación funcional) y otros sin él (calidad de vida, deterioro cognitivo y biomarcadores de neuroimagen). Las principales limitaciones metodológicas halladas son la confusión entre depresión postictus y sintomatología depresiva, la variabilidad en las escalas de evaluación usadas y la variabilidad en el momento temporal de la evaluación del estado de ánimo. Hasta ahora son muy pocos los estudios en el ictus minor o el AIT. Conclusiones. Se necesitan nuevos estudios con mejor diseño que ayuden a establecer el riesgo de depresión postictus a diferentes tiempos tras el ictus, el ictus minor o el AIT, y establecer la importancia de los factores descritos previamente (AU)

Introduction. Stroke is a leading cause of disability in adults. The development of depressive symptoms is the most common emotional complication. To date, most studies of post-stroke depression have excluded patients who have suffered a minor stroke or transient ischaemic attack (TIA), although they are equally vulnerable subgroups of this sickness. Aim. We present a review of published studies of post-stroke depression to elucidate aspects that have already been widely demonstrated and those who need more evidence. Development. The post-stroke depression is both frequent in patients with established stroke and minor stroke or TIA. Although there are discrepancies in the definition used, in up to one out of three patients will develop this complication. We have identified risk factors of post-stroke depression with a broad scientific background (female, history of depression or other psychiatric disorders, stroke severity, functional impairment) and other without it (quality of life, cognitive impairment and neuroimaging biomarkers). The main methodological limitations found are: confusion between poststroke depression and depressive symptoms; variability in rating scales used; and temporal variability in the time of the evaluation of mood. To date very few studies focused on minor stroke or TIA. Conclusions. Further studies are required with improved design in order to help establish the risk of post-stroke depression at different times after the stroke, minor stroke or TIA and the importance of all the factors described above (AU)

XVIII Curso Internacional de Actualización en Neuropediatría y Neuropsicología Infantil. Pósters / No disponible

No disponible

Test de comparación perceptual de Salthouse: normalización y estandarización de la prueba en población española / The Salthouse Perceptual Comparison Test: normalization and standardization for Spanish population

Introducción. El test de comparación perceptual de Salthouse (TCPS) evalúa la velocidad de percepción y de procesamiento. Aunque es un test ampliamente utilizado en neuropsicología, no cuenta hasta la fecha con baremos normativos adaptados a la población española. Objetivo. Normalizar y estandarizar el TCPS en población española, teniendo en cuenta las características sociodemográ- ficas de nuestra sociedad. Sujetos y métodos. Este estudio se enmarca dentro del proyecto multicéntrico Normacog, mediante el cual se administró el TCPS a 700 participantes, con edades comprendidas entre 18 y 90 años. Se analizó el efecto de variables sociodemográficas, como la edad, el nivel educativo o el sexo, sobre el rendimiento cognitivo en el TCPS, y se crearon los percentiles y las puntuaciones escalares ajustadas por edad y nivel educativo. Resultados. Los resultados mostraron un efecto significativo de la edad y del nivel educativo sobre las variables analizadas del TCPS (respuestas correctas y errores del TCPS-3 y TCPS-6), y la edad fue la que mayor porcentaje de varianza explicaba sobre el rendimiento del TCPS-3 (47%) y el TCPS-6 (45%). A mayor edad y menor nivel educativo, el número de respuestas correctas disminuía y se realizaba mayor cantidad de errores. Conclusión. El presente estudio presenta por primera vez los baremos normativos del TCPS para población española teniendo en cuenta las características sociodemográficas del país, que confirman la influencia de la edad y el nivel educativo sobre el rendimiento en el test. Como para el resto de pruebas del proyecto Normacog, se presentan las instrucciones de administración y corrección del TCPS (AU)

