Characteristics and influencing factors of cognitive impairment in patients with multiple sclerosis / 公共卫生与预防医学

Objective To observe the characteristics of cognitive impairment in patients with multiple sclerosis (MS) and analyze its influencing factors. Methods A total of 105 patients with MS admitted to the West China Hospital from April 2019 to April 2022 were selected as the MS group, and 30 healthy individuals who received physical examination during the same period were selected as the control group. Both groups were examined with brain magnetic resonance imaging (MRI). The Wechsler Adult Intelligence Scale (WAIS) and Wisconsin Card Sorting Test (WSCT) system were used to evaluate the patients' overall cognitive function. Patients in the MS group were additionally evaluated with the Expanded Disability Status Scale (EDSS). Results On the WAIS scale, the verbal IQ, operational IQ and total IQ of the MS group were lower than those of the control group (P<0.05). The scores for the total number of tests, false responses, persistent errors, and non-persistent errors in the WSCT of the MS group were higher than those in the control group, while the scores for classification, correct responses, and percentage of correct responses were lower than those in the control group (P<0.05). The operation IQ (r= -0.695) and SDS score (r= -0.420) were negatively correlated with EDSS score in the MS group (P<0.05). Conclusion Patients with MS have cognitive impairment, which manifests as the reduction of summary abstraction, comprehension and expression, thinking and observation, structural synthesis of memory ability, abstract spatial skills and executive function. The more severe the physical dysfunction, the lower the operational IQ score.

Estudio exploratorio para la validación de la Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) en la población con esclerosis múltiple remitente recurrente del Hospital San Juan de Dios en Santiago de Chile / Exploratory study for the validation of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in the population with recurrent remitting multiple sclerosis of the San Juan de Dios Hospital in Santiago, Chile

La evaluación cognitiva en personas adultas con esclerosis múltiple (EM) es un área fundamental a tener en cuenta en el proceso de intervención, debido a la alta prevalencia de deterioro cognitivo. En la actualidad, se ha recomendado la evaluación cognitiva por medio de la BICAMS (del inglés Brief International Cognitive Assessment for MS), que es una batería específica para evaluar a personas con EM, pero que no cuenta con validación en nuestro país. El presente estudio tiene como objetivo identificar el impacto de algunos factores clínicos (meses de evolución de la enfermedad y nivel de discapacidad) y personales (sexo, años de escolaridad y edad) que influyen en las medidas cognitivas de la BICAMS, a fin de contar con información relevante y precisa en un futuro proceso de validación. La muestra estuvo constituida por 38 personas con Esclerosis Múltiple Remitente Recurrente (EMRR). Los resultados mostraron que de los cinco factores clínicos observados, solo edad y sexo influyeron de manera significativa sobre los puntajes de las tres pruebas de la BICAMS. Por lo tanto, la validación de esta batería para la población chilena debiera incluir y/o controlar ambas variables de edad y sexo.

The evaluation of cognitive aspects among individuals with multiple sclerosis (MS) is key when considering intervention, because of high prevalence of cognitive impairments. At present, cognitive evaluation has been recommended by means of BICAMS (Brief International Cognitive Assessment for MS), which is a battery specifically constructed to assess individuals with MS. However, the battery has not been validated in Chile.The present study aims atdetermining the impact of clinical factors (months since condition's diagnosis and severeness level) and individual factors (sex, age, and years of schooling), which is expected to be accurate and valuable input for future validation processes. Sample consisted of 38 people with remittent-recurrent multiple sclerosis (RRMS). Results showed that only age and gender do significantly impact cognitive performance on all of three BICAMs subtests. Therefore, when validating this battery for Chilean individuals, both age and gender should be included and or controlled.

Application of virtual reality in diagnosis and treatment of obsessive-compulsive disorder / 中华行为医学与脑科学杂志

The application of diagnosis and treatment technology based on virtual reality (VR) in obsessive-compulsive disorder (OCD) has attracted more and more attention from researchers around the world. The preliminary exploration shows that it is a promising auxiliary evaluation and treatment method. From the perspective of effectiveness and suitability, this paper systematically reviewed the research status of the application of VR technology in OCD clinical symptom evaluation, cognitive function evaluation and clinical intervention, discussed the similarities and differences, advantages and limitations between traditional evaluation and treatment methods and VR-based diagnosis and treatment technology, and prospected the new trend of the application of VR technology in OCD diagnosis and treatment, and provided a reference for the introduction, development and application of VR technology in China to improve the effect of OCD diagnosis and treatment.

