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2.
Inf. psiquiátr ; (235): 47-52, ene.-mar. 2019.
Artigo em Espanhol | IBECS | ID: ibc-183985

RESUMO

La parálisis cerebral es un síndrome que asocia desórdenes del desarrollo del movimiento, la postura y el tono muscular, que causan limitaciones en las actividades y están acompañados de déficits sensitivos, cognitivos, de comunicación, de percepción, comportamiento, y crisis comiciales. El tratamiento debe ser preventivo, activo e interdisciplinar a nivel farmacológico, rehabilitador, psicoemocional y cognitivo. La exposición a ambientes sensoriales enriquecidos y programas de desarrollo temprano basados en la teoría de la neuroplasticidad, mejoran la función cognitiva y el crecimiento cerebral favoreciendo una atención rehabilitadora integral sobre los trastornos motores y los trastornos asociados, y lográndose mejorar la calidad de vida de las personas afectadas y sus familias


Cerebral palsy is a syndrome that associates disorders of the development of movement, posture and muscle tone, which cause limitations in activities and are accompanied by sensory and cognitive failures, alterations of communication, perception, behavior, and epilepsy. The treatment must be preventive, active and interdisciplinary at the pharmacological, rehabilitation, psycho-emotional and cognitive levels. The exposure to enriched sensorial environments and early development programs based on the theory of neuroplasticity, improve cognitive function and brain growth, favoring comprehensive rehabilitative care on motor disorders and associated disorders, and improving the quality of life of affected people and their families


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Paralisia Cerebral/diagnóstico , Paralisia Cerebral/reabilitação , Qualidade de Vida/psicologia , Plasticidade Neuronal/fisiologia , Fatores de Risco , Neuropsicologia/métodos , Paralisia Cerebral/terapia , Psiquiatria Geriátrica/métodos , Psiquiatria Geriátrica/tendências , Dissonância Cognitiva , Terapia Cognitivo-Comportamental
3.
Rev. neurol. (Ed. impr.) ; 68(5): 207-212, 1 mar., 2019.
Artigo em Espanhol | IBECS | ID: ibc-180390

RESUMO

Hubo un tiempo en que los clínicos despreciaban cualquier toma de decisiones que no dependiera de su propio juicio. Los estadísticos se reían de tal ingenuidad, conociendo lo falible de los heurísticos que guían las decisiones humanas, incluso en los individuos más entrenados. Tras más de 60 años del inicio del enfrentamiento, ambas posturas aún no se han asimilado en psicología clínica ni en neuropsicología. El presente trabajo respalda la aplicación práctica de la estadística en la toma de decisiones clínica y muestra que incluso el juicio de tipo intuitivo descansa de algún modo en la aplicación del uso básico de conceptos estadísticos, sin obviar que en ocasiones se ha hecho mal uso de las herramientas estadísticas. Para ello contrasta las opiniones ofrecidas por algunos clínicos en forma de frase con la bibliografía consultada, que se extiende desde los primeros trabajos del psicólogo clínico Paul Meehl hasta la actualidad. Lejos de querer imponer una opinión, se comenta la ventaja de asumir un enfoque que aproveche los conocimientos matemáticos como apoyo a la toma de decisiones clínica. Finalmente se comenta la necesidad de equipos multidisciplinares en las unidades especiales de nuestros centros hospitalarios


There was a time when clinicians looked down on any decision-making that did not depend on their own judgement. Statisticians laughed at such naivety, as they were fully aware of the extent to which the heuristics that guide human decisions are capable of error, even in the most highly trained individuals. More than 60 years after the beginning of this conflict, the two standpoints have still not been adopted in clinical psychology or in neuropsychology. This work defends the practical application of statistics in clinical decision-making and shows that even intuitive-type judgement is somehow based on applying the basic use of statistical concepts, without neglecting the fact that statistical instruments have sometimes been misused. To this end, this study compares the opinions offered by some clinicians in sentence form with the bibliography consulted, which spans the period from the earliest works by the clinical psychologist Paul Meehl to the present day. We have no intention whatsoever of imposing an opinion, but instead of discussing the advantage of adopting an approach that uses mathematical knowledge to support clinical decision-making. Attention is also drawn to the need for multidisciplinary teams in the special units of our hospitals


