Study of prefrontal cortex activation characteristics of patients with psychiatric disorders in verbal fluency task using functional near-infrared spectroscopy / 四川精神卫生

BackgroundFunctional near-infrared spectroscopy （fNIRS） is a new generation of imaging tool that can be used to assist the diagnosis of psychiatric disorders. However， whether the patterns of prefrontal cortex activation observed by fNIRS are specific for different psychiatric disorders remains to be explored. ObjectiveTo investigate the characteristics of prefrontal cortex activation in patients with depression， anxiety disorder， bipolar disorder and schizophrenia in verbal fluency task （VFT） using fNIRS. MethodsFrom September to December 2021， 39 patients with schizophrenia， 205 patients with depressive disorder， 212 patients with anxiety disorder and 77 patients with bipolar disorder meeting the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited in the outpatient and inpatient department of West China Hospital， Sichuan University. fNIRS was used to monitor the prefrontal cortex hemodynamic changes of patients under VFT， and the clinical symptoms of patients were assessed by Symptom Checklist 90 （SCL-90） and Hypomania Checklist-32 items（HCL-32）. Differences in mean oxyhemoglobin （HbO2） concentration and the initial slope from 2 to 7 second during VFT were compared among patients with different diseases， and the correlation between mean HbO2 concentration/initial slope and clinical symptoms was analyzed by partial correlation analysis. ResultsThe concentration of HbO2 in channel 4 （Z=2.828， P=0.028） and channel 6 （Z=2.912， P=0.022） in patients with depression were significantly higher than those in patients with schizophrenia. Patients with anxiety had significantly higher changes in mean HbO2 concentration in channel 4 （Z=3.154， P=0.010）， channel 5 （Z=3.021， P=0.015）， channel 6 （Z=2.980， P=0.017） and of all channels （Z=2.881， P=0.024） than those of schizophrenia patients. There was a statistically significant difference in the initial slope of channel 3 between patients with depressive disorder and those with bipolar disorder （Z=2.691， P=0.039）. Among patients with bipolar disorder， the anger-hostility scores of SCL-90 were negatively correlated with the mean HbO2 concentration changes in channel 4 （r=-0.505， P=0.004）， channel 6 （r=-0.390， P=0.004）， channel 15 （r=-0.546， P=0.002）， channel 16 （r=-0.550， P=0.002） and the mean HbO2 concentration changes of all channels （r=-0.491， P=0.006）. ConclusionPatients with schizophrenia had lower activation in frontopolar and orbitofrontal region than patients with depression and anxiety disorder， and the initial slope of the right frontopolar， inferior frontal and orbitofrontal region in patients with depression is higher than patients with bipolar disorder. In addition， patients with bipolar disorder had less activation in the frontopolar and orbitofrontal lobe， the insular cover of Broca's area and the upper outer frontal cortex， and were more irritable and hostile. ［Funded by 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project， West China Hospital， Sichuan University （number， ZYJC21083）］

Three verbal fluency tasks: Normative data and convergent validity in Argentines over 50 years / Três tarefas de fluência verbal: dados normativos e validade convergente em argentinos com mais de 50 anos

ABSTRACT Verbal fluency tasks are frequently used in neuropsychological assessment, standing out for their easy application and good sensitivity to early cognitive impairment. However, in Argentina, the availability of updated norms is limited, especially for the action fluency variant. There is also little evidence of validity. Objectives: The aim of this study was to obtain Argentine norms for three verbal fluency tasks and to analyze their convergent validity. Methods: Using a nonprobability sampling method, 303 Argentines from a nonclinical population (age mean=66.8, 50-91 years) were recruited to participate in this study. Those with medical conditions that could compromise neuropsychological performance were excluded. Three verbal fluency tasks (i.e., phonological, semantic, and action), the Montreal Cognitive Assessment (MoCA) test, and the Digit Span-WAIS III test were administered. Correlations and multiple regressions were subsequently performed. Results: Education and age significantly explained 11.8% of the variance in phonological fluency, 15.8% of the variance in semantic fluency, and 20.2% of the variance in action fluency. Hence, the normative data varied according to educational level and age group, with normal performance limit values between 9 and 14 for phonological fluency, 11 and 18 for semantic fluency, and 8 and 17 for action fluency. Positive correlations were obtained between all verbal fluency tasks, as well as between the MoCA test and the Digit Span test. Conclusions: This study supports the applicability of three verbal fluency tasks in an Argentine context by providing age- and education-corrected norms and acceptable evidence of convergent validity.

RESUMO As tarefas de fluência verbal são frequentemente utilizadas na avaliação neuropsicológica, destacando-se pela facilidade de aplicação e boa sensibilidade ao comprometimento cognitivo incipiente. No entanto, na Argentina, a disponibilidade de padrões atualizados é limitada, especialmente pela variante de fluência de ações. Assim sendo, a evidência de validade é escassa. Objetivos: Obter normas argentinas para três tarefas de fluência verbal e analisar sua validade convergente. Métodos: Usando um método de amostragem não probabilística, 303 argentinos de uma população não clínica (idade M=66,8, 50-91 anos) foram recrutados para participar deste estudo. Foram excluídos aqueles com condições médicas que pudessem comprometer o desempenho neuropsicológico. Três tarefas de fluência verbal (ou seja, fonológica, semântica e ações), o teste Montreal Cognitive Assessment (MoCA) e o teste Digit Span-WAIS III foram administrados. Correlações e regressão múltipla foram realizadas posteriormente. Resultados: A escolaridade e a idade explicaram significativamente 11,8% da variância da fluência fonológica, 15,8% da variância da fluência semântica e 20,2% da variância da fluência de ações. Assim, os dados normativos variaram de acordo com a escolaridade e a faixa etária, com limite de desempenho normal entre 9 e 14 para fluência fonológica, 11 e 18 para fluência semântica e 8 e 17 para fluência de ações. Foram obtidas correlações positivas entre todas as tarefas de fluência verbal, bem como entre estas, o teste MoCA e o Digit Span. Conclusões: Este estudo apoia a aplicabilidade de três tarefas de fluência verbal no contexto argentino, fornecendo normas corrigidas por idade e educação e evidências aceitáveis de validade convergente.

