Cognitive impairment in post-acute COVID-19 syndrome: a scoping review / Comprometimento cognitivo na síndrome pós-COVID-19 aguda: uma revisão de escopo

Abstract Emerging studies indicate the persistence of symptoms beyond the acute phase of COVID-19. Cognitive impairment has been observed in certain individuals for months following infection. Currently, there is limited knowledge about the specific cognitive domains that undergo alterations during the post-acute COVID-19 syndrome and the potential impact of disease severity on cognition. The aim of this review is to examine studies that have reported cognitive impairment in post-acute COVID-19, categorizing them into subacute and chronic phases. The methodology proposed by JBI was followed in this study. The included studies were published between December 2019 and December 2022. The search was conducted in PubMed, PubMed PMC, BVS - BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo, and EBSCOHost. Data extraction included specific details about the population, concepts, context, and key findings or recommendations relevant to the review objectives. A total of 7,540 records were identified and examined, and 47 articles were included. The cognitive domains most frequently reported as altered 4 to 12 weeks after acute COVID-19 were language, episodic memory, and executive function, and after 12 weeks, the domains most affected were attention, episodic memory, and executive function. The results of this scoping review highlight that adults with post-acute COVID-19 syndrome may have impairment in specific cognitive domains.

Resumo Estudos emergentes indicam a persistência dos sintomas além da fase aguda da COVID-19. O comprometimento cognitivo foi observado em alguns indivíduos durante meses após a infecção. Atualmente, há pouco conhecimento sobre os domínios cognitivos específicos que sofrem alterações durante a síndrome pós-aguda da COVID-19 e o possível impacto da gravidade da doença na cognição. O objetivo desta revisão é examinar estudos que relataram comprometimento cognitivo na COVID-19 pós-aguda, categorizando-os em fases subaguda e crônica. A metodologia proposta pela Joanna Briggs Institute foi seguida neste estudo. Os estudos incluídos foram publicados entre dezembro de 2019 e dezembro de 2022. A busca foi realizada no PubMed, PubMed PMC, BVS - BIREME, Embase, SCOPUS, Cochrane, Web of Science, Proquest, PsycInfo e EBSCOHost. A extração de dados incluiu detalhes específicos sobre a população, os conceitos, o contexto e as principais descobertas ou recomendações relevantes para os objetivos da revisão. Um total de 7.540 registros foi identificado e examinado, e 47 artigos foram incluídos. Os domínios cognitivos mais frequentemente relatados como alterados de 4 a 12 semanas após a COVID-19 aguda foram linguagem, memória episódica e função executiva e, após 12 semanas, os domínios mais afetados foram atenção, memória episódica e função executiva. Os resultados dessa revisão de escopo destacam que adultos com síndrome pós-aguda da COVID-19 podem apresentar comprometimento em domínios cognitivos específicos.

Indagações sobre experiência de quase morte, memória episódica e o psicóide na visão da psicología / Inquiries about near-death experiences, episodic memory and the psychoid from the view of analytical

Busca-se discutir a relação da Experiência de Quase Morte (EQM) a partir dos conceitos junguianos, particularmentea Individuação e a Espiritualidade. Pretende-se ainda, explorar possíveis relações entre a memória da EQM e Neuropsicologia, analisando o arquétipo psicóide e possíveis relações entre ele e a memória episódica, procurando-se possibilidades viáveis de pesquisas exploratórias que possam trazer maiores esclarecimentos na relação entre a experiência de quase morte, o conceito do psicóide da Psicologia analítica de C. G. Jung e a memória episódica tratada em neuropsicologia AU

We seek to discuss the relationship of the Near Death Experience (NDE) from the Jungian concepts, particularly Individuation and Spirituality. It is also intended to explore possible relationships between NDE memory and Neuropsychology, analyzing the psychoid archetype and possible relationships between it and episodic memory, looking for viable possibilities for exploratory research that can bring further clarification on the relationship between the experience of almost death, the psychoid concept from C. G. Jung's Analytical Psychology and the episodic memory treated in neuropsychology AU

Desarrollo y validación de una tarea experimental de Memoria Episódica verbal en español / Development and validation of an experimental verbal Episodic Memory task in Spanish

RESUMEN Propósito Elaborar y validar una tarea experimental de memoria episódica verbal en español. Método Se elaboraron seis bloques de codificación: tres profundos y tres superficiales, cado uno con distintas demandas de esfuerzo cognitivo. Los bloques fueron revisados por cuatro jueces expertos y examinados en una aplicación piloto. Se evaluó la concordancia respecto a si la tarea permitía manipular combinadamente el nivel de procesamiento y el esfuerzo cognitivo durante la codificación incidental de palabras, así como la claridad de las instrucciones, ejemplos y dinámica de trabajo. Resultados Variables como la disponibilidad léxica, metría y fuerza de asociación fueron útiles para diferenciar el esfuerzo cognitivo entre cada bloque. Los jueces concordaron que los bloques de procesamiento admiten una manipulación combinada del nivel de procesamiento y esfuerzo cognitivo y que las instrucciones son precisas. Luego del pilotaje, los participantes concordaron que las instrucciones, ejemplos y forma de trabajo eran fácil de comprender y realizar. Conclusión Los resultados proporcionan evidencia de validez relacionada con el contenido para la tarea experimental propuesta, transformándose con ello en una alternativa viable de considerar en investigaciones orientadas a identificar factores ambientales que contribuyan a compensar los defectos que muestra la memoria episódica con la edad.

