Advances in the electrophysiological research on neurocognitive function in adolescents with non-suicidal self-injury / 中国当代儿科杂志

Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI.

Elementos neurocognitivos da atenção seletiva para a compreensão da transição escolar de noções matemáticas / Neurocognitive elements of selective attention for the comprehension of the school transition of mathematical notions

A aprendizagem de noções matemáticas exige estratégias que favoreçam a "atenção seletiva" dos alunos de modo a considerar informações relevantes e ignorar as irrelevantes. O objetivo central desta pesquisa foi identificar as noções matemáticas que requisitam atenção seletiva, configurando-se, nesta pesquisa, como as mais importantes do Ensino Fundamental (EF) esperadas pelo Ensino Médio (EM). Trata-se de uma pesquisa qualitativa de cunho teórico e documental. Considerou-se princípios da epistemologia das noções matemáticas, da análise de funções cognitivas em atividades de trigonometria e dos Níveis do Funcionamento do Conhecimento. Apropriou-se também de fundamentos neurocognitivos da atenção para a elaboração de uma matriz de referência, que serviu de lente para identificar os tipos e níveis de tarefas que requisitam atenção seletiva. Os resultados apontaram que existe um conjunto de conhecimentos no EF (Grandezas e Medidas) potencial motor para dar suporte aos pares de ideias fundamentais (BNCC, 2017), no que se refere às "relações e inter-relações" do EM. Como proposta baseada nas discussões deste trabalho, foram apresentados três tipos de tarefas que pretendem alcançar as exigências neurocognitivas e didáticas esperadas pela transição escolar entre o EF-EM.

The learning of mathematical notions requires strategies that favourthe students' "selective attention" toconsider relevant information and ignore the irrelevant ones. Themain objective of this research was to identify the mathematical notions that require selective attention, being in this research, as the most important of the Elementary School expected by High School. This is a qualitative research of a theoretical and documental kind. It was considered principles of the epistemology of mathematical notions, of the analysis of cognitive functions in trigonometry activities and of the Levels of the Functioning of Knowledge. It also considered neurocognitive fundamentals of attention for the elaboration of a reference matrix, which served as a lens to identify the types and levels of tasks that require selective attention. The results pointed out that there is a set of knowledge in the Elementary School (Quantities and Measures) potential motor to support the pairs of fundamental ideas (BNCC, 2017), regarding the "relations and interrelations" of High School. As a proposal based on the discussions of this paper, three types of tasks were presented that aim to achieve the neurocognitive and didactic requirements expected by the school transition between the Elementary School and High School.

Research progress of nervous system and neurocognition-related complications after liver transplantation / 器官移植

The postoperative nervous system and neurocognition-related complications have become an important issue of research focus with the gradual increase of the survival rate after liver transplantation. Compared to other solid organ transplantation, the incidence of nervous system complications after liver transplantation is higher and closely related to death. This paper mainly overviewed the nervous system complications, neurocognition-related complications after liver transplantation and the risk factors inducing these complications. It also discussed how to evaluate, monitor, and prevent these complications in order to provide reference for future studies.

Función cognitiva e hipertensión arterial en niños y adolescentes / Cognitive function and arterial hypertension in children and adolescents

Los jóvenes con hipertensión arterial pueden manifestar efectos adversos en órganos blanco como el corazón y la vasculatura, incluyendo hipertrofia ventricular izquierda, aumento de la rigidez arterial y aumento del grosor de la carótida. También existe evidencia reciente de efectos adversos debido a hipertensión en el cerebro, hallazgo con implicancias significativas del impacto de la hipertensión arterial primaria en la cognición, tanto durante la infancia como a lo largo de la vida. En los últimos 15 años, estudios de bases de datos y estudios uni y multicéntricos han evidenciado que la presión arterial elevada en niños y adolescentes se asocia con un menor rendimiento en las pruebas neurocognitivas durante la juventud. Se presenta un resumen de la literatura sobre el efecto de la hipertensión arterial en la neurocognición en niños y jóvenes, así como también se analizan posibles mecanismos. El hallazgo de un rendimiento más bajo en las pruebas neurocognitivas en jóvenes hipertensos sugiere que el tratamiento de la hipertensión arterial en la adolescencia podría representar una oportunidad para mejorar el deterioro posterior y, por lo tanto, mejorar la salud cognitiva futura

Youth with hypertension can manifest adverse target-organ effects on the heart and vasculature, including left ventricular hypertrophy, increased arterial stiffness, and increased carotid thickness. There is emerging evidence for hypertensive adverse effects on the brain as well, findings with significant implications for the impact of primary hypertension on cognition both during childhood and later in life. Over the past 15 years, database, single-center, and multicenter studies have provided evidence that elevated BP in children and adolescents is associated with lower performance on neurocognitive testing during youth itself. In this review, we summarize the literature on the effect of hypertension on neurocognition in youth as well as review possible mechanisms of altered cognition. The finding of lower neurocognitive test performance in hypertensive youth suggests that treatment of hypertension from adolescence may represent an opportunity to ameliorate subsequent cognitive decline and thereby improve downstream cognitive health

