Las funciones ejecutivas: su significado y aplicación clínica / Executive functions: meaning and clinical application

Las funciones ejecutivas generalmente se conceptualizan como un conjunto de procesos generales de control de orden superior que trabajan juntos para dirigir y gestionar las funciones cognitivas, emocionales y conductuales, especialmente durante la resolución activa de problemas. Su disfunción es frecuente de ser detectada como comorbilidad de otros trastornos del neurodesarrollo, causa o efecto? La detección precoz de la disfunción ejecutiva y su abordaje terapéutico temprano, mejora el pronóstico global madurativo en el periodo infantojuvenil. Esta sucinta revisión de las funciones ejecutivas intenta resaltar su importancia para el pediatra y su mirada de los trastornos del neurodesarrollo (AU)

Executive functions are typically understood as a set of general higher-order control processes that collectively direct and manage cognitive, emotional, and behavioral functions, especially during active problem solving. Their dysfunction is often detected as a comorbidity of other neurodevelopmental disorders; cause or effect? Early detection of executive dysfunction and a prompt therapeutic approach improves the overall developmental prognosis in childhood and adolescence. This brief review of executive functions aims to highlight their importance for the pediatrician and his/her view of neurodevelopmental disorder (AU)

Modulation of Spike Count Correlations Between Macaque Primary Visual Cortex Neurons by Difficulty of Attentional Task / 神经科学通报·英文版

Studies have shown that spatial attention remarkably affects the trial-to-trial response variability shared between neurons. Difficulty in the attentional task adjusts how much concentration we maintain on what is currently important and what is filtered as irrelevant sensory information. However, how task difficulty mediates the interactions between neurons with separated receptive fields (RFs) that are attended to or attended away is still not clear. We examined spike count correlations between single-unit activities recorded simultaneously in the primary visual cortex (V1) while monkeys performed a spatial attention task with two levels of difficulty. Moreover, the RFs of the two neurons recorded were non-overlapping to allow us to study fluctuations in the correlated responses between competing visual inputs when the focus of attention was allocated to the RF of one neuron. While increasing difficulty in the spatial attention task, spike count correlations were either decreased to become negative between neuronal pairs, implying competition among them, with one neuron (or none) exhibiting attentional enhancement of firing rate, or increased to become positive, suggesting inter-neuronal cooperation, with one of the pair showing attentional suppression of spiking responses. Besides, the modulation of spike count correlations by task difficulty was independent of the attended locations. These findings provide evidence that task difficulty affects the functional interactions between different neuronal pools in V1 when selective attention resolves the spatial competition.

Study on homeostasis and circadian rhythm of attention performance of different chronotypes in sleep deprivation / 生物医学工程学杂志

Difference of chronotypes makes influence to cognitive performance of individuals in routine duties. In this paper, 55 subjects with different chronotypes were subjected to continuous sleep deprivation for 30 h by using the constant routine protocol, during which core body temperature was measured continuously, and subjective sleepiness self-rating and the performance of selective attention were measured hourly. The results showed that the phase difference of core body temperature has no significant difference, yet the amplitude and term difference among the three chronotypes are significant. There was an advance in phase between subjective sleepiness self-rating and core body temperature, and the self-rating sleepiness of evening type came the latest, and the self-rating sleepiness of morning type dissipated the fastest. The response time of selective attention showed a 2 h phase delay with subjective sleepiness self-rating. And the analysis of core body temperature showed that the later the chronotype was, the greater the phase delay was. The correct rate of selective attention of different chronotypes were inconsistent with delay of subjective sleepiness self-rating and core body temperature. We provide reference for industry, aviation, military, medical and other fields to make a more scientific scheduling/ shifting based on cognitive performance characteristics of different chronotypes.