ABSTRACT Purpose To develop and validate an experimental verbal episodic memory task in Spanish. Methods Six encoding blocks were elaborated, three deep and three superficial, each one with different demands of cognitive effort. The blocks were reviewed by four expert judges and tested in a pilot application. The agreement was assessed on whether the task allowed combined processing level and cognitive effort to be manipulated during incidental encoding of words, as well as clarity of instructions, examples, and workflow. Results Variables such as lexical availability, metrics, and strength of association were useful to differentiate the cognitive effort between each block. The judges agreed that the processing blocks allowed a combined manipulation of the level of processing and cognitive effort and that the instructions are precise. After the pilot, the participants agreed that the instructions, examples, and way of working were easy to understand and perform. Conclusion The results provide evidence of validity related to the content for the proposed experimental task, thus becoming a viable alternative to consider in research aimed at identifying environmental factors that contribute to compensating the defects shown by episodic memory with age.

Teoría de la Mente en pacientes Traumatizados Craneoencefálico

Antecedentes: Uno de los impedimentos más importantes en los traumatismos craneoencefálicos (TEC), revistan en las dificultades de interacción social, la Teoría de la Mente (ToM) es un factor fundamental de la cognición social, que permite una interacción satisfactoria del sujeto. Objetivo: Observar la capacidad de ToM en pacientes TEC moderado o severo, y su relación con dominios neurocognitivos. Método: Pacientes diagnosticados con TEC moderado o severo, evaluados neuropsicológicamente, edad 16 y 45 años, se aplicaron Test de la Mirada (TdlM) e Historias Extrañas (HT). Resultados: Se encontraron correlaciones entre TdlM y HT con memoria y funciones ejecutivas. Pacientes lesionados izquierdos, rinden significativamenie menos en HT. Conclusiones: Pacientes con TEC moderado o grave tienen una disminución de la capacidad de ToM. Existe una relación entre memoria episódica y ToM, podría deberse a que esta última requiere información a experiencias pasadas. Durante la infancia la ToM depende de la memoria episódica, pero cuando ambas se desarrollan adecuadamente, son independientes. Existe una relación entre funciones ejecutivas y ToM. Ambos constructos están vinculados en la infancia, pero luego comienzan a ser más independientes. Sin embargo, la ToM igualmente va a requerir de las funciones ejecutivas.

Background: One of the most important impediments in traumatic brain injuries (TBI), are the difficulties of social and family interaction. The Theory of Mind (ToM) is a fundamental factor of social cognition, which allows a satisfactory interaction of the individual with his environment. Objetive: To observe the ability of ToM in moderate or severe TBI patients, and its relationship with neurocognitive domains. Methods: Outpatients with diagnosis of moderate or severe TBI, evaluated neuropsychologically, age between 16 and 45 years, were applied Eyes Test (ET) and the Hinting task (HT). Results: Correlations were found between ET and HT with memory and executive functions. Injured left, perform significantly less in HT Patients with moderate or severe TBI have a decrease in ToM capacity. Conclusions: There is a relationship between episodic memory and ToM, which could be due to the latter 's need to request information from past experiences through episodic memory. During childhood ToM depends on episodic memory, but when both are achieved and developed properly, they are independent. There is a relationship between executive functions and ToM. Both constructs are linked in childhood, but then they begin to be more independent. However, ToM tasks will also require executive functions.

The effectiveness and safety of cranial nerve block in migraine: a critical review / A eficácia e segurança do bloqueio de nervos cranianos na enxaqueca: uma revisão crítica

Cranial nerve blocks (CNBs) have been used for the acute and preventive treatment of a variety of headaches, including migraine. The effectiveness of CNBs in migraine is usually observed beyond the duration of the nerve block, possibly due to central pain modulation. The most used target is the greater occipital nerve. Other commonly targeted nerves are the lesser occipital nerve and various branches of the trigeminal nerve, including the supratrochlear, supraorbital, and auriculotemporal nerves. CNBs are generally safe and well-tolerated procedures that can be performed in either emergency or outpatient settings. There is currently no guideline standardizing CNBs in migraine. In clinical practice, as well as the few published studies, the results are encouraging, justifying further studies in the area. In the present study we critically review the literature about the safety and efficacy of CNBs in the treatment of migraine attacks and in the preventive treatment of migraine.

Bloqueios de nervos cranianos (BNCs) têm sido usados ​​para o tratamento agudo e preventivo de uma variedade de dores de cabeça, incluindo enxaqueca. A eficácia dos BNC na enxaqueca é geralmente observada além da duração do bloqueio nervoso, possivelmente devido à modulação central da dor. O alvo mais utilizado é o nervo occipital maior. Outros nervos comumente alvo são o nervo occipital menor e vários ramos do nervo trigêmeo, incluindo os nervos supratroclear, supraorbital e auriculotemporal. Os CNBs são geralmente procedimentos seguros e bem tolerados que podem ser realizados em ambientes de emergência ou ambulatoriais. Atualmente não há nenhuma diretriz padronizando BNCs na enxaqueca. Na prática clínica, assim como nos poucos estudos publicados, os resultados são animadores, justificando novos estudos na área. No presente estudo revisamos criticamente a literatura sobre a segurança e eficácia dos BNC no tratamento de crises de enxaqueca e no tratamento preventivo da enxaqueca.