El "efecto Tortoni" en la prosopagnosia / The "Tortoni effect" in prosopagnosia

Resumen La prosopagnosia es un tipo de agnosia visual caracterizada por la incapacidad de reconocer los rostros de las personas. Existen básicamente dos variantes, aperceptivas y asociativas. El "efecto Tortoni" es un fenómeno descripto por Bekinschtein y col. hace unos años en mozos de café en Buenos Aires, quienes utilizaban esta herramienta para recordar los pedidos de cada integrante de una mesa. Presentamos un caso de prosopagnosia asociada a lesión temporo-occipital bilateral secundaria a traumatismo encefalocra neano, manifestada en forma inicial por la falta de reconocimiento de rostros, con la utilización de una estra tegia asociativa similar a la descripta en el efecto "Tortoni" como compensación. Mujer de 62 años que sufrió un traumatismo encefalocraneano grave. Pocos meses después del evento, presentó dificultad para reconocer personas conocidas, hecho evidenciado por sus allegados cuando en una mesa los integrantes cambiaron su asiento, permanecieron callados por unos instantes, y posteriormente la paciente continuó nombrándolos por su ubicación previa. En la resonancia magnética de cerebro se objetivaron lesiones contusas de aspecto secuelar en región temporo-occipital bilateral. La prosopagnosia adquirida secundaria a lesiones focales en la región temporo-occipital generalmente bilateral, derecha, y raramente izquierda, es un cuadro poco frecuente. La es trategia utilizada en el "efecto Tortoni" fue en nuestra paciente una de las manifestaciones iniciales del cuadro. La realización de un test neuropsicológico ecológico que considere esta estrategia podría ser de utilidad en el rastreo y detección precoz de esta entidad.

Abstract Proposapnosia is a type of visual agnosia characterized by the inability to recognize people's faces. There are basically two variants, apperceptive and associative. The "Tortoni effect" is a phenomenon described by Bekinschtein et al a few years ago in waiters from Buenos Aires, who used this tool to remember the orders of each member of a table. We present a case of prosopagnosia associated with bilateral temporo-occipital injury secondary to head trauma, initially manifested by the lack of face recognition with the use of an associative strategy similar to that described in the "Tortoni effect" as compensation, in a 62-year-old female who suffered a severe head injury. A few months after this event, the patient had difficulty in recognizing familiar people, a fact evidenced by her relatives when at a restaurant table, they changed their seats, remained silent momentarily, and right after the patient kept naming them by their previous location. The magnetic resonance imaging of the brain revealed blunt sequelae lesions in the bilateral temporo-occipital region. Acquired prosopagnosia due to focal lesions in the temporo-occipital region, generally bilateral and right, and less frequently left, is a rare condition. The strategy used in the "Tortoni effect" was one of the initial manifestations of the condition in our patient. Carrying out an ecological neuropsychological test that considers this strategy could be useful in the screening and early detection of this entity.

Performance characteristics and diagnostic efficacy of the digital clock drawing test in patients with amnestic mild cognitive impairment / 中华行为医学与脑科学杂志

Objective:To explore the performance characteristics of the digital clock-drawing test(dCDT) for amnestic mild cognitive impairment(aMCI), and its diagnostic value for aMCI patients compared with the traditional clock-drawing test (tCDT).Methods:Total 81 middle-aged and elderly outpatients in Affiliated Hospital to Shanxi Medical University from November 2020 to May 2021 were selected, including 42 cognitively normal people (control group) and 39 aMCI patients (aMCI group). The dCDT developed by our team was used to collect drawing process parameters (such as stroke length, time and speed). The Cognitive Domain Indexs of Montreal Cognitive Assessment (MoCA) were calculated using the CDIS scoring method, and the correlation between dCDT parameters and MoCA indexs were analyzed.Logistic regression analysis was used to construct the predictive model, and the sensitivity and specificity of different methods for the diagnosis of aMCI patients were compared by the area under the ROC curve.Results:(1) The total time(51.25(38.80, 63.75)s vs 42.42(33.64, 51.91)s) and time in air(36.34(26.81, 47.25)s vs 28.47(22.37, 33.98)s) of the aMCI group were significantly higher than those of the control group, and the minute hand/hour hand ratio(1.23±0.35 vs 1.39±0.34), strokes per minute((31.31±10.44) vs (41.05±9.48))and tCDT score(3.0(3.0, 4.0), 4.0(3.0, 4.0))were significantly lower than those of the control group, and the differences were statistically significant (all P<0.05). Other dCDT parameters were not statistically significant between the two groups ( Z=-1.835--0.440, P>0.05). (2) Correlation analysis showed that the total time was negatively correlated with MoCA MIS( r=-0.224, P=0.049), LIS( r=-0.237, P=0.037)and AIS( r=-0.236, P=0.038); time in air was negatively correlated with MoCA MIS( r=-0.268, P=0.018), LIS( r=-0.271, P=0.016), AIS( r=-0.259, P=0.022)and OISA( r=-0.267, P=0.018); the minute hand/hour hand ratio was positively correlated with MoCA EIS( r=0.259, P=0.022)and VIS( r=0.309, P=0.006); the strokes per minute was positively correlated with MoCA MIS( r=0.376, P=0.001), EIS( r=0.290, P=0.010), VIS( r=0.294, P=0.009), AIS( r=0.238, P=0.036)and OISA( r=0.301, P=0.007). (3)dCDT model composed of the pre-second hand latency, the ratio of minute hand/hour hand, and the strokes per minute can correctly classify 77.8% of aMCI, with a sensitivity of 74.36% and a specificity of 80.95%.Its diagnostic power for aMCI was significantly higher than the tCDT scoring( Z=2.335, P=0.02). Conclusion:The cognitive impairment in aMCI can be detected by dCDT, and different dCDT parameters can reflect the impairment of different cognitive domains.Compared with tCDT scoring, dCDT can improve the diagnostic efficacy of aMCI patients.

