A Comparative Assessment of Comprehensive Trail Making Test and Wisconsin Card Sorting Test Among Alcohol Dependence Patients

@#Introduction: Alcohol, when used frequently, accelerates the ageing process, causes brain damage, and results in a reduced volume of grey and white matter, leading to frontal lobe abnormalities. The neurotoxicity resulting from alcohol overuse affects the higher functions of the brain. This study aimed to evaluate the effect of alcohol dependence on the executive functioning of the brain. Methods: This study was carried out as a case-control study among 60 patients with alcohol dependence and 60 controls. Assessment of executive function was carried out using the Comprehensive trail-making test (CTMT) and the Wisconsin card sorting test (WCST). Comparison between the alcohol dependence group and normal healthy controls were calculated using the Mann-Whitney U test as data followed a non-parametric distribution. Results: The mean age of the participants among the cases and controls was 38.3±5.5 years and 37.8±5.4 years, respectively. The results showed a significant difference in both WCST and CTMT between cases and controls (p<0.05). Conclusion: This study concludes that there was an impaired performance in executive functions in alcohol- dependence patients in early abstinence compared to normal controls showing frontal lobe impairment in alcohol-dependence patients.

Study of isolation efficiency of new islet isolation solution for mouse islets / 器官移植

Objective To investigate the isolation and protective effect of a new islet purification solution (IPS)-Optiprep solution on the islet in mouse models. Methods The digested pancreatic islets were divided into the IPS and UW groups according to the islet volume. The pancreatic islets were isolated by the continuous gradient density centrifugation using IPS-Optiprep or UW-Optiprep solutions. The purification efficiency and isolated islet activity of purification solution were compared between two groups. The diabetic mouse models were successfully induced and randomly assigned into three groups. In the experimental group (n=10), the mice received pancreatic islet transplantation using islets isolated and purified by the IPS-Optiprep solution. In the control group (n=10), the mice underwent pancreatic islet transplantation using islets isolated and purified by the UW-Optiprep solution. In the sham surgery group (n=5), the mice merely underwent surgery without pancreatic islet transplantation. Postoperative blood glucose levels were detected and compared among three groups. The blood glucose levels of intraperitoneal glucose tolerance test at postoperative 21 d were statistically compared between the experimental and control groups. The cost of the preparation of two isolation solutions was also compared. Results Compared with the UW group, the islet equivalent (IEQ), islet purity, recovery rate and islet integrity were significantly higher in the IPS group. Islet morphological observation revealed that the islet membrane was complete and the islet diameter in the IPS group was considerably larger than that in the UW group. The activity of purified islets in the UW group was significantly higher than that in the IPS group [(88±5)% vs. (84±3)%, P<0.01]. Compared with the UW-Optiprep solution, identical in vivo islet function was obtained in the IPS-Optiprep solution.The cost of IPS-Optiprep solution was significantly less than that of the UW-Optiprep solution. Conclusions The new IPS-Optiprep solution yields higher islet isolation efficiency, purification, integrity and recovery rate and significantly reduces the purification cost compared with the UW-Optiprep solution. Nevertheless, IPS-Optiprep solution exerts a less protective effect on the activity of islet cells, which is probably correlated with the high islet integrity and the endotoxin in the IPS-Optiprep solution.

Visual-motor maturity and executive functions in schoolchildren / Maturidade visomotora e funções executivas em escolares / Madurez visomotora y funciones ejecutivas en escolares

Visual-motor maturity and executive functions are closely related in the child development process. This study aimed to investigate the relation between visual-motor abilities and executive functions in 83 healthy children between 7 and 10 years old. The tools used were the Bender Gestalt Visual-Motor Test - Gradual Scoring System (B-GSS), Wisconsin Card Sorting Test (WCST), Raven's Progressive Matrices (RPM), and Rey-Osterrieth Complex Figure (ROCF). The correlation between the B-GSS and WCST scores was significantly negative (r = -.23, p < .033), while ROCF variables, such as Total Memory and Total Copy, had a moderate, significant correlation with total B-GSS score (r = -.55, p < .001; r = -.44, p < .001, respectively). The results empirically show the relation between executive functions and visual-motor maturity and are discussed in face of developmental neuropsychology.