Assuntos
Humanos , Neuropsicologia/métodos , Interpretação Estatística de Dados , Técnicas de Apoio para a Decisão , Previsões/métodos , Medicina Baseada em Evidências/tendências , Equipe de Assistência ao Paciente/tendências
4.
Clin Neuropsychol ; 33(2): 187-199, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30760098

RESUMO

OBJECTIVE: We introduce this special issue which focuses on how advances in neuroscience and technology can modernize and transform clinical neuropsychological assessment. METHOD: We included both invited and solicited papers to reflect on the strengths and weaknesses of currently used, standardized neuropsychological tests and to explore how we might incorporate new technologies and neuroscientific advances to modernize neuropsychological assessment methods. RESULTS: The papers are organized along the following themes: (1) A critique of the current clinical neuropsychological test armamentarium; (2) A description of new opportunities for collecting neurobehavioral data with technology; (3) Digital science, biomedical big data and the internet; (4) Integrating neuropsychological, neuroimaging, and neurophysiological assessments; (5) Modernization, globalization and culture. CONCLUSION: The process of modernizing methods of assessment in clinical neuropsychology is laborious and requires a coordinated, sustained effort among clinicians, researchers, and the test industry. While embracing technology is necessary, we must also be aware of unintended consequences as we navigate this exciting new territory.


Assuntos
Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Testes Neuropsicológicos , Neuropsicologia/tendências , Humanos , Neuropsicologia/métodos
5.
Appl Neuropsychol Adult ; 26(3): 283-296, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29236528

RESUMO

Deep Brain Stimulation (DBS) is an effective surgical therapy for several neurological movement disorders. The clinical neuropsychologist has a well-established role in the neuropsychological evaluation and selection of surgical candidates. In this article, we argue that the clinical neuropsychologist's role is much broader, when considered in relation to applied psychologists' core competencies. We consider the role of the clinical neuropsychologist in DBS in relation to: assessment, formulation, evaluation and research, intervention or implementation, and communication. For each competence the relevant evidence-base was reviewed. Clinical neuropsychology has a vital role in presurgical assessment of cognitive functioning and psychological, and emotional and behavioral difficulties. Formulation is central to the selection of surgical candidates and crucial to intervention planning. Clinical neuropsychology has a well-established role in postsurgical assessment of cognitive functioning and psychological, emotional, and behavioral outcomes, which is fundamental to evaluation on an individual and service level. The unique contribution clinical neuropsychology makes to pre- and postsurgical interventions is also highlighted. Finally, we discuss how clinical neuropsychology can promote clear and effective communication with patients and between professionals.


Assuntos
Competência Clínica , Estimulação Encefálica Profunda , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/terapia , Neuropsicologia , Relações Profissional-Paciente , Competência Clínica/normas , Estimulação Encefálica Profunda/métodos , Estimulação Encefálica Profunda/normas , Humanos , Transtornos dos Movimentos/cirurgia , Neuropsicologia/métodos , Neuropsicologia/normas
6.
Appl Neuropsychol Child ; 8(2): 174-181, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29364695

RESUMO

Neuropsychological assessments in preschoolers have not received as much attention as in older children and adults. Attention-deficit/hyperactivity disorder (ADHD) is a common disorder that occurs in early childhood associated with poor academic and personal outcomes, such as learning and social difficulties. Preschoolers with ADHD may present cognitive deficits that are related with the ADHD symptoms of inattention, hyperactivity, and impulsivity, but may also interfere, beyond and above the ADHD symptoms, with everyday functioning. Most importantly, cognitive deficits in preschoolers seem to predict future ADHD symptoms. Yet, the practice of neuropsychological assessment in this age-group has been limited. The present selective review highlights the contribution of comprehensive neuropsychological assessments to the early identification of symptomatic preschoolers and to our understanding of the nature and developmental trajectory of ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Disfunção Cognitiva/diagnóstico , Testes Neuropsicológicos , Neuropsicologia/métodos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Pré-Escolar , Disfunção Cognitiva/etiologia , Humanos
7.
Clin Neuropsychol ; 33(1): 32-56, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29923448

