La planificación cognitiva en el contexto de la evaluación neuropsicológica e investigación en neurociencia cognitiva: una revisión sistemática / Cognitive planning in the context of neuropsychological assessment and research in cognitive neuroscience: a systematic review

La planificación es definida como la habilidad de desarrollar un plan secuenciado de pasos conductuales para alcanzar una meta y forma parte de un conjunto de funciones cognitivas de alto orden denominadas funciones ejecutivas. Esta función se ve afectada en diversas situaciones de la vida cotidiana y en una variedad de trastornos neuropsiquiátricos (por ej., depresión, ansiedad, déficit atencional, esquizofrenia, etc.). Tanto el diseño de pruebas cognitivas para evaluar planificación en el contexto clínico, como también el diseño de paradigmas experimentales de evaluación de la planificación en el contexto de investigación, continúa siendo un desafío para la neuropsicología clínica y para las neurociencias. En este artículo de revisión sistemática que sigue las direcciones PRISMA, revisamos la teoría e investigación en relación con la evaluación clínica y la investigación de las bases neurobiológicas de la planificación y los aportes a la comprensión de los mecanismos de su implementación. Se reportan medidas metodológicas comunes y se resumen las aproximaciones teóricas que contribuyen en su comprensión. Nuestros hallazgos muestran la implicancia de la corteza prefrontal en el rendimiento en planificación, en particular el área dorsolateral, corteza cingulada anterior y frontopolar. Mayores estudios clínicos, instrumentales y experimentales son necesarios para comprender mejor la planificación en el contexto de una teoría integrativa de las funciones ejecutivas y del rol de la corteza prefrontal.

Planning is defined as the ability to develop a sequenced plan of behavioral steps to achieve a goal and is part of a set of high-order cognitive functions called executive functions. This function is affected in various daily life situations and in a variety of neuropsychiatric disorders (e.g., depression, anxiety, attention deficit disorder, schizophrenia, etc.). Both the design of cognitive tests to assess planning in the clinical context, as well as the design of experimental paradigms for evaluating planning in research context, continues to be a challenge for clinical neuropsychology and neurosciences. In this PRISMA systematic review article, we review theory and research regarding clinical assessment and research into the neurobiological bases of planning and contributions to understanding the mechanisms of its implementation. Common methodological measures are reported and the theoretical approaches that contribute to their understanding are summarized. Our findings show the involvement of the prefrontal cortex in planning performance, particularly the dorsolateral area, the anterior cingulate cortex, and the frontopolar cortex. Further clinical, instrumental, and experimental studies are needed to better understand planning in the context of an integrative theory of executive functions and the role of the prefrontal cortex.

Comparación del rendimiento de pruebas cognitivas en pacientes con Enfermedad de Parkinson con y sin estimulación cerebral profunda / Comparison of the performance of cognitive tests in Parkinson Disease patients with and without Deep Brain Stimulation

Resumen Los pacientes diagnosticados con Enfermedad de Parkinson (EP) presentan alteraciones motoras concomitantes a otras alteraciones de tipo cognitivo, conductual o emocional. Una de las alternativas al tratamiento farmacológico es la estimulación cerebral profunda (ECP). Existen reportes de alteraciones en el rendimiento de tareas cognitivas tras procedimiento de ECP, lo que podría sugerir que el procedimiento es responsable de estos cambios cognitivos. El objetivo del estudio fue comparar los resultados del rendimiento en pruebas cognitivas de pacientes con EP de dos grupos (con ECP y sin ECP). Se recolectaron los resultados de 47 pacientes (n = 16 ECP; n = 31 sin ECP) durante los años de 2011 hasta 2015. Dentro de las funciones y variables evaluadas se encuentran: categorización visual, flexibilidad cognitiva, solución de problemas, atención selectiva, velocidad de procesamiento, inhibición conductual y calidad de vida. En general, no se encontraron diferencias significativas entre los grupos en las funciones evaluadas. En el grupo de participantes con ECP, se encontró mayor cantidad de correlaciones entre las pruebas de semejanzas y las de dígitos inversos, listas de palabras, búsqueda de símbolos y las subpruebas del Wisconsin Card Sorting Test. Así mismo, en los pacientes con ECP se presentó una percepción menor de calidad de vida asociada al tiempo de la enfermedad en comparación con el grupo sin ECP. En conclusión, estos resultados son congruentes con estudios similares de evaluación neuropsicológica y se discute el papel del tratamiento de estimulación en los pacientes, los cuales no siempre tienen un impacto positivo sobre la calidad de vida percibida.

Abstract Patients diagnosed with Parkinson's disease show motor alterations together to cognitive, behavioral, and emotional disturbances. An alternative treatment to the exclusive pharmacological medication is the Deep Brain Stimulation procedure (DBS). Some studies have shown altered behavioral patterns after DBS device implantation, suggesting a relationship between a particular performance in cognitive tests derived from the DBS procedure. Our study aimed to compare the performance of cognitive tests in Parkinson's disease patients with and without DBS. Results were analyzed from 47 patients (n = 16 DBS; n = 31 without DBS) in a range since 2011 to 2015. Functions tested were visual categorization, cognitive flexibility, problem solutions, selective attention, cognitive processing speed, behavioral inhibition, and quality of life. In general, there are non-significative differences between groups in functions tested. However, correlations were found depending on the group (DBS or without DBS patients), with more positive correlations inside the DBS group between the similarity test and inversed digits, list of words, symbol search and the sub-test of the Wisconsin Card Sorting Test. In addition, the DBS group showed a low perception of the quality of life associated with the disorder´s time compared to the without DBS group. In conclusion, these results are congruent with similar studies of neuropsychological evaluation, and the role of treatment is discussed below the perception of the quality of life.