Gaming como método de intervención en el trastorno por déficit de atención e hiperactividad / Gaming as a method of intervention in attention deficit hyperactivity disorder

El presente estudio tiene como objetivo realizar una intervención utilizando como base los videojuegos. Para el mismo, se ha utilizado un videojuego indie llamado GRIS. El estudio es de tipo cuasi-experimental, donde se ha evaluado a los niños/as antes y después de la intervención. La evaluación de la intervención se realizó ha realizado mediante el test de Toulouse, que se mide mediante el índice global de atención y percepción (IGAP), y una guía creada específicamente para este estudio. El grupo de participantes, seleccionado por conveniencia, se conformó por tres niños procedentes del centro DIVERTEA en Cáceres (España) que presentaban trastorno por déficit de atención e hiperactividad o déficit de atención como trastorno comórbido. La comparación de los resultados obtenidos en los test previo y posterior indican una mejora en la atención y en la percepción, con unos resultados entre el 80% y el 100 por ciento en el IGAP posterior a la intervención. Estos resultados refuerzan la idea de utilizar los videojuegos como método de intervención para el trastorno por déficit de atención e hiperactividad. Queda abierta la posibilidad de seguir investigando sobre la utilización de los videojuegos como método de intervención en otros tipos de patologías y trastornos.

The aim of this study was to deliver an intervention using videogames as a base. For this study, it was used an indie videogame called GRIS. This was a quasi-experimental study, where children were evaluated before and after the intervention. For the assessment, Toulouse test was used, which is measured by global index of attention and perception (GIAP) and a guide created specifically for this study. The group of participants, selected by convenience, was made up of three children from DIVERTEA in Caceres (Spain) which had attention deficit/hyperactivity disorder, or attention deficit as a co-morbid disorder. The results obtained with the pre.post testing were compared, suggesting an attention and perception improvement with result between 80 and 100 percent in GIAP post- intervention. This result reinforces the idea of using videogames as intervention method in attention deficit/hyperactivity disorder. The possibility of using videogames as an intervention method in other pathologies and disorders, is open to continue research.

The association between neurocognitive functioning and clinical features of borderline personality disorder

Objective: To investigate the relationship between neurocognitive profiles and clinical manifestations of borderline personality disorder (BPD). Methods: Forty-five patients diagnosed with BPD and 35 healthy volunteers were included in the study. The BPD group was evaluated with the Borderline Personality Inventory for dissociative, impulsivity and suicidal dimensions. The Verbal Memory Processes Test and the Cambridge Neurophysiological Assessment Battery were administered to both the BPD and healthy control groups. Results: BPD patients differed from controls in sustained attention, facial emotion recognition, and deteriorated verbal memory function. A model consisting of the Dissociative Experiences Scale - Taxon (DES-T), motor impulsivity and Scale for Suicidal Behavior scores explained 52% of the variance in Borderline Personality Inventory scores. It was detected that motor impulsivity, decision-making and recognizing sadness may significantly predict DES-T scores, and response inhibition and facial emotion recognition scores may significantly predict impulsivity. Conclusion: Our findings demonstrate that the disassociation, impulsivity, and suicidality dimensions are sufficient to represent the clinical manifestations of BPD, that they are related to neurocognitive differences, and that they interact with clinical features.

Assessing driving risk in patients with glaucoma / Avaliação do risco de dirigir em pacientes com glaucoma

ABSTRACT Glaucoma is the leading cause of irreversible blindness worldwide and can affect a broad array of daily activities, including driving. Recently, studies investigating the relationship between driving performance and glaucoma have received a great deal of interest. Assessment of driving behavior is not straightforward because driving is a complex skill involving significant multi-tasking ability. In this review, we summarize recent work from clinical studies investigating how glaucoma can affect driving performance. Patients with glaucoma are more likely to be involved in motor vehicle collisions when compared to healthy subjects. Here we describe how conventional functional tests performed in glaucoma patients, such as visual field measurements via standard automatic perimetry, are associated with driving performance. However, the risk of motor vehicle collisions is not entirely attributable to visual field impairment in glaucoma, suggesting that other factors also account for both driving safety and performance. Finally, we show different studies suggesting that parameters from driving simulators can be helpful because they can identify the impact of visual loss on complex situations.

RESUMO O glaucoma é a principal causa de cegueira irreversível em todo o mundo e pode afetar uma ampla gama de atividades diárias, incluindo a direção veicular. Recentemente, estudos que investigam a relação entre o desempenho na condução veicular e o glaucoma têm recebido grande interesse. A avaliação do comportamento de dirigir não é direta porque dirigir é uma habilidade complexa que envolve habilidade multitarefa significativa. Nesta revisão, resumimos trabalhos recentes de estudos clínicos que investigam como o glaucoma pode afetar o desempenho na direção. Pacientes com glaucoma têm maior probabilidade de se envolverem em colisões de veículos motorizados quando comparados a indivíduos saudáveis. Descrevemos aqui como os testes funcionais convencionais realizados em pacientes com glaucoma, como as medições de campo visual por meio de perimetria automática padrão, estão associados ao desempenho na direção. No entanto, o risco de colisão de veículo motorizado não é totalmente atribuível ao comprometimento do campo visual no glaucoma, sugerindo que outros fatores também são responsáveis pela segurança e pelo desempenho. Finalmente, mostramos diferentes estudos sugerindo que os parâmetros dos simuladores de direção podem ser úteis porque eles podem identificar o impacto da perda visual em situações de complexas.