RESUMO

OBJECTIVE: The aims of the study were to analyze the current European situation of specialist education and training within clinical neuropsychology, and the legal and professional status of clinical neuropsychologists in different European countries. METHOD: An online survey was prepared in 2016 by a Task Force established by the European Federation of Psychological Associations, and representatives of 30 countries gave their responses. Response rate was 76%. RESULTS: Only three countries were reported to regulate the title of clinical neuropsychologist as well as the education and practice of clinical neuropsychologists by law. The most common university degree required to practice clinical neuropsychology was the master's degree; a doctoral degree was required in two countries. The length of the specialist education after the master's degree varied between 12 and 60 months. In one third of the countries, no commonly agreed upon model for specialist education existed. A more systematic training model and a longer duration of training were associated with independence in the work of clinical neuropsychologists. CONCLUSIONS: As legal regulation is mostly absent and training models differ, those actively practicing clinical neuropsychology in Europe have a very heterogeneous educational background and skill level. There is a need for a European standardization of specialist training in clinical neuropsychology. Guiding principles for establishing the common core requirements are presented.


Assuntos
Testes Neuropsicológicos/normas , Neuropsicologia/métodos , Médicos/normas , Europa (Continente) , Feminino , Humanos , Masculino , Inquéritos e Questionários
8.
Annu Rev Psychol ; 70: 9-28, 2019 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-30125134

RESUMO

Volition refers to a capacity for endogenous action, particularly goal-directed endogenous action, shared by humans and some other animals. It has long been controversial whether a specific set of cognitive processes for volition exist in the human brain, and much scientific thinking on the topic continues to revolve around traditional metaphysical debates about free will. At its origins, scientific psychology had a strong engagement with volition. This was followed by a period of disenchantment, or even outright hostility, during the second half of the twentieth century. In this review, I aim to reinvigorate the scientific approach to volition by, first, proposing a range of different features that constitute a new, neurocognitively realistic working definition of volition. I then focus on three core features of human volition: its generativity (the capacity to trigger actions), its subjectivity (the conscious experiences associated with initiating voluntary actions), and its teleology (the goal-directed quality of some voluntary actions). I conclude that volition is a neurocognitive process of enormous societal importance and susceptible to scientific investigation.


Assuntos
Encéfalo/fisiologia , Metas , Neuropsicologia/métodos , Volição/fisiologia , Humanos
9.
Clin Neuropsychol ; 33(2): 357-368, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30394172

RESUMO

OBJECTIVE: In cognitive neuroscience, well-controlled and highly specific paradigms have been developed to measure cognitive processes over the last decades, often using computer-assisted presentation and response registration. This approach is in contrast with the traditional paper-and-pencil tests used in clinical neuropsychology, which typically assess cognitive function in a less specific manner, often even at the level of a cognitive domain. As a result, important aspects of cognitive (dys)function may be missed during a neuropsychological assessment. This paper focuses on the main challenges that need to be overcome in order to successfully integrate experimental paradigms from cognitive neuroscience into the clinical practice of neuropsychologists. METHOD: Six challenges are discussed: (i) experimental paradigms are often lengthy and may be overly specific; (ii) technical limitations even today hamper their application in clinics; (iii) the psychometric properties of methods used in cognitive neuroscience are under-examined or poor; (iv) many paradigms from cognitive neuroscience rely on reaction times rather than accuracy, limiting their use in the many brain-injured patients with processing speed deficits; (v) the predictive and ecological validity of these paradigms often unclear; (vi) technological progress (e.g. Moore's law) seriously affects the continuous availability of experimental computerized assessment methods. CONCLUSION: Both cognitive neuroscientists and clinical neuropsychologists should work together to develop and validate novel paradigms for use in clinical assessments that are platform-independent, reliable and valid, user friendly and easy to use in clinical practice.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/psicologia , Neurociência Cognitiva/tendências , Testes Neuropsicológicos , Neuropsicologia/tendências , Cognição/fisiologia , Neurociência Cognitiva/normas , Humanos , Estudos Longitudinais , Testes Neuropsicológicos/normas , Neuropsicologia/métodos , Valor Preditivo dos Testes
10.
Clin Neuropsychol ; 33(2): 287-304, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30513257