Análise da fluência verbal semântica em idosos altamente escolarizados / Semantic verbal fluency analysis in highly educated older adults

RESUMO Objetivo comparar o desempenho de idosos saudáveis com alta escolaridade nas análises quantitativas e qualitativas do Teste de Fluência Verbal Semântica, nas categorias "animais" e "frutas", comparar o desempenho de subgrupos de participantes (com escolaridade alta e muito alta) em ambas as categorias, assim como o desempenho entre homens e mulheres. Métodos participaram do estudo 31 idosos, (>60 anos), com oito anos ou mais de escolaridade, procedentes do Distrito Federal (DF-Brasil). Todos realizaram o teste de 60 segundos, nas duas categorias. Foram analisados: total de palavras, clustering, switching, intersecção, retorno, tempo de teste e erros, atendendo às variáveis demográficas, como gênero e escolaridade (escolaridade alta: oito a 16 anos de estudo; escolaridade muito alta: 17 a 25 anos de estudo). Resultados participantes com escolaridade muito alta obtiveram melhor desempenho em ambas as categorias, com maior número total de palavras evocadas na categoria "animais" e maior quantidade de switches (p<0,05) em "frutas". Quanto ao gênero, os homens obtiveram melhor desempenho na categoria "animais", com maior número total de palavras evocadas e nos diferentes blocos de tempo (p<0,05), e maior quantidade de clusters e interseções (p<0,001). Conclusão o desempenho de idosos saudáveis com alta escolaridade foi influenciado por variáveis demográficas como anos de estudo e gênero, sugerindo que a aplicação do Teste de Fluência Verbal Semântica deve considerar o impacto dessas variáveis e realizar uma interpretação cautelosa dos resultados.

ABSTRACT Purpose to compare the performance of a group of highly educated, healthy older adults in the quantitative and qualitative analysis of the Semantic Verbal Fluency (SVF) test in the Animals and Fruits categories, the performance of the subgroups of participants (with high [HE] and very high [VHE] educational level) in both categories, as well as the performance between men and women. Methods The study included 31 older adults (> 60 years old), with eight years or more of formal education, from the Federal District (DF-Brazil). All performed the 60-second test in both categories. The following items were analyzed: total words, clustering, switching, intersection, return, test time, and errors, considering demographic variables such as gender and educational level (HE: 8 to 16 years; VHE: 17 to 25 years). Results Participants with VHE had a better performance in both categories, with a greater total number of words evoked for "animals" and a greater number of switches (p<0.05) for "fruits". In relation to gender, men obtained a better performance for "animals" with the highest total number of evoked words and in the different time blocks (p<0.05) and greater number of clusters and intersections (p<0.001). Conclusion The performance of healthy older adults with a high educational level is influenced by demographic variables such as years of formal education and gender, suggesting that the application of the SVF should consider the impact of these variables, with a cautious interpretation of the results.

Comparación del desempeño de jóvenes en pruebas neuropsicológicas en formato lápiz y papel e informatizadas / Comparison of the Performance of Young Adults in Neuropsychological Tests in Paper-and-Pencil and Computerized Formats

Resumen Los campos de la aplicación de pruebas psicológicas y neuropsicológicas se han visto impactos por la tecnología específicamente con las pruebas informatizados. Una de las preguntas frecuentes en versiones papel y lápiz comparadas con una versión informatizada de la misma prueba, es si éstas son equivalentes. El objetivo de este estudio fue comparar el desempeño de pruebas neuropsicológicas en formato lápiz y papel y formato computarizado. Participaron 41 estudiantes en dos aplicaciones de las mismas pruebas en las dos versiones. Se encontró que los desempeños fueron equivalentes en la mayoría de las pruebas. Sin embargo, existen variaciones en las modalidades dependiendo de la ejecución de la prueba y con alta variabilidad entre sujetos. Esto sugiere que la diferencia en las puntuaciones podría deberse a la diferencia en los procesos cognitivos subyacentes a la ejecución de las dos modalidades.

Abstract The application of psychological and neuropsychological tests has been impacted by technology, specifically by computerized testing. One of the frequently asked questions is whether the version in pencil and paper and the computerized one can be considered equivalent tests. This study aimed to compare the performance on neuropsychological tests in pencil-and-paper and in computerized format. Forty-one students participated in two applications of the same tests in the two versions. It was found that the performances were equivalent in most of the tests. However, there are variations in the modalities depending on the execution of the test, and high intersubject variability. Results suggest that the difference in scores may be due to the difference in the underlying cognitive processes during the performance of the two modalities.