Hipotermia episódica postraumática

Introducción: La regulación de temperatura es uno de los mecanismos de control vital de mayor importancia en el ser humano. Entre las causas de hipotermia se describe varias de origen neurológico y no neurológicas. En la mayoría de los casos de hipotermia que se desarrolla secundaria a trauma craneal, se trata de pacientes con daño neurológico severo mantenido pero se encuentran escasas descripciones relacionadas con trauma craneoencefálico leve o en pacientes sin otras secuelas importantes. Objetivo: Examinar un caso de hipotermia episódica postraumática sin afectaciones neurológicas asociadas y sin lesiones orgánicas demostradas. Presentación del caso: Paciente masculino, 14 años, antecedentes de salud. Sufre trauma de cráneo sin repercusión clínica aparente en ese momento. Una semana posterior al trauma comienza a presentar episodios de hipotermia nocturna de duración variable, autolimitados, siempre durante el sueño del paciente. Entre los episodios el paciente se mantiene asintomático. Examen físico normal. Estudios de neuroimagen sin alteración. Se indica reposo y tratamiento médico, primero con carbamazepina y luego con valproato de sodio. Actualmente el paciente muestra mejoría del cuadro, aunque no remisión completa de los episodios. Conclusiones: La hipotermia se relaciona con un elevado número de afecciones. La mayoría de los pacientes con trauma de cráneo que presentan hipotermia tienen asociados otros daños y presentan la afección de forma mantenida. Existen otros pacientes, como el caso presentado, sin lesiones orgánicas demostrables en estudios de imágenes que exteriorizan los trastornos de la termorregulación de forma recurrente con periodos de normalidad entre ellos.

Introduction: Temperature regulation corresponds to one of the most important vital control mechanisms in humans. Among the causes of hypothermia are described several of neurological and non-neurological origin. In most cases of hypothermia that develops secondary to cranial trauma described in literature, these are patients with sustained severe neurological damage but there are few descriptions related to mild cranioencephalic trauma or in patients without other important sequelae. Objective: To examine a case of post-traumatic episodic hypothermia without associated neurological affectations and without demonstrated organic lesions. Case presentation: Male patient, 14 years old, health history. He suffered from a cranial trauma with no apparent clinical repercussion at the time. A week after the trauma, episodes of nocturnal hypothermia of variable duration, self-limiting, always during the patient's sleep, begin to occur. Between episodes the patient remains asymptomatic. Normal physical exam. Neuroimaging studies without alteration. Rest and medical treatment are indicated first with carbamazepine and then with sodium valproate. Currently, the patient shows improvements but not complete remission of the episodes. Conclusions: Hypothermia is associated with a high number of conditions. Most patients with cranial trauma who present hypothermia have other associated damages and present hypothermia in a frequent manner, but there are other patients, such as the case presented, without comprobable organic lesions in imaging studies that present thermoregulation disorders on a recurrent basis with periods of normality between them.

Efeitos de intervenções combinadas em memória episódica e depressão em idosos saudáveis / Effects of combined interventions in episodic memory and depression in healthy elderly people

RESUMO O objetivo deste estudo foi verificar associações entre medidas de memória episódica e depressão em idosos saudáveis submetidos a intervenções cognitivas, físicas e psicopedagógicas. A amostra foi composta por 31 idosos, com idade média de 69,70 anos (DP± 6,38), sendo 25 mulheres e 6 homens. O procedimento consistiu em diferentes combinações de intervenções e suas avaliações em testes diagnósticos e de memória em follow-up de um ano. A análise de dados consistiu-se no teste não paramétrico de Friedman, com o nível de significância de p=0,05. Os resultados indicaram que a combinação que melhor apresentou desempenho cognitivo frente às variáveis relacionadas à aprendizagem (p=0,04) e interferência proativa (p=0,01) foi a "Stimulus + Psicopedagógica". O nível de depressão diminuiu ao longo das avaliações em todas as combinações (p=0,01). Esses achados indicam que intervenções combinadas podem ser promissoras em ganhos cognitivos e de humor

ABSTRACT The objective of this study was to verify associations between measures of episodic memory and depression in healthy elderly people submitted to cognitive, physical and psychopedagogical interventions. The sample consisted of 31 elderly people, with an average age of 69.70 years (SD ± 6.38), 25 women and 6 men. The procedure consisted of different combinations of interventions and their evaluations in diagnostic and memory tests in a one-year follow-up. Data analysis consisted of Friedman's non-parametric test, with a significance level of p=0.05. The results indicated that the combination that best presented cognitive performance in relation to the variables related to learning (p=0.04) and proactive interference (p=0.01) was the "Stimullus + Psicopedagógica". The level of depression decreased throughout the evaluations in all combinations (p=0.01). These findings indicate that combined interventions can be promising in cognitive and mood gains

Random number generation and the ability of mentally reconstructing context in patients with organic amnesia / Geração aleatória de números e a capacidade de reconstruir mentalmente o contexto em pacientes com amnésia orgânica

ABSTRACT. Studies investigating amnesic patients have shown the involvement of the medial temporal lobe during working memory (WM) tasks, especially when multiple items or features have to be associated. However, so far, no study has examined the relationship between episodic memory and WM components in patients with amnesia for comprehensive neuropsychological evaluation. Objective: The objective of this study was to investigate whether the null retention relates to deficits in the episodic buffer (EB) or the central executive (CE) components of WM. Methods: This study included 15 amnesic patients with mixed etiologies and 13 matched healthy controls. These 15 amnesic patients with mixed etiologies were divided into two subgroups: NUL subgroup (n=7) patients whose raw score was 0 (zero) on the Logical Memory delayed recall test and MOR subgroup (n=8) patients who recalled at least 1 item. The EB was assessed by complex span tasks, and the CE was assessed by random number generation (RNG) test. Results: EB tasks were impaired in both subgroups compared with controls. RNG was impaired in NUL (p=0.03), but not in MOR (p=0.99), subgroup. Conclusions: CE impairment hampers the retrieval mode action, preventing it from initiating the mental reconstruction of the context in which the to-be-remembered information was presented minutes ago.