Cognitive evaluation following the evolution of brain myofibroblastic tumor in the adolescence: a case study report / Avaliação cognitiva após a evolução do tumor miofibroblástico cerebral na adolescência: relato de estudo de caso

ABSTRACT Objective To report the case of a teenager (12 years old) diagnosed with a brain tumor in the right frontal-parietal region emphasizing the main characteristics observed in neuropsychological examinations. Methods In the pre-surgical evaluation, the patient presented behavioral alterations, including deficits in verbal comprehension, perceptual organization, working memory, processing speed, and slight alterations regarding constructive praxis. Results A reevaluation after two years surgery revealed significant improvement in verbal and perceptual comprehension and constructive praxis while remaining a slight change in processing speed. These results suggest that the tumor's surgical resection produced significant improvements in the patient's neurocognitive context, especially in executive functions. This study also indicates that Neuropsychological evaluation are useful for pre- and post- surgical evaluation of cognitive functioning and its evolution. Conclusion Brain tumor causes cognitive and behavioral changes and its resection can result in improvements in the patient's quality of life.

RESUMO Objetivo Relatar o caso de uma adolescente (12 anos de idade) diagnosticada com tumor cerebral na região frontoparietal direita, enfatizando as principais características observadas em exames neuropsicológicos. Métodos Na avaliação pré-cirúrgica, a paciente apresentou alterações comportamentais, incluindo déficits na compreensão verbal, organização perceptual, memória de trabalho, velocidade de processamento e pequenas alterações na praxia construtiva. Resultados Uma reavaliação dois anos após a cirurgia revelou melhora significativa na compreensão verbal e perceptiva e na práxis construtiva, permanecendo uma ligeira alteração na velocidade de processamento. Esses resultados sugerem que a ressecção cirúrgica do tumor produziu melhoras significativas no contexto neurocognitivo da paciente, sobretudo nas funções executivas. Este estudo também indica que a avaliação neuropsicológica é útil para avaliação pré e pós-cirúrgica do funcionamento cognitivo e sua evolução. Conclusão O tumor cerebral causa alterações cognitivas e comportamentais e a sua ressecção pode resultar em melhorias na qualidade de vida do paciente.

Fundamentos teórico-técnicos para la comprensión y detección de la simulación de déficits neurocognitivos / Theoretical-technical foundations for the understanding and detection of the simulation of neurocognitive deficits

La neuropsicología está desarrollándose y migrando a otras áreas tales como la judicial, en donde el neuropsicólogo forense ayuda al juez a tomar decisiones ecuánimes e imparciales, sin embargo, nace como problemática el fenómeno de la simulación de déficits neurocognitivos con el propósito de obtener ganancias secundarias. Este artículo tiene como objetivo abordar dicho fenómeno mediante una sistematización bibliográfica, estableciendo un marco teórico-comprensivo del fenómeno, así como también identificando las principales herramientas para su detección. Se esquematizan apartados que forman un hilo conductor que arrojan como resultado que la detección de la simulación de déficits neurocognitivos es una tarea compleja, multidimensional y que debería tener un enfoque holístico, por lo tanto, es necesario seguir investigando al respecto para perfeccionar sus métodos de identificación.

Neuropsychology is developing and migrating to other areas such as the judicial, where the forensic neuropsychologist helps the judge to make fair and impartial decisions, however, the phenomenon of the simulation of neurocognitive deficits with the purpose of obtaining secondary gains is born as a problem. This article aims to address this phenomenon through a bibliographic systematization, establishing a theoretical-comprehensive framework of the phenomenon, as well as identifying the main tools for its detection. Thus, sections are outlined that form a common thread that show as a result that the detection of the simulation of neurocognitive deficits is a complex, multidimensional task and that it should have a holistic approach, therefore, it is necessary to continue researching in this regard. to perfect its results identification methods.

Demencia frontotemporal desde una mirada neuropsicológica / Frontotemporal dementia from a neuropsychological point of view

Introducción: La riqueza de las manifestaciones neuropsicológicas de la demencia frontotemporal, ha permitido la identificación de diferentes variantes de la enfermedad, sin embargo, existen pacientes en los que se entrelazan las características clínicas de más de una variante, lo que ha llevado a cuestionar lo relativo de las clasificaciones vigentes. Objetivo: Caracterizar el funcionamiento cognitivo de un paciente donde concomitan alteraciones conductuales y del lenguaje, típicas de la demencia frontotemporal. Caso clínico: Mujer diestra, de 50 años de edad, con cambios conductuales marcados, a los cuales, de forma progresiva, se sumaron alteraciones del lenguaje, en un periodo de evolución de aproximadamente un año y seis meses. Por imágenes de tomografía axial computarizada, se confirma atrofia cortical a predominio frontal. Se emplearon para la evaluación la batería neuropsicológica breve NEUROPSI, la escala Hasegawa y la batería de evaluación frontal de Litvan; se constata predominio de alteraciones en el lenguaje impresivo y expresivo, las funciones ejecutivas y en la memoria verbal. Conclusiones: Las alteraciones detectadas, confirman la coexistencia de manifestaciones de la variante conductual (con tendencia a la desinhibición) y la variante semántica de la demencia frontotemporal(AU)

Introduction: The richness of the neuropsychological manifestations of frontotemporal dementia has allowed the identification of different variants of the disease. However, there are patients in whom the clinical characteristics of more than one variant are intertwined, which has led to question the current classifications. Objective: To characterize the cognitive functioning of a patient with concomitant behavioral and language disorders, typical of frontotemporal dementia. Case presentation: Right-handed female, 50 years old, affected by marked behavioral changes, to which language alterations were progressively added in a period of evolution of approximately one year and six months. Images of Computerized Axial Tomography that confirm cortical atrophy mainly frontal. The Neuropsychological Battery abbreviated NEUROPSI, the Hasegawa Scale and the Litvan Frontal Evaluation Battery were used for the evaluation, with a predominance of alterations in printed and expressive language, executive functions and verbal memory. Conclusions: The alterations detected confirm the coexistence of manifestations of the behavioral variant (with a tendency to disinhibition) and the semantic variant of frontotemporal dementia(AU)

Evidencia de sobrediagnóstico en el TDAH en base a evaluación neuropsicológica: un estudio en escolares chilenos / Evidence of overdiagnosis in Attention Deficit Hyperactivity Disorder (ADHD) based on neuropsychological evaluation: a study in Chilean students