Development, Cognition, Adaptive Function and Maladaptive Behavior in HIV-infected and HIV-exposed Uninfected Children Aged 2-9 Years

Objectives: To compare development/cognition, adaptive function and maladaptive behaviorof HIV-infected and HIV-exposed uninfected children between 2 to 9 years with HIV-uninfected controls. Methods: This hospital-based cross-sectional study was conductedfrom November, 2013 to March, 2015. 50 seropositive HIV-infected, 25 HIV-exposeduninfected and 25 HIV-uninfected children between 2 to 9 years were administeredDevelopmental Profile 3, Vineland Adaptive Behavior Scale 2, and Child Behavior Checklistfor assessing development, adaptive function and maladaptive behaviour, respectively.Additional data were obtained by history, examination and review of records. Results:Significant developmental/cognitive impairment was observed in 38 (76%), 16 (64%) and 6(24%) HIV-infected, HIV-exposed uninfected, and HIV-uninfected children, respectively.Significant impairment in adaptive function was found in 12 (24%) and 2 (8%) HIV-infectedand HIV-exposed uninfected children, respectively. Maladaptive behavior was not seen in anygroup. Conclusions: High magnitude of impaired development/cognition and adaptivefunction in HIV-exposed and HIV-infected children warrants assessment of these domainsduring follow-up of these children, and incorporation of interventions for these deficits instandard care for this group.

Neurocognitive profiles and related factors of subjective cognitive decline / 中华行为医学与脑科学杂志

Objective@#To investigate the neurocognitive characteristics and related factors in the elderly with subjective cognitive decline.@*Methods@#Among the 1 850 elderly volunteers aged over 50, 377 cognitive normal elderly (NC group), 234 subjective cognitive decline (SCD Group) and 291 patients with mild cognitive impairment (aMCI Group) were screened with the brief elderly cognitive screening questionnaire and the elderly rapid cognitive screening scale.They were all received clinical interview and examination and core neurocognitive test.@*Results@#(1) There were statistically significant differences in the three groups on the age, education, occupation, HAMD, low density lipoprotein and blood pressure (P<0.01). (2) The score of the picture-symbol association in SCD group(8.94±4.05)was lower than that in NC group(9.83±4.18)and higher than that in aMCI group (7.12±4.17)(all P<0.05), while the scores of the other neuropsychological tests were higher than those in aMCI group.There were no statistically significant difference between SCD group and NC group on the other neuropsychological tests(P>0.05). (3)The SCD was mainly influenced by age(β=0.063, OR=1.065, 95%CI=1.033-1.099), depression(β=0.182, OR=1.199, 95%CI=1.084-1.327)and hypertension(β=0.473, OR=1.604, 95%CI=1.185-2.171)(all P<0.01). And the aMCI was mainly influenced by age(β=0.078, OR=1.081, 95%CI=1.048-1.115), education(β=-0.174, OR=0.840, 95%CI=0.778-0.907), occupation(β=-0.406, OR=0.666, 95%CI=0.535-0.830)and low density lipoprotein(β=-0.451, OR=0.637, 95%CI=0.497-0.816)(all P<0.01 ).@*Conclusion@#Objective neurocognitive function of the elderly with subjective cognitive decline is basically normal.Age, depression and hypertension are risk factors of subjective cognitive decline.

Neurocognitive profiles and related factors of subjective cognitive decline / 中华行为医学与脑科学杂志

Objective To investigate the neurocognitive characteristics and related factors in the elderly with subjective cognitive decline. Methods Among the 1 850 elderly volunteers aged over 50,377 cognitive normal elderly (NC group),234 subjective cognitive decline ( SCD Group) and 291 patients with mild cognitive impairment (aMCI Group) were screened with the brief elderly cognitive screening question-naire and the elderly rapid cognitive screening scale. They were all received clinical interview and examina-tion and core neurocognitive test. Results ( 1) There were statistically significant differences in the three groups on the age,education,occupation,HAMD,low density lipoprotein and blood pressure (P<0. 01). (2) The score of the picture-symbol association in SCD group( 8. 94 ± 4. 05) was lower than that in NC group (9. 83±4. 18)and higher than that in aMCI group (7. 12±4. 17)(all P<0. 05),while the scores of the other neuropsychological tests were higher than those in aMCI group. There were no statistically significant differ-ence between SCD group and NC group on the other neuropsychological tests(P>0. 05). (3) The SCD was mainly influenced by age( β=0. 063, OR=1. 065,95% CI=1. 033-1. 099), depression ( β=0. 182,OR=1. 199,95%CI=1. 084-1. 327) and hypertension(β=0. 473,OR=1. 604,95% CI=1. 185-2. 171) ( all P<0. 01). And the aMCI was mainly influenced by age(β=0. 078,OR=1. 081,95%CI=1. 048-1. 115),educa-tion(β=-0. 174,OR=0. 840,95%CI=0. 778-0. 907),occupation( β=-0. 406,OR=0. 666,95%CI=0. 535-0. 830)and low density lipoprotein(β=-0. 451,OR=0. 637,95%CI=0. 497-0. 816)(all P<0. 01 ). Conclu-sion Objective neurocognitive function of the elderly with subjective cognitive decline is basically normal. Age,depression and hypertension are risk factors of subjective cognitive decline.