RESUMO

OBJECTIVE: Neuropsychology is poised for a fundamental shift as we modernize the ways in which behavior is measured. The amount and complexity of data generated by these new methods will be several orders of magnitude greater than what is currently created by analog measures and will quickly adopt characteristics of "Big Data." Adequate preparation for managing the influx of data will be critical for technology integration and modernization to be successful. Drawing from information technology, mathematics, statistics, computer science, and engineering, as well as, biology, genetics, and medicine, the field of biomedical informatics has rapidly evolved from its early days in computational biology to a burgeoning independent discipline that has much to offer neuropsychology. METHOD: Following a critical review of the relevant literature, the present article (1) provides an introductory overview of biomedical informatics and how these concepts are relevant to neuropsychology; (2) describes how biomedical informatics applications can be utilized to leverage existing data sources more effectively; and (3) discusses ideas for future developments designed to facilitate integration of new data derived from novel, technologically driven measurement tools. Within this context, applications intended for use by both the individual neuropsychologist to increase clinical efficiencies, as well as, larger field-wide initiatives intended to generate new information and derive new knowledge are discussed. CONCLUSIONS: By no means a comprehensive review of biomedical informatics, the present paper highlights that our approach to data needs to become a multidisciplinary endeavor in order to develop applications capable of effectively utilizing modern data sources.


Assuntos
Big Data , Informática Médica/tendências , Neuropsicologia/tendências , Mudança Social , Encéfalo/diagnóstico por imagem , Humanos , Informática Médica/métodos , Testes Neuropsicológicos , Neuropsicologia/métodos
11.
Rev. int. med. cienc. act. fis. deporte ; 18(72): 769-781, dic. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-180244

RESUMO

Este estudio tuvo como objetivo comparar los efectos de un programa de ejercicios de Brain Gym(R) con un programa de gimnasia de mantenimiento en pacientes mayores institucionalizados con deterioro cognitivo. Veintinueve personas institucionalizadas con deterioro cognitivo participaron en dos programas, uno basado en ejercicios de Brain Gym(R) y otro de gimnasia de mantenimiento, durante 18 semanas. Se emplearon los test Mini-examen cognoscitivo, Fototest, Trail Making Test, Índice de Barthel y el Timed up and Go. No se encontraron mejoras significativas en las variables analizadas. Se observó una tendencia positiva, especialmente en el grupo de gimnasia de mantenimiento, en la función cognitiva global y salud física. En conclusión, los efectos de un programa de ejercicios de Brain Gym(R) en una muestra de personas mayores institucionalizadas con deterioro cognitivo fueron similares a los de un programa de gimnasia de mantenimiento, sin mejoras significativas de la función cognitiva o independencia funcional


This study aimed at comparing the effects of a program based on Brain Gym(R) exercises against a fitness exercise program on the cognitive function and functional independence in institutionalized older adults with cognitive impairment. Twenty-nine institutionalized older adults with cognitive impairment took part either on a Brain Gym(R) based exercise program or on a fitness exercise program during eighteen weeks. The assessment measures used were the Mini-Examen Cognoscitivo, Fototest, Trail making test, Barthel Index and the Timed up and Go Test. None of the variables analysed improved significantly. A trend towards improvement, particularly in the fitness exercise group, in both cognitive status and functional independence was observed. In conclusion, the performance of a Brain Gym(R) exercise-based program had the same effects than taking part in a fitness exercise program, with no significant improvements on the cognitive function or functional independence, in a sample of institutionalized older adults with cognitive impairment


Assuntos
Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/terapia , Terapia por Exercício/métodos , Terapia por Exercício/tendências , Ginástica/fisiologia , Saúde do Idoso Institucionalizado , Exercício/fisiologia , Neuropsicologia/métodos , Análise Estatística
12.
Pediatr Neurol ; 89: 58-62, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30442440

RESUMO

BACKGROUND: Pediatric critical care survivors often suffer persisting multisystem health problems and are left with treatment needs that go unmet due to limits in current care models. We proposed that integration of neuropsychology into neurocritical care follow-up provides incremental benefit to the identification and treatment of persisting complications and reduction in co-morbidities. BASIC PROCEDURES: The aims of this study were three-fold. First, we described pilot programs at two pediatric hospitals as models for implementing systematic follow-up care with interdisciplinary clinic teams consisting of critical care, neurology, and neuropsychology. Second, we described working models specific to neuropsychological service delivery in these programs. Third, we presented preliminary data from the first six months of one of the pilot programs in order to examine incremental benefit of neuropsychology in improving patient care and parent satisfaction. MAIN FINDINGS: A total of 16 patients (age range three to 17 years) were seen by neuropsychology within the first six months of the program. Results showed that integration of neuropsychology into follow-up care resulted in recommendations being made for services or concerns not already addressed in 81% of cases. Parents reported high satisfaction, endorsing the highest possible rating on 96% of all items. Parents reported that neuropsychological consultation improved their understanding and communication with their child, and helped them know what to expect from their child during postacute recovery. CONCLUSIONS: The results of this pilot study suggest that integration of neuropsychology into neurocritical care follow-up programs contributes to parent satisfaction and may provide incremental benefit to patient care.