Resumen Objetivo: El Trastorno por Déficit de Atención con Hiperactividad/impulsividad (TDAH) es una de las dificultades de aprendizaje más comunes en las escuelas chilenas. Se caracteriza por un patrón de funcionamiento atípico en atención e inhibición, con fuerte compromiso de otras funciones ejecutivas. Uno de los desafíos que plantea este trastorno está referido al proceso de diagnosis, el cual no suele ser suficientemente preciso. Se pretende explorar las diferencias en la distribución de dos muestras de estudiantes con y sin TDAH diagnosticadas con una escala de observación conductual a través de la evaluación de las funciones ejecutivas de atención, inhibición y flexibilidad cognitiva. Método: En este estudio se evaluó a 132 escolares, 66 con TDAH y 66 sin TDAH, en las variables de atención, inhibición y flexibilidad cognitiva de un colegio de la ciudad de Concepción en Chile. Se contrastó el rendimiento cognitivo con los diagnósticos y se reagrupó a los estudiantes en los subtipos conocidos del trastorno. Resultados: La evaluación neuropsicológica mostró que en el grupo con TDAH había alumnos que no cumplían los criterios diagnósticos para estar incluidos en él. En el grupo sin TDAH se observó un fenómeno semejante. En ambos grupos la evaluación neuropsicológica de la atención y la inhibición resultaron útiles para diagnosticar con mayor certeza y para determinar el subtipo al que pertenecía cada estudiante con TDAH detectado. La flexibilidad cognitiva solo permitió diferenciar a los sujetos con y sin TDAH. Conclusiones: En ambos grupos estudiados fue posible encontrar sujetos mal diagnosticados; el sobrediagnóstico fue de 43,93 % en el grupo con TDAH, mientras que el infradiagnóstico fue de 42,42 % en el grupo sin TDAH.

Abstract Objective: Attention Deficit Hyperactivity/Impulsivity Disorder (ADHD) is one of the most common learning difficulties in Chilean schools. It is characterized by an atypical functioning pattern in attention and inhibition, strongly compromising other executive functions. One of the challenges posed by this disorder is the diagnosis process, which is often not sufficiently accurate. The intention is to study the distribution of two students samples, with and without ADHD, diagnosed by a behavioral observation scale through the evaluation of attention, inhibition, and cognitive flexibility executive functions. Method: This study evaluated 132 students, 66 with ADHD and 66 without ADHD, considering the attention, inhibition, and cognitive flexibility variables of a school in the city of Concepción in Chile. Cognitive performance was contrasted with the diagnoses, and students were regrouped in the disorder known subtypes. Results: The neuropsychological evaluation showed that in the ADHD group, there were students who did not meet the diagnostic criteria to be included in the group. A similar phenomenon was observed in the group without ADHD. In both the groups, the neuropsychological evaluation of attention and inhibition was useful in providing a more certain dignosis and in determining the subtype to which each student detected with ADHD belonged. Cognitive flexibility was only useful in differentiating betwen the subjects with and without ADHD. Conclusions: In both the groups studied, it was possible to find misdiagnosed subjects; the overdiagnosis was 43,93 % in the ADHD group, while the under-diagnosis was 42,42 % in the group without ADHD.

Complejo de esclerosis tuberosa: perfil neuropsicológico y propuesta de intervención / Tuberous Sclerosis Complex: neuropsychological profile and intervention proposal

El Complejo de Esclerosis Tuberosa (CET) es un trastorno genético de heren-cia autosómica dominante causado por la mutación en uno de los genes TSC1 o TSC2. Los pacientes con una afectación CET grave de tipo neurológica posible-mente presentarán epilepsia, discapacidad intelectual, problemas específicos del aprendizaje y trastornos de la conducta, por lo que la evaluación neuropsicológica en individuos con esta patología cobra un carácter importante al proporcionar información sobre los déficits cognitivos que subyacen en la afectación cerebral, que alteran el funcionamiento intelectual y los aspectos adaptativos. El actual tra-bajo presenta el perfil de una paciente adulta femenina con antecedente de CET, epilepsia y discapacidad intelectual, así como la descripción de una propuesta de intervención neuropsicológica basada en el funcionamiento ejecutivo dorsolateral.

Tuberous Sclerosis Complex (TSC) is an autosomal dominant inherited genetic disorder caused by mutation in one of the TSC1 or TSC2 genes. Patients with severe neurological-type CET involvement may have epilepsy, intellectual disability, specific learning problems, and behavioral disorders. For this reason, the neuropsychological evaluation in individuals with this pathology becomes an important character by providing information on the cognitive deficits that underlie brain involvement that alter intellectual functioning and adaptive aspects. The current work presents the cognitive profile of a female adult patient with a history of TSC, epilepsy and intellectual disability and the description of a proposed neuropsychological intervention based on dorsolateral executive functioning.

Test del dibujo del reloj / The clock drawing test

El test del reloj es una evaluación utilizada para valorar diversas funciones cognitivas, entre ellas el lenguaje (la comprensión verbal), la atención, la memoria, la planificación, el razonamiento, la capacidad de inhibición y el análisis visoespacial en el espacio gráfico. En el presente estudio de tipo descriptivo y transversal, se utilizó esta prueba como una herramienta sencilla de screening en base a una selección de 100 pacientes adultos y se propone, a partir de los hallazgos obtenidos, una tabla de valoración con nuevos criterios de puntuación evaluando posteriormente, si existen variaciones en la interpretación subjetiva de la misma mediante la participación de otros inter-evaluadores (E1, E2, E3). Los resultados indican que los nuevos criterios de puntuación resultaron fáciles de aplicar e interpretar, no encontrándose diferentes estadísticamente relevantes entre todos los inter-evaluadores.

The quick test is an evaluation used to assess various cognitive functions, including language (verbal comprehension), attention, memory, planning, reasoning, the ability to inhibit, and visuospatial analysis in graphic space. In the present study, this test will be found as a simple detection tool based on a selection of 100 adult patients and, based on the obteined findings, a valuation table with new scoring criteria is proposed, subsequently evaluating whether there are variations in the subjective interpretation of it through the participation of other inter-evaluators (E1, E2, E3). The results indicated by the new scoring criteria were easy to apply and interpret, and no statistically relevant differences were found among all the inter-evaluators.