Neuro-cognitive Ramifications of Fasting and Feeding in Obese and Non-obese Cases

Preliminary studies have claimed that short term fasting would negatively affect school performance and cognition. In contrast some other studies have reported not important decline in cognition and executive function as a result of fasting. Also limited attention was generally devoted to dietetic regimens, nutritional status and body weight. Yet neuroscience and neuro-cognitive aspects of acute hunger on the electroencephalogram and differences between obese and non-obese cases is not well understood. Hence, we decided to design and perform a case study in a more controlled situation similar to reality. Therefore, we performed several examinations including subjective tests (for eating status) and objective tests (cognitive tests such as Stroop effect and Sternberg search and electroencephalogram measures such as steady-state visual evoked potential and auditory steady-state responses) for an obese and a non-obese academic case before and after a simple breakfast. The results showed that the breakfast effects on the neuro-cognitive functions depend on either obesity status, nutritional status of the case or the type of cognitive task (visual or auditory). This paper would open a new insight to answer some important questions about the neuro-cognitive implications of fasting and feeding in obese and non-obese human cases.

Aberrant Tendency of Noncurrent Emotional Experiences in Individuals at Ultra-High Risk for Psychosis

OBJECTIVE: This study aimed to investigate whether aberrant tendency of noncurrent emotion was present in individuals at ultra-high risk (UHR) for psychosis and to explore its associations with various clinical profiles. METHODS: Fifty-seven individuals at UHR and 49 normal controls were enrolled. The tendency of experiencing noncurrent emotion was assessed using various noncurrent emotional self-reported formats, including trait [Neuroticism and Extraversion of the Eysenck Personality Questionnaire], hypothetical (Chapman’s Revised Physical and Social Anhedonia Scales), and retrospective [Anhedonia-Asociality Subscale of the Scale for the Assessment of Negative Symptoms (SANS)] measures. Self-related beliefs (Self-Perception Scale), clinical positive and negative symptoms (SA Positive Symptoms and SANS), psychosocial function (Global Functioning Scale: Role Function and Global Functioning Scale: Social Function) were also examined. RESULTS: Subjects at UHR for psychosis reported more trait unpleasant and less trait pleasant emotions, more hypothetical physical and social anhedonia, and more retrospective anhedonia than normal controls. In UHR, self-perception was correlated to trait unpleasant emotion and hypothetical physical and social anhedonia. Negative symptoms in UHR were associated with hypothetical physical anhedonia and retrospective anhedonia. Global social functioning was related to trait pleasant emotion, hypothetical physical and social anhedonia, and retrospective anhedonia. Neurocognitive function, positive symptoms, and global role functioning were not related with any noncurrent emotional experience measures in UHR. CONCLUSION: These findings suggest that the aberrant tendency of noncurrent emotional experience may be present at the ‘putative’ prodromal phase and are grossly associated with self-related beliefs and psychosocial functioning but not neurocognitive functioning.

Fragile Self and Malevolent Others: Biased Attribution Styles in Individuals at Ultra-High Risk for Psychosis

OBJECTIVE: Biased attribution styles of assigning hostile intention to innocent others and placing the blame were found in schizophrenia. Attribution styles in individuals at ultra-high risk (UHR) for psychosis, however, have been less studied especially for its association with various psychological factors. We investigated whether UHR individuals show increased hostility perception and blaming bias and explored the associations of these biased styles of attribution with the factor structure of multifaceted self-related psychological variables and neurocognitive performances. METHODS: Fifty-four UHR individuals and 80 healthy controls were assessed by evaluating resilience, self-perception, self-esteem, and aberrant subjective experiences of schizotypy (physical anhedonia, social anhedonia, magical ideation, and perceptual aberration), basic symptoms, and carrying out a comprehensive neurocognitive test battery. Attribution styles were assessed using the Ambiguous Intentions Hostility Questionnaire. RESULTS: UHR individuals, compared with normal controls, showed increased hostility perception and blaming bias. Factor analysis of self-related psychological variables and neurocognitive performances in the entire subject population showed a three-factor solution, which was designated as reflective self, pre-reflective self, and neurocognition. Multiple regression analysis in UHR individuals revealed that hostility perception bias was associated with reflective self and composite blame bias was associated with reflective and pre-reflective self. CONCLUSION: This study supports the emergence of attribution biases in the putative ‘prodromal’ phase of schizophrenia. The associations of biased attribution styles with multifaceted self-related psychological constructs suggest that psychosocial interventions for biased attribution styles in UHR individuals should focus not only on reflective self but also pre-reflective self-related psychological constructs.