Evaluation of selective attention in patients with misophonia / Avaliação da atenção seletiva em pacientes com misofonia

Abstract Introduction: Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been inferred that misophonia, as well as tinnitus, is associated with hyperconnectivity between auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet. Objective: To characterize a sample of misophonic subjects and compare it with two control groups, one with tinnitus individuals (without misophonia) and the other with asymptomatic individuals (without misophonia and without tinnitus), regarding the selective attention. Methods: We evaluated 40 normal-hearing participants: 10 with misophonia, 10 with tinnitus (without misophonia) and 20 without tinnitus and without misophonia. In order to evaluate the selective attention, the dichotic sentence identification test was applied in three situations: firstly, the Brazilian Portuguese test was applied. Then, the same test was applied, combined with two competitive sounds: chewing sound (representing a sound that commonly triggers misophonia), and white noise (representing a common type of tinnitus which causes discomfort to patients). Results: The dichotic sentence identification test with chewing sound, showed that the average of correct responses differed between misophonia and without tinnitus and without misophonia (p = 0.027) and between misophonia and tinnitus (without misophonia) (p = 0.002), in both cases lower in misophonia. Both, the dichotic sentence identification test alone, and with white noise, failed to show differences in the average of correct responses among the three groups (p ≥ 0.452). Conclusion: The misophonia participants presented a lower percentage of correct responses in the dichotic sentence identification test with chewing sound; suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger this condition.

Resumo Introdução: A misofonia é caracterizada pela aversão a certos sons muito seletivos, que evocam uma forte reação emocional. Tem sido demonstrado que a misofonia, bem como o zumbido, está associada à hiperconectividade entre os sistemas auditivo e límbico. Indivíduos com zumbido incômodo podem ter comprometimento da atenção seletiva, mas isso ainda não foi demonstrado em caso de misofonia. Objetivo: Caracterizar uma amostra de indivíduos misofônicos e compará-la com dois grupos controle, um com indivíduos com zumbido (sem misofonia) e o outro com indivíduos assintomáticos (sem misofonia e sem zumbido) em relação à atenção seletiva. Método: Avaliamos 40 participantes com audição normal: 10 com misofonia, 10 com zumbido (sem misofonia) e 20 sem zumbido e sem misofonia. Para avaliar a atenção seletiva, o teste de identificação de sentenças dicóticas foi usado em três situações: no primeiro, aplicou-se o teste em português do Brasil. Então, o mesmo teste foi aplicado em duas outras situações, combinado com dois sons competitivos: som de mastigação (representa um som que geralmente desencadeia misofonia) e ruído branco (representa um tipo comum de zumbido que causa desconforto nos pacientes). Resultados: No teste de identificação de sentenças dicóticas com som de mastigação, observou-se que a média de respostas corretas diferiu entre os grupos misofonia e sem zumbido e sem misofonia (p = 0,027) e entre misofonia e zumbido (sem misofonia) (p = 0,002) e, em ambos os casos, foi menor em misofonia. Em relação ao teste feito isoladamente e com ruído branco, nenhuma diferença foi observada na média das respostas corretas nos três grupos (p ≥ 0,452). Conclusão: Os participantes do grupo misofonia apresentaram uma menor porcentagem de respostas corretas no teste de identificação de sentenças dicóticas com som de mastigação, sugeriu que indivíduos com misofonia podem ter comprometimento da atenção seletiva quando expostos a sons que desencadeiam a condição.

Executive functions in children with dyslexia / Funções executivas em crianças com dislexia

ABSTRACT This study aimed to verify whether children with dyslexia have difficulties in executive functions (shifting, working memory, inhibition). Methods: A sample of 47 children (ages 8-13 years) participated in the study: 24 who were dyslexic and 23 controls with typical development. A battery of neuropsychological tests was used. Results: Results revealed executive function difficulties among the dyslexic children when compared with controls, encompassing selective attention modulation processes, shifting, and inhibitory control. These difficulties appeared to be affected by phonological working memory deficits, typically associated with dyslexia. Conclusion: Our findings support the consensus among scholars regarding the central involvement of phonological skill dysfunctions in dyslexia.