A maturidade visomotora e as funções executivas estão intimamente relacionadas no processo de desenvolvimento infantil. O objetivo deste estudo foi investigar a relação entre habilidades visomotoras e funções executivas em 83 crianças hígidas, de 7 a 10 anos. Os instrumentos utilizados foram Teste Gestáltico Visomotor de Bender - Sistema de Pontuação Gradual (B-GSS), Teste Wisconsin de Classificação de Cartas (WCST), Matrizes Progressivas de Raven (RPM) e Rey- Osterrieth Figura Complexa Test (ROCF). A correlação entre os escores de B-GSS e WCST foi negativa e significativa (r = 0,23, p < 0,033) e variáveis do ROCF, como Cópia Total e Memória Total apresentaram correlação moderada e significativa com o escore total do B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Os resultados evidenciam empiricamente a relação entre funções executivas e maturidade visomotora e são discutidos à luz da neuropsicologia do desenvolvimento.

La madurez visual-motora y las funciones ejecutivas están estrechamente relacionados en el proceso de desarrollo del niño. El objetivo de este estudio fue investigar la relación entre habilidades visomotoras y funciones ejecutivas en 83 niños sanos, de 7-10 años. Los instrumentos utilizados fueron Prueba Gestáltica Visomotora de Bender - Sistema de Puntuación Gradual (B-GSS), Prueba Wisconsin de Clasificación de Cartas (WCST), Matrices Progresivas de Raven (RPM) y Prueba Rey- Osterrieth Figura Compleja (ROCF). La correlación entre las puntuaciones B-GSS y WCST fue negativa y significativa (r = 0,23, p < 0,033) y ROCF variables, como Copiar y Memoria Total mostraron correlación moderada y significativa con la puntuación total de la B-GSS (r = -0,55, p < 0,001; r = -0,44, p < 0,001, respectivamente). Los resultados demuestran empíricamente la relación entre las funciones ejecutivas y la madurez visomotora y se discuten a la luz de la neuropsicología del desarrollo.

Desempenho de idosos com e sem sintomas depressivos no WCST-64 / Elderly performance with and without depressive symptoms on the WCST-64 / Rendimiento de ancianos con y sin síntomas depresivos em WCST-64

É natural que idosos apresentem dificuldades nas funções executivas mesmo nos estágios iniciais de um quadro depressivo, que podem ser detectadas pelo Teste Wisconsin de Classificação de Cartas (WCST). O objetivo do presente estudo foi comparar o desempenho de idosos com e sem sintomas depressivos no WCST, versão abreviada de 64 cartas (WCST-64). A amostra foi composta por 153 idosos, divididos em dois grupos: com e sem sintomas depressivos. Os grupos foram pareados em relação à idade, escolaridade e escore no Mini Exame do Estado Mental (MEEM). Utilizou-se uma ficha de dados sociodemográficos, a Escala de Depressão Geriátrica, o MEEM e o WCST-64. Observou-se que, na medida em que os sintomas de depressão se intensificavam, aumentavam o total de erros, as respostas perseverativas e os erros perseverativos no WCST-64. Os resultados mostraram que idosos que apresentam sintomas depressivos tiveram pior desempenho no WCST-64, quando comparados com aqueles sem sintomatologia depressiva.

It is natural that the elderly would present difficulties in executive functions even in the early stages of a depressive condition, which may be detected by the Wisconsin Card Sorting Test (WCST). This study aimed to compare the performance of elderly people with and without depressive symptoms on the shortened version of the WCST, containing 64 cards (WCST-64). The sample consisted of 153 elderly subjects who were divided into two groups: with and without depressive symptoms. The groups were matched in terms of age, educational level and score on the Mini Mental State Examination (MMSE). A Socio-Demographic Data Sheet, the Geriatric Depression Scale, MMSE and the WCST-64 were used. It was observed that, to the extent that depressive symptoms intensified, total errors, perseverative responses and perseverative errors increased on the WCST-64. The results showed that elderly people who present depressive symptoms had poorer performance on the WCST-64, compared to those without depressive symptoms.

En las etapas iniciales de un cuadro de depresión es natural que los ancianos presenten dificultades en las funciones ejecutivas, que pueden ser detectadas por el Test de Wisconsin de Clasificación de Cartas (WCST). El objetivo de este estudio fue comparar el desempeño de las personas mayores con y sin síntomas de depresión en el WCST, versión abreviada de 64 cartas (WCST-64). La muestra estuvo constituída por 153 ancianos divididos en dos grupos: con y sin síntomas de depresión. Los grupos fueron comparados por edad, nivel educativo y resultado en el Mini Mental State Examination (MMSE). Se utilizó una ficha de datos sociodemográficos, la Escala de Depresión Geriátrica, MMSE y el WCST-64. A medida que los síntomas de depresión se intensificaban, aumentaba el número total de errores, respuestas perseverativos y errores perseverativos en el WCST-64. Los resultados mostraron que los ancianos que presentan síntomas de depresión tuvieron peor desempeño en el WCST-64, comparados con aquellos que no poseían esos síntomas.