Assuntos
Cuidados Críticos/métodos , Doenças do Sistema Nervoso/reabilitação , Neuropsicologia/métodos , Resultado do Tratamento , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Hospitais Pediátricos , Humanos , Masculino , Neurologia , Pais/psicologia , Projetos Piloto , Avaliação de Programas e Projetos de Saúde
13.
Handb Clin Neurol ; 158: 179-191, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30482345

RESUMO

Sport-related concussions are complex injuries of the brain. Since concussions can only be diagnosed clinically and manifest in different ways among athletes, diagnosis and management often require a multidisciplinary team approach. Sports neuropsychologists contribute to the team through their ability to assess cognitive, behavioral, and social-emotional domains that may or may not be a direct effect of the injury. This chapter describes the new field of sports neuropsychology and articulates how neuropsychologists can contribute to assessment and management. The strengths and weaknesses of neuropsychological assessment are reviewed, including traditional paper-and-pencil testing and computer-administered tests, both as baseline and postinjury evaluations. Neuropsychologists can provide biopsychosocial evaluation and treatment services to athletes, including postinjury education and emotional reassurance, guiding symptom management and emotional support, and assisting with return-to-play and return-to-school processes. They also provide important insight for decisions regarding retirement, including articulating the relevant factors and supporting athletes in their decision process. Given the varying and behavioral responses that can accompany concussion, neuropsychologists can provide unique support to athletes to help them cope with their injury and its effects.


Assuntos
Traumatismos em Atletas/complicações , Concussão Encefálica , Neuropsicologia/métodos , Concussão Encefálica/etiologia , Concussão Encefálica/psicologia , Concussão Encefálica/terapia , Gerenciamento Clínico , Humanos , Testes Neuropsicológicos
14.
Rev. neurol. (Ed. impr.) ; 67(9): 355-364, 1 nov., 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-175267

RESUMO

Introducción. Los trastornos de la alimentación son trastornos mentales graves que se manifiestan de diferentes formas diagnósticas, como la anorexia nerviosa y la bulimia nerviosa. En los últimos años, diversos estudios han enfatizado la participación de procesos neuropsicológicos en la anorexia y la bulimia nerviosas. Objetivo. Revisar las evidencias sobre los déficits en funciones ejecutivas, sesgos atencionales y coherencia central en la anorexia y la bulimia nerviosas en relación con un perfil neuropsicológico de riesgo, un perfil neuropsicológico diferente asociado a las mencionadas patologías alimentarias y el papel de variables (índice de masa corporal, edad, ansiedad, impulsividad, alexitimia, estado de ánimo, imagen corporal) en la presencia de déficits neuropsicológicos. Desarrollo. Revisión de los estudios empíricos de los últimos siete años encontrados en las bases de datos Medline y PsycINFO para inglés, y Dialnet y Psicodoc para castellano. Se han seleccionado 28 artículos para el objetivo propuesto. La elección de los documentos se realizó conforme a unos criterios preestablecidos. Conclusiones. Según las evidencias disponibles, parece existir un perfil de riesgo caracterizado por rigidez cognitiva y coherencia central débil. Los resultados parecen más consistentes en relación con el perfil de riesgo en la anorexia nerviosa. Además, tanto en la anorexia como en la bulimia nerviosa existen sesgos atencionales relacionados con el reconocimiento de emociones y aspectos sociales, y el rasgo de alexitimia es una variable moduladora en dicha dificultad