RESUMO O objetivo deste estudo foi verificar se crianças com dislexia têm dificuldades nas habilidades de funções executivas (shifting, memória operacional e inibição). Métodos: Uma amostra de 47 crianças (idades entre 8 e 13 anos) participaram do estudo: 24 crianças disléxicas e 23 crianças com desenvolvimento típico. Uma bateria de avaliação neuropsicológica foi usada. Results: Os resultados revelaram dificuldades nas funções executivas nas crianças disléxicas quando comparadas com as controle, envolvendo processos de modulação de atenção seletiva, shifting e controle inibitório. Essas dificuldades parecem ser afetadas pelos déficits na memória operacional fonológica, tipicamente associada à dislexia. Conclusion: Assim, nossos achados suportam o consenso de que a disfunção central da dislexia está nas habilidades fonológicas.

Diferencias en procesamiento cerebral visual temprano en niños con trastorno del déficit de atención / Differences in early visual cerebral processing in children with attention deficit / hyperactivity disorders with predominance of no attention

Para evaluar los procesos atencionales a estímulos visuales que no requieren repuesta motora, se llevó a cabo un estudio con potenciales evocados a 17 niños con trastornos del déficit de atención/ hiperactividad (TDAH-I) con predominio inatento y a 15 controles de edades entre 7 y 11 años. Se analizó la latencia y localización de fuentes de los potenciales evocados visuales tempranos P100 y N100 durante la realización de una tarea oddball visual (20% rayas horizontales y 80% verticales) en que las rayas verticales no exigían respuesta motora. Los resultados indican que los niños con TDAH-I procesan la información visual que no requiere respuesta motora con un mayor aumento de la actividad cerebral y mediante la vía temporal ventral mientras que el grupo control lo hace mediante la vía parietal dorsal. Este proceso neurobiológico de procesamiento de la información visual vía temporal ventral de los niños con TDAH-I podría deberse a alteraciones en los procesos emocionales que influyen directamente en el reconocimiento visual o a un déficit en el control de los procesos atencionales por parte de la vía parietal dorsal.

To evaluate attentional processes to visual stimuli that do not require motor response, a study with evoked potentials was carried out on 17 children with attention deficit disorder predominantly inattentive (ADDH-I) and 15 controls between the ages of 7 and 11 years. The latency and localization of sources of the early visual evoked potentials P100 and N100 were analyzed during the performance of a visual oddball task (20% horizontal and 80% vertical lines) where the vertical lines did not require motor response. The results indicate that ADDH-I group process visual information that does not require motor response with a greater increase in brain activity and through the ventral temporal pathway, while the control group does so by means of the dorsal parietal stream. This neurobiological process of visual information processing by ventral temporal pathway of ADDH-I group could be due to alterations in emotional processes that directly influence visual recognition or as consequence of deficit in the control of attentional processes by the dorsal parietal pathway.

Valores normativos del test de Toulouse-Piéron de atención selectiva y sostenida en una muestra de estudiantes de educación física de Santiago de Chile / Normative values of Toulouse-Piéron's test of attention selective and supported in a students' sample of physical education of Santiago of Chile

El objetivo del presente estudio fue determinar valores normativos para cada puntaje del test de atención de Toulouse-Piéron para estudiantes de educación física de una Universidad de Santiago de Chile. La muestra estuvo constituida por 125 estudiantes, de los cuales el 68% corresponden a varones y un 32% a damas. Se utilizó el test de atención de Tolulouse-Piéron, utilizando los 2 primeros minutos para evaluar la atención selectiva y su ejecución total (10 minutos) para evaluar la atención sostenida. Los resultados muestran una media del Índice Global de Atención y Percepción (IGAP) de 38,3±12,5 en 2 minutos y de 185,4±55,4 en 10 minutos. Los análisis no muestran diferencias por sexo o edad en ninguna de las 2 atenciones evaluadas. La atención selectiva presenta un IGAP de 31,5 para el percentil 25, de 39 para el percentil 50 y de 46 para el percentil 75. Por su parte, la atención sostenida presenta un IGAP de 158 para el percentil 25, de 190 para el percentil 50 y de 217 para el percentil 75. Son necesarias más investigaciones con muestras de diversas escuelas de educación física del país.