Storage effect and transplant outcomes of University of Wisconsin preservation solution and histidine-tryptophan-ketoglutarate preservation solution on liver allografts: a Meta-analysis / 中华消化外科杂志

Objective To systematically evaluate the storage effect and transplant outcomes of University of Wisconsin (UW) preservation solution and histidine-tryptophan-ketoglutarate (HTK) preservation solution on liver allografts.Methods Literatures were researched using PubMed,Embase (1980-),Ovid Medline (1948-),The Cochrane Library,Wanfang database,VIP database from the database establishement to October 2015 with the key words including organ preservation,storage solutions,Histidine-tryptophan-ketoglutarate or HTK,custodial,bretschneider,University of Wisconsin,UW solution,viaspan,cardiosol,belzer solution,hepatic transplantation,liver transplantation,viscera transplantation,liver grafts,hepatic grafts,liver allografts,hepatic allografts,器官移植,器官保存液,UW,HTK,肝移植and比较.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.All the patients using UW and HTK preservation solutions were respectively allocated into the UW group and HTK group.Count data were represented as the odds ratio (OR) and measurement data were represented as the standardized mean difference (SMD) and 95％ confidence interval (CI).The heterogeneity of the studies was analyzed using the I2 test.Results Eleven literatures were retrieved,and the total sample size were 34 475 patients including 25 248 in the UW group and 9 227 in the HTK group.The results of Meta analysis showed that there were no statistically significant differences in the primary transplants nonfunction,retransplant rate and 1-year grafts overall survival rate between the 2 groups (OR =1.18,0.84,0.97,1.02,95％ CI:0.55-2.57,0.47-1.50,0.66-1.42,0.66-1.58,P ＞0.05).There were also no statistically significant differences in the levels of alanine transaminase (ALT),aspartate transaminase (AST),total bilirubin (TBil) at postoperative day 1 between the 2 groups (SMD =-0.19,-O.30,0.30,95％ CI:-0.62-0.23,-0.70-0.10,-0.01-0.61,P ＞0.05).There were no statistically significant differences in the postoperative prothrombin time(PT) and alkaline phosphatase(ALP) between the 2 groups (P ＞0.05) and in the incidence of postoperative biliary complications between the 2 groups (OR =1.49,95％ CI:0.97-2.30,P ＞ 0.05).Conclusion There is similar storage effect between UW and HTK preservation solutions on liver allografts,and no difference in the transplant outcomes.

Executive Function Deficits in Patients with Brain Injury / 中国康复理论与实践

Objective To investigate the characteristics of executive function in patients with brain injury. Methods From March 1st, to June 30th, 2015, 44 patients with brain injury were investigated with Wisconsin Card Sorting Test (WCST), the indexes including Responses Answer, Categories Completed, Correct Responses, Errors Responses, Trials to Complete First Category, Percent Conceptual Level Respons-es Percentage, Perseverative Responses Errors, Nonperseverative Responses Errors, Failure to Maintain Set, and Learning to Learn. Results The abnormal rates were the most in Nonperseverative Responses Errors and Percent Conceptual Level Responses Percentage (61.36%), and then in Responses Answer/Categories Completed/Correct Responses (59.09%), Correct Responses (43.18%), Trials to Complete First Category (38.64%), Perseverative Errors (29.51%), Learning to Learn (25.00%), and Failure to Maintain Set (9.09%). The patients with trau-matic brain injury were different from those with stroke in Responses Answer, Errors Responses, Perseverative Responses Errors, Catego-ries Completed, Percent Conceptual Level Responses Percentage, and Learning to Learn (Z>2.444, t>2.156, P<0.05). The patients injured in frontal lobe were different from those in other areas in Perseverative Responses Errors (t=2.595, P=0.015). Conclusion Executive function damaged generally in patients with brain injury, which related to concentration, abstract, shifting attention, working memory, etc. The frontal lobe damage may associate with the disorder of shifting attention.