Theory of mind impairment in Huntington's disease patients and their relatives / Déficits en teoría de la mente en pacientes con enfermedad de Huntington y sus familiares

ABSTRACT Huntington disease (HD) is an autosomal dominant genetic disorder characterized by movement disorders, cognitive impairment, and psychiatric symptoms. Relatives of HD patients experience a great burden as the latter suffer from altered social conduct and deterioration of interpersonal relationships. Theory of mind (ToM) is the ability to attribute mental states (to oneself and others). Deficits in ToM are thought to have a role in the changes in empathy and interpersonal difficulties that HD patients face. Methods: We conducted a cross sectional study to compare ToM task scores of patients with mild to moderate HD, their relatives (spouse or at-risk first-degree relative with a negative gene test) and controls.Individuals with dementia or depression were excluded. The ToM test battery included Spanish versions of the Reading Mind in the Eyes Test (RMET), Happé's Strange Stories (Social and Physical Stories subtests) and the Hinting Task. Results: The series comprised 12 HD patients, 12 relatives and 12 controls. The HD patients showed lower affective ToM scores than controls (RMET 19 [3.5] vs 23.9 [2.7], p = 0.016). Cognitive ToM tasks scores were lower in HD patients than controls as well (Happé's Social Stories 9 [2.6] vs 13 [1.9], p = 0.001; the Hinting Task 13.6 [3.4] vs 17.5 [4.0], p = 0.009). In the Hinting Task, HD relatives had lower scores in than controls (13 [3.2] vs 17.5 [4.0], p = 0.009) and similar scores to controls in the rest of the battery. Conclusion: The HD patients with mild to moderate disease severity and their relatives show ToM deficits.

RESUMEN La enfermedad de Huntington (EH) es una enfermedad genética autosómica dominante caracterizada por trastornos del movimiento, deterioro cognitivo y síntomas psiquiátricos. Los familiares de las personas con EH experimentan gran carga dado que los pacientes sufren de conducta social alterada y deterioro de relaciones interpersonales. La Teoría de la mente (ToM) consiste en la habilidad para atribuir estados mentales (a uno mismo o a otros). Se piensa que déficits en ToM tienen un rol en los cambios en empatia y en las dificultades interpersonales que los pacientes con EH enfrentan. Métodos: Condujimos un estudio transversal para comparar el desempeño en puntajes de tareas de ToM en pacientes con EH leve a moderada, sus familiares (pareja o familiar en riesgo con prueba genética negativa) y controles sanos. Se excluyó a sujetos con demencia o depresión. La batería de pruebas de ToM incluyó versiones en español de la prueba de lectura de la mente en los ojos (RMET), Historias Extrañas de Happé (subpruebas Social y Física) y Hinting Task. Resultados: La serie consistió de 12 pacientes con EH, 12 familiares y 12 controles. Los pacientes con EH mostraron puntajes menores de tareas de ToM afectiva que los controles (RMET 19 [3.5] vs 23.9 [2.7], p = 0.016). Los puntajes de tareas de ToM cognitiva fueron inferiores a los controles en los pacientes con EH (Historias Sociales de Happé 9 [2.6] vs 13 [1.9], p = 0.001; Hinting task 13.6 [3.4] vs 175 [4.0], p = 0.009). En la Hinting task los familiares de pacientes con EH mostraron puntajes inferiores que los de los controles (13 [3.2] vs 175 [4.0], p = 0.009) y puntajes similares a aquellos de los controles en el resto de la batería. Conclusión: Los pacientes con EH con enfermedad leve a moderada y sus familiares muestran déficits en tareas de ToM.

The Influence of Body Mass Index at Diagnosis on Cognitive Decline in Parkinson's Disease

BACKGROUND AND PURPOSE: Associations between alterations in body mass index (BMI) and cognitive function have been reported in Parkinson's disease (PD). We investigated whether the BMI at a PD diagnosis is associated with cognitive decline and the future development of dementia. METHODS: We recruited 70 patients with de novo PD who underwent neuropsychological testing every 3 years and were followed up for more than 6 years. We classified patients into the following three groups based on their BMI at the diagnosis: under-/normal weight (n=21), overweight (n=22), and obese (n=27). We evaluated differences in the rate of cognitive decline over time among the groups using linear mixed models and the conversion rate to dementia using survival analysis. RESULTS: The obese patients with PD showed a slower deterioration of global cognitive function as well as language and memory functions than did the under-/normal-weight group during the 6-year follow-up. The three BMI groups showed different rates of conversion to dementia (log-rank test: p=0.026). The combined overweight and obese group showed a lower risk of developing dementia compared with the under-/normal-weight group (hazard ratio= 0.36, 95% CI=0.12–0.82, p=0.046). CONCLUSIONS: We have demonstrated that a higher-than-normal BMI at the time of a PD diagnosis has a protective effect against the deterioration of cognitive function and the conversion to dementia.