RESUMO. Estudos que investigaram pacientes amnésicos demonstraram envolvimento do lobo temporal medial durante tarefas de memória de trabalho, especialmente quando vários itens ou características devem ser associados. No entanto, até o momento, não há estudos que tenham examinado a relação entre memória episódica e os subcomponentes da memória de trabalho em pacientes com amnésia por meio de avaliação neuropsicológica ampla. Objetivo: Investigar se a retenção nula está relacionada a déficits no buffer episódico ou nos componentes do executivo central da memória operacional. Métodos: Quinze pacientes amnésicos com etiologias mistas foram divididos em dois subgrupos: subgrupo NUL (n=7), de pacientes cuja pontuação bruta foi 0 (zero) na memória lógica tardia, e subgrupo MOR (n=8), de pacientes que recordaram pelo menos um item; além de 13 controles saudáveis pareados. O retentor episódico foi avaliado por tarefas de spam complexo e o executivo central com geração aleatória de números. Resultados: As tarefas do retentor episódico estavam prejudicadas em ambos os subgrupos em comparação com os controles. O teste de geração aleatória de números foi prejudicado em NUL (p=0,03), mas não no subgrupo MOR (p=0,99). Conclusões: O comprometimento do executivo central dificulta a ação do modo de recuperação, impedindo-o de iniciar a reconstrução mental do contexto em que a informação a ser lembrada foi apresentada, minutos antes.

Advances on the spectrum of neurological diseases related to the CACNA1A gene / 中华实用儿科临床杂志

The CACNA1A gene encodes a voltage-gated calcium channel of the pore-forming protein, which has important functions in the central nervous system.The CACNA1A gene mutation can lead to a variety of neurological diseases, including familial hemiplegic migraine 1, spinocerebellar ataxia 6, episodic ataxia 2 and early infantile epileptic encephalopathy 42.Overlapping phenotypes could be observed in a small number of patients.This review summarized the clinical and genetic characteristics of the CACNA1A gene mutation.

Clinical features and CACNA1A gene mutation in a family with episodic ataxia type 2 / 中南大学学报(医学版)

Episodic ataxia (EA) is a group of disorders characterized by recurrent spells of vertigo, truncal ataxia, and dysarthria. Episodic ataxia type 2 (EA2), the most common subtype of EA, is an autosomal dominant disease caused by mutation of the CACNA1A gene. EA2 has been rarely reported in the Chinese population. Here we present an EA2 family admitted to Xiangya Hospital in October 2018. The proband was a 22-year-old male who complained of recurrent spells of vertigo, slurred speech, and incoordination for 4 years. Brain magnetic resonance imaging (MRI) showed cerebellar atrophy. He had neuropsychological development disorder in childhood, and cognitive assessment in adulthood showed cognitive impairment. The proband's mother and grandmother had a similar history. Peripheral blood samples from the proband and family members were collected, and genomic DNA was isolated. Whole exome sequencing of the proband detected a heterozygous frameshift mutation c.2042_2043del (p.Q681Rfs*100) of CACNA1A gene. This mutation was verified in the proband and 2 family members using Sanger sequencing. One family member carrying this mutation was free of symptoms and signs, suggesting an incomplete penetrance of the mutation. We reported a variant c.2042_2043del of CACNA1A gene as the pathogenic mutation in a Chinese EA2 family for the first time. This case enriched the clinical spectrum of CACNA1A related EA2, and contributed to the understanding of clinical and genetic characteristics of EA2 to reduce misdiagnosis.

Acupuncture at sphenopalatine ganglion combined with conventional acupuncture for episodic cluster headache: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical effect of acupuncture at sphenopalatine ganglion combined with conventional acupuncture for episodic cluster headache (CH).@*METHODS@#One hundred and eighty patients with episodic CH were randomly divided into a combined group (60 cases, 3 cases dropped off)，an acupuncture group (60 cases, 2 cases dropped off) and a sphenopalatine ganglion group (60 cases, 2 cases dropped off and 1 case was removed). The patients in the acupuncture group were treated with conventional acupuncture at Touwei (ST 8), Yintang (GV 24+), Yangbai (GB 14), Hegu (LI 4), etc., once a day, 6 times a week. The patients in the sphenopalatine ganglion group were treated with acupuncture at sphenopalatine ganglion, once every other day, 3 times a week. On the basis of the conventional acupuncture, the combined group was treated with acupuncture at sphenopalatine ganglion once every other day. Two weeks were taken as a course of treatment, and 3 courses of treatment were required in the 3 groups. The score of visual analogue scale (VAS), the number of headache attacks per week, the duration of each headache attack and the score of migraine-specific quality of life questionnaire version 2.1 (MSQ) were observed before and after treatment and in follow-up of 3 months after treatment. The clinical efficacy of each group was compared.@*RESULTS@#After treatment and in follow-up, the VAS score of headache, the number of headache attacks per week, the duration of each headache attack, and each various scores and the total score of MSQ of each group were lower than those before treatment (P<0.01). Except that the number of headache attacks per week in the combined group was lower than the sphenopalatine ganglion group (P<0.01), other indexes in the combined group were lower than the other two groups (P<0.05, P<0.01). The total effective rate in the combined group was 93.0% (53/57), which was higher than 75.9% (44/58) in the acupuncture group and 73.7% (42/57) in the sphenopalatine ganglion group（P<0.05, P<0.01).@*CONCLUSION@#Acupuncture at sphenopalatine ganglion combined with conventional acupuncture could reduce the degree of pain in patients with episodic CH, reduce the number and duration of headache attacks, and improve the quality of life of patients. It is more effective than simple conventional acupuncture or acupuncture at sphenopalatine ganglion alone.