Comparative study of effect of mechanical perfusion and simple cold preservation on DCD pancreas in pigs / 器官移植

Objective To compare the effect of mechanical perfusion and simple cold preservation on donation after cardiac death (DCD)pancreas in pigs.Methods Ten healthy pigs were randomized into simple cold preservation group and the mechanical perfusion group (5 pigs in each group ).DCD model was established in pigs.The pancreas was cut and stored in University of Wisconsin solution (UW solution).The pancreas of the simple cold preservation group was preserved with simple UW solution and that of the mechanical perfusion group was preserved by mechanical perfusion.Specimen was collected from pancreatic tail at 1,2,3,4,6 and 24 h to prepare tissue section.Then,the tissue section was stained with hematoxylin-eosin (HE).Histopathological examination was conducted and pathological score of the two groups was compared.Results Microthrombus in DCD pancreas of pig was removed at 180 min of mechanical perfusion and injury to pancreas islet caused by excessive perfusion was avoided.The pathological score of the mechanical perfusion group was (4.2 ±0.8)and that of the simple cold preservation group was (8.4 ±1.1),and the difference had statistical significance (P <0.05).Conclusions Mechanical perfusion may effectively remove thrombus in pancreatic vessels.Compared with simple cold preservation,mechanical perfusion may maintain the integrity of pancreas islet better after the preservation of the same period of time.

Posterior Spinal Reconstruction with Pedicle Screws, Multiple Iliac Screws and Wisconsin Spinal Wires in a Patient with Neurofibromatosis Scoliosis: A Case Report

A 54-year-old female with neurofibromatosis type 1 presented with progressing truncal shift owing to spinal deformity. On plain radiograph, the Cobb angle was 54 degree in coronal plane. Radiological examinations showed severe dystrophic change with dysplastic pedicles, bony scalloping, neural foraminal widening from dural ectasia. The patient underwent deformity correction and reconstruction surgery from the T9 to the pelvis using multiple iliac screws and Wisconsin interspinous segmental instrumentation by wiring due to maximize fixation points. The postoperative course was uneventful. One-year follow-up radiographs showed a successful curve correction with solid fusion. We report a case of pedicle dysplasia and dystrophic change treated by posterior segmental spinal instrumentation and fusion with help of multiple iliac screws and modified Wisconsin interspinous segmental wiring.

Tetramethylpyrazine protects Schwann cells from ischemia-like injury and increases cell survival in cold ischemic rat nerves

Tetramethylpyrazine (TMP), a major active ingredient of Ligusticum wallichi Franchat extract (a Chinese herb), exhibits neuroprotective properties in ischemia. In this study, we assessed its protective effects on Schwann cells (SCs) by culturing them in the presence of oxygen glucose deprivation (OGD) conditions and measuring cell survival in cold ischemic rat nerves. In the OGD-induced ischemic injury model of SCs, we demonstrated that TMP treatment not only reduced OGD-induced cell viability losses, cell death, and apoptosis of SCs in a dose-dependent manner, and inhibited LDH release, but also suppressed OGD-induced downregulation of Bcl-2 and upregulation of Bax and caspase-3, as well as inhibited the consequent activation of caspase-3. In the cold ischemic nerve model, we found that prolonged cold ischemic exposure for four weeks was markedly associated with the absence of SCs, a decrease in cell viability, and apoptosis in preserved nerve segments incubated in University of Wisconsin solution (UWS) alone. However, TMP attenuated nerve segment damage by preserving SCs and antagonizing the decrease in nerve fiber viability and increase in TUNEL-positive cells in a dose-dependent manner. Collectively, our results indicate that TMP not only provides protective effects in an ischemia-like injury model of cultured rat SCs by regulating Bcl-2, Bax, and caspase-3, but also increases cell survival and suppresses apoptosis in the cold ischemic nerve model after prolonged ischemic exposure for four weeks. Therefore, TMP may be a novel and effective therapeutic strategy for preventing peripheral nervous system ischemic diseases and improving peripheral nerve storage.