Changes of brain oxygenated hemoglobin concentration in adolescent patients with depression under speech fluency task / 中华行为医学与脑科学杂志

Objective:To explore the characteristics and differences of oxygenated hemoglobin responses in different brain regions in adolescent depressive disorder patients and healthy adolescents during speech fluency task based on functional near-infrared spectroscopy imaging.Methods:From March 2021 to June 2021, twenty-nine adolescents with depression(depressed group) and 26 healthy adolescents(normal group) were enrolled. The severity of depression was assessed by Hamilton depression scale, and the speech fluency task was performed by functional near-infrared spectroscopy brain imaging, and the relative concentrations of oxyhemoglobin in the prefrontal and bilateral temporal lobes were measured.SPSS 26.0 statistical software was used for data analysis, chi-square test was used for gender count data. The t-test was used for comparison of two groups. The measurement data that did not conform to normal distribution were compared between the two groups by Mann-Whitney U test. Results:In the speech fluency task, there was no significant difference in the concentration of oxygenated hemoglobin in prefrontal and left temporal between the depressed group and the normal group (both P>0.05); the oxygenated hemoglobin concentration in the right temporal lobe(-9.179(-22.231, 4.789)) of depressed group was significantly lower than that of the normal group (12.754(-9.438, 35.008)), and the difference was statistically significant ( U=538.00, P<0.05). The oxygenated hemoglobin concentration in right temporal lobe of depressed group had no correlation with the score of Hamilton depression rating scale ( r=0.092, P>0.05). Conclusion:The right temporal lobe function of adolescent depression patients is lower than that of healthy controls during speech fluency tasks, which provides a basis for study of the relationship between depression and some cognitive sensitivity impairment and the function of right temporal lobe.

Clustering and switching in verbal fluency: a comparison between control and individuals with brain damage / Clustering e switching na fluência verbal: comparação entre controles e indivíduos com prejuízo cerebral

ABSTRACT Purpose The aim of this study is to analyze and compare the performance and strategies used by control subjects and patients with unilateral brain damage on phonemic and semantic Verbal Fluency tasks. Methods The sample consisted of 104 participants divided into four groups (26 with left hemisphere damage and aphasia- LHDa, 28 with left hemisphere damage and no aphasia- LHDna, 25 with right hemisphere damage- RHD and 25 neurologically healthy control subjects). All participants were administered the phonemic ("M" letter-based) and semantic (animals) verbal fluency tasks from the Montreal-Toulouse Language Assessment Battery (MTL-BR). Results Patients in the LHDa group showed the worst performance (fewer words produced, fewer clusters and switches) in both types of fluency task. RHD group showed fewer switching productions when compared with controls and LHDna had fewer words productions than controls in the first 30 seconds block. Conclusion Our findings suggest that the LHDa group obtained lower scores in most measures of SVF and PVF when compared to the other groups.

RESUMO Objetivo analisar e comparar o desempenho e as estratégias utilizadas por indivíduos controle e pacientes com lesão cerebral unilateral em tarefas de Fluência Verbal fonêmica e semântica. Método A amostra foi composta por 104 participantes, divididos em quatro grupos (26 com lesão no hemisfério esquerdo e afasia - LHEa, 28 com lesão no hemisfério esquerdo e sem afasia - LHEna, 25 com lesão no hemisfério direito - LHD e 25 controles neurologicamente saudáveis). Todos os participantes realizaram tarefas de fluência verbal fonêmica - FVF (com letra "M") e semântica- FVS (animais) da Bateria Montreal-Toulouse de Avaliação da Linguagem (MTL-BR). Resultados Pacientes do grupo LHEa apresentaram pior desempenho (menos palavras produzidas, menos clusters e switching) nos dois tipos de tarefas de fluência. O grupo LHD mostrou menos produções de switching quando comparado aos controles. O grupo LHEna teve menos produções de palavras que os controles no primeiro bloco de 30 segundos. Conclusão Nossos achados concluem que o grupo LHEa obteve escores mais baixos na maioria das medidas de FVS e FVF quando comparado aos demais grupos.

Velocidad de la marcha y cognición en adultos mayores en atención secundaria de salud / Velocidade da marcha e cognição em idosos da atenção secundária em saúde / Gait speed and cognition in elderly users of secondary care service

Objetivo: analizar la asociación entre la velocidad de la marcha y la cognición de adultos mayores que se encuentran en asistencia ambulatoria geriátrica y gerontológica. Materiales y método: estudio cuantitativo transversal realizado con 407 adultos mayores (≥ 60 años) atendidos en el Centro Ambulatorio de Geriatría y Gerontología del municipio de São José dos Pinhais, Paraná (Brasil). La condición de fragilidad física se evaluó utilizando el fenotipo de fragilidad y el cribado cognitivo mediante el Mini-Mental State Examination y el test de fluencia verbal semántica. El análisis univariado se realizó mediante una prueba de chi-cuadrado con nivel de significación estadístico de p ≤ 0,05. Resultados: del total de participantes, se observaron 226 (55,5 %) adultos mayores prefrágiles, 238 (58,5 %) reportaron deterioro cogntivo, 90 (22 %) de la fluidez verbal semántica y 205 (50,4 %) presentaron velocidad de la marcha reducida, variable que registró una asociación significativa con el deterioro cognitivo (p = 0,003) y las alteraciones de la fluencia verbal semántica (p < 0,001).Conclusiones: los resultados señalan la necesidad de implementar la evaluación de la velocidad de la marcha en adultos mayores como parte de la práctica clínica de geriatría y gerontología. Este componente revela un posible deterioro cognitivo y permite la realización de acciones que puedan perfeccionar el manejo de los cuidados ante la fragilidad física en adultos mayores.