Neurocognitive Graphs of First-Episode Schizophrenia and Major Depression Based on Cognitive Features / 神经科学通报·英文版

Neurocognitive deficits are frequently observed in patients with schizophrenia and major depressive disorder (MDD). The relations between cognitive features may be represented by neurocognitive graphs based on cognitive features, modeled as Gaussian Markov random fields. However, it is unclear whether it is possible to differentiate between phenotypic patterns associated with the differential diagnosis of schizophrenia and depression using this neurocognitive graph approach. In this study, we enrolled 215 first-episode patients with schizophrenia (FES), 125 with MDD, and 237 demographically-matched healthy controls (HCs). The cognitive performance of all participants was evaluated using a battery of neurocognitive tests. The graphical LASSO model was trained with a one-vs-one scenario to learn the conditional independent structure of neurocognitive features of each group. Participants in the holdout dataset were classified into different groups with the highest likelihood. A partial correlation matrix was transformed from the graphical model to further explore the neurocognitive graph for each group. The classification approach identified the diagnostic class for individuals with an average accuracy of 73.41% for FES vs HC, 67.07% for MDD vs HC, and 59.48% for FES vs MDD. Both of the neurocognitive graphs for FES and MDD had more connections and higher node centrality than those for HC. The neurocognitive graph for FES was less sparse and had more connections than that for MDD. Thus, neurocognitive graphs based on cognitive features are promising for describing endophenotypes that may discriminate schizophrenia from depression.

Regulación Emocional En Pacientes Con Esquizofrenia: Un Estudio Piloto / Emotion Regulation In Schizophrenia Patients: A Pilot Study

RESUMEN Antecedentes: Se ha reportado que los pacientes con esquizofrenia presentan alteraciones en el procesamiento emocional, específicamente en la percepción de emociones. Sin embargo, poco se sabe sobre otros aspectos de este proceso, como la regulación emocional. Objetivo: Evaluar y comparar la regulación emocional y neurocognición en pacientes con esquizofrenia y sujetos control, así como identificar correlaciones entre regulación emocional, neurocognición y datos demográficos. Método: Se evaluaron nueve pacientes (GE) y nueve controles (GC). Se obtuvieron datos demográficos, para evaluar regulación emocional se utilizó la Prueba de Inteligencia Emocional Mayer-Salovey Caruso, sección Manejo de Emociones y se realizó una breve evaluación neurocognitiva. Resultados: El GE tuvo un desempeño significativamente inferior que el GC en la prueba de regulación emocional y en neurocognición (p<.05). No se encontraron correlaciones entre regulación emocional, neurocognición, datos demográficos y clínicos. Discusión y conclusión: Los pacientes con esquizofrenia presentan menor capacidad de regulación emocional y alteraciones en la neurocognición. Estos resultados son consistentes con lo descrito en la literatura.

ABSTRACT Background: It has been reported that schizophrenia patients display emotional processing impairments, specifically in the emotion perception domain. However, less is known about other domains of emotional processing, like emotion regulation. Objective: The aim of this study was to assess and compare emotion regulation abilities and neurocognition in schizophrenia patients and healthy controls, as well as to identify correlations between emotion regulation, neurocognition and demographic data. Methods: 9 patients (GE) and 9 controls (GC) were recruited. Demographic data was obtained. To assess emotion regulation, the Mayer-Salovey-Caruso Emotional Intelligence Test -Managing Emotions section- was administered. Finally, a brief neurocognitive assessment was conducted. Results: The GE showed significant poorer performance than the GC in the emotion regulation test as well as in the neurocognitive assessment (p < .05). No correlations were identified between emotion regulation, neurocognition, demographic and clinical data. Discussion and conclusion: Schizophrenia patients show emotion regulation impairment, as well as neurocognitive deficits. Our results are consistent with other studies.