Effect of Paper-Based Cognitive Training in Early Stage of Alzheimer's Dementia

BACKGROUND AND PURPOSE: Cognitive training refers to a series of standardized tasks with inherent challenges that target specific cognitive domains. Positive outcome of cognitive training in persons with Alzheimer's disease has been reported. In this study, the objective was to design sets of cognitive training program, “Gipum-seo” which is combined cognitive training, consists of different levels of difficulty using predesigned paper-and-pencil exercises. Also, to evaluate the effects of the cognitive training on patients' with early stage of Alzheimer's disease. METHODS: The subjects for this study were forty participants who were diagnosed with early stage of Alzheimer's dementia. To test the efficacy of paper-based cognitive training programs to cognition, all patients were randomly grouped to either an intervention group (n=20) or a control group (n=20). The intervention group regularly received 24 sessions of paper-based cognitive training over a 12-week period. Neuropsychological examinations were conducted before and after this training period. RESULTS: After the 12 weeks, the intervention group showed a significant change in Korean version of the Mini-Mental State Examination (25.90±3.8), compared to the control group (23.7±2.8) (p=0.042). The training group also showed a significant improvement in language, attention and executive function, as compared with controls. CONCLUSIONS: Paper-based cognitive training might have beneficial effects on the general cognitive functions in the early stage of Alzheimer's dementia.

Normative data for the Neuropsychological Assessment Battery of Reading, Writing and Cognitive Functions (ENLEF) / Datos normativos para la batería de evaluación neuropsicológica de lectura, escritura y funciones cognitivas (enlef)

Resumen Las dificultades de aprendizaje constituyen una problemática frecuente en las escuelas. Aunque diversos instrumentos de evaluación neuropsicológica han sido creados, la mayoría se han desarrollado y estandarizado para población no colombiana, o no están diseñados para niños menores de seis años y no permiten relacionar claramente las habilidades académicas y los procesos cognitivos subyacentes a ellas. El objetivo de este estudio es construir los datos normativos de la batería ENLEF en población infantil colombiana a partir de la evaluación de la influencia de las variables sociodemográficas en el desempeño de la prueba. Participaron 516 niños y niñas escolarizados de entre cuatro y siete años, quienes fueron evaluados por psicólogos entrenados con la batería ENLEF. Los resultados mostraron una influencia de la edad y el estrato sobre el desempeño de los participantes en la mayoría de las pruebas. Sin embargo, en algunas pruebas de lenguaje y de lectura se observó solo una influencia del estrato socioeconómico. Los resultados del presente estudio permiten el uso de la ENLEF en la población infantil colombiana como una alternativa culturalmente contextualizada para la evaluación de funciones cognitivas y habilidades de lectoescritura. Además, se confirma la influencia de la edad y el nivel socioeconómico sobre el desarrollo cognitivo.

Abstract Learning disabilities are a frequent problem identified at school. Although there are several neuropsychological tests available, most of them have been developed and standardized for non-Colombian population, haven't been designed for children below six years old, and don't allow to clearly relate academic skills with cognitive process. The aim of this study was to develop normative data for the ENLEF test for Colombian children, by assessing the influence of sociodemographic characteristics on the test performance. Trained psychologists assessed 516 school-children aged from four to seven years using the ENLEF test. Results showed an influence of age and socioeconomic status on the participants' performance in most of the subtest. Nevertheless, in some language and reading subtests, only the influence of socioeconomic status showed an influence on the performance. These results allow the use of the ENLEF test for children in Colombia, as a culturally-contextualized option to assess cognitive functions and reading and writing skills. Furthermore, influence of age and socioeconomic status on cognitive development is also confirmed.

Assessing knowledge: psychometric properties of the BAMS semantic memory battery

Abstract Background: Semantic memory is a cultural influenced cognitive domain that is responsible for our knowledge about words and the world. Semantic Memory Battery (BAMS) is a new battery that evaluate semantic memory based on a compendium of tasks, including verbal fluency, naming, conceptualization, categorization, general questions, and word definitions, and was designed to consider cultural aspects. Objectives: We aimed to evaluate the BAMS psychometrics structure comprising classical and modern analysis, and also evaluate a clinical subdivision of the battery. Methods: 114 Brazilian cognitively healthy older adults BAMS performance provided data for psychometric analysis using validity tests, item response theory analysis and confirmatory factor analysis for goodness-of-fit measures. Results: BAMS results revealed good validity and good-fit measures in each subtest, total score (X2 = 20.684, p = 0.110) and a hierarchical structure with clinical subdivision of the battery (X2 = 20.089, p = 0.093). Discussion: BAMS is a new compendium of tasks that evaluate distinct aspects of semantic memory and can clinically consider the impact of executive function. This battery evaluates verbal fluency, naming, conceptualization, categorization, general knowledge and word definitions. The BAMS has clinical importance once semantic memory is mostly influenced by culture and language, and there is an absence of broadly semantic memory tests in our scenario, especially with older adults that can have a pathological aging condition that affects primarily or secondarily this domain.