Objetivo: analisar a associação entre a velocidade da marcha e a cognição de idosos em assistência ambulatorial de geriatria e gerontologia. Materiais e método: estudo quantitativo transversal, realizado com 407 idosos (≥ 60 anos), atendidos no Ambulatório de Geriatria e Geron-tologia, do município de São José dos Pinhais, Paraná, Brasil. A condição de fragilidade física foi avaliada mediante o fenótipo de fragilidade e o rastreio cognitivo pelo Mini-Exame do Estado Mental e Teste de Fluência Verbal Semântica. A análise univariada foi realizada por teste de quiquadrado com nível de significância estatístico de p ≤ 0,05. Resultados:do total de participantes, foram observados 226 (55,5 %) idosos pré-frágeis, 238 (58,5 %) apresentaram declínio cognitivo, 90 (22 %) comprometimento na fluência verbal semântica e 205 (50,4 %) velocidade da marcha reduzida, variável que registrou associação significativa com o comprometimento cognitivo (p = 0,003) e alterações da fluência verbal semântica (p < 0,001). Conclusões: os resultados apontam para a necessidade de implementar na prática clínica de geriatria e gerontologia a avaliação da velocidade da marcha em idosos. Esse componente revela possibilidades de comprometimento cognitivo e faculta ações que possam aprimorar a gestão de cuidados diante da fragilidade física em idosos

Objective: To study the association between gait speed and cognition in elderly patients undergoing geriatric and gerontological outpatient treatment. Materials and method:Quantitative and cross-sectional study with 407 elderly patients (≥60 years) treated at the Geriatrics and Gerontology Outpatient Clinic in the town of São José dos Pinhais, Paraná (Brazil). Physical frailty condi-tion was assessed using the frailty phenotype and the cognitive assessment by means of the Mini Mental State Examination and the Semantic Verbal Fluency Test. The univariate analysis was performed using a chisquare test with a level of statistical significance of p ≤ 0.05. Results: Out of the total participants, we observed that 226 (55.5%) elderly patients were pre-frail, 238 (58.5%) had cognitive impairments, 90 (22%) showed impaired semantic verbal fluency, and 205 (50.4%) decreased gait speed. This last variable showed a significant association with cognitive decline (p = 0.003) and changes in semantic verbal fluency (p < 0.001). Conclusions: Our results indicate the need of implementing gait speed assessment in elderly patients in the geriatrics and gerontology clinical practice. This component reveals a possible cognitive deterioration and enables us to develop actions that may improve care management in the face of physical frailty in elderly individuals.

Accuracy of the semantic fluency test to separate healthy old people from patients with Alzheimers disease in a low education population / Acurácia do teste de fluência semântica para separar pessoas saudáveis de pacientes com doença de Alzheimer em uma população de baixa escolaridade

OBJECTIVE: Evaluate the accuracy of two semantic categories of the verbal fluency test (supermarket and animal categories) to separate healthy elderly individuals and lower educated Alzheimer's disease patients. METHODS: We evaluated 69 older adults with less than 5 years of schooling, consisting of 31 healthy elderly, and 38 patients diagnosed with Alzheimer's disease. Semantic verbal fluency was evaluated using the animal and supermarket categories. Mann-Whitney U and Independent t Tests were used to compare the two groups, and the diagnostic accuracy of the tests was analyzed by sensitivity, specificity, likelihood ratio's, and the Area Under the Curve (AUC). RESULTS: We found a significant difference between the healthy older and Alzheimer's disease groups, in both, animal (p = 0.014) and supermarket verbal fluency (p < 0.001). The supermarket category showed better overall diagnostic accuracy (AUC = 0.840, 95% CI = 0.746-0.933; p < 0.001) compared to the animal category (AUC = 0.671, 95% CI = 0.543-0.800; p = 0.014). CONCLUSION: The supermarket category of semantic verbal fluency provides better accuracy than the animal category for the identification of dementia in a Brazilian elderly population with low educational level.

OBJETIVO: Avaliar a acurácia de duas categorias semânticas do teste de fluência verbal (categorias de supermercado e animal) para separar idosos saudáveis e pacientes com doença de Alzheimer com baixa escolaridade. MÉTODOS: Avaliamos 69 idosos com menos de 5 anos de escolaridade, consistindo em 31 idosos saudáveis e 38 pacientes diagnosticados com a doença de Alzheimer. A fluência verbal semântica foi avaliada nas categorias animal e supermercado. O teste de Mann-Whitney U e o teste t independente foram usados para comparar os dois grupos, e a precisão diagnóstica dos testes foi analisada por sensibilidade, especificidade, razão de verossimilhança e área sob a curva (AUC). RESULTADOS: Encontramos uma diferença significativa entre os grupos de idosos saudáveis e com doença de Alzheimer, tanto na fluência verbal de animais (p = 0,014) quanto na de supermercado (p < 0,001). A categoria supermercado apresentou melhor precisão diagnóstica geral (AUC = 0,840; IC 95% = 0,746- 0,933; p < 0,001) em comparação com a categoria animal (AUC = 0,671; IC 95% = 0,543-0,800; p = 0,014). CONCLUSÃO: A categoria supermercado de fluência verbal semântica fornece melhor acurácia do que a categoria animal para a identificação de demência em uma população idosa brasileira com baixo nível educacional.