Tetrametilpirazina (TMP), o principal componente do extrato de Ligusticum wallichi Franchat (erva chinesa), apresenta propriedades neuroprotetoras na isquemia. Nesse estudo, avaliamos seus efeitos protetores nas células de Schwann (SC), cultivando-as na presença de condições de depleção de oxigênio da glicose (OGD) e medindo a sobrevivência dos nervos de ratos isquêmicos pelo resfriamento. No modelo de lesão isquêmica em SC induzida por OGD, demonstramos que o tratamento com TMP não somente reduziu as perdas de viabilidade celular induzida por OGD, a morte celular, a apoptose de SC dose-dependente e inibiu a liberação de LDH, mas, também, suprimiu a infra-regulação do Vcl-2 e a supra-regulação de Bax e caspase-3, e inibiu a consequente ativação da caspase-3. No modelo de nervo isquêmico por resfriamento, observamos que a exposição prolongada ao resfriamento por quatro semanas estava, marcadamente, associada com a ausência de SC, com o decréscimo da viabilidade celular e a apoptose em segmentos de nervo incubados na solução da Universidade de Wisconsin apenas. Entretanto, a TMP atenuou o dano no segmento do nervo preservando SC e antagonizando a diminuição da viabilidade da fibra nervosa e o aumento das células TUNEL-positiva de modo dose-dependente. De forma conjunta, nossos resultados indicam que o TMP não só fornece efeitos protetores em um modelo de dano semelhante à isquemia de SC de ratos cultivados pela regulação de BCl-2, Bax e caspase 3, mas, também, aumenta a sobrevivência celular e suprime a apoptose no modelo de isquemia por resfriamento por exposição prolongada por quatro semanas. Então, TMP pode ser uma estratégia terapêutica eficaz para prevenir doenças isquêmicas do sistema nervoso periférico e melhora a armazenagem do nervo periférico.

Neuropsychological characteristics of dyslexic children / Características neuropsicológicas de crianças com dislexia

The aim of this study was to identify the neuropsychological characteristics of dyslexic children. Seventy-three children underwent neuropsychological assessment and were divided into two groups: a group with dyslexia (DG; n=39) and a control group (CG; n= 34). A general linear model showed a significant difference between the groups regarding the following abilities: reading, writing and mathematics; forward and backward digit span tasks; semantic and phonological fluency; number of completed categories and total number of cards in the Wisconsin Cards Sorting Test; as well as right and left discrimination on self and on other. These results suggest impairment in executive functions, phonological working memory and semantic memory among dyslexic children, rather than impairment of just phonological abilities, as suggested in previous studies. (AU)

O objetivo deste trabalho foi identificar as características neuropsicológicas de crianças com dislexia. Foram incluídas 73 crianças divididas em dois grupos: um grupo composto por crianças disléxicas (GD; n=39), e um grupo controle (GC; n= 34). A análise de modelo linear geral mostrou diferença significativa entre os grupos nas habilidades de leitura, escrita, matemática, dígitos ordem direta, dígitos ordem inversa, fluência semântica e fonológica, número de categorias e total de cartas do Teste de Classificação de Cartas de Wisconsin, discriminação direita e esquerda em si e no outro. Esses resultados demonstram que podem existir déficits nas funções executivas, memória operacional fonológica e memória semântica e não apenas nas habilidades fonológicas. (AU)

Detecção de simulação com o uso do wisconsin card sorting test e do trail making test / Detection of malingering using the wisconsin card sorting test and the trail making test

Neste trabalho, tentamos identificar índices de simulação na avaliação neuropsicológica forense, através da avaliação dos padrões de resposta em provas neuropsicológicas. A amostra foi constituída por 56 sujeitos com traumatismo crânioencefálico. Todos se encontravam numa situação de possível recompensa monetária por incapacidade. Utilizamos os instrumentos Wisconsin Card Sorting Test (WCST), Trail Making Test (TMT), Inventário de Sintomas Psicopatológicos (BSI), e a grelha de análise dos autos do processo. Cerca de 30% da amostra enquadrou-se no grupo de prováveis simuladores. Essa porcentagem é congruente com a literatura. Verificou-se uma grande homogeneidade entre os indivíduos com e sem indicadores de simulação, a nível sintomatológico e características sócio-demográficas, o que reforça a necessidade de desenvolvimento de métodos eficazes na detecção da simulação.

The objective of this study was to identify indicators of malingering in forensic neuropsychological assessment by identifying response patterns in neuropsychological tests. The sample was composed by 56 subjects diagnosed with a cranioencephalic trauma. All subjects were in a situation of monetary reward if incapacity was proven. The instruments used were the Wisconsin Card Sorting Test (WCST), the Trail Making Test (TMT), the Brief Symptom Inventory (BSI), and a legal process data file. Approximately 30% of the studied sample was identified as probable malingerers. This percentage is consistent with the literature. We identified a high level of homogeneity of psychological symptoms and socio-demographic features in the group of subjects with indicators of malingering and in the group without such indicators. These results reinforce the necessity to develop efficient methods to detect malingering.