Introduction. The Salthouse Perceptual Comparison Test (SPCT) assesses the processing and perceptual speed. Although this test is widely used in neuropsychology, it has not normative data adapted to Spanish population. Aim. To normalize and standardize the SPCT in Spanish population taking into account the sociodemographic characteristics of our society. Subjects and methods. This study is part of the multisite Normacog project. Seven hundred participants from 18 to 90 years old were assessed using the SPCT. The effect of sociodemographic characteristics such as age, level of education and sex, were analyzed on the SPCT performance, and percentiles and scalar scores adjusted by age and level of education were created. Results. The effect of age and level of education on the SPCT variables analyzed (correct answers and errors of the SPCT-3 and SPCT-6) was statistically significant. Age explained the higher percentage of the variance in SPCT (SPCT-3: 47%; SPCT-6: 45%). The older participants with lower level of formal education obtained worse performance in the number of correct answers and higher number of errors. Conclusion. The present study reports the first normative data of the SPCT for Spanish population taking into account the sociodemographic characteristics of Spain which confirm the influence of age and level of education on the performance of the SPCT. As part of the Normacog project, this study presents the administration and correction instructions (AU)

Validez y fiabilidad de la versión española de la escala ‘perfil de deterioro cognitivo grave’ (SCIP) para la evaluación cognitiva de personas con enfermedad de Alzheimer en estadios avanzados / The validity and reliability of the Spanish version of the Severe Cognitive Impairment Profile (SCIP) for the cognitive assessment of persons with advanced stages of Alzheimer’s disease

Introducción. Existen pocas herramientas validadas al castellano para realizar una evaluación precisa del funcionamiento cognitivo de personas con demencias avanzadas. Esta población supone un reto por el elevado número de personas que alcanzan estos estadios y por la complejidad de cuidados que requieren. Este trabajo presenta la validación al castellano de un instrumento, la escala ‘perfil de deterioro cognitivo grave’ (SCIP), que permite la evaluación del funcionamiento cognitivo de personas con enfermedad de Alzheimer avanzada. Pacientes y métodos. Estudio transversal con 133 sujetos (29 hombres y 104 mujeres; edad media: 81,61 ± 7,41 años) con diagnóstico de enfermedad de Alzheimer en estadios de moderado a muy grave, según la escala de deterioro global (GDS 5-7). Se realizaron análisis de discriminación de los ítems, estudio de la consistencia interna y fiabilidad interjueces y testretest, y se contrastó la estructura factorial y la validez del instrumento. Resultados. Sólo el 1% de los 160 ítems de la escala resultó no discriminativo. La consistencia interna de la escala es adecuada, así como la fiabilidad interjueces y test-retest. Respecto a la validez de constructo, la correlación con el miniexamen cognitivo es 0,74 (p < 0,01), y se encuentran diferencias significativas entre la escala SCIP y los tres niveles de la GDS analizados. La estructura factorial de la escala muestra la existencia de un solo factor que explica el 66,12% de la varianza. Conclusión. La escala SCIP es un instrumento útil, fiable y válido para la evaluación exhaustiva en castellano de las funciones cognitivas en personas con demencia en estadios de moderado a muy grave (AU)

Introduction. Few validated tools exist in Spanish for conducting a precise assessment of the cognitive functioning of persons with advanced dementia. This population is a challenge due to the large number of persons who reach these states and owing to the complexity of the care that they require. This study presents a validated Spanish version of an instrument, the Severe Cognitive Impairment Profile (SCIP), which allows assessment of the cognitive functioning of persons with advanced Alzheimer’s disease. Patients and methods. We conducted a cross-sectional study with 133 subjects (29 males and 104 females; mean age: 81.61 ± 7.41 years) diagnosed with Alzheimer’s disease in moderate to very severe stages, according to the Global Deterioration Scale (GDS 5-7). The following were performed: discrimination analyses of the items, a study of the internal consistency and interrater reliability and test-retest. Likewise, the factorial structure and the validity of the instrument were also tested. Results. Only 1% of the 160 items on the scale were found to be non-discriminatory. The internal consistency of the scale is adequate, as is the interrater and the test-retest reliability. As regards the validity of the construct, the correlation with the mini-mental state examination is 0.74 (p < 0.01) and significant differences are found between the SCIP and the three levels of the GDS that were analysed. The factorial structure of the scales shows the existence of a single factor that accounts for 66.12% of the variance. Conclusions. The SCIP scale is a useful, reliable and valid instrument for the exhaustive evaluation in Spanish of the cognitive functions of persons with dementia in moderate to very severe states (AU)