Fluidez verbal fonológica, morfológica y semántica en sujetos con enfermedad de Parkinson / Phonologic, morphologic and semantic verbal fluency in Parkinson disease subjects

Resumen La Enfermedad de Parkinson (EP) es una patología progresiva con degeneración del sistema dopaminérgico nigro-estriatal con disfunción de proyecciones frontales que genera alteraciones en funciones ejecutivas. Esta condición debería afectar particularmente la capacidad de evocar unidades léxicas y recuperarlas desde la memoria de largo plazo; no obstante, si bien se cuenta con datos acerca de este comportamiento, aún es necesario determinar qué subcomponentes del lenguaje se ven afectados a fin de comprender con mayor especificidad tanto la patología como su manifestación lingüística. En este marco, el objetivo del presente estudio consistió en describir el rendimiento en tareas de fluidez verbal de tipo fonológica, morfosintáctica, semántica y sus combinaciones en participantes con enfermedad de Parkinson (EP). Para ello, se realizó un estudio transversal con 42 sujetos, agrupados en Adulto Mayor Sano (AMS; n = 23) y Adulto Mayor Diagnosticado con EP (EP; n = 19). Cada sujeto realizó un total de 15 tareas de fluidez verbal en las que debió evocar la mayor cantidad de unidades léxicas en 60 segundos, las que fueron, además, medidas en intervalos de 15 segundos. Los resultados permitieron observar diferencias estadísticamente significativas en las subtareas de tipo fonológica de fonema excluido, categoría gramatical, relaciones semánticas y de combinación campo léxico y fonema inicial. Estos datos parecen indicar que los sujetos con EP muestran un rendimiento significativamente inferior en tareas que exigen alto control inhibitorio, dado que las subtareas que combinan niveles de la lengua implican evocación e inhibición.

Abstract Parkinson's disease (PD) is a progressive pathology that implies a degeneration of the nigro-striatal dopaminergic system with dysfunction of frontal projections, which generates alterations in executive functions, specifically in sustained attention, working memory, planning and cognitive flexibility, among others. In fact, this pathology has repercussions on several language components. Particularly, there is evidence indicating that the ability to evoke lexical units and recover them from long-term memory or lexicon is affected. Although these types of tasks seem to be sensitive for the detection of Parkinson's disease, both in patients with mild cognitive impairment and another with dementia, it is still necessary to have evidence to determine which specific subcomponents of the language are affected, since this will allow us to understand with more specificity both the pathology and its linguistic manifestation, at the same time as to design therapies by support teams for this type of patients. In this context, verbal fluency (VF) tests could contribute to obtaining this type of information. VF is defined as an executive function that involves the access and evocation of clusters of linguistic information, and that is related to attention and working memory processes, since it is initiated by the activation of information groups through specific search strategies Moreover, it involves various linguistic functions, such as the naming, and executive functions of planning, working memory and initiation of behavior. Specifically, this type of task consists of requesting the subject under evaluation to nominate the largest number of elements of a lexical category according to a specific rule for a specific time, such as names of countries or word containing the phoneme / f /. From there, it has been observed which associated language areas are activated: ventral-anterior lower frontal gyrus in categorical tasks, dorsal-posterior lower frontal gyrus in phonological tasks and parietal areas of the right hemisphere that are associated with executive functions and attentional processes in tasks of greater complexity. Within this framework, the aim of the present study was to describe the performance in tasks of verbal fluency of a phonological, morph syntactic, semantic type and their combinations in participants diagnosed with Parkinson's disease (PD). For this, a cross-sectional study was conducted with 42 subjects, grouped as healthy older adults (AMS; n = 23) and older adults diagnosed with PD without dementia (EP; n = 19). The subjects of the control group had a mean age of 66 years (SD = 6.9) and 11.5 years of schooling (SD = 3.1); on the other hand, subjects with PD had a mean age of 71 years (SD = 8.03) and 13.2 years of schooling (SD = 3.9). Each subject performed a total of 15 verbal fluency tasks, in which he had to evoke the greatest number of lexical units in 60 seconds, which were also measured in intervals of 15 seconds. The results shown statistically significant differences in the sub-tasks of the phonemic type of excluded phoneme (FVFLE1: p = .012 and FVFLE2: p = .047), morph syntactic adjective categories (FVM2: p = .005), in the synonymy relationships (FVS3: p = .028) and lexical field and phonology (FVSF: p = .004). These data seem to indicate that subjects with Parkinson's disease show significantly lower performance in tasks that require high inhibitory control, since subtasks that combine tongue levels involve evocation and inhibition at the same time. These results are consistent with the pathophysiology of the condition.

Fluidez verbal, inteligencia y velocidad de procesamiento en adultos jóvenes con y sin actividad escolar: el impacto de la reserva cognitiva en adultos jóvenes / Verbal fluency, intelligence and processing speed in young adults with and without school activity: The impact of the cognitive reserve in young adults

Es conocido el impacto positivo de la reserva cognitiva y de mantenerse activo intelectualmente en el funcionamiento cognitivo en el adulto mayor, sin embargo, el impacto de dichas variables en funciones ejecutivas en jóvenes apenas ha sido investigada. Por ello, el objetivo de la presente investigación fue comparar el desempeño de la fluidez verbal (fonológica, semántica y de verbos), inteligencia (fluida y cristalizada) y velocidad de procesamiento entre jóvenes con diferentes grados académicos y personas con el mismo grado, pero que han dejado de estudiar. Participaron 68 adultos, de 20 a 35 años de edad; todos ellos sanos y residentes de la ciudad de Morelia. Los resultados señalan que el grupo sin actividad escolarizada (con nivel de licenciatura) obtuvo peor rendimiento respecto a los grupos activamente escolarizados (de licenciatura y maestría) en las pruebas de fluidez verbal semántica y de verbos, mientras que no se reportan diferencias significativas entre los grupos conformados por estudiantes activos. En fluidez fonológica el grupo con grado de licenciatura inactivo obtuvo menor rendimiento que el grupo de mayor grado escolar activo. Se concluye que la actividad escolar incide favorablemente en el desempeño de fluidez verbal en jóvenes adultos. Ello no sólo puede ser un elemento que a largo plazo puede transferirse en reserva cognitiva, sino que también puede tener una injerencia notable en la propia vida adulta a nivel laboral.