Resolución temporal visual en pacientes con anemia drepanocítica / Visual temporal resolution in patients with sickle cell anemia / Resolução temporal visual em pacientes com anemia drepanocítica

El desarrollo del Sistema Nervioso (SN) está afectado en los pacientes con Anemia Drepanocítica (AD). La Resolución Temporal Visual (RTV) es considerada como una medida de la velocidad de procesamiento y de activación cortical. Se utiliza como indicador general del funcionamiento del SN y puede evaluarse mediante la Frecuencia Crítica de Fusión (FCF). Se midió la FCF en 84 pacientes sin antecedentes de eventos neurológicos, en edades entre 8-68 años, y en controles sanos. Se midió el valor de la hemoglobina (Hb) de los pacientes al momento de la evaluación neuropsicológica. La FCF de los pacientes fue significativamente más baja. La edad correlacionó inversamente con la FCF; no se hallaron associaciones estatisticamente significativas entre los valores de la Hb y los resultados de la FCF. Se concluye que la RTV está disminuida en los pacientes con AD, lo que sugiere la existencia de afectación del neurodesarrollo como resultado de la enfermedad.

The Nervous System (NS) is affected in patients with Sickle Cell Anemia (SCA). The Visual Temporal Resolution (VTR) is considered as a measure of processing speed and cortical activation. It is used as general indicator of NS functioning, and it can be tested by Critical Frequency Fusion (CFF). The CFF was examined in 84 patients without previous neurologic events and the same amount in healthy subjects. The participants were ranging in age from 8 to 68. The patients' hemoglobin level was measured at the moment of the neuropsychological assessment. The patients' CFF was significantly lower than healthy people. Age correlated inversely with CFF, and statistically significant associations between hemoglobin and CFF was not found. We concluded that VTR is diminished en patients with SCA, which suggests that neurodevelopment is affected due to SCA.

O desenvolvimento do Sistema Nervoso (SN) está afetado nos pacientes com Anemia Drepanocítica (AD). A Resolução Temporal Visual (RTV) é considerada uma medida da velocidade de processamento e de ativação cortical. Como indicador geral do funcionamento do SN essa medida é utilizada e pode ser mensurada mediante a Frequência Crítica de Fusão (FCF). Foi verificada a FCF em uma amostra de 84 pacientes sem antecedentes de eventos neurológicos, com idades entre 8 e 68 anos e em controles sadios. Mensurou-se o valor da hemoglobina (Hb) dos pacientes durante a avaliação neuropsicológica. A FCF dos pacientes foi significativamente mais baixa. A idade correlacionou inversamente com a FCF; não foram encontradas associações estatisticamente significativas entre os valores da hemoglobina e os resultados da FCF. Conclui-se que a RTV está diminuída nos pacientes com AD sugerindo que há afetação do neurodesenvolvimento como resultado da doença.

Predictors of response in the treatment of moderate depression

Objective: To identify neurocognitive and sociodemographic variables that could be associated with clinical response to three modalities of treatment for depression, as well as variables that predicted superior response to one treatment over the others. Method: The present study derives from a research project in which depressed patients (n=272) received one of three treatments – long-term psychodynamic psychotherapy (n=90), fluoxetine therapy (n=91), or a combination thereof (n=91) – over a 24-month period. Results: Sociodemographic variables were not found to be predictive. Six predictive neurocognitive variables were identified: three prognostic variables related to working memory and abstract reasoning; one prescriptive variable related to working memory; and two variables found to be moderators. Conclusions: The results of this study indicate subgroups of patients who might benefit from specific therapeutic strategies and subgroups that seem to respond well to long-term psychodynamic psychotherapy and combined therapy. The moderators found suggest that abstract reasoning and processing speed may influence the magnitude and/or direction of clinical improvement.

Lateralidad, perfil cognitivo y rendimiento escolar en pacientes con mielomeningocele / Laterality, cognitive profile, and school performance in children with myelomeningocele