Usefulness of Early Neurodevelopmental Testing for High-Risk Neonates / 대한소아신경학회지

PURPOSE: To identify the significance of the 12-month developmental assessment in high-risk neonates by comparing their 12 month and later childhood development. METHODS: We retrospectively reviewed the records of high risk neonates admitted to neonatal intensive care units of Korea University Ansan Hospital for ten years. Data of 146 patients, who underwent the Bayley test at 12 months of age and retook the same test at 24–36 months, was analyzed. Changes in mental developmental index (MDI) and psychomotor developmental index (PDI) were assessed and < 85 scores of indices were defined as abnormal. RESULTS: At 12 months of age, 35 (24.0%) had normal development, 45(30.8%) had psychomotor developmental delay (MDI≥85, PDI < 85), 7(4.8%) had mental developmental delay (MDI < 85, PDI≥85), and 59(40.4%) had global delay (MDI& PDI < 85). At 24–36 months of age, 52(35.6%) had normal development, 10(6.8%) had mental delay, 16(11.0%) had psychomotor delay, and 68(46.6%) had global delay. Out of 35 patients with normal development at 12 months, 27(77.1%) showed normal development after that, and 46(78.0%) of 59 patients with global delay showed a global delay. All 7 patients who had delayed mental development at 12 months showed global delay at 24–36 months of age (P < 0.01). The 12-month development of high-risk neonates was associated with later developmental status. CONCLUSION: Considering the importance of early intervention for delayed development, the 12-month Bayley test of high-risk neonates may be useful for prediction of later developmental progress.

The Five Digits Test in the assessment of older adults with low formal education: construct validity and reliability in a Brazilian clinical sample / O Teste dos Cinco Dígitos na avaliação de idosos com baixa escolaridade: validade de construto e confiabilidade em uma amostra clínica do Brasil

Abstract Introduction In the assessment of older adults with very low formal education, typical tests of selective attention and inhibitory control are biased by reading abilities. In this sense, we aim to assess the psychometric characteristics of the Five Digits Test (FDT), a numerical Stroop paradigm, in older adults without cognitive disorders, with mild cognitive impairment, and with dementia. Methods We assessed 211 Brazilian older adults with low formal education using the FDT and other cognitive measures. Construct validity and reliability were assessed by correlations and internal consistency. Results The FDT test had weak correlations with crystalized intelligence tests and moderate-high correlations with fluid intelligence measures and tests of global cognitive status and executive functions. The split-half coefficient of reliability showed high internal consistency (>0.900). Conclusion Together, the results suggest that the FDT is a valid and reliable measure for the assessment of processing speed and executive functions in older adults with low formal education.

Resumo Introdução Na avaliação de idosos com educação formal muito baixa, os testes típicos de atenção seletiva e controle inibitório são enviesados devido à dependência de habilidades básicas de leitura. Nesse sentido, pretende-se avaliar as características psicométricas do Teste dos Cinco Dígitos (Five Digits Test, FDT), teste de paradigma Stroop-numérico, em idosos sem transtornos cognitivos, em pacientes com comprometimento cognitivo e em pacientes com demência. Métodos Foram avaliados 211 idosos brasileiros com baixa escolarização formal por meio do FDT e outras medidas cognitivas. Analisamos a validade de construto e a confiabilidade por correlações e consistência interna. Resultados O FDT apresentou correlações fracas com testes de inteligência cristalizada e correlações de moderadas ou fortes com medidas de inteligência fluida, medidas cognitivas globais e testes de funções executivas. O teste apresentou consistência interna elevada (>0.900). Conclusão Em conjunto, os resultados sugerem que o FDT é uma medida válida e confiável para a avaliação da velocidade de processamento e funções executivas em idosos com baixa escolaridade.

Fluencia verbal: un test neuropsicológico breve para la detección de trastornos cognitivos en pediatría / Verbal fluency: A rapid neuropsychological test for the detection of cognitive disorders in pediatrics

RESUMEN INTRODUCCIÓN: La fluencia verbal es un test psicométrico breve utilizado en evaluaciones neuropsicológicas para estudiar funciones ejecutivas y verbales. El desempeño en la población pediátrica en esta prueba no ha sido profundamente estudiado. Tampoco encontramos estudios en pediatría que analicen la fluidez verbal fonológica (FF) en relación al nivel intelectual utilizando la versión española con letras iniciales "P" y "M". OBJETIVO: Analizar el rendimiento en FF en función del nivel intelectual y del diagnóstico. MÉTODO: Corte transversal. Se incluyeron pacientes entre 6 y 16 años con evaluación neuropsicológica con nivel intelectual (WISCIV) y FF (NEPSYII) entre enero y junio del 2016. Se realizó una regresión lineal simple para analizar la relación entre FF y el resto de las variables de estudio. RESULTADOS: Se incluyeron 95 pacientes, edad media de 10 años. La FF mostró correlación positiva con el nivel intelectual total (CIT) (r=3,71; p<0,001; IC95 % 2,77- 4,65). El 73 % de pacientes con FF normal tuvieron un CIT normal. La probabilidad de presentar un CIT descendido presentado una FF menor de 7 fue 5,5 veces mayor (OR=5,5 p<0,003; IC95 %=2,23-13,76). Quienes presentaron una FF descendida con CIT normal (n=19), El 80 % tenía diagnóstico de trastorno por déficit de atención (15/19) y 21 % dislexia (4/19). CONCLUSIONES: Nuestros resultados tienen una importante implicancia clínica, pues no siempre se dispone del acceso y tiempo necesario para realizar una evaluación neuropsicológica extensa. El presente trabajo demuestra que la prueba FF de rápida administración con letras "P" y "M" resulta una herramienta de screening neuropsicológica efectiva en revelar déficit no sólo en funciones ejecutivas y habilidades verbales, sino también en detectar el rendimiento intelectual descendido.