The positive impact of cognitive reserve and of being intellectually active in cognitive functioning in the elderly is known, however, the impact of these variables on executive functions in young people has hardly been investigated. Therefore, the objective of this research was to compare the performance of verbal fluency (phonological, semantic and verbs), intelligence (fluid and crystallized) and processing speed among young people with different academic degrees and people with the same degree, but who have stopped studying. 68 adults participated, from 20 to 35 years of age; all of them healthy and residents of the city of Morelia. The results indicate that the group with no school activity (with a bachelor's degree) performed worse than the groups actively enrolled (undergraduate and master's degree) in verbal semantic fluency and verbs, while no significant differences were reported between the groups made up of active students. In phonological fluency, the group with an inactive bachelor's degree obtained lower performance than the group with the highest active school grade. It is concluded that school activity has a favorable impact on the performance of verbal fluency in young adults. This can not only be an element that can be transferred in cognitive reserve in the long term, but it can also have a notable interference in adult life at work level.

Effects of Working Memory Updating Training on Verbal Fluency for Patients with Motor Aphasia / 中国康复理论与实践

Objective:To explore the effect of working memory updating training on verbal fluency for patients with motor aphasia. Methods:From June, 2015 to June, 2018, 80 patients with motor aphasia were randomly divided into control group (n = 40) and study group (n = 40). The control group accepted routine speech training, while the study group accepted working memory updating training in addition, for eight weeks. They were assessed updating function and verbal fluency before and after training. Results:The updating function and verbal fluency improved in the study group after training (t > 2.418, P < 0.05), and were better than those in the control group (t > 2.407, P < 0.05). Conclusion:Working memory updating training can improve both speech and cognition for patients with motor aphasia.

Patrones de correlación de fluencias semánticas y fonológicas en niños en edad escolar / Correlational Patterns in Semantic and Phonological Fluency in School Aged Children

Resumen Las tareas de fluidez verbal semántica (FVS) y fluidez verbal fonológica (FVF) son medidas sensibles para detectar y diagnosticar diversas patologías tanto en la población adulta como en la infantil. Dado que las tareas de FVS y FVF permiten detectar problemas específicos de determinadas facultades lingüísticas o cognitivas, el objetivo de este trabajo es indagar las posibles relaciones existentes entre FVS y FVF en una población de niños argentinos de nivel escolar primario de 3°, 5° y 7° grado y edades comprendidas entre los 8 y 12 años. Los 86 niños participantes respondieron a una tarea de FVS en la que se evaluaron cinco categorías (animales, partes del cuerpo, medios de transportes, ropa e instrumentos musicales) y una tarea de FVF en la que respondieron a los fonemas /f/, /a/, /s/. Se realizó un análisis de correlaciones cuyo resultado muestra que existe una asociación de mediana intensidad entre ambas tareas. Además, se llevaron a cabo un análisis factorial exploratorio y uno confirmatorio, que detectaron dos factores diferenciados: un factor verbal semántico y un factor verbal fonológico. Los resultados obtenidos muestran que los procesos fonológicos y semánticos se encuentran diferenciados desde edades tempranas, aunque por su correlación es posible concluir que ambos procesos confluyen en un mismo almacén de búsqueda en la memoria verbal.

Abstract Semantic verbal fluency tasks (SVF) and phonological verbal fluency tasks (PVF) are highly sensitive measures used to detect and diagnose different pathologies in adult and child populations. The results of numerous investigations point out differential performances between these two tasks both in adults and children. Based on this evidence, we intend to identify the possible connections between SVF and PVF in a group of Argentinian children aged 8 to 12 years old who attended to 3rd, 5th and 7th school primary levels. Participants answered to a SVF task which tested five categories (animals and body parts for living things and transports, cloth and musical instruments for inanimate objects domain) and a PVF task where the phonemes /f, a, s/ were assessed. A correlations analysis was carried out. The result showed there is a mild association between both tasks. In addition, an exploratory factor analysis and a confirmatory factor analysis were conducted. Two differential factors were detected: a semantic verbal factor and a phonological verbal factor. Our results show that phonological and semantic are different processes and function separately in early development, although due to their correlation it is possible to conclude that both processes converge in the same store in verbal memory.

Influence of age and education on the processing of clustering and switching in verbal fluency tasks / Influência da idade e da escolaridade nos processos de agrupamento e alternância em tarefas de fluência verbal

ABSTRACT Verbal fluency (VF) is a widely used tool in neuropsychological assessment. Objective: We aimed to investigate the influence of age and educational level on clustering and switching in three VF modalities: phonemic (PVF), semantic (SVF) and unconstrained (UVF). We evaluated type of cluster, mean cluster size, and quantity of clusters, intersections, and returns. A total of 260 healthy subjects were assessed. Methods: Participants were divided into three age groups: young adults (18 to 39 years), middle-aged adults (40 to 59 years) and older adults (60 to 80 years) and into two groups of educational level: 1-8 years (low), 9 years or more (high). A two-way ANOVA analysis was conducted to analyze the effect of age and educational level and its interactions. A repeated measures ANOVA was performed to verify the performance during the task. Results: A main effect of age was detected on the UVF and SVF scores for total switches, taxonomic clusters, and for the total semantic clusters on the SVF. There was a greater effect of educational level on total switches (UVF, PFV and SVF), taxonomic clusters (UVF and SVF), thematic clusters and total semantic cluster (UVF), phonemic and mixed clusters (PVF), mean cluster size (UVF and SVF) and intersections (SVF). Educational level had a greater effect on all three VF tasks.