Memory impairment: an intermediate clinical syndrome symptom in HTLV-1-infected patients? / Comprometimento da memória: um sintoma de síndrome clínica intermediária em pacientes infectados pelo HTLV-1?

Background Although classical human T-cell lymphocyte virus type 1 (HTLV-1)-associated myelopathy/tropical spastic paraparesis syndrome is the most frequent HTLV-1-associated neurological disorder, some "minor" neurological disorders can be seen in "asymptomatic" carriers. These disorders, including cognitive alterations already described in clinical cases and studies, may constitute an intermediate syndrome (IMS) between the asymptomatic state and myelopathy. The aim of this study was to investigate the presence of cognitive deficits in patients with HTLV-1 virus, who usually are diagnosed as asymptomatic. Methods A total of 54 HTLV-1-infected patients were evaluated, 35 asymptomatic and 19 with minor neurological alterations (evaluated by a neurologist); 25 HTLV-1-seronegative individuals served as controls. The instruments used were: Beck's Depression Inventory, Lawton's Daily Life Activity Scale, and a complete neuropsychological battery. The application of these evaluation instruments was performed blindly, with the evaluator neuropsychologist not knowing the clinical condition of the patient. Results Most of the participants in this cohort, including seronegative controls, were female (n = 57, 72.21%), their mean age was 52.34 years (SD = 14.29) and their average schooling was 9.70 years (SD = 4.11). Discussion Participants classified with IMS had lower gross scores when compared with both the patients classified as asymptomatic and with the control group, and when tested for auditory episodic memory of immediate (p < 0.01), and late (p = 0.01), recall. Conclusion Patients with IMS presented with memory impairment when compared with asymptomatic patients and seronegative individuals; this is one of the symptoms that aids in the classification of the syndrome.

RESUMO Apesar da síndrome de HAM / TSP clássica ser a perturbação neurológica mais atribuída, alguns distúrbios neurológicos denominados "menores" são vistos em portadores "assintomáticos" de HTLV-1. Esses distúrbios, incluindo alterações cognitivas já observadas em descrições de casos clínicos e estudos, podendo constituir uma verdadeira síndrome clínica intermediária (SI) entre o estado assintomático e mielopatia. O objetivo deste estudo foi investigar a presença de déficits cognitivos em pacientes portadores do vírus HTLV-1 diagnosticados classicamente como assintomáticos. Métodos Foram avaliadas 54 pessoas, sendo 35 assintomáticos, 19 com alterações neurológicas menores (avaliados por um neurologista) e 25 HTLV-1 negativo. Os instrumentos utilizados foram: Inventário Beck de Depressão, Escala de Atividades de Vida Diária de Lawton e uma completa bateria neuropsicológica. A aplicação destes instrumentos de avaliação foi realizada de forma cega, ou seja, a avaliadora não sabia a condição clinica do paciente. Resultados A maioria dos participantes era do sexo feminino (n = 57, 72,21%), com idade média de 52.34 anos (DP = 14,29) e escolaridade média de 9.70 anos (DP = 4,11). Discussão Avaliando o desempenho cognitivo nos três grupos, foi possível observar que os participantes classificados com SI, apresentaram menores escores brutos, quando comparados, com os pacientes com classificação assintomática e grupo controle e, em relação à memória episódica auditiva de evocação imediata (p < 0,01) (p = 0,01) e tardia. Conclusão Diante dos resultados foi possível concluir que os pacientes com SI apresentam comprometimento de memória quando comparado com os outros grupos, sendo possível, ser este um dos sintomas para auxiliar na classificação da síndrome.

Avaliação neuropsicológica da memória operacional em escolares / Neuropsychological evaluation of working memory in schoolchildren

INTRODUÇÃO: A memória operacional é composta por um conjunto de processos cognitivos elaborados que combinam tanto o armazenamento temporário como o processamento das informações recebidas. Este sistema está envolvido em atividades cognitivas superiores como compreensão da linguagem, leitura, aritmética e resolução de problemas. A literatura indica que estudantes com dificuldades de aprendizagem podem apresentar prejuízos no processamento, armazenamento ou manipulação de informações. Assim, estudos que investigam o desenvolvimento da memória operacional são essenciais para a compreensão do processo de aprendizagem. OBJETIVO: Avaliar a memória operacional de escolares e correlacionar os resultados com o desempenho acadêmico. MÉTODO: A amostra foi composta por 30 escolares do Ensino Fundamental e Médio, com idade média de 10,4 (DP=3,45) anos, 50% do sexo feminino e 73,3% de escola particular. Os participantes foram avaliados a partir dos subtestes que compõem o Índice de Memória Operacional do WISC-IV (Dígitos, Aritmética e Sequência de Números e Letras) e pelo instrumento complementar Cubos de Corsi. A duração de cada avaliação foi de aproximadamente 1 hora. O desempenho acadêmico dos estudantes foi analisado a partir do boletim escolar. RESULTADOS/CONCLUSÃO: Os resultados demonstram que a memória operacional exerce uma influência direta no desempenho acadêmico, sendo necessária a sua investigação e a identificação precoce de déficits, para que medidas de prevenção e de intervenção possam ser adotadas, evitando, assim, prejuízo acadêmico e futuras dificuldades de aprendizagem.

INTRODUCTION: Working memory consists of a set of elaborate cognitive processes developed that combine the temporary storage and the processing of the information received. This system is involved in higher cognitive activities such as language comprehension, reading, arithmetic and problem solving. The literature indicates that students with learning disabilities may have losses in processing, storage or manipulation of information. Thus, studies that investigate the development of working memory are essential for understanding the learning process. OBJECTIVE: To evaluate the working memory of schoolchildren and to correlate the results with the academic performance. METHODS: The sample was composed of 30 elementary and middle school students, with an average age of 10.4 (SD=3.45) years, 50% female and 73.3% of private school. Participants were evaluated from the subtests that comprise the Working Memory Index of the WISC-IV (Digits, Arithmetic and Sequence of Numbers and Letters) and the complementary instrument Corsi Block. The time of each evaluation was approximately 1 hour. The academic performance of the students was analyzed from the school report card. RESULTS/CONCLUSION: The results show that working memory exerts a direct influence on academic performance, requiring its investigation and early identification of deficits, so that prevention and intervention measures can be adopted, avoiding academic impairment and future learning difficulties.