Introduction. Eating disorders are severe mental disorders that appear in different diagnostic forms, such as anorexia nervosa and bulimia nervosa. In recent years, a number of studies have highlighted the involvement of neuropsychological processes in anorexia and bulimia nervosa. Aim. To review the evidence on the deficits in the executive functions, attentional biases and central coherence in anorexia and bulimia nervosa in relation to a neuropsychological risk profile, a different neuropsychological profile associated with the aforementioned eating pathologies and the role of variables (body mass index, age, anxiety, impulsiveness, alexithymia, mood, body image) in the presence of neuropsychological deficits. Development. We reviewed the empirical studies conducted in the last seven years found in the Medline and PsycINFO databases for English, and Dialnet and Psicodoc for Spanish. Twenty-eight articles were selected as suitable for the purposes of this study. The documents were chosen on the basis of a set of pre-established criteria. Conclusions. According to the evidence available, there seems to be a risk profile characterised by cognitive rigidity and weak central coherence. The results appear to be more consistent as regards the risk profile in anorexia nervosa. Furthermore, in both anorexia and bulimia nervosa there are attentional biases related to the recognition of emotions and social aspects, and the alexithymia trait is a modulating variable in this difficulty


Assuntos
Humanos , Bulimia Nervosa/psicologia , Neuropsicologia/métodos , Função Executiva/fisiologia , Viés de Atenção/fisiologia , Anorexia Nervosa/complicações , Comportamento Verbal/fisiologia , Transtornos da Alimentação e da Ingestão de Alimentos
15.
PLoS One ; 13(10): e0205754, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30335801

RESUMO

In clinical neuropsychology the cognitive abilities of neurological patients are commonly estimated using well-established paper-based tests. Typically, scores on some tests remain relatively well preserved, whilst others exhibit a significant and disproportionate decline. Scores on those tests that measure preserved cognitive functions (so-called 'hold' tests) may be used to estimate premorbid abilities, including scores in non-hold tests that would have been expected prior to the onset of cognitive impairment. Many hold tests entail word reading, with each word being graded as correctly or incorrectly pronounced. Inevitably, such tests are likely to contain words that provide little or no diagnostic power (i.e., can be eliminated without negatively affecting prediction accuracy). In this paper, a genetic algorithm is developed and demonstrated, using n = 92 neurologically healthy participants, to identify optimal word subsets from the National Adult Reading Test that minimize the mean error in predicting the most widely used clinical measure of IQ and cognitive ability, the Wechsler Adult Intelligence Scale Fourth Edition IQ. In addition to requiring only 17-20 of the original 50 words (suggesting that this test could be revised to be up to 66% shorter) and minimizing mean prediction error, the algorithm increases the proportion of the variance in the predicted variable explained in comparison to using all words (from r2 = 0.46 to r2 = 0.61). In a clinical setting this would improve estimates of premorbid cognitive function and, if an abbreviated revision to this test were to be adopted, reduce the arduousness of the test for patients. The proposed method is evaluated with jackknifing and leave one out cross validation. The general approach may be used to optimize the relationship between any two psychological tests by finding the question subset in one test that minimizes the prediction error in a second test by training the genetic algorithm using data collected from participants upon whom both tests have been administered. This approach may also be used to develop new predictive tests, since it provides a method to identify an optimal subset of a set of candidate questions (for which empirical data have been collected) that maximizes prediction accuracy and the proportion of variance in the predicted variable that can be explained.


Assuntos
Disfunção Cognitiva/diagnóstico , Modelos Biológicos , Neuropsicologia/métodos , Leitura , Escalas de Wechsler , Adulto , Idoso , Algoritmos , Cognição , Feminino , Voluntários Saudáveis , Humanos , Inteligência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Adulto Jovem
16.
Sci Rep ; 8(1): 13627, 2018 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-30206283

RESUMO

Peculiar cognitive profile of patients with SBMA has been described by fragmented literature. Our retrospective study reports the neuropsychological evaluations of a large cohort of patients in order to contribute towards the understanding of this field. We consider 64 neuropsychological evaluations assessing mnesic, linguistic and executive functions collected from 2013 to 2015 in patients attending at Motor Neuron Disease Centre of University of Padova. The battery consisted in: Digit Span forwards and backwards, Prose Memory test, Phonemic Verbal fluency and Trail making tests. ANCOVA statistics were employed to compare tests scores results with those obtained from a sample of healthy control subjects. Multiple linear regressions were used to study the effect on cognitive performance of CAG-repeat expansion, the degree of androgen insensitivity and their interaction to cognitive performance. Statistical analyses did not reveal altered scores in any neuropsychological tests among those adopted. Interestingly, patients performed significantly better in the Prose Memory test's score. No relevant associations were found with genetic, hormonal or clinical patients' profile. Results inconsistent with previous studies have been interpreted according to the phenomenon of somatic mosaicism. We suggest a testosterone-related and the mood state-dependant perspectives as two possible interpretations of the enhanced performances in the Prose Memory test. Further studies employing more datailed tests batteries are encouraged.