RESUMO Fluência verbal (FV) são ferramentas amplamente utilizadas na avaliação neuropsicológica. Objetivo: Nosso objetivo foi investigar a influência da idade e do nível de escolaridade no agrupamento e alternância em três modalidades de fluência verbal: fonêmica (FVF), semântica (FVS) e livre (FVL). Métodos: Avaliamos o tipo, tamanho médio e quantidade de agrupamentos, alternâncias, intersecções e retornos. Foram divididos 260 indivíduos, em três grupos etários: jovens adultos (18 a 39 anos), adultos de idade intermediária (40 a 59 anos) e idosos (60 a 80 anos) e dois grupos de escolaridade 1-8 (baixa), 9 ou mais (alto). Uma análise ANOVA de dois fatores foi conduzida para analisar o efeito da idade e do nível educacional e suas interações, além de uma ANOVA de medidas repetidas para verificar o desempenho ao longo da tarefa. Resultados: Encontrou-se efeito principal da idade nas tarefas de FVL e FVS nos seguintes escores: total de alternâncias, agrupamento taxonômicos e no total de agrupamentos semânticos na FVS. Houve um efeito principal do nível educacional no total de alternâncias (FVL, FVF e FVS), agrupamento taxonômicos (FVL e FVS), agrupamento temáticos e cluster semântico total (FVL), clusters fonêmicos e mistos (FVF), tamanho médio de cluster (FVL e FVS) e, finalmente, interseções (FVS). O nível educacional teve efeito maior nas três tarefas de FV.

Relación entre la fluidez verbal escrita y el rendimiento académico escolar / Relationship between written verbal fluency and school academic performance

Las tareas de fluidez verbal son procedimientos que se realizan con regularidad en la evaluación neuropsicológica, las cuales para llevarse a cabo requieren del reclutamiento de una serie procesos cognitivos, entre los que destacan las funciones ejecutivas y las habilidades lingüísticas. Se realizó un estudio piloto empírico con metodología cuantitativa experimental, en donde se evaluaron con tareas de fluidez verbal escrita a dos grupos de estudiantes, de alto y bajo rendimiento académico, que asistieron a 4° año de primaria. Se concluye que la fluidez verbal escrita, tanto si se aplica sólo la tarea semántica o en conjunto con la fonológica, sería útil para diferenciar entre aquellos estudiantes con alto o bajo rendimiento académico que asistan a 4° año de primaria. Se espera que los resultados encontrados en el presente estudio, además se ser útiles para aquellos profesionales que se dedican al área tanto clínica como educativa, sirvan de aliciente para seguir indagando en esta temática.

The tasks of verbal fluency are procedures that are performed regularly in the neuropsychological evaluation, which to be carried out require the recruitment of a series of cognitive processes, among which executive functions and language skills stand out. Was performed an empirical pilot study with experimental quantitative methodology, evaluating with tasks of verbal fluency written to two groups of students, high and low academic performance, belonging to 4th year of primary school. It is concluded that written verbal fluency, whether applied only the semantic task or in conjunction with the phonological, would be useful to differentiate between those students with high or low academic performance belonging to 4th grade. It is expected that the results found, besides being useful for professionals working in the clinical and educational area, serve as an incentive to continue investigating this issue.

Contrasting Two Verbal Fluency Scoring Systems Using the Rasch Rating Scale Model / Comparación de Dos Sistemas de Puntuación de la Fluidez Verbal Mediante el Modelo de Escalas de Calificación

Resumen Objetivo: Comparar dos sistemas de puntuación para un test de fluidez verbal con el Modelo de Escalas de Calificación. Método: Se analizaron datos de 289 participantes, de los cuales 92 habían sido diagnosticados con Parkinson. Las puntuaciones se calcularon con dos sistemas de categorización: un procedimiento convencional y otro basado en percentiles. Resultados: Las puntuaciones Rasch procedentes de percentiles dan lugar a categorías adecuadas y medidas fiables; la correlación con las puntuaciones del test Minimental es evidencia de validez concurrente. Tras controlar estadísticamente el efecto de la edad, las medidas Rasch procedentes de percentiles discriminan entre ambos grupos, lo que evidencia validez predictiva. Conclusiones: El análisis de los dos procedimientos permite recomendar el uso de las categorías basadas en percentiles.

Abstract Objective: Two scoring systems for a verbal fluency test were compared using the Rasch Rating Scale Model. Method: The analysis was carried out on 289 participants, 92 of whom had had a Parkinson's disease diagnosis. Scores were calculated with two different category systems: a conventional procedure and a percentile-based one. Results: The percentile-based Rasch scores produce adequate categories and reliable measures, while the correlation with the Mini Mental State Examination evinces concurrent validity. After statistically controlling for age, percentile-based Rasch measures discriminated between both groups, demonstrating predictive validity. Conclusions: The analysis of the two procedures allows for the recommendation of the use of percentile-based categories.

Los padres como promotores del desarrollo de lenguaje de bebés prematuros: propuesta de intervención temprana / Parents as Promoters of Language Development in Premature Babies: a Proposal for Early intervention

Resumen Objetivo: Comparar dos sistemas de puntuación para un test de fluidez verbal con el Modelo de Escalas de Calificación. Método: Se analizaron datos de 289 participantes, de los cuales 92 habían sido diagnosticados con Parkinson. Las puntuaciones se calcularon con dos sistemas de categorización: un procedimiento convencional y otro basado en percentiles. Resultados: Las puntuaciones Rasch procedentes de percentiles dan lugar a categorías adecuadas y medidas fiables; la correlación con las puntuaciones del test Minimental es evidencia de validez concurrente. Tras controlar estadísticamente el efecto de la edad, las medidas Rasch procedentes de percentiles discriminan entre ambos grupos, lo que evidencia validez predictiva. Conclusiones: El análisis de los dos procedimientos permite recomendar el uso de las categorías basadas en percentiles.