Evaluación De Las Habilidades De La Corteza Prefrontal: La Escala Efeco Ii-Vc Y Ii-Vr / Evaluation Of The Skills Of The Prefrontal Cortex: The Efeco Ii-Vc And Ii-Vr

Resumen La corteza pre-frontal es la base de las habilidades mentales de mayor complejidad del desarrollo humano. En su proceso de evaluación, la escala EFECO brinda un importante aporte para valorar su estado. En investigaciones previas se ha estudiado esta escala con su configuración de 67 ítems, narrativa centrada en el déficit y evaluación de 8 funciones ejecutiva. En esta investigación se presentan los siguientes aportes: una nueva versión de la escala, centrada en su narrativa en la habilidad ejecutiva, propuesta de ítems para valorar la función ejecutiva de verificación y una versión resumida de la escala en 42 ítems. En el estudio participaron 118 adultos saludables entre 18 y 25 años de edad (M edad = 20.72, DE = 1.65). En los resultados se encontró que la escala EFECO II-VC (versión modificada y completa) obtuvo como consistencia interna α = .96 y sus sub-escalas consistencia interna entre α = .64 y .81. La escala EFECO II-VR (versión modificada y resumida) obtuvo α = .94 y sus sub-escalas entre α = .68 y .79. La consistencia interna de los factores en los que se engloban las funciones ejecutivas se presentaron adecuados: el sistema supervisor de la cognición II-VC α = .93 y II-VR α = .70, mientras que el sistema supervisor de la conducta II-VC α = .93 y II-VR α = .81. Las correlaciones entre las funciones ejecutivas valoradas con ambas escalas fueron entre medianas y grandes r = .36 y .94. Se cierra el trabajo discutiendo el aporte clínico y científico de la modificación de la escala EFECO.

Abstract The pre-frontal cortex is the basis of the most complex mental abilities of human development. In its evaluation process, the EFECO scale provides an important contribution to assess its status. In previous investigations this scale has been studied with its configuration of 67 items, narrative focused on the deficit and evaluation of 8 executive functions. This research presents a new version of the scale, centered on its narrative in executive ability, proposed items to assess executive verification function and a summarized version of 42 items. The study included 118 healthy adults between 18 and 25 years of age (M age = 20.72, SD = 1.65). In the results it was found that the EFECO II-VC scale (modified and complete version) obtained as internal consistency α = .96 and its sub-scales internal consistency between α = .64 and .81. The EFECO II-VR scale (modified and summarized version) obtained α = .94 and its sub-scales between α = .68 and .79. The internal consistency of the factors in which the executive functions are included were adequate: the supervisory system of cognition II-VC α = .93 and II-VR α = .70, while the supervisor system of behavior II- VC α = .93 and II-VR α = .81. The correlations between the executive functions assessed with both scales were between medium and large r = .36 and .94. The work is closed discussing the clinical and scientific contribution of the modification of the EFECO scale.

Imaging & neuropsychological changes in brain with spiritual practice: A pilot study

Background & objectives: Some studies have systematically assessed the effects of spiritual practice (SP) on the brain using combined neuropsychological testing and functional imaging. The objective of the present study was to compare imaging and neuropsychological changes in healthy individuals after SP and those with only physical exercise. Methods: Healthy adult male volunteers, aged 25-45 yr were randomized into two groups. Group 1 (SP group) underwent the SP and group 2 (controls) did brisk walk for 30 min daily. Detailed neuropsychological evaluation, resting-state functional magnetic resonance imaging (fMRI) and brain 99mTc ethyl cysteinate dimer single-photon emission computed tomography (SPECT) were carried out for both groups before and three months after intervention. Results: Post-intervention, resting state fMRI showed increased connections of left precuneus (in the posterior cingulate cortex area of default mode network) in group 1 and increased left frontal connections in group 2. The neuropsychological tests showed significant improvement in 'Speed of Processing' (Digit Symbol Test) in group 1 and in Focused Attention (Trail Making A) in group 2. The SPECT data in group 1 showed significant improvement in perfusion of the frontal areas, with relatively lesser improvement in parietal areas. Group 2 showed significant improvement in perfusion predominantly in parietal areas, as compared to frontal areas. In addition, significantly improved mood was reported by group 1 and not by group 2. Interpretation & conclusions: This pilot study shows important functional imaging and neuropsychological changes in the brain with SP.

Funciones cognitivas y terapia electroconvulsiva en pacientes psiquiátricos con enfermedad afectiva / Cognitive functions and electroconvulsive therapy in affective psychiatric patients / Funções cognitivas e terapia eletroconvulsiva em pacientes psiquiátricos com doenças afetiva

Objetivo: la terapia electroconvulsiva (TEC) se ha considerado un tratamiento seguro y eficaz para episodios de depresión mayor, para episodios maníacos y otros trastornos psiquiátricos serios. El estudio describe los efectos cognitivos de la TEC en pacientes referidos para tratamiento a una clínica privada. Metodología: estudio descriptivo del tipo de serie de casos. En cada participante se realizó una evaluación basal antes del inicio de la TEC y otras dos (una a la semana y otra a los seis meses) después de terminado el ciclo de tratamientos, para describir el efecto de la TEC frontotemporal bilateral en la función neurocognitiva mediante el cambio, desde el estado basal hasta la evaluación final en los dominios de memoria, velocidad psicomotora, tiempo de reacción, atención compleja y flexibilidad cognoscitiva, así como en la función cognoscitiva global; y determinar su seguridad por el reporte de eventos adversos. La evaluación cognitiva se realizó con una batería de pruebas neuropsicológicas y la severidad de la enfermedad psiquiátrica se evaluó con la escala Clinical Global Impression Severity (CGI-S). Se incluyeron seis pacientes remitidos para tratamiento durante el periodo de seis meses. Resultados: no se observaron diferencias estadísticamente significativas entre las medianas de las evaluaciones de CGI-S, ni de la función cognitiva global, así como de ninguno de los dominios evaluados. Conclusiones: la TEC no produjo cambios en las funciones cognitivas analizadas en los seis pacientes estudiados.