SUMMARY INTRODUCTION: Verbal fluency is a brief psychometric test used in neuropsychological assessments to study executive and verbal functions. Pediatric population performance in this trial has not been thoroughly studied. We also did not find studies in pediatrics that analyze the phonological verbal fluency (FF) in relation to the intellectual level using the Spanish version with initial letters "P" and "M". OBJECTIVE: Analyze FF performance based on intellectual level and diagnosis. METHODS: It's a cross-section research. We included patients between 6 and 16 years old with neuropsychological assessment with intellectual level (WISCIV) and FF (NEPSYII) between January and June of 2016. A simple linear regression was performed to analyze the relationship between FF and the rest of the variables. RESULTS: We included 95 patients, mean age of 10 years. The FF showed a positive correlation with the total intellectual level (ITC) (r = 3.71, p <0.001, 95% CI 2.77-4.65). The 73% of patients with normal FF had a normal ITC. The probability of showing a lower ITC when the FF was lower than 7 was 5.5 times greater (OR = 5.5, p <0.003, 95% CI = 2.23-13.76). Those who presented a lower FF with normal ITC (n = 19) 80% had diagnosis of Attention Deficit Disorder (15/19) and 21% dyslexia (4/19). CONCLUSIONS: Our results have important clinical implications because the access and time necessary for an extensive neuropsychological evaluation is not always available. The present research shows that FF of 2 minutes long with letters "P" and "M" is an effective neuropsychological screening tool in revealing deficit not only in executive functions and verbal abilities, but also in detecting decreased intellectual performance. Those patients with poor performance in this test should perform a complete neuropsychological assesment in order to clarify the diagnosis.

Tablas de normalidad de la población en Cuba para las pruebas psicométricas utilizadas en el diagnóstico de la encefalopatía hepática mínima / Cuban Normality Tables for Psychometric Tests Used for Diagnosis of Minimal Hepatic Encephalopathy

Objetivos: la encefalopatía hepática mínima constituye el estadio subclínico previo al desarrollo de encefalopatía hepática clínica en el paciente cirrótico, además de asociarse con un deterioro de la calidad de vida de estos pacientes y con un riesgo incrementado de accidentes laborales e incapacidad de conducción de vehículos. El Psychometric Hepatic Encephalopathy Score es considerado actualmente el método diagnóstico de elección en el diagnóstico de la EHM. El objetivo de este trabajo fue diseñar las tablas de normalidad del PHES para la población cubana. Población y métodos: se estudió una muestra conformada por 520 personas sanas de las provincias de Villa Clara, Sancti Spíritus y Cienfuegos. Las mismas realizaron las 5 pruebas incluidas en el PHES. Se analizaron las variables edad, sexo, años de escolarización, procedencia y consumo diario de alcohol. Mediante la prueba de la t de Student, ANOVA y el coeficiente de correlación de Pearson, se realizó el análisis univariante. Se efectuó un análisis de regresión lineal múltiple para cada prueba, y se construyeron las tablas de normalidad. Resultados: en el análisis multivariante (regresión lineal múltiple) la edad y los años de escolarización fueron las 2 variables independientes relacionadas con el rendimiento en cada una de las cinco pruebas. Conclusión: la disponibilidad de las tablas de normalidad del PHES permitirá contar con un método diagnóstico de referencia aplicable a los pacientes cubanos con cirrosis hepática, sin la necesidad de configurar grupos controlados por la edad y el nivel de escolaridad regionalmente

Objectives: Minimal hepatic encephalopathy (MHE) is the subclinical stage prior to the development of clinical hepatic encephalopathy in cirrhotic patients. For these patients, it is associated with impaired quality of life, increased risk of accidents, and incapacity for driving vehicles. The Psychometric Hepatic Encephalopathy Score (PHES) is currently considered to be the diagnostic method of choice for diagnosis of MHE. The aim of this work was to design PHES normality tables for the Cuban population. Population and Methods: The study sample consisted of 520 healthy people from the provinces of Villa Clara, Sancti Spiritus and Cienfuegos who all took the 5 tests included in the PHES. Variables of age, sex, years of schooling, place of origin, and daily alcohol consumption were analyzed. Univariate analysis with the Student’s t test, ANOVA and Pearson correlation coefficient was performed. Multivariable linear regression for each test was performed and normality tables were constructed. Results: Multivariate analysis used multiple linear regression with age and years of schooling as the independent variables related to performance for each of the 5 tests. Conclusions: The availability of normality tables provides a diagnostic reference method for PHES which is applicable to Cuban patients with liver cirrhosis without requiring control groups for age and regional education level

Does previous presentation of verbal fluency tasks affect verb fluency performance? / A apresentação prévia de tarefas de fluência verbal afeta o desempenho da fluência de verbos?