Abstract Objective: Two scoring systems for a verbal fluency test were compared using the Rasch Rating Scale Model. Method: The analysis was carried out on 289 participants, 92 of whom had had a Parkinson's disease diagnosis. Scores were calculated with two different category systems: a conventional procedure and a percentile-based one. Results: The percentile-based Rasch scores produce adequate categories and reliable measures, while the correlation with the Mini Mental State Examination evinces concurrent validity. After statistically controlling for age, percentile-based Rasch measures discriminated between both groups, demonstrating predictive validity. Conclusions: The analysis of the two procedures allows for the recommendation of the use of percentile-based categories.

Verbal fluency in elderly with and without hypertension and diabetes from the FIBRA study in Ermelino Matarazzo / Fluência verbal em idosos com e sem hipertensão e diabetes no estudo fibra em ermelino matarazzo

ABSTRACT. Background: There are few studies on the qualitative variables derived from the animal category verbal fluency test (VF), especially with data originating from low-income samples of community-based studies. Objective: To compare elderly with and without hypertension (HTN) and diabetes mellitus (DM) regarding the total number of animals spoken, number of categories, groups and category switches on the VF test. Methods: We used the database of the FIBRA (Frailty in Brazilian Elderly) community-based study. The variables number of Categories, Groups and Category Switches were created for each participant. The total sample (n = 384) was divided into groups of elderly who reported having HTN, DM, both HTN and DM, or neither of these conditions. Results: There were no significant differences between the groups with and without these chronic diseases for VF total score or for the qualitative variables. Conclusion: Among independent community-dwelling elderly, the qualitative variables derived from the VF animal category may not add information regarding the cognitive profile of elderly with chronic diseases. Total VF score and the qualitative variables Category, Group and Switching did not differentiate elderly with and without HTN and DM.

RESUMO. Introdução: Existem poucos estudos sobre as variáveis qualitativas decorrentes do teste de fluência verbal (FV) categoria animais, em especial com dados provenientes de amostra populacional de países com baixa renda. Objetivo: Comparar idosos com e sem hipertensão (HAS) e diabetes mellitus (DM) quanto ao número total de animais falados, número de categorias, grupos e trocas de categoria no teste de FV. Métodos: Utilizou-se o banco de dados do estudo FIBRA (Fragilidade em Idosos Brasileiros) de base populacional em Ermelino Matarazzo. Foram criadas as variáveis Categoria, Grupo e Troca de Categoria para cada participante. A amostra total (n = 384) foi dividida entre aqueles idosos que relataram ter HAS, DM, ambas ou nenhuma destas condições. Resultados: Não houve diferença significativa entre os grupos com e sem estas doenças crônicas para o escore total da FV nem para as variáveis qualitativas. Conclusão: Entre idosos independentes residentes na comunidade, as variáveis qualitativas derivadas da FV animais podem não adicionar informações sobre o perfil cognitivo de idosos com condições crônicas. O escore total da FV e as variáveis qualitativas Categoria, Grupo e Troca de Categoria não diferenciaram idosos com e sem HAS e DM.

Study on impairment of verbal fluency in patients with castration-resistant prostate cancer after chemotherapy / 中华行为医学与脑科学杂志

Objective To investigate the changes of verbal fluency test(VFT) in patients with castration resistant prostate cancer(CRPC) after chemotherapy.Methods 61 patients with CRPC were recruited.Thirty-one of those patients voluntarily accepted chemotherapy as CT group.The other thirty patients who did not received chemotherapy served as control group.CT group underwent VFT assessments at 3 time points:pre-chemotherapy (T1),during-chemotherapy (T2) and post-chemotherapy (T3).Patients in the control group were also assessed at the same time.Results (1) In phonetic fluency tasks,the interaction of time and group (time×group) between the CT group and control group was insignificant in the aspects of word capacity,cluster size,mean cluster size and phonetic switches(P＞0.05).The effect of time between the CT group and control group was significant difference in word capacity,cluster size,mean cluster size and phonetic switches(P＜0.05),but the effect of group was not significant(P＞0.05).CT group and control group both produced more words at T2 and T3 compared with that at T1 (P＜0.05).CT group had a lower score in cluster size and average cluster size than that of the control group at T3 ((6.17 ± 2.71) vs (7.64 ± 2.36),(3.14±0.78)vs (4.28± 1.53),P＜0.05).(2)In semantic fluency tasks,the interaction of time and group (time×group) between the CT group and control group was insignificant in the aspects of word capacity,cluster size,mean cluster size and semantic switches(P＞0.05).The effect of time between the CT group and control group was significantly different in word capacity,cluster size and semantic switches(P＜0.05),but the effects of groups and the effect of time in mean cluster were not significantly different(P＞0.05).The control group produced more words at T2 and T3 than T1 (P＜0.05).The CT group had a smaller cluster size at T3 than T1 and T2,and it was aslo smaller than control Group(P＜0.05).CT group had smaller cluster size at T3 than T2 ((5.47± 1.28) vs (7.15± 1.49),P＜ 0.05).At T3,the semantic switches of the CT group were more than T1,but less than control Group((20.81 ±3.63) vs (19.36±4.84) vs (21.54±6.18),P＜ 0.05)).The semantic switches of CT group were less at T2 than T1 ((18.25±4.25) vs (19.36±4.84),(P＜0.05)).Conclusion Standard dose chemotherapy has no significant impairment on the verbal fluency of patients with CRPC.Chemotherapy does not induce the impairment of patients' phonetic fluency,but may have a negative influence on semantic fluency.