Objective: Electroconvulsive therapy (ECT) has been considered a safe and effective treatment for depression, manic episodes, and other serious psychiatric conditions. Its main reported side effect has been cognitive impairment. This study describes the cognitive effects of ECT in psychiatric patients referred for treatment at a private clinic. Methodology: Descriptive case series study. A baseline assessment conducted before starting ECT, and another two (at one week and at six months) after completing the treatment cycle were used to describe the effects of frontotemporal bilateral ECT on neurocognitive function in terms of the change from the baseline to the final assessment in the domains of memory, psychomotor speed, reaction time, complex attention, and cognitive flexibility, as well as global cognitive function, as well as to determine ECT's safety by reporting adverse events. Cognitive assessment was conducted with a neuropsychological test battery and severity of psychiatric illness with the Clinical Global Impression-Severity scale (CGI-S). Six patients referred for treatment during six months were included. Results: No statistically significant differences were observed between the medians of the evaluations of CGI-S scale, global cognitive function or any of the domains evaluated. Conclusions: ECT did not produce changes in the cognitive functions assessed in the six studied patients.

Objetivo: a terapia eletroconvulsiva (TEC) se há considerado um tratamento seguro e eficaz para episódios de depressão maior, para episódios maníacos e outros transtornos psiquiátricos sérios. O estudo descreve os efeitos cognitivos da TEC em pacientes referidos para tratamento a uma clínica privada. Metodologia: estudo descritivo do tipo de série de casos. Em cada participante se realizou uma avaliação basal antes do início da TEC e outras dois (uma em uma semana e outra aos seis meses) depois de terminado o ciclo de tratamentos, para descrever o efeito da TEC frontotemporal bilateral na função neurocognitiva mediante a mudança, desde o estado basal até a avaliação final nos domínios de memória, velocidade psicomotora, tempo de reação, atenção complexa e flexibilidade cognoscitiva, assim como na função cognoscitiva global; e determinar sua segurança pelo reporte de eventos adversos. A avaliação cognitiva se realizou com uma bateria de provas neuropsicológicas e a severidade da doença psiquiátrica se avaliou com a escala Clinical Global Impression Severity (CGI-S). Se incluíram seis pacientes remitidos para tratamento durante o período de seis meses. Resultados: não se observaram diferencias estatisticamente significativas entre as média das avaliações de CGI-S, nem da função cognitiva global, assim como de nenhum dos domínios avaliados. Conclusões: a TEC não produziu mudanças nas funções cognitivas analisadas nos seis pacientes estudados.

Evaluación Neuropsicológica Del Control Inhibitorio Y El Control De La Interferencia: Validación De Tareas Experimentales En El Contexto Ecuatoriano / Neuropsychological Evaluation Of Inhibitory Control And Interference Control: Validation Of Experimental Tasks In The Ecuadorian Context

RESUMEN En este artículo se reporta un estudio en el cual se adaptó y validó tres tareas experimentales (SIMON, Go/No-Go y Stroop Victoria) para valorar el control inhibitorio y control de la interferencia en una muestra de estudiantes ecuatorianos. La muestra estuvo conformada por 100 estudiantes entre 6 y 15 años de edad (M=10,13 años, DE= 2,48) pertenecientes al sistema educativo público de Ecuador. El proceso que se siguió en la adaptación y validación fue mediante la traducción lingüística de los experimentos, posteriormente se siguió un juicio de expertos y un estudio piloto. En los resultados se encontró que no existen diferencias estadísticamente significativas en las medidas que valoran el control inhibitorio y de la interferencia considerando como factores de comparación las variables sociodemográficas de los participantes. En el análisis correlacional se encontró una asociación estadísticamente significativa entre las mediciones de los experimentos. Se concluye analizando las asociaciones encontradas y subrayando la necesidad de continuar aportando evidencia en la línea de investigación de adaptación y validación de reactivos de uso en la evaluación neuropsicológica.

ABSTRACT In this article we report a study in which three experimental tasks (SIMON, Go / No-Go and Stroop Victoria) were adapted and validated to evaluate the inhibitory control and interference control in a sample of Ecuadorian students. The sample consisted of 100 students between 6 and 15 years old (M = 10.13 years, SD = 2.48) belonging to the public education system of Ecuador. The process followed in the adaptation and validation was through the linguistic translation of the experiments, followed by an expert judgment and a pilot study. In the results it was found that there are no statistically significant differences in the measures that assess the inhibitory control and the interference considering the sociodemographic variables of the participants as comparison factors. In the correlation analysis we found a statistically significant association between the measurements of the experiments. We conclude by analyzing the associations found and underlining the need to continue providing evidence in the research line of adaptation and validation of test for using in neuropsychological evaluation.

Conceptos Fundamentales En La TeorÌa NeuropsicolÛgica / Fundamental Concepts In The Neuropsychological Theory

Resumen En este artÌculo se presentan tres conceptos que son fundamentales en la formaciÛn teÛrica neuropsicolÛgica: datos histÛricos en el estudio del cerebro humano, evaluaciÛn neuropsicolÛgica de las funciones cerebrales y la rehabilitaciÛn neuropsicolÛgica de las funciones cerebrales. Como datos relevantes en el desarrollo teÛrico del estudio del cerebro humano se hace un recorrido por los actos de trepanaciÛn realizados cientos de aÒos atr·s, los aportes de la frenologÌa, los magistrales hallazgos de Broca y Wernicke, el aporte heurÌstico de Luria y la revoluciÛn actual que se vive con la neuro-imagen. En la evaluaciÛn neuropsicolÛgica de funciones cerebrales se analiza el papel de las pruebas especÌficas, no especÌficas y de observaciÛn diferida en la interpretaciÛn del estado neuropsicolÛgico del ser humano, que permiten analizar las funciones neuropsicolÛgicas en el laboratorio y en las actividades de la vida real. Finalmente, se analiza el proceso de rehabilitaciÛn neuropsicolÛgica de las funciones cerebrales, en donde se hace menciÛn a los procesos de restauraciÛn, compensaciÛn, sustituciÛn, activaciÛn-estimulaciÛn e integraciÛn, que son de gran utilidad al momento de intervenir en un cerebro que ha sufrido un daÒo adquirido. Se concluye que el ritmo acelerado actual ha determinado el avance de la neurociencia, en donde la tecnologÌa y el contundente aporte cientÌfico proponen dÌa a dÌa nuevas tÈcnicas y teorÌas para entender los procesos de evaluaciÛn y rehabilitaciÛn del funcionamiento cerebral.