El mielomeningocele (MMC) es la forma más grave de los disrafismos de la columna vertebral. Afecta a 1/1200 recién nacidos vivos. Su etiología es multifactorial. El 80% cursa con hidrocefalia (HC) asociada a malformación de Arnold Chiari. El coeficiente intelectual (CI) oscila en un rango entre fronterizo y normal promedio. La tasa mundial de la población general de zurdos es del 10% pero se describe un aumento de su presentación en niños con MMC. Además se evidencian déficits visoespaciales, grafomotores, atencionales, memorísticos, dificultades en aritmética y en la comprensión de textos. Materiales y métodos: Este es un trabajo analítico, descriptivo, transversal. Se evaluaron 179 pacientes derivados del Consultorio Interdisciplinario de MMC; edad: entre 5 años, 0 meses y 15 años, 11 meses. No se emplearon controles sanos. Instrumentos administrados: Stanford Binet IV, Prolec ­ Prolec-Se, Wrat3, TMT A y B, d2, Stroop y pruebas de lateralidad de Zazzo. Objetivo: Describir la lateralidad, el perfil cognitivo y el rendimiento escolar en pacientes pediátricos con patología de mielomeningocele, analizando también las funciones ejecutivas, los procesos atencionales, memorísticos y la modalidad escolar en la cual se encuentran inmersos. Resultados: El 20% (35/179 pacientes) con edades que oscilan entre los 5 años, 0 meses y 15 años, 11 meses han presentado lateralidad zurda, y de ellos presentaban antecedentes familiares de zurdera 26%. Se observó lateralidad cruzada en 6% y eran ambidiestros 11%. El perfil cognitivo de la muestra completa (N: 179) fue homogéneo en todas las áreas (verbal, abstracto/visual y memoria de corto plazo), arrojando puntuaciones fronterizas. En pruebas atencionales el 100% obtuvo niveles descendidos. Todos reportaron dificultades en el rendimiento escolar. Sólo el 14% tuvo plan de integración y el 11% accedió a algún tipo de tratamiento. Conclusiones: Los niños con MMC evidencian déficits neuropsicológicos y alta tasa de zurdera, siendo probablemente los problemas de lateralidad una de las causas que ocasionarían el bajo rendimiento escolar y afectando el rendimiento académico (AU)

Myelomeningocele (MMC) is the most severe form of spinal dysraphism, affecting 1/1200 live newborns. Its etiology is multifactorial. Overall, 80% develops hydrocephalus (HC) associated with an Arnold Chiari malformation. The intelligence quotient (IQ) ranges from borderline to average. The worldwide incidence in the general population of left-handedness is 10%; however, an increase is found among children MMC. Additionally, visuospatial, graphomotor, attention, memory deficits as well as difficulties in arithmetic and text comprehension is found. Material and methods: A cross-sectional, analytical, descriptive study was conducted. Overall, 179 patients aged between 5 years 0 months and 15 years 11 months referred from the interdisciplinary MMC clinic were evaluated. No healthy control group was used. Instruments administrated: Stanford Binet IV, Prolec ­ Prolec-Se, Wrat3, TMT A and B, d2, Stroop and Zazzo's laterality test. Aim: To describe laterality, cognitive profile, and school performance in pediatric patients with MMC, analyzing executive functions, attention and memory, and the school system the children were attending. Results: 20% (35/179 patients) aged between 5 years, 0 months and 15 years, 11 months were left-handed, 26% of whom had a family history of left-handedness. Cross dominance was observed in 6% and ambidexterity in 11%. Overall, the cognitive profile of the sample (N: 179) was homogeneous in all areas (verbal, abstract/visual, and short-term memory), with borderline scores. In attention tasks, levels were low in 100%. All children had difficulties in school performance. Only 14% had an integration program and 11% received some type of treatment. Conclusions: Children with MMC show neuropsychological deficits and a high rate of left-handedness, the latter of which may be one of the causes of poor school performance and affecting academic achievements (AU)

Mecanismos neurocognitivos de la terapia basada en Mindfulness / Neurocognitive mechanisms of the Mindfulness based therapy

Presentamos un resumen y una breve historia del creciente campo de Intervenciones Basadas en mindfulness o conciencia plena. En los últimos tiempos, existe un gran interés en este modelo terapéutico para reducir la vulnerabilidad al estrés crónico y distrés emocional. Mindfulness requiere intencionalmente enfocar nuestra atención a las experiencias que ocurren en el momento presente. A medida que la investigación avanza en esta temática, es vital definir cuidadosamente la estructura de mindfulness y comprender mejor sus mecanismos de acción neurocognitiva. Este informe presenta un marco conceptual que enfatiza el papel central de control atencional y mecanismos de sostenibilidad para desarrollar las habilidades de conciencia plena. También, repasamos la estructura de mindfulness y la autorregulación de las emociones; luego describimos brevemente nuestra investigación relacionada con nuestro programa de Reducción del Estrés en Cáncer de Mama basado en Mindfulness (MBSR-AC) en la University of South Florida. Se presenta, a partir de esta premisa, un modelo propuesto que explica nuestros mecanismos cognitivos basados en la lógica del modelo de biocomportamental.

We are presenting an overview and a brief history of the growing field of Mindfulness Based Interventions. There has been a significant interest in this therapeutic model to reduce vulnerability to chronic stress and emotional distress in recent times. Mindfulness requires intentionally bringing our attention to the experiences that occur in the present moment. As the research advances in this line of inquiry, it is vital to carefully define the construct of Mindfulness and better understand its neurocognitive mechanisms of action. This review presents conceptual framework that emphasizes the central role of attentional control and sustainability mechanisms to build mindfulness skills. We also review the construct of Mindfulness and self-regulation of emotions; then describe briefly our research related to our Mindfulness Based-Stress Reduction Breast Cancer (MBSR-BC) program at the University of South Florida. With this premise, we present a model explaining our proposed cognitive mechanisms based on the Logic of the Biobehavioral Model.