The Val66Met polymorphism at the BDNF gene does not influence Wisconsin Card Sorting Test results in children and adolescents with bipolar disorder

OBJECTIVES: To assess the role of the Val66Met polymorphism at the brain-derived neurotrophic factor (BDNF) gene on the performance of children and adolescents with bipolar disorder [juvenile bipolar disorder (JBD)] on the Wisconsin Card Sorting Test (WCST). METHODS: Children and adolescents were assessed by the K-SADS-PL and a clinical evaluation for BD and comorbid conditions. Manic and depressive symptoms were assessed with the Young Mania Rating Scale and the Children Depression Rating Scale - Reviewed. The Val66Met polymorphism at the BDNF was genotyped from a blood sample. Patients' IQ and executive functions were assessed by a standard cognitive flexibility test (WCST). RESULTS: Fifty-three subjects were included in the study. No significant difference was observed between the Val/Val and Val/Met+Met/Met groups on any WCST scores in the MANCOVA (F48,5 = .76; p = .59; Perseverative Errors, p = .66; Nonperseverative Errors, p = .58; Categories Completed, p = .34; Attempts to Reach First Category, p=.64; and Percentage of Conceptual Level Responses, p = .99). CONCLUSIONS: Our findings from this sample of children and adolescents with BD do not replicate results from studies of adults and suggest the existence of differences in the neurobiology of this disorder across the life cycle. Investigations of larger samples are necessary to confirm these data.

Effect of Perfadex and Wisconsin Unviersity solution on the function of pulmonary artery endothelium / 中华器官移植杂志

Objective To study the effect of Perfadex and Wisconsin Unviersity solution on the function of pulmonary artery endothelium.Methods Small lobe pulmonary arteries were dissected from nine porcine lungs.The artery from each lung was cut into six rings in 2mm.Two of them were randomly incubated in Krebs,Perfadex or Wisconsin Unviersity solution (UW solution) at 4℃ for 4 hours.Endothelium-derived hyperpolarizing factor (EDHF)-mediated relaxation (percentage of-7.5 logM U46619 precontraction) induced by bradykinin or calcium ionophone A23187 in the present of indomethacin,L-NNA and oxyhemoglobin were measured at 37 ℃ in the organ chambers.Results Vasoconstriction induced by U46619 is no significant difference among three groups (P＞ 0.05).Compared with Krebs group,the relaxation induced by bradykinin or A23187 was significantly decreased in Perfadex group (P＜0.01),while there is no significant difference in UW group (P＞0.05).Conclusion Endothelium-derived hyperpolarizing factor (EDHF) plays an important role in endothelium-mediated relaxation of porcine pulmonary artery.EDHF-mediated relaxation is impaired when the lung preserved with Wisconsin Unviersity solution,wheras its function is not affected by Perfadex solution.

Adolescent Normative Data on Simple Neuropsychological Tests for Cognitive Behavioral Disorders / The Japanese Journal of Rehabilitation Medicine

Although the Trail Making Test (TMT) Part A, B, Wisconsin Card Sorting Test-KFS version (WCST-KFS) and Miyake's Verbal Paired-Associate Learning Test (MVPLT) are simple tools to evaluate cognitive dysfunction in patients with traumatic brain injury, there is very little normative data for young persons available in Japan. Therefore, we evaluated 124 healthy persons who were from 15 to 30 years old with the three assessment tools. Median numbers of TMT Part A and Part B were 23.8 seconds and 49.0 seconds, respectively. Median numbers of achieved categories, perseverative errors of the Nelson type, and difficulties of maintaining set in the WCST-KFS were 5, 2 and 0, respectively. Median numbers of correct answers for related and unrelated pairs of MVPLT were 10 and 9 at the third trial, respectively. TMT Part B and perseverative errors of the Nelson type had a negative and weak correlation with age. And related pairs of MVPLT at the first trial had a positive and weak correlation with age. The normative values obtained in this study would be a useful standard for clinical assessments and acknowledgment of disabilities.

Evaluación de trastorno de personalidad a partir de estudios de Neuro-SPECT / Assessment of personality disorder by means of NeuroSPECT

We report on functional imaging results in 24 patients of Personality Disorder (P.D.) performed with NeuroSPECT by means of Tc99m HMPAO, in Basal state and during frontal cortical activation by means of the Wisconsin Card Sorting Test. Results demonstrate that we can make the diagnosis of P.D. when we detect significant hypoperfusion (- 2 Stand/ Deviations below the normal mean for the same age group) in the subgenual area (Area 25 of Brodmann) and in Area 24 of Brodmann, the anterior cingulated gyrus. Both areas are paradoxically more hypoperfused during the Wisconsin Test. Among patients diagnosed with P.D. NeuroSPECT can distinguish between patients of Cluster B from the ones from Cluster C in both Basal and Activation State, while Cluster A from B could be differentiated only in Basal State. On the other hand Motor Impulsivity patients could be differentiated from the Cognitive group due to paradoxical hypoperfusion in motor areas 1,2,3, and 4 of Brodmann. While the number of patients studied appears reduced these results demonstrate the capability of diagnosing Personality Disorder and also the capability to improved understanding of the subgroups of this Disorder.