Sistema de procesamiento numérico y cálculo: evidencias desde la neuropsicología cognitiva / The number processing and calculation system: Evidence from cognitive neuropsychology

Introducción: La neuropsicología cognitiva se centra en los conceptos de disociación y doble disociación. Mediante la descripción de las ejecuciones de pacientes con daño cerebral adquirido en tareas de procesamiento numérico y cálculo podemos caracterizar cómo el sistema cognitivo sano manipula los símbolos numéricos y/o las cantidades. Así, el objetivo de este trabajo es conocer y caracterizar los distintos componentes que forman el sistema de procesamiento numérico y cálculo. Métodos: Los participantes en este trabajo son 6 pacientes con daño cerebral adquirido en diferentes localizaciones cerebrales. Como instrumento se ha empleado la Batería de Evaluación del Procesamiento Numérico y el Cálculo. Para el análisis de los datos se ha realizado una diferencia de proporciones. Resultados: El conocimiento numérico cuantitativo es independiente de la recodificación numérica, el conocimiento numérico cualitativo y el cálculo. La recodificación es independiente del conocimiento numérico cualitativo y del cálculo. El conocimiento numérico cualitativo y el cálculo funcionan de manera independiente. Conclusiones: El sistema de procesamiento numérico y cálculo parece estar formado por al menos 4 componentes que funcionarían de manera independiente, y estos son: conocimiento numérico cuantitativo, recodificación numérica, conocimiento numérico cualitativo y cálculo. De ahí que cada uno de ellos pueda dañarse de forma selectiva sin afectar al funcionamiento de los otros. Según los principales modelos de procesamiento numérico y cálculo, cada uno de ellos tiene características y localizaciones cerebrales diferentes

Introduction: Cognitive neuropsychology focuses on the concepts of dissociation and double dissociation. The performance of number processing and calculation tasks by patients with acquired brain injury can be used to characterise the way in which the healthy cognitive system manipulates number symbols and quantities. The objective of this study is to determine the components of the numerical processing and calculation system. Methods: Participants consisted of 6 patients with acquired brain injuries in different cerebral localisations. We used Batería de evaluación del procesamiento numérico y el cálculo, a battery assessing number processing and calculation. Data was analysed using the difference in proportions test. Results: Quantitative numerical knowledge is independent from number transcoding, qualitative numerical knowledge, and calculation. Recodification is independent from qualitative numerical knowledge and calculation. Quantitative numerical knowledge and calculation are also independent functions. Conclusions: The number processing and calculation system comprises at least 4 components that operate independently: quantitative numerical knowledge, number transcoding, qualitative numerical knowledge, and calculation. Therefore, each one may be damaged selectively without affecting the functioning of another. According to the main models of number processing and calculation, each component has different characteristics and cerebral localisations

Can Teleneuropsychology Help Meet the Neuropsychological Needs of Western Africans? The Case of Ghana.

In Ghana, the services of psychologists, particularly clinical psychologists and neuropsychologists, remain largely inaccessible to a large proportion of those in need. Emphasis has been placed on "physical wellness" even among patients with cognitive and behavioral problems needing psychological attention. The small number of clinical psychologists and neuropsychologists, the deplorable nature of road networks and transport systems, geopolitical factors, and a reliance on the face-to-face method in providing neuropsychological services have further complicated the accessibility problem. One way of expanding and making neuropsychological services available and accessible is through the use of information communication technology to provide these services, and this is often termed teleneuropsychology. Drawing on relevant literature, this article discusses how computerized neurocognitive assessment and videoconferencing could help in rendering clinical neuropsychological services to patients, particularly those in rural, underserved, and disadvantaged areas in Ghana. The article further proposes recommendations on how teleneuropsychology could be made achievable and sustainable in Ghana.