Impacto de la diabetes tipo 1 en el desarrollo neurocognitivo de niños entre 5 y 18 años / Impact of type-1 diabetes on neurocognitive development in children between 5 and 18 years of age

Introducción: la diabetes tipo 1 es la segunda enfermedad crónica más frecuente de la infancia. Dentro de sus comorbilidades de la diabetes tipo 1, los efectos sobre el riñón, la retina, los nervios, los vasos sanguíneos y el sistema cardiovascular son ampliamente conocidos, sin embargo y a pesar de su importancia, en los niños, aún se conoce poco acerca del impacto de la diabetes tipo 1 sobre el sistema nervioso central en desarrollo. Objetivo: estudiar el desarrollo neurocognitivo alcanzado por nuestros pacientes con diabetes tipo 1 de comienzo temprano, analizando su relación con el control metabólico de la enfermedad y con factores socio-ambientales. Material y Métodos: se realizó un estudio descriptivo, observacional y transversal, con análisis retrospectivo. Fueron incluidos los niños atendidos en el Hospital de Pediatría Garrahan, con diabetes tipo 1, con comienzo de la enfermedad antes de los 7 años de vida. Se evaluó perfil neurocognitivo incluyendo capacidad cognitiva general, razonamiento verbal y perceptivo motor, velocidad de procesamiento y memoria operativa. Las variables metabólicas analizadas fueron mal control por hiperglucemia o por hipoglucemia y grado de descompensación al debut. Resultados: El coeficiente intelectual total se relacionó significativamente con educación secundaria materna. (R2 0.56 F= 5.21, p= 0.01). El índice de comprensión verbal se relacionó significativamente tanto con el escore de hiperglucemia como con educación secundaria materna. (R2 0.56 F= 5.16, p= 0.01). El índice de velocidad de procesamiento presentó relación significativa solo con el valor de bicarbonato al debut. (R2 0.39 F= 3.72, p= 0.03) y el índice de memoria operativa presentó relación significativa con vivienda propia y valor de bicarbonato al debut. (R2 0.50 F= 5.32, p= 0.009). Los pacientes con mayores eventos de hipoglucemias no presentaron diferencias significativas en ninguna variable neurocognitiva con respecto a los demás. Conclusión: hemos hallado alteraciones neurocognitivas leves asociadas principalmente a hiperglucemia, grado de descompensación al debut y a causas socioambientales. Resulta clara la necesidad de alcanzar objetivos de control glucémico con el fin de evitar o retrasar la posible aparición de complicaciones crónicas entre las cuales deben incluirse las que afectan al sistema nervioso central en desarrollo (AU)

Introduction: Type-1 diabetes is the second-most common chronic disease in childhood. Among the co-morbidities of type-1 diabetes, kidney, retina, nerve, blood-vessel, and cardiovascular involvement is widely known; however, in spite of its importance in children little is known about the impact of type-1 diabetes on the developing central nervous system. Aim: To study neurocognitive development in our patients with early-onset type-1 diabetes, with a focus on the association with metabolic control of the disease. Material and Methods: A descriptive, observational, and transsectional study was conducted using retrospective data analysis. Children with type-1 diabetes with a disease onset before 7 years of age seen at the pediatric Hospital Garrahan were included in the study. The neurocognitive profile was assessed, including general cognitive abilities, verbal and perceptive motor reasoning, processing speed, and working memory. Metabolic variables evaluated were poor hyperglycemia control or hypoglycemia and degree of decompensation at onset. Results: Total intellectual quotient was significantly related to maternal secondary education (R2 0.56 F= 5.21, p= 0.01). Verbal comprehension index score was significantly associated both with hyperglycemia score and maternal secondary education (R2 0.56 F= 5.16, p= 0.01). Processing speed index was significantly related only to bicarbonate levels at onset (R2 0.39 F= 3.72, p= 0.03) and working memory index was significantly related to family homeownership and bicarbonate levels at onset (R2 0.50 F= 5.32, p=0.009). Patients with a greater number of hypoglycemia events did not have significant differences in any of the neurocognitive variables compared to the other children. Conclusion: We found that mild neurocognitive impairment was mainly associated with hyperglycemia, degree of decompensation at onset, and environmental causes. There is a clear need to achieve the goal of glycemia control so as to avoid or delay possible chronic complications including those that affect the developing central nervous system (AU)

Perfil neuropsicológico pós-traumatismo cranioencefálico: há sempre extensas sequelas cognitivas? / Neuropsychological profile in traumatic brain injury: are there always cognitive impairments?