Research progress on familial episodic pain syndrome / 中华神经科杂志

Familial episodic pain syndrome is characterized by ion channel gene mutation in dorsal root ganglion neurons, and there can be neuropathic pain in different parts. However, the lack of awareness of familial episodic pain syndrome, along with the absence of uniform diagnostic and treatment standards, may lead to frequent missed diagnosis and misdiagnosis. This article will review the concepts, classification, pathogenesis, clinical features, diagnosis and treatment of familial episodic pain syndrome, aimed at deepening the understanding of the diseases as well as facilitating early diagnosis and treatment.

Memoria episódica posterior a cirugía de epilepsia del lóbulo temporal / Episodic memory after temporal lobe epilepsy surgery

RESUMEN INTRODUCCIÓN: La cirugía resectiva del lóbulo temporal anterior con amigdalo-hipocampectomía es un tratamiento efectivo para la epilepsia farmacorresistente del lóbulo temporal con esclerosis hipocampal. Sin embargo, este procedimiento conlleva riesgo de deterioro de la memoria episódica verbal y no verbal postoperatoria, dependiendo de la dominancia hemisférica para la memoria y el lenguaje. OBJETIVO: Explorar el desenlace de la memoria episódica posterior a la cirugía resectiva mediante lobectomía temporal anterior con amigdalo-hipocampectomía. MÉTODOS: Se analizó retrospectivamente la memoria episódica verbal y no verbal mediante pruebas neurop-sicológicas de 51 pacientes consecutivos sometidos a lobectomía temporal anterior con amigdalo-hipocampectomía del lado izquierdo y derecho. Todos los pacientes fueron sometidos a resonancia magnética cerebral preoperatoria, video-electroencefalografía y evaluaciones neuropsicológicas. A 12 pacientes (24 %) no se les realizó el test de Wada. RESULTADOS: Hubo disminución en la memoria episódica verbal postoperatoria con diferencias respecto a la preoperatoria, en la subprueba de textos II recuerdo de la escala de memoria de Wechsler III (p = 0,035). El resultado en la memoria episódica visual se mantuvo igual, no hubo diferencias en el grupo de lobectomía temporal estándar. CONCLUSIÓN: La lobectomía temporal anterior más amigdalo-hipocampectomía izquierda afecta levemente el desempeño de la memoria episódica postoperatoria, que clínicamente no es significativo en pacientes con epilepsia del lóbulo temporal mesial farmacorresistente.

SUMMARY INTRODUCTION: Resective surgery of the anterior temporal lobe with amygdalohippocampectomy is an effective treatment for drug-resistant epilepsy of the temporal lobe with hippocampal sclerosis. However, this procedure carries a risk of post-operative episodic verbal and nonverbal memory impairment depending on the hemispheric dominance for memory and language. OBJECTIVE: To explore the outcome of episodic memory after resective surgery by means of anterior temporal lobectomy with amygdalohippocampectomy. METHODS: Verbal and non-verbal episodic memory was retrospectively analyzed by neuropsychological tests of 51 consecutive patients undergoing anterior temporal lobectomy with amygadalohyppocampectomy on the left and right sides. All patients underwent preoperative brain MRI, video electroencephalography, and neuropsychological evaluations. 12 patients (24%) did not undergo the Wada test. RESULTS: There was a decrease in postoperative verbal episodic memory with differences compared to preoperative, in the text II subtest recall of the Wechsler III memory scale (p = 0.035). The result in visual episodic memory remained the same, there were no differences in the standard temporal lobectomy group. CONCLUSION: Anterior temporal lobectomy plus left amygadalohyppocampectomy slightly affects the performance of postoperative episodic memory, which is clinically not significant in patients with drug-resistant mesial temporal lobe epilepsy.

Age-related episodic memory decline and the role of amyloid-ß: a systematic review / Declínio da memória episódica relacionado à idade e o papel da beta-amiloide: uma revisão sistemática

ABSTRACT Aging has been associated with the functional decline of episodic memory (EM). Unanswered questions are whether the decline of EM occurs even during healthy aging and whether this decline is related to amyloid-β (Aβ) deposition in the hippocampus. Objective: The main purpose of this study was to investigate data on the relationship between the age-related EM decline and Aβ deposition. Methods: We searched the Cochrane, MEDLINE, Scopus, and Web of Science databases and reference lists of retrieved articles that were published in the past 10 years. The initial literature search identified 517 studies. After screening the title, abstract, key words, and reference lists, 56 studies met the inclusion criteria. Results: The overall results revealed that increases in Aβ are related to lower hippocampal volume and worse performance on EM tests. The results of this systematic review revealed that high levels of Aβ may be related to EM deficits and the progression to Alzheimer's disease. Conclusions: We discussed the strengths and pitfalls of various tests and techniques used for investigating EM and Aβ deposition, methodological issues, and potential directions for future research.