A statistical characterization of the finger tapping test: modeling, estimation, and applications.

Sensory-motor performance is indicative of both cognitive and physical function. The Halstead-Reitan finger tapping test is a measure of sensory-motor speed commonly used to assess function as part of a neuropsychological evaluation. Despite the widespread use of this test, the underlying motor and cognitive processes driving tapping behavior during the test are not well characterized or understood. This lack of understanding may make clinical inferences from test results about health or disease state less accurate because important aspects of the task such as variability or fatigue are unmeasured. To overcome these limitations, we enhanced the tapper with a sensor that enables us to more fully characterize all the aspects of tapping. This modification enabled us to decompose the tapping performance into six component phases and represent each phase with a set of parameters having clear functional interpretation. This results in a set of 29 total parameters for each trial, including change in tapping over time, and trial-to-trial and tap-to-tap variability. These parameters can be used to more precisely link different aspects of cognition or motor function to tapping behavior. We demonstrate the benefits of this new instrument with a simple hypothesis-driven trial comparing single and dual-task tapping.

Rehabilitation Tool: A Pilot Study On A New Neuropsychological Interactive Training System.

Over the past 20 years, research has led to the development of new technologies to improve the quality of life of brain-damaged user. Introduction of new neuropsychological rehabilitation tools based both on the new knowledge on brain plasticity and on the latest developments in computer sciences is both necessary and scientifically challenging for health professionals, particularly neuropsychologists. Here we present a pilot study in which the use of a new Apple

Versão angolana do INECO Frontal Screening: indicadores psicométricos e capacidade discriminativa na perturbação de stress pós-traumático / Angolan Version of INECO Frontal Screening: Psychometric indicators and discriminative capacity in post-traumatic stress disorder

O INECO Frontal Screening (IFS) é um teste de rastreio das funções do lobo frontal, utilizado no contexto das demências e de diversas patologias psiquiátricas. O presente trabalho tem como objetivo determinar as características psicométricas da versão angolana do IFS: aceitabilidade, validade de constructo e capacidade discriminativa no contexto da perturbação de stress pós-traumático (PTSD). Métodos: O IFS foi aplicado a dois grupos: grupo controlo (n=51), constituído por participantes sem historial de perturbação neuropsiquiátrica, e um grupo de pacientes com PTSD (n=35), composto por utentes da consulta externa do Hospital Central do Huambo. Resultados Os efeitos de piso e de teto no total do IFS e em suas diferentes subprovas foram inferiores a 80%. O alfa de Cronbach obtido foi 0,791. As correlações entre as subprovas e entre estas e o total do IFS foram significativas. O grupo PTSD obteve resultados significativamente inferiores no total do IFS e nas subprovas de instruções conflituosas e memória de trabalho espacial. Para um ponto de corte de 13 pontos, o IFS apresenta uma sensibilidade de 100% e uma especificidade de 87% na identificação de participantes com PTSD. O IFS correlaciona-se de forma negativa com o total da IES-R. Conclusão: O IFS revela excelentes níveis de aceitabilidade. O valor de consistência interna obtido é muito próximo ao da versão original e da versão portuguesa da prova. IFS é sensível (100%) e especifico (87%) na identificação dos participantes com PTSD, posicionando-se como um instrumento válido para uso clínico. Tanto quanto é do nosso conhecimento, este será o primeiro instrumento de avaliação frontal a ser adaptado e validado para uso em Angola...