Assuntos
Atrofia Bulboespinal Ligada ao X/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Cognição/fisiologia , Memória/fisiologia , Adulto , Atrofia Bulboespinal Ligada ao X/diagnóstico , Transtornos Cognitivos/diagnóstico , Função Executiva/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Neuropsicologia/métodos , Estudos Retrospectivos
17.
Acta fisiátrica ; 25(3)set. 2018.
Artigo em Inglês, Português | LILACS | ID: biblio-999698

RESUMO

Objetivo: O estudo objetivou traçar um perfil neuropsicológico breve de pacientes com amputação maior de membros inferiores por etiologia vascular e investigar a existência de correlações dos aspectos cognitivos com fatores sociodemográficos e clínicos. Método: Trata-se de um estudo transversal descritivo, realizado em um centro de reabilitação física de São Paulo - Brasil, em que foram aplicados: um instrumento de avaliação neuropsicológica breve (Neupsilin), um questionário de caracterização da amostra próprio e a Escala de Ansiedade e Depressão Hospitalar (HAD). Resultados: O desempenho cognitivo foi pior em funções que requerem habilidades aritméticas (42,2% dos pacientes com desempenho abaixo do esperado); percepção (46,3% dos pacientes abaixo do esperado); funções executivas, notadamente nas tarefas praxia construtiva (40,6% abaixo do esperado) e fluência verbal (35,9% abaixo do esperado), e linguagem (31,2% abaixo do esperado). Conclusão: O perfil cognitivo dos pacientes deste estudo revelou dificuldades relevantes das funções cognitivas avaliadas, especialmente em funções diretamente relacionadas à funcionalidade do paciente.


Objective: To describe the neuropsychological profile of patients with major lower limb amputation and to investigate the existence of correlations between these cognitive aspects, socio-demographic and clinical aspects. Method: This is a cross-sectional, analytic, descriptive study carried out at an outpatient rehabilitation center. The instruments used were Hospital Anxiety and Depression Scale (HADS), a brief neuropsychological assessment instrument (Neupsilin) along with a questionnaire to characterize the sample. Results: Cognitive performance was worse in functions that require arithmetic skills (42,2% of the patients underperformed); perception (46,3% underperformed); executive functions, notably in constructive praxis (40,6% underperformed) and verbal fluency (35,9% underperformed) and language (31,2% underperformed). The best performances were in spacial orientation (92,2% performed as expected) and verbal memory (87,5% performed as expected). Conclusion: The cognitive profile of these patients revealed alterations in most of the assessed cognitive functions, especially in functions directly related to functionalities of the patient.


Assuntos
Humanos , Perfil de Saúde , Cognição , Doença Arterial Periférica/etiologia , Amputação , Neuropsicologia/métodos , Testes Psicológicos , Epidemiologia Descritiva , Estudos Transversais
18.
Rev. neurol. (Ed. impr.) ; 67(3): 84-90, 1 ago., 2018. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-174875

RESUMO

Introducción. En estudios previos se ha señalado que las funciones ejecutivas pueden actuar como mediadoras entre el estrés percibido y las quejas subjetivas de memoria. Sin embargo, no se ha evaluado qué funciones ejecutivas son las que median en mayor medida dicha relación. Objetivo. Determinar si las funciones ejecutivas tienen un papel mediador en la relación entre el estrés percibido y las quejas subjetivas de memoria, y cuáles son las que tienen un mayor poder explicativo. Pacientes y métodos. La muestra estuvo compuesta por 743 universitarios (76,4% mujeres), con una edad media de 22,24 ± 3,64 años. Las quejas subjetivas de memoria se evaluaron con el cuestionario de fallos de memoria de la vida cotidiana; el estrés, con la escala de estrés percibido; y las funciones ejecutivas, con el inventario de síntomas prefrontales. Resultados. Las funciones ejecutivas y el estrés percibido explicaron en conjunto un 57% de las quejas subjetivas de memoria, y los problemas atencionales y los problemas del control ejecutivo fueron las dos variables con un mayor peso en el modelo. Por otro lado, los problemas del control ejecutivo, los problemas atencionales y los problemas de la conducta social mostraron un efecto mediador entre el estrés percibido y las quejas subjetivas de memoria. Conclusiones. Los problemas del control ejecutivo y los problemas atencionales podrían ser factores de elección para la intervención clínica, puesto que actúan por sí solos como generadores de quejas subjetivas de memoria y además se encuentran implicados en procesos de mediación del estrés percibido