Se comunican los resultados de 24pacientes con Trastornos de Personalidad estudiados mediante Neuro-SPECT HMPAO Tc99m, técnica de imagenología funcional cerebral en condicionas basales y durante activación de la corteza frontal ejecutiva mediante la prueba de Wisconsin. Los resultados demuestras fehacientemente que el diagnóstico de Trastorno de Personalidad se basa en la presencia de disminución de perfusión (- 2 Desviaciones Standard bajo el promedio normal para el mismo grupo etario) en el Cingulado Anterior y región subgenual, exageradas paradojalmente durante la prueba de Wisconsin. Dentro de los pacientes demostrados como Trastorno de Personalidad, Neuro-SPECT es capaz de distinguir los pacientes del Cluster B de los del Cluster C en ambos estados de medición,(Estado Basal vs Prueba de Wisconsin) mientras los Cluster A y B fueron diferenciables en estado Basal solamente. Por otra parte, la Impulsividad Motora pudo ser distinguida de la Cognitiva por la hipoperfusión paradojal de las áreas frontales de Brodmann motoras 1,2,3 y 4. Si bien el número total de pacientes reportados en este trabajo, es relativamente limitado, abre posibilidades interesantes a la imagenología funcional cerebral en estado basal y durante activación mediante la prueba de Wisconsin para el diagnóstico y exploración del Trastorno de Personalidad.

Performance of a Brazilian sample on the computerized Wisconsin Card Sorting Test

The computerized version of the Wisconsin Card Sorting Test (WCST) is based on the same normative data developed previously for the manual version. However, equivalence of the measures of both versions is controversial. This study investigated the performance of a Brazilian student sample with subjects aged 6-15 years in the computerized version of the WCST. As a result of the analyses, the study pointed out that type of school (public or private) was significant in almost all measures and also that age and gender effects were similar to those previously described in the manual version. These results showed that the computerized WCST may not be free of cultural and socioeconomic influences and that the validation and standardization of this version is warranted.

Executive Function in Attention-Deficit/Hyperactivity Disorder : Relationship of Comprehensive Attention, Stoop Color-Word, Children's Color Trails, and Wisconsin Card Sorting Tests / 신경정신의학

OBJECTIVES: The objective of this study was to investigate the relationship of the Comprehensive Attention (CAT), Stoop Color-Word (STROOP), Children's Color Trails (CCTT), and Wisconsin Card Sorting Tests (WCST) in evaluating the executive function in attention-deficit/hyperactivity disorder (ADHD). METHODS: A total of 197 children and adolescents with ADHD (mean age 10.4+/-3.2 years, 173 boys) and 62 without ADHD (mean age 11.8+/-3.5 years, 48 boys) have completed the Swanson, Nolan, and Pelham-IV questionnaire (SNAP-IV), and also the CAT, STROOP, CCTT and WCST. RESULTS: The selective, sustained, divided attention and Flanker tests of the CAT significantly discriminated between the ADHD and non-ADHD groups. The results of the CCTT were significantly correlated with the results of the CAT only in the ADHD group. The results of the STROOP were associated with selective, sustained, divided attention and Flanker tests. The results of the WCST were significantly correlated with the scores of the Working Memory subtest of the CAT only in the non-ADHD group. CONCLUSION: The results of this study suggest that the CAT has strong discriminant validity and moderate concurrent validity. The CAT could be a tool for the evaluation of the executive function of ADHD.