RESUMO O envelhecimento tem sido associado a um declínio funcional da memória episódica (ME). Algo ainda sem resposta é se o declínio da ME ocorre mesmo no envelhecimento saudável e se esse declínio pode estar relacionado à deposição de Aβ no hipocampo. Objetivo: Nosso objetivo principal foi investigar os dados sobre a relação entre a memória episódica e a deposição de Aβ no envelhecimento saudável. Métodos: Nós buscamos nas bases de dados Cochrane, MEDLINE, Scopus, Web of Science e nas listas de referências dos estudos dos últimos 10 anos. A busca inicial nas bases de dados identificou 517 estudos. Após a triagem de título, resumos, palavras-chave e referências, 56 estudos atenderam aos critérios de inclusão. Resultados: O resultado geral revelou que o aumento de Aβ estava relacionado ao menor volume do hipocampo e pior desempenho em testes de ME. Em resumo, os resultados da presente revisão sistemática revelaram que altos níveis de Aβ podem estar relacionados ao declínio de ME e conversão progressiva para a Doença de Alzheimer. Conclusões: Aqui, discutimos os pontos fortes e as limitações dos testes e técnicas para investigar a deposição ME e Aβ, bem como questões metodológicas e direções futuras.

El cerebelo y sus afecciones en los niños / The cerebellum and its conditions in children

Introducción: Cuando se piensa en estudiar el cerebelo es posible que lo primero que viene a la mente sean las siguientes preguntas: ¿cuáles son sus enfermedades?, ¿cómo se expresan clínicamente? y quizás, ¿cómo es su estructura y cuáles las funciones de este órgano? Objetivo: Examinar las principales características anatómicas y funcionales del cerebelo y relacionarlas con su expresión clínica cuando enferma, así como comentar sobre su abanico de etiologías en el niño. Métodos: Las fuentes de búsquedas fueron las bases de datos computarizadas: PubMed, Ebsco y SciELO. Se utilizaron las palabras clave: cerebelo, ataxia, erores congénicos del metabolismo y ataxias, ataxias episódicas, enfermedades progresivas del sistema nervioso y ataxias; en idioma español e inglés. Resultados: El cerebelo recepciona múltiples informaciones y las envía a diversas estructuras cerebrales por medio de las cuales modula la excitabilidad de estas estructuras y sus sistemas descendentes. Este órgano organiza, dirige, coordina múltiples funciones que se traducen en fuerza, tiempo y secuencia. El cerebelo enfermo impide que la persona ejecute sus funciones y movimientos de forma uniforme y coordinada; puede resultar afectado por un amplio abanico de posibilidades etiológicas, genéticas o adquiridas y enfermarse todo o parte de él. Consideraciones finales: El cerebelo cumple importantes funciones dentro del sistema nervioso, tiene una expresividad muy típica cuando está enfermo. El uso adecuado de las nuevas técnicas de estudios por imágenes y genéticas, entre otras, permiten al pediatra clínico estar en mejores condiciones para el diagnóstico de sus afecciones y tratamiento oportuno(AU)

Introduction: When we think about studying the cerebellum, the first thing that comes to mind may be the following questions: Which are its diseases? How they are clinically expressed? , and perhaps: What is its structure and what functions do this organ has? Objective: Examine the main anatomical and functional characteristics of the cerebellum and relate them to its clinical expression when it becomes ill, as well as comment on its range of etiologies in the child. Methods: Search sources were computerized databases like: PubMed, Ebsco, and SciELO. Keywords used were: cerebellum, ataxia, metabolism congenital errors and ataxias, episodic ataxias, progressive diseases of the nervous system and ataxias; in Spanish and English. Results: The cerebellum receives information and sends it to various brain structures through which it modulates the excitability of these structures and their downstream systems. This organ organizes, directs, and coordinates multiple functions that translate into strength, time and sequence. An ill cerebellum prevents the person from performing their functions and movements in a uniform and coordinated way; it can be affected by a wide range of etiological, genetic or acquired possibilities and make all or part of it ill. Final considerations: The cerebellum performs important functions within the nervous system; it has a very typical expressiveness when it is ill. Proper use of new imaging and genetic study techniques, among others, allows the clinical pediatricians to be better able to diagnose its conditions and timely treatment(AU)

Episodic angioedema with eosinophilia (Gleich's syndrome) associated with urticarial vasculitis: a coincidence or a novel clinical entity?