Prejuízos neuropsicológicos, neurológicos, psiquiátricos e funcionais de pacientes vítimas de traumatismo cranioencefálico (TCE) são largamente descritos na literatura internacional.Entretanto, no Brasil, a avaliação neuropsicológica de pacientes pós-TCE é incipiente, pois não há a disponibilização desta avaliação na grande maioria dos serviços de saúde pública e privada do país. Frente aos diversos deficit neurocognitivos e à escassez de estudos nacionais sobre o perfil destes pacientes, ressalta-se a importância de estudos de caso com tal finalidade. Neste trabalho, objetivou-se caracterizar o perfil neurocognitivo de um paciente pós-TCE grave, com 45 anos, em seus aspectos socioculturais, psiquiátricos, neuropsicológicos e funcionais. O paciente apresentou classe socioeconômica C1, 11 anos de escolaridade formal, alta frequência de hábitos de leitura e escrita, TCE grave com complicações (craniotomia descompressiva) em estado crônico.Foi realizada uma avaliação com instrumentos normatizados e em desenvolvimento, entrevistas, questionários e observação clínica. Foram encontrados deficit executivos de velocidade de processamento, iniciação e tomada de decisão.Destaca-se a recuperação surpreendente após o trauma ilustrando a hetereogeneidade do quadro de TCE e possíveis variáveis relacionadas ao prognóstico favorável

The neuropsychological, neurological, psychiatric and functional deficit in victims of traumatic brain injury (TBI) have been extensively describedin the literature. However, studies involving the neuropsychological assessment of patients with TBI are still incipient in Brazil, and there is a pronounced lack of neuropsychological assessment services in both the private and public health sectors. Given the extent of neurocognitive deficit reported in TBI and the scarcity of scientific research on the topic in Brazil, there is a need for studies of the neuropsychology of TBI in the Brazilian population. The objective of this case report was to explore the neuropsychological profile of a forty-five years old patient with severe TBI in connection with sociodemographic, psychiatric, neuropsychological and functional variables. Data was collected by means of a neuropsychological assessment battery composedof instruments with normative data for the Brazilian population, interviews, questionnaires and clinical observation. Executive function deficitin processing speed, initiation and decision making were identified. Evidence of patient recoveryover time was also obtained, highlighting the heterogeneity of patients with TBI and the need to investigate favorable prognostic factors

Clinical Correlators of Homelessness in Patients with Schizophrenia: Focused on Social Function / 신경정신의학

OBJECTIVES: The purpose of this study is to investigate the differences between homeless with schizophrenia and non-homeless with schizophrenia, and to identify the correlators of homelessness in schizophrenic patients. METHODS: Forty two schizophrenic inpatients were divided into the homeless group (n=19) and non-homeless group (n=23). Psychopathologic measures, neurocognitive tests, hinting task, and the Social and Occupational Function Assessment Scale (SOFAS) were administered in both groups. RESULTS: SOFAS showed high correlation with homelessness in schizophrenic inpatients. Duration of Untreated Psychosis, negative component of Positive and Negative Syndrome Scale, Continuous Performance Test (CPT) correct number, and hinting task were all mediated by SOFAS to explain homelessness in schizophrenic inpatients. In particular, CPT correct number showed direct correlation with homelessness without mediation by SOFAS. CONCLUSION: The results of this study suggest that cognitive rehabilitation and social skill training may be helpful in prevention of homelessness of schizophrenic patients. Social cognition and neurocognitive test including CPT may be useful for evaluating the risk of homelessness in schizophrenic patients.

Oxidative stress markers, cognitive functions, and psychosocial functioning in bipolar disorder: an empirical cross-sectional study

Objective: This study aimed to evaluate the relationship between oxidative stress markers and cognitive functions and domains of psychosocial functioning in bipolar disorder. Methods: Oxidative stress markers, cognitive functions, and domains of psychosocial functioning were evaluated in 51 patients with bipolar disorder who were in remission. Correlation analyses between these parameters were calculated with data controlled for duration of illness and number of episodes. Results: There was no statistically significant correlation between oxidative stress markers and cognitive functions. In terms of psychosocial functioning, significant correlations were found between malondialdehyde and sense of stigmatization (r = -0.502); household activities and superoxide dismutase (r = 0.501); participation in social activities and nitric oxide (r = 0.414); hobbies and leisure time activities and total glutathione (r = -0.567), superoxide dismutase (r = 0.667), and neurotrophin 4 (r = 0.450); and taking initiative and self-sufficiency and superoxide dismutase (r = 0.597). There was no correlation between other domains of psychosocial functioning and oxidative stress markers. Conclusion: These results imply that oxidative stress markers do not appear to correlate clearly with cognitive impairment and reduced psychosocial functioning. However, there were some associations between selected oxidative markers and activity-oriented functional markers. This may represent a true negative association, or may be an artifact of oxidative stress being a state rather than a trait marker. .