Introduction. Previous studies have shown that executive functions can be mediators between perceived stress and subjective memory complaints. However, it has not been evaluated which executive functions are those that most mediate this relationship. Aim. To determine if executive functions have a mediating role in the relationship between perceived stress and subjective memory complaints, and which ones have the greatest explanatory power. Patients and methods. The sample consisted of 743 university students (76.4% women), with an average age of 22.24 ± 3.64 years. The subjective memory complaints were evaluated with the Memory Failure of Everyday Questionnaire, the stress with the Perceived Stress Scale, and the executive functions with the Prefrontal symptoms Inventory. Results. The executive functions and the perceived stress explained altogether 57% of the subjective memory complaints, being the attentional problems and the executive control problems the two variables with a greater weight in the model. On the other hand, the executive control problems, attentional problems and social behaviour problems showed a mediating effect between perceived stress and subjective memory complaints. Conclusions. The executive control problems and the attentional problems could be factors of choice for clinical intervention, since they act on their own as generators of subjective memory complaints and, moreover, are involved in mediation processes of perceived stress


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Memória/fisiologia , Psicometria/métodos , Emoções Manifestas/fisiologia , Inquéritos e Questionários , Neuropsicologia/métodos , Comportamento Social , Autorrelato , Análise de Regressão , Intervalos de Confiança
19.
Clin Neuropsychol ; 32(5): 960-980, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29708011

RESUMO

OBJECTIVE: There has been a recent rapid development of research characterizing prospective memory performance in mild cognitive impairment (MCI) in older age. However, this body of literature remains largely separated from routine clinical practice in neuropsychology. Furthermore, there is emerging evidence of effective interventions to improve prospective memory performance. Therefore, our objective in this article was to offer a clinical neuropsychological perspective on the existing research in order to facilitate the translation of the evidence-base into clinical practice. METHOD: By conducting a critical review of the existing research related to prospective memory and MCI, we highlight how this data can be introduced into clinical practice, either within diagnostic assessment or clinical management. CONCLUSIONS: Prospective memory is impaired in older adults with MCI, with a pattern of performance that helps with differential diagnosis from healthy aging. Clinical neuropsychologists are encouraged to add prospective memory assessment to their toolbox for diagnostic evaluation of clients with MCI. Preliminary findings of prospective memory interventions in MCI are promising, but more work is required to determine how different approaches translate to increasing independence in everyday life.


Assuntos
Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Memória Episódica , Neuropsicologia/métodos , Idoso , Idoso de 80 Anos ou mais , Cognição/fisiologia , Feminino , Humanos , Masculino , Testes Neuropsicológicos/normas , Neuropsicologia/normas
20.
J Clin Exp Neuropsychol ; 40(10): 1022-1029, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29843556

RESUMO

Workload is a common and useful construct in human factors research that has been largely overlooked in other areas of psychology, including neuropsychology, where it could be effectively employed both theoretically and practically. A popular subjective measure of workload, the NASA-Task Load Index (NASA-TLX), is illustrated with a computerized version of the Tower of Hanoi (TOH), a typical neuropsychological test of executive function. Reported workload, especially as an overall measure and also for the Mental Demand and Effort subscales, was greater in the more difficult TOH conditions and was positively correlated with number of moves to complete the TOH as well as completion time. Thus, results support the utility or construct validity of the NASA-TLX in reflecting workload states in the individual as well as various demands of the neuropsychological test (the timing, physical demands, etc.). It is argued that workload can be a useful construct in neuropsychological assessment, providing an additional channel of information on patient status. For instance, what does it mean if test performance for a patient is at a typical level (indicating no deficit) but workload is exceptionally high?


Assuntos
Testes Neuropsicológicos , Neuropsicologia/métodos , Carga de Trabalho/psicologia , Adolescente , Feminino , Humanos , Individualidade , Masculino , Desempenho Psicomotor , Reprodutibilidade dos Testes , Adulto Jovem
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