Word finding difficulties in multiple sclerosis

Word finding difficulty is a known impairments in multiple sclerosis (MS). The purpose of this study is to adapt homophone meaning generation test to Persian language, and then examine word storage and access in multiple sclerosis patients through these three word-finding tests. This study examined the word retrieval in 90 Persian speaking patients with multiple sclerosis and 90 matched healthy controls through three tasks: semantic fluency, phonemic fluency, and homophonic meaning generation. The Persian homophone meaning generation test had a strong convergent validity with semantic and phonemic switching and an adequate divergent validity with semantic and phonemic clustering. There was a significant difference between two groups in all three tests (p<0.001) except semantic and phonetic clustering (p≥ 0.05). Multiple sclerosis is a disease affecting word access, but not the word storage, and Persian homophone meaning generation test is an appropriate, valid, and reliable test to evaluate word-finding difficulties in this population. HMGT

Study of the sensitivity and specificity on near-infrared spectroscopy in diagnosis of depression / 中华行为医学与脑科学杂志

Objective To explore the sensitivity and specificity of near-infrared spectroscopy ( NIRS) in the diagnosis of depression. Methods From March 2013 to August 2013,62 patients with de-pression and 70 normal controls were collected from Peking University Sixth Hospital. Optical Tomography System (52 channels) was used to collect the NIRS data during the Verbal Fluency Test (VFT),and the number of words produced during VFT task was recorded. The wave analysis was performed by a professional psychiatrist. Results There was statistical difference in the number of words produced during VFT task be-tween the patients with depression (8.65±0.49)and control group(10.19±0.43) ( t=2.385, P<0.05). Through the wave analysis of NIRS to test patients with depression,the results demonstrated that the sensitivi-ty was 66.1% and the specificity was 91.4%. Conclusion The results of NIRS test display high specificity in the diagnosis of depression,which can be used as an objective index for clinical auxiliary diagnosis.

Methodological criteria for scoring clustering and switching in verbal fluency tasks / Critérios metodológicos para análises de clustering e switching em tarefas de fluência verbal / Criterios metodológicos para análisis de estrategias de agrupación en tareas de fluidez verbal

The objective of this study was to describe an adaptation to Brazilian Portuguese of the methodological criteria for analysis of clustering and switching in semantic verbal fluency (SVF) and phonemic verbal fluency (PVF) tasks. The adaptation process consisted of six steps, including the selection of the clustering and switching variables based on data from a sample of 419 children and the analysis of inter-rater reliability (six raters). The following variables were scored: the total number of words generated the raw number of clusters, the mean cluster size, and the raw number of switches. There was a significant association between raters (intra-class correlation coefficients between 0.95 and 0.99), showing that the analytical method was reliable. Our study provides an evaluation of SVF and PVF tasks that goes beyond the overall score, making it possible to investigate the cognitive processes underlying this neuropsychological function.

Este artigo objetiva apresentar uma adaptação ao português brasileiro dos critérios metodológicos para análises de clustering e switching em tarefas de fluência verbal semântica (FVS) e ortográfica (FVO). São descritas as seis etapas realizadas no processo de adaptação destes critérios, incluindo o processo de extração das variáveis de clustering e switching a partir de dados de amostras de crianças (N=419) e a análise da fidedignidade da concordância entre juízes (N=6). As variáveis avaliadas são número total de palavras evocadas, número de clusters, média do tamanho dos clusters e número de switches. Houve forte associação entre juízes (Coeficientes de Correlação Intraclasse entre 0,95 a 0,99) indicando fidedignidade do método de análise. Este estudo contribui com a avaliação da FVS e FVO para além do escore geral, permitindo investigar os processos cognitivos subjacentes a esta função neuropsicológica.

Este artículo presenta una adaptación para el portugués brasileño de criterios metodológicos de análisis de estrategias de agrupación (clustering y switching) en tareas de fluidez verbal semántica (FVS) y fluidez verbal fonológica (FVF). El proceso de adaptación de estos criterios consiste en seis pasos, incluyendo el proceso de extracción de las variables de clustering y switching de una muestra formada por 419 niños y el análisis de fiabilidad entre seis jueces. Se investigaron las siguientes variables: número total de palabras generadas, número de grupos de palabras (clusters), tamaño medio de los grupos y número de saltos (switches). Hubo una fuerte asociación entre jueces (coeficientes de correlación intraclase entre 0,95 y 0,99), indicando así la fiabilidad del método analítico. Este estudio contribuye a la evaluación de la FVS y FVF más allá de la puntuación global, lo que permite investigar los procesos cognitivos subyacentes a esta función neuropsicológica.

Neuropsicología del lenguaje de niños entre 6 y 10 años de edad con antecedente de nacimiento prematuro / Neuropsychology of language in children between 6 and 10 years old with a premature birth condition

En esta investigación se caracterizó el estado neuropsicológico de los componentes del lenguaje en niños entre 6 y 10 años de edad con antecedente de nacimiento prematuro. Para la evaluación se utilizaron los test, clasificación semántica y fluidez verbal (BANFE), lenguaje, denominación de imágenes, seguimiento de instrucciones, comprensión del discurso y coherencia narrativa (ENI), en una muestra de 80 niños prematuros y 80 niños en condición par y nacidos a término. Los datos obtenidos se analizaron mediante estadística descriptiva-correlacional. Se encontró que a nivel de la acción verbal las estructuras gramaticales y narrativas se ven comprometidas, así como los elementos sintácticos que involucran aspectos fonológicos de imitación verbal, con tendencia a que estas dificultades mejoren con el paso de los años.

This research focused on the neuropsychological status of the language components in children between 6-10 years of age with a history of premature birth. Several research tools were used like tests, semantic classification and verbal fluency (BANFE), language, image labeling, following directions, discourse comprehension, understanding speech and narrative coherence (ENI). The research tools were used in 80 premature and 80 non-premature infants. The data obtained was analyzed using descriptive and correlational statistics. It was found that the grammatical and narrative structures can be compromised as well as syntactic elements that involve phonological aspects at the level of verbal action. It was also found that these difficultie scan be overcome over the years.