Abstract This article presents three concepts that are fundamental in the neuropsychological theoretical: historical data in the study of the human brain, neuropsychological evaluation of brain functions and neuropsychological rehabilitation of brain functions. As relevant data in the theoretical development of the study of the human brain is a tour of the trepanation acts performed hundreds of years ago, the contributions of phrenology, the masterful findings of Broca and Wernicke, the heuristic contribution of Luria and the current revolution with neuroimaging. In the neuropsychological evaluation of brain functions the role of specific, non-specific and delayed observation tests in the interpretation of the neuropsychological state of the human being is analyzed, which allow analyzing neuropsychological functions in the laboratory and in real life activities. Finally, we analyze the process of neuropsychological rehabilitation of brain functions, where mention is made of the processes of restoration, compensation, substitution, activation-stimulation and integration, which are very useful when intervening in a brain that has suffered an acquired damage. It is concluded that the current accelerated pace has determined the advance of neuroscience, where technology and the forceful scientific contribution propose new techniques and theories to understand the processes of evaluation and rehabilitation of brain functioning.

Estudio comparativo del estado cognitivo para el aprendizaje en niños y niñas de instituciones educativas públicas del departamento del Cauca, Colombia / Comparative study of learning cognitive state children in public schools of Cauca, Colombia

Resumen El presente estudio se realizó con una población final de 292 niños y niñas de 12 escuelas públicas del departamento del Cauca en los grados transición, primero, segundo y tercero de básica. Para el propósito de la investigación se emplearon 36 pruebas de la batería de Evaluación Neuropsicológica Infantil (ENI), con una duración de 1h 20" por cada niño. Los objetivos que se establecieron en la presente investigación fueron: describir el desempeño de los niños en 35 pruebas neuropsicológicas; evaluar si el desempeño en estas pruebas variaba según factores como la edad del niño, su grado, su género y la institución educativa a la que asistía. El muestreo fue por conveniencia, en tanto que participaron de la investigación solo aquellos niños que fueron autorizados por sus padres o acudientes. Se les realizó valoración neuropsicológica, con la Batería de Evaluación Neuropsicológica Infantil (ENI), en forma individual durante las horas escolares; para ello se emplearon espacios condicionados de manera apropiada para tales propósitos, en las instalaciones de cada colegio. Dentro de los hallazgos relevantes, se observa que no hay diferencias significativas, en términos globales, en las diferentes pruebas, tanto en la condición de género, como en las edades. Es así como los niños y niñas más pequeños tienen comportamientos similares en las diferentes pruebas que los niños y niñas más grandes. La variable "indígena-no indígena", de igual manera, no presentó variación significativa alguna en las pruebas.

Abstract The present study has been performed with a final population of 292 children from 12 public schools in the department of Cauca in transition, first, second and third base grades. For the purpose of this investigation, 36 tasks of battery of child Neuropsychological evaluation was used (ENI), with a duration of 1h 20" per child. The objectives established in this investigation were to describe the performance of children in 35 neuropsychological tests to assess whether the performance in these tests varied according to factors such as the child's age, grade, gender, educational institution she attended. The statistical sampling was for convenience, while research-involving children whose parents or guardians authorized. They underwent to a neuropsychological assessment with Child Neuropsychological Evaluation (ENI) individually during school hours; for this, were used a space properly and appropriately conditioned for such purposes within each school facilities. Among the key findings observed no significant differences in overall terms, in the different tests both gender status, and age. This is how children and smaller girls have similar behavior in the different tests that children and older girls. "Indigenous - non-indigenous" variable also did not present any significant variation in the tests.

Trastorno del espectro autista y función ejecutiva / Autism spectrum disorder and executive functions

Introducción: las alteraciones en la función ejecutiva, especialmente en flexibilidad cognoscitiva, planeación,control inhibitorio y memoria de trabajo constituyen un elemento cardinal dentro las manifestaciones deltrastorno del espectro autista (TEA).Objetivo: el objetivo de este trabajo fue evaluar el desempeño de las pruebas de función ejecutiva en unapoblación de pacientes con trastorno del espectro autista (TEA).Materiales y métodos: se realizó un estudio observacional en niños de una institución de rehabilitación. Seevaluó el desempeño en las subpruebas de la evaluación neuropsicológica infantil, el puntaje de CARS (ChildhoodAutism Rating Scale) y otras variables, mediante un análisis de correlación de Spearman. El estudio fueaprobado por el Comité de Ética en Investigación y se obtuvo consentimiento de los padres.Resultados: se evaluaron ocho niños con edad promedio de 8,9 años (6,1-13,7) y puntaje CARS entre 32 y 46.Se encontró mejor desempeño en habilidades gráficas y menor fluidez gráfica y verbal y de flexibilidad cognitiva.La edad tuvo correlación directa con el puntaje en memoria de trabajo y con la capacidad de planeación.Un puntaje de CARS alto se correlacionó con bajo rendimiento en flexibilidad cognitiva, memoria de trabajoy fluidez gráfica no semántica.Conclusión: los niños con TEA son susceptibles de presentar alteraciones significativas en tareas relacionadascon las funciones ejecutivas, lo que puede explicar la tendencia a la perseveración, incapacidad de cambio decriterio y conductas estereotipadas. Esta disfunción se correlaciona con la severidad del autismo y varía segúnla edad. Aunque esta alteración no es un fenómeno que se presente exclusivamente en el TEA, constituye unelemento a tener en cuenta al momento de evaluar estos niños.