Cognição e Diabetes Mellitus tipo 2 em idosos / Cognition and type 2 diabetes in the elderly

Estudos sobre o status cognitivo em idosos tem tido maior destaque nas pesquisas atuais, identificando prejuízos, principalmente quando uma doença crônica encontra-se presente. A hiperglicemia pode ser um fator significativo para incidência de Alzheimer e uma causa secundária de demência. A Diabetes Mellitus Tipo 2 (DM2) está associada a déficits cognitivos e funcionais, e um dos instrumentos que pode ser utilizado para avaliar funções executivas é o WCST. O objetivo foi avaliar os prejuízos cognitivos em idosos com DM2. Participaram do estudo 254 idosos de ambos os sexos, com idade igual ou superior a 60 anos, sendo 44 idosos com diagnóstico de DM2 e 210 idosos do grupo controle da população geral. O delineamento foi de um estudo quantitativo e transversal. Os instrumentos utilizados foram: Ficha de Dados Sociodemográficos,WCST, MEEM, BDI, BAI e GDS. Os subtestes Vocabulário, Códigos, Dígitos e Cubos da WAIS-III. Os resultados mostraram que houve diferença significativa no desempenho de idosos com DM2, quando comparados com os idosos do grupo controle em quatro descritores do WCST, indicando prejuízos.

Teste Wisconsin de classificação de cartas: uma revisão sistemática de 1952 a 2009 / The Wisconsin card sorting test: systematic review (1952-2009)

O WCST é um teste neuropsicológico de resolução de problemas. Os critérios de resolução são inicialmente desconhecidos e mutantes, exigindo do respondente uma compreensão dos princípios lógicos do problema. Diante da relevância do WCST na avaliação neuropsicológica, este trabalho descreve uma revisão bibliográfica dos artigos que fazem referência ao teste. Realizou-se uma busca bibliográfica em três bases internacionais: Medline, Science Direct, PsycINFO, usando como descritor o unitermo "WCST". Foram identificados 1.076 artigos científicos, desde 1952 até 2009, observando-se significativo aumento das publicações com WCST a partir de 1993, com proporções crescentes a cada ano. Os países que mais publicaram sobre este teste neuropsicológico foram Holanda, Estados Unidos e Reino Unido, sendo os principais descritores das revistas que publicaram sobre o WCST: Psiquiatria, Neuropsicologia, Psicologia e Cérebro. O presente trabalho demonstra, ainda, que os periódicos que publicaram 10 ou mais artigos sobre o WCST têm elevado fator de impacto (JCR).

The WCST is a problem-solving, neuropsychological test, with solving criteria initially unknown and mutant. Such task requires the respondent to understand the logical principles of the proposed problem. Considering the relevance of such test for neuropsychological assessment, this present study describes a bibliographic review of articles mentioning the WSCT. Such articles were searched for in three international databases (Medline, Science Direct and PsycINFO), with WSCT used as the descriptor. From 1952 to 2009, 1076 scientific articles were indentified, with a significant increase of publications from 1993 on. The countries with most studies on the WSCT were the Netherlands, USA, and UK. The main descriptors of journals that published these studies were Psychiatry, Neuropsychology, Psychology and Brain. This present study also demonstrates that the journals that published 10 or more articles on WSCT show an elevated impact factor (JCR).

Idosos com diabetes mellitus tipo 2 e o desempenho cognitivo no teste Wisconsin de classificação de cartas(WCST) / Elderly people with Diabetes Mellitus Type 2 and Cognitive Performance in the Wisconsin Card Sorting Test (WCST)

Estudos identificam a existência de uma conexão entre Diabetes Mellitus (DM) e demência. A hiperglicemia pode ser um fator significativo para incidência de Alzheimer e uma causa secundária de demência. Pesquisas revelaram que as funções executivas dos idosos com DM estavam mais prejudicadas do que naqueles sem DM. A Diabetes Mellitus Tipo 2 (DM2) está associada a déficits cognitivos e funcionais, e um dos instrumentos que pode ser utilizado para avaliar funções executivas é o WCST. Foi realizada uma revisão sistemática com o objetivo de verificar as características das publicações indexadas nos últimos oito anos, que abordam os temas DM2, idosos, WCST, flexibilidade cognitiva, do pensamento e funções executivas. Os resultados demonstraram que estudos envolvendo DM2, idosos e WCST são reduzidos.

Studies have identified the existence of a connection between Diabetes Mellitus and dementia. High blood sugar level can be a significant factor of the incidence of Alzheimer, which could be a secondary cause of dementia. Other research revealed that the executive functions of the elderly with DM were more impaired than in those without DM. Type 2 Diabetes Mellitus (DM2) is associated with cognitive and functional deficits and, one of the tools, which can be used to assess executive functions, is the Wisconsin Card Sorting Test (WCST). A systematic review was performed with the aim of verifying the characteristics of indexed publications in the last eight years, using the following subjects: Type 2 Diabetes, elderly people, the WCST,thought and cognitive flexibility, and executive functions. Results show that studies involving DM2, elderly people and WCST are few.