Episodic angioedema with eosinophilia (EAE) is a rare condition characterized by recurrent attacks of angioedema and urticaria accompanied by a marked elevation of peripheral eosinophil count. We report the case of a young female patient diagnosed with EAE associated with urticarial vasculitis. A 40-year-old female patient was admitted to our institution due to recurrent episodes of cheek and eyelid angioedema in the previous year. Episodes of facial angioedema lasted for two months with spontaneous remission afterwards. In addition, she presented pruritic and painful skin eruptions of erythematous circles, which persisted for longer than 24 h, that were palpable, somewhat purplish, and more pronounced on the face, arms, and trunk. Laboratory investigation showed a sustained elevation of white cell counts with marked eosinophilia. Serum IgM, IgE, and IgA were normal; IgG was slightly elevated. C1-esterase inhibitor and tryptase test were normal. Reverse transcriptase-polymerase chain reaction was performed for detection of FIP1L1-PDGFRA and BCR-ABL rearrangements. None of these alterations were found. Skin biopsies were suggestive of urticarial vasculitis. The patient was submitted to esophagogastroduodenoscopy, which showed mild chronic gastritis, with no eosinophilic infiltration. Cardiac dimensions and function were normal. Abdominal ultrasound and total body CT-scan failed to show lymphadenopathy, organomegaly, and tumors. We report the first case of association between episodic angioedema with eosinophilia and urticarial vasculitis. It is possible that both conditions share a physiopathological mechanism, suggesting that it is not just a chance association.

Associations of objectively measured sedentary behavior and physical activity with cognitive function among older Japanese adults: An isotemporal substitution model / 体力科学

Increasing light-intensity physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) and decreasing sedentary behavior (SB) are important to maintain cognitive function in older adults. However, there is a lack of studies examining the influence of replacing time spent in SB, LPA and MVPA on cognitive function. Therefore, this study applied an isotemporal substitution (IS) model approach to examine the associations of objectively measured SB, LPA, and MVPA on multiple cognitive functions in older adults. We analyzed data from 145 older persons (mean age, 75.1 ± 4.5 years; 61.4% women) in Kasama City, Japan. We assessed SB, LPA, and MVPA for seven consecutive days with a triaxial accelerometer. To evaluate the cognitive function, we used the Five-Cog test (character position referencing task, category cued recall task, clock drawing task, animal name listing task, and analogy task). The IS model of the multiple regression analysis was used to examine the effects of replacing time spent on one activity type with 30 minutes per day of SB, LPA, and MVPA on multiple cognitive functions, adjusting for age, gender, body mass index, education, smoking, sleep duration, history of stroke, medication for hypertension, dyslipidemia, and diabetes and accelerometer wear time. The results showed that reallocation from SB to LPA was significantly related to the category cued recall task score (B = 0.69, 95% confidence interval 0.07 - 1.31). In contrast, other reallocations were not associated with any cognitive tasks. The results suggest that substituting SB with LPA is positively associated with verbal episode memory among older Japanese adults.

The effect of intentionality on verbal memory assessment over days / O efeito da intencionalidade na avaliação da memória verbal ao longo de dias

ABSTRACT Background: Intentionality to remember is associated with better performances in episodic memory retrieval. The practice effect has better performance in memory retrieval. However, little is known about the effect of intentionality on memory over days and the influence of age, gender, and level of education on it as well as on practice effect. Objectives: To verify the effect of intentionality and practice effect on memory performance over days, using an ecological approach. Methods: One hundred and twenty subjects from 18 to 81 years of age and free of psychiatric and neurological disorders were evaluated. They were randomized into a "testing effect group" and a "intentionality group" and then were asked to read a text on the FIFA World Cup. The "intentionality group" was instructed to pay careful attention to the text because they would answer a questionnaire with 10 factual items from the text after 2 and 7 days. The "testing effect group" had the same procedure at the same time as the first group but were not instructed about the intentionality, and answered the questionnaire immediately after reading the text. Results: Memory performance was better 2 days after the exposure session than 7 days later in the "intentionality group". On the other hand, there was no difference in memory performance from the "testing effect group" 2 and 7 days later. Conclusions: Intention to recall may enhance memory over a short period of days, while retaining similar amount of information over days to what was acquired immediately after text exposure.

RESUMO Introdução: A intencionalidade de lembrar associa-se a melhores desempenhos na recuperação da memória episódica. O efeito da prática também apresenta melhores desempenhos na recuperação da memória. Entretanto, pouco se sabe sobre a intencionalidade na memória ao longo dos dias sob influência da idade, sexo e escolaridade, assim como sob efeito da prática. Objetivos: Verificar o efeito da intencionalidade e de testes no desempenho da memória ao longo dos dias, utilizando abordagem ecológica. Métodos: Foram avaliados 120 sujeitos (idade 18-81 anos) e a ausência de distúrbios psiquiátricos e neurológicos. Eles foram randomizados para o "grupo de efeito de testes" ou para o "grupo de intencionalidade" e expostos ao texto da Copa do Mundo de Futebol. O "grupo de intencionalidade" foi instruído a prestar muita atenção ao texto, pois seria aplicado um questionário com 10 itens factuais do texto 2 e 7 dias depois. O "grupo de efeito de testes" realizou o mesmo procedimento no mesmo tempo que o primeiro grupo, mas não foi instruído em relação à intencionalidade e responderam ao questionário imediatamente após a leitura do texto. Resultados: O desempenho da memória foi melhor 2 dias após a exposição do que 7 dias depois no "grupo de intencionalidade". Por outro lado, não houve diferença no desempenho de memória no "grupo de efeito de testes" 2 e 7 dias depois. Conclusões: A intenção de recordar pode melhorar a memória por um curto período de dias. Enquanto o efeito de teste pode reter ao longo de dias quantidade similar de informação que foi adquirida imediatamente após a exposição do texto.