Background : Performance on the verb fluency (VF) task may be influenced by administration procedures and demographic factors of each population. Objective : The aim of this study was to verify whether the previous administration of semantic and phonemic verbal fluency tasks can influence performance on VF; and to analyze the correlation of VF performance with education, age and type of errors in Brazilian healthy elderly. Methods : Sixty-two participants were subdivided into experimental (semantic and the phonemic fluency tasks were administered before the VF) and control groups (VF only). The total score and the types of errors on the VF task were determined. Additional information was computed for the correlational analysis. Results : VF performance did not differ statistically between experimental and control groups, but correlated positively with education and negatively with intrusions. Conclusion : The lack of influence of other verbal fluency tasks on performance of the VF task in elderly individuals allows the use of this order of administration. A strong influence of educational level on VF task performance reinforces the need for further studies in different populations.

Introdução : O desempenho na tarefa de fluência de verbos (FV) pode ser influenciado pelo modo de administração e por fatores sócio-demográficos de cada população. Objetivo : Este estudo teve como objetivo verificar se a administração prévia das tarefas de fluência verbal (fluência semântica e fonêmica) poderia influenciar no desempenho da FV, assim como analisar a correlação da FV com escolaridade, idade e tipos de erros em Brasileiros idosos saudáveis. Métodos : Sessenta e dois participantes foram divididos em grupo experimental (fluências semântica e fonêmica foram aplicadas antes da FV) e em grupo controle (apenas a FV foi aplicada). O escore total e os tipos de erros da FV foram verificados. Informações adicionais foram consideradas para a análise de correlação. Resultados : Não houve diferença estatisticamente significativa entre os grupos experimental e controle quanto ao desempenho da FV. A FV se correlacionou positivamente com a escolaridade e negativamente com as intrusões. Conclusão : A falta de influência de outras tarefas de fluência verbal no desempenho da FV em indivíduos idosos permite o uso dessa ordem de administração. Uma forte influência da escolaridade sobre o desempenho da FV reforça a necessidade de estudos em diferentes populações.

Clinical Usefulness of Korean Version of Older Adult Behavior Checklist in Screening for Diverse Psychopathology of Cognitive Impairment

OBJECTIVE: This study aimed to investigate the differences of results of Older Adult Behavior Checklist (OABCL) in subjects with dementia, mild cognitive impairment (MCI), and normal group. METHODS: The data was composed of 42 patients with MCI, 71 patients with dementia, and 111 randomly collected participants who were recruited for standardization of Korean version of Achenbach System of Empirically Based Assessment Older Adult Forms. Medical records, results of OABCL, neuropsychological tests, activities of daily living scale, and clinical dementia rating scale of the subjects were retrospectively analyzed to find significant factors in distinguishing the groups. RESULTS: In dementia group, almost of the empirically base problem scales and Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales showed significantly higher scores than MCI or normal groups. MCI group also showed higher scores in several empirically base problem and DSM-oriented scales than normal group. Also, functional impairment, memory/cognition, thought problems, irritable/disinhibited scales of empirically base problem and depressive, dementia, psychotic problems DSM-oriented scales significantly predict in distinguishing the three groups. CONCLUSION: The results implicated that OABCL is not only useful in assessing cognition decline but also in investigating psychological and behavioral problems of older adults.

A Comparative Study of Computerized Memory Test and The Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet for Assessing Memory Function in the Elderly

OBJECTIVE: The aim of this study was to examine the concurrent validity of a newly developed computerized memory diagnostic system (MDS) with the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). METHODS: Subtests of the MDS and CERAD-K, including the auditory-verbal, visuo-spatial, and working memory tests, were administered to 43 adults aged 60 to 74 years. We calculated the correlations between the subtest scores of the MDS and CERAD-K to examine the concurrent validity of the MDS. RESULTS: We found significant correlations between the subtest scores in the verbal-auditory memory, including immediate recall, delayed recall, and delayed recognition. The working memory subtest scores between the MDS and CERAD-K also showed a significant positive correlation. CONCLUSION: We verified the concurrent validity of the memory subtests in the MDS for the elderly. The results of the present study suggest that the MDS could be a valuable tool for an efficient and valid assessment of memory function.

The Thai Version of the Addenbrooke's Cognitive Examination III

The objective of our study was to assess the accuracy of the Thai version of the Addenbrooke's Cognitive Examination III (ACE-T). We used the ACE-T to assess 107 participants aged 60 or over, divided into the following groups: early dementia, n=30; mild cognitive impairment (MCI), n=29; and normal controls (NC), n=48. The ACE-T exhibited good internal consistency (0.93) and inter-rater reliability (1.0). The optimal cut-off score for the ACE-T to differentiate MCI from NC was 75/76, giving a sensitivity of 0.9 and specificity of 0.86. At the optimal cut-off of 61/62, the ACE-T had excellent sensitivity (1.0) and specificity (0.97) to distinguish early dementia from non-dementia. The ACE-T had high diagnosis accuracy in the detection of the MCI and early dementia in the Thai population.