Introduction: executive function disturbances, especially in cognitive flexibility planning, inhibitory control and working memory constitute a cardinal element within the manifestations of autism spectrum disorder (ASD).Objective: the aim of this research was to evaluate the performance of executive function tests in children with ASD.Materials and methods: an observational study was conducted in children attending a rehabilitation institution. An analysis between the performance of the Childhood Neuropsychological assessment subtests, scores of CARS (Childhood Autism Rating Scale) and other variables was performed by a Spearman correlation test. The study was approved by the Institutional Ethics Committee and parental consent was obtained.Results: we evaluated eight children with a mean age of 8.9 years (min: 6.1, max: 13.7) and CARS score between 32 and 46. Better performance was found in graphical abilities, less in graphical and verbal fluency and in cognitive flexibility. Age was directly correlated with scores on working memory and planning. A high CARS score was correlated with poor performance on cognitive flexibility, working memory and non-semantic graphic fluency.Conclusion: children with ASD are prone to show disturbances in executive functions related tasks which may explain the inflexible adherence to routines, the persistence of stereotypical behaviors and the perseveration observed in ASD patients. This dysfunction correlates with the severity of autism and varies with age. Although this condition is not present exclusively in ASD, it is a factor to consider when evaluating children with autism.

Overcoming barriers in cognitive assessment of Alzheimers disease / Superando barreiras na avaliação cognitiva da doença de Alzheimer

Diagnosis of Alzheimer's disease (AD) requires a reliable neuropsychological assessment, but major barriers are still encountered when such tests are used across cultures and during the lifespan. This is particularly problematic in developing countries where most of the available assessment tools have been adapted from developed countries. This represents a major limitation as these tests, although properly translated, may not embody the wealth of challenges that a particular culture poses on cognition. This paper centers on two shortcomings of available cognitive tests for AD, namely, their sensitivity to the educational background and to the age of the individual assessed.

O diagnóstico da doença de Alzheimer (DA) necessita de uma avaliação neuropsicológica de confiança, barreiras importantes ainda são encontradas quando esses testes são usados em através de culturas e durante a vida. Isto é particularmente problemático em países em desenvolvimento, onde a maioria das ferramentas de avaliação disponíveis foram adaptadas a partir de países desenvolvidos. Isto representa uma grande limitação, pois mesmo devidamente traduzidas, podem não pode capturar a riqueza de desafios que uma determinada cultura representa na cognição. Neste artigo vou me concentrar em duas falhas de testes cognitivos disponíveis para AD, sensibilidade ao nível educacional e idade do indivíduo avaliado.

A short neuropsychological evaluation of patients with primary Sjogren's syndrome / Avaliacao neuropsicologica breve em pacientes com sindrome de Sjogren primaria

Objective: To investigate cognitive deficits in patients with primary Sjögren’s syndrome (PSS). Method: Eighteen patients with PSS, aged between 25 and 61 years, were subjected to a short neuropsychological battery and compared with 18 patients with multiple sclerosis and 18 healthy controls. Results: The analysis of variance (ANOVA) revealed that the clinical groups had significantly worse performance than the control group on the Rey Auditory Verbal Learning Test 3; (F 2,53 =3.500, p=0.038) and 7 (F 2,53 =5.068, p=0.010). The clinical groups had elevated levels of depression on the Beck Depression Inventory (BDI); (p=0.003). The analysis of the data from the Trail Making Test B-A revealed a significant difference between the clinical and control groups (p=0.023). The analysis of covariance with BDI score as a covariate, did not change the outcome. Conclusion: Our study revealed cognitive deficits in patients with PSS detectable by a short neuropsychological battery. .

Objetivo: Investigar déficits cognitivos em pacientes com síndrome de Sjögren primária (SSP) utilizando bateria neuropsicológica breve. Método: Dezoito pacientes com SSP e idade entre 25 e 61 anos, foram submetidos a uma bateria neuropsicológica breve e os resultados comparados com 18 pacientes com esclerose múltipla e com 18 controles saudáveis. Resultados: A análise da variância revelou que os grupos clínicos apresentaram desempenho significativamente pior que os controles ao Rey Auditory Verbal Learning Test 3 (RAVLT 3; F 2,53 =3,500, p=0,038) e RAVLT 7 (F 2,53 =5,068, p=0,010). Os grupos clínicos apresentaram índices elevados de depressão pela Beck Depression Inventor y (BDI); (F 2,53 =0.003). O desempenho no Trail Making Test B-A revelou diferença significativa entre os grupos clínicos e o grupo controle (p=0,023). A análise de covariância tomando a BDI como covariante, não revelou mudanças nos resultados. Conclusão: Nosso estudo revelou comprometimento cognitivo em pacientes com SSP detectável por bateria neuropsicológica breve. .

Construção de uma escala para avaliação do planejamento cognitivo / Construction of a scale to assess cognitive planning

Esta pesquisa objetivou construir uma escala de autorrelato para avaliar o planejamento cognitivo em adultos e levantar evidências iniciais de validade. O planejamento foi considerado como um subdomínio das Funções Executivas e entendido como a habilidade de definir e estruturar ações e recursos intencionalmente a fim de atingir um objetivo de maneira eficiente. As etapas envolvidas na construção foram as recomendadas na literatura. Participaram 279 pessoas de ambos os sexos, com diferentes níveis de escolaridade e socioeconômico, residentes em diversos estados brasileiros, com idade entre 18 a 63 anos. A coleta de dados se deu principalmente por meio eletrônico. Os resultados indicam que a Escala de Planejamento Cognitivo (EPC) possui propriedades psicométricas bastante satisfatórias.

This research aimed to construct a self-report scale in order to assess the cognitive planning in adults and to gather initial evidence of its validity. Planning was considered a subdomain of the Executive Functions and it was understood as the ability to intentionally define and structure actions and resources with the purpose of achieving an objective efficiently. The steps of the scale development process were those recommended in the literature. A total of 279 people of both sexes, with different educational and socioeconomic levels, living in several Brazilian states, with ages varying from 18 to 63 years participated in the study. Data collection was performed mainly electronically. Results indicate that the Cognitive Planning Scale (CPS) holds quite satisfactory psychometric properties.