The INECO Frontal Screening (IFS) is a screening test of frontal lobe functions used in the context of dementia and psychiatric pathologies. The present work aims to determine the psychometric characteristics of the Angolan version of the IFS: acceptability, construct validity, and discriminative capacity in the context of post-traumatic stress disorder (PTSD). Methods: The IFS was administered to two groups: a control group (n=51), composed of participants with no history of neuropsychiatric disorder, and a group of PTSD patients (n=35), made up of patients from the day clinic of Hospital Central do Huambo. Results: Ceiling and floor effects of the IFS and its subtasks were lower than 80%. The Cronbach’s alpha was 0.791. The correlations between the subtasks themselves and between them and total IFS scores were significant. The PTSD group obtained significantly lower results for total IFS scores and conflicting instructions and spatial working memory subtasks. For a cut-off value of 13 points, IFS has a sensitivity of 100% and a specificity of 87% in the detection of PTSD participants. IFS scores were negatively correlated to total IES-R scores. Conclusion: IFS has excellent levels of acceptability. The internal consistency coefficient is very similar to those of the original and Portuguese versions. IFS is sensitive (100%) and specific (87%) in the identification of PTSD participants, establishing itself as a valid instrument for clinical use. As far as we know, this is the first instrument for the assessment of frontal functioning to be adapted and validated for use in Angola...

Intelligent Therapy Assistant (ITA) for cognitive rehabilitation in patients with acquired brain injury.

BACKGROUND: This paper presents the design, development and first evaluation of an algorithm, named Intelligent Therapy Assistant (ITA), which automatically selects, configures and schedules rehabilitation tasks for patients with cognitive impairments after an episode of Acquired Brain Injury. The ITA is integrated in "Guttmann, Neuro Personal Trainer" (GNPT), a cognitive tele-rehabilitation platform that provides neuropsychological services. METHODS: The ITA selects those tasks that are more suitable for the specific needs of each patient, considering previous experiences, and improving the personalization of the treatment. The system applies data mining techniques to cluster the patients according their cognitive impairment profile. Then, the algorithm rates every rehabilitation task, based on its cognitive structure and the clinical impact of executions done by similar patients. Finally, it configures the most suitable degree of difficulty, depending on the impairment of the patient and his/her evolution during the treatment. RESULTS: The ITA has been evaluated during 18 months by 582 patients. In order to evaluate the effectiveness of the ITA, a comparison between the traditional manual planning procedure and the one presented in this paper has been done, taking into account: a) the selected tasks assigned to rehabilitation sessions; b) the difficulty level configured for the sessions; c) and the improvement of their cognitive capacities after completing treatment. CONCLUSIONS: The obtained results reveal that the rehabilitation treatment proposed by the ITA is as effective as the one performed manually by therapists, arising as a new powerful support tool for therapists. The obtained results make us conclude that the proposal done by the ITA is very close to the one done by therapists, so it is suitable for real treatments.

Pointing the way to new constraints on the dynamical claims of computational models.

The reach-to-touch paradigm has become an increasingly popular tool in the study of human cognition. It is widely held that reaching responses are able to reveal the moment-by-moment unfolding of decision processes by virtue of an assumed continuity between reaching trajectories and the underlying "cognitive trajectory." Yet the standard analysis of reaching trajectories aggregates the trajectories across stimulus viewing times, which yields ambiguous results. Here we introduce a new version of the reach-to-touch paradigm that incorporates the response-signal procedure to elicit reaching movements across a wide range of stimulus viewing times. We then analyze the direction of the initial movement by stimulus viewing time, which produces a sigmoidal growth pattern. Of note, we show how this sigmoidal relationship between stimulus viewing time and initial direction can be used to test and constrain the dynamical claims of computational models of basic cognitive processes. We introduce our new version of the reach-to-touch paradigm and analyses in the context of a lexical decision task and we compare our results with the dynamical claims of the dual-route cascaded model of reading.