Associação dos sintomas depressivos com o comprometimento da memória episódica em pacientes com a doença de Parkinson / Association of depressive symptoms with impaired episodic memory in patients with Parkinson's disease

RESUMO Objetivo: Avaliar a correlação de sintomas depressivos e comprometimento da memória episódica em pacientes com doença de Parkinson (DP). Métodos: Trata-se de um estudo transversal, não probabilístico e intencional. Foram selecionados indivíduos diagnosticados com DP e idade igual ou maior que 60 anos, matriculados em dois ambulatórios de distúrbios de movimento na cidade de Maceió, AL. Foram selecionados 62 idosos, divididos em dois grupos, sendo 40 com sintomas depressivos e 22 sem sintomas depressivos. Utilizaram-se um questionário sociodemográfico, a Escala de Depressão Geriátrica (GDS-15, versão reduzida), o Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT) e a Avaliação Cognitiva de Montreal (MoCA). Resultados: Diante da amostra composta por 62 idosos, apresentou-se alta prevalência de idosos do sexo feminino, 64,5% com média de idade de 66,72 anos (±5,12). Em relação aos dados sociodemográficos, identificou-se diferença estatisticamente significativa entre os grupos apenas quanto uso de antidepressivos (p<0,001) e, em relação às características clínicas, houve diferença em relação à memória episódica (RAVLT) (p < 0,001) da MoCA (p = 0,018) e aos domínios abstração (p = 0,044) e função executiva (p = 0,021) da MoCA. Quanto à relação entre sintomas depressivos e prejuízo da memória episódica, identifica-se uma correlação inversa moderada (r = −0,575; p < 0,001). Conclusão: Pacientes com DP e sintomas depressivos apresentam pior desempenho nas medidas de memória episódica do que aqueles sem sintomas depressivos. Além disso, é possível identificar que os níveis de sintomas depressivos são diretamente proporcionais à perda de memória episódica.

ABSTRACT Objective: To evaluate the correlation of depressive symptoms and impaired episodic memory in patients with Parkinson's disease (PD). Methods: This is a cross-sectional, non-probabilistic and intentional study. Individuals diagnosed with PD and aged 60 years or older, who were enrolled at two movement disorders outpatient clinics in the city of Maceió, AL, were selected. 62 elderly people were selected, divided into two groups, 40 with symptoms of depression and 22 without symptoms of depression. A sociodemographic questionnaire, Geriatric Depression Scale (GDS-15 reduced version), the Rey Auditory-Verbal Learning Test (RAVLT) and Montreal Cognitive Assessment (MoCA) were used. Results: In view of the sample of 62 elderly people, there was a high prevalence of female elderly, 64.5% with a mean age of 66.72 years (±5.12). Regarding sociodemographic data, a statistically significant difference was identified between groups only in the use of antidepressants (p < 0.001) and in relation to clinical characteristics, there was a difference in relation to episodic memory (RAVLT) (p < 0.001) of MoCA (p = 0.018) and in the abstraction (p = 0.044) and executive function (p = 0.021) domains of MoCA. Regarding the relationship between depressive symptoms and impaired episodic memory, a moderate inverse correlation was identified (r = −0.575; p < 0.001). Conclusion: PD associated with depressive symptoms presents impairments in episodic memory when compared to those without symptoms. In addition, it is possible to identify that the levels of depressive symptoms are directly proportional to the loss of episodic memory.

A relação do fading affect bias com o humor e a memória episódica / The relation between the fading affect bias, mood and episodic memory / La relación del fading affect bias con el humor y la memoria episódica

O fading affect bias (FAB) atua na memória autobiográfica humana, favorecendo a manutenção das emoções positivas em detrimento das negativas. Este trabalho questionou se esse mecanismo poderia ser influenciado pela depressão e se seria encontrado na memória episódica. Cinquenta e cinco voluntários registraram eventos autobiográficos positivos e negativos durante uma semana. Eles preencheram o Inventário de Depressão de Beck e realizaram um teste de memória com palavras de conotação positiva, negativa e neutra. Os resultados sugeriram que o humor deprimido pode interferir no funcionamento do FAB e prejudicar a manutenção das emoções positivas na memória. Os efeitos na memória episódica foram menos conclusivos.

The fading affect bias (FAB) works in human autobiographical memory in favour of the maintenance of positive emotions over negative ones. This study questioned whether this mechanism could be influenced by depression and if it could also be found in episodic memory. 55 volunteers registered personal positive and negative life events for a week, filled the Beck Depression Inventory and performed a recognition memory test with positive, neutral and negative words. The results suggested the depressed mood could influence the well functioning of the FAB and damage the maintenance of positive emotions in memory. The effects on the episodic memory were less conclusive.

El fading affect bias (FAB) actúa sobre la memoria autobiográfica humana favoreciendo el mantenimiento de las emociones positivas sobre las negativas. Este trabajo cuestionó si este mecanismo podría estar influenciado por la depresión y si se encontraría en la memoria episódica. 55 voluntarios registraron eventos autobiográficos positivos y negativos durante una semana, completaron el Inventario de depresión de Beck y se sometieron a una prueba de memoria con connotaciones positivas, negativas y neutrales. Los resultados sugirieron que el estado de ánimo deprimido puede interferir con el funcionamiento del FAB y afectar el mantenimiento de las emociones positivas en la memoria. Los efectos sobre la memoria episódica fueron menos concluyentes.