The aim of the present study was to determine normative values for every puntaje of the test of Toulouse-Piéron's attention for students of physical education of a University of Santiago of Chile. The sample was constituted by 125 students, of which 68 % corresponds to males and 32 % to ladies. There was in use the test of Tolulouse-Piéron's attention, using the first two minutes to evaluate the selective attention and his total execution (ten minutes) to evaluate the supported attention. The results show an average of the Global Index of Attention and Perception (GIAP) of 38,3±12,5 in two minutes and of 185,4±55,4 in ten minutes. The analyses do not show differences for sex or age in any of two evaluated attentions. The selective attention presents an GIAP of 31,5 for the percentile 25, of 39 for the percentile 50 and of 46 for the percentile 75. For your part, the supported attention presents an GIAP of 158 for the percentile 25, of 190 for the percentile 50 and of 217 for the percentile 75. More investigations are necessary with samples of diverse schools of physical education of the country.

The effect of noise on attention and performance in reading and writing tasks / Interferência do ruído no foco atencional e no desempenho em testes de leitura e escrita

ABSTRACT Purpose This study investigated the effects of two levels of noise on the performance of young students of three educational levels and tested their ability to maintain attentional focus in reading and writing tasks. Methods 162 school children in the third, fourth and fifth grades were placed in three groups according to their educational level: Control Group (CG), Experimental Group A (GEA) and Experimental Group B (GEB). All groups were submitted to a Sustained Attention Test, Reading Assessment and Isolated Words Test and Writing Dictation Sub-test (part of the International Dyslexia Test). The GEA and GEB performed the tests in a noisy environment: 20dB and 40dB, respectively. The CG was assessed in the usual school environmental noise at the same time of the day. The data was submitted to an ANOVA, the Kruskal-Wallis test and Spearman correlation test. Results The higher the score on the Sustained Attention Test, the shorter the time spent reading and fewer errors in the dictation task. There were no differences across the three grades within the GEA (lower levels of noise) with regard to the effect of noise on attention and in the reading and writing task performance. The higher levels of noise for the GEB, however, decreased the attention levels, therefore increasing mistakes on the dictation test. Comparing the performance across educational levels on the reading tasks, the fourth grade presented decreased reading time, while the third and fifth grades spent more time reading. Conclusion Auditory interference can influence the ability to focus attention as well as worsen performance in reading and writing tasks at more intense noise levels.

RESUMO Objetivo Investigar os efeitos de dois níveis de ruído sobre tarefas de atenção e de escrita e leitura em estudantes de três níveis de escolaridade. Método 162 sujeitos entre o 3º, 4º e 5º ano do Ensino Fundamental foram alocadas em três grupos conforme a escolaridade: controle (GC), experimental A (GEA) e experimental B (GEB). Todos os grupos foram submetidos aos testes de Atenção Concentrada de Cambraia; Avaliação de Leitura e Palavras Isoladas; Subteste Escrita sob Ditado do International Dyslexia Test. Os grupos GEA e GEB realizaram os testes em ambiente com ruídos de 20 dB e 40dB respectivamente. Os resultados foram analisados com teste de Kruskal-Wallis e correlação de Spearman com significância em 5%. Resultados Foi observado que quanto maior o escore no teste de atenção, menor o tempo gasto na leitura e menor o número de erros no ditado. Não houve diferenças nos três anos de escolaridade para o grupo GEA quanto à influência do ruído sobre a atenção e o desempenho de leitura e escrita. O grupo GEB apresentou decréscimo nos testes de atenção com aumento de erros no ditado. Comparando a escolaridade no teste de leitura, o 4º ano diminuiu o tempo de leitura enquanto os sujeitos dos 3º e 5º ano gastaram mais tempo de leitura. Conclusão A interferência auditiva é capaz de influenciar a capacidade de foco de atenção assim como o desempenho de leitura e de escrita em níveis de ruído mais intenso. Não foram observadas influências da escolaridade sobre os efeitos distratores.

Children with ADHD shown different alpha, beta and SMR EEG bands during habil motor tasks with high attention demand / Crianças com TDAH exibem diferente perfil no EEG durante tarefas motoras que demandam atenção / Niños con TDAH exhiben diferente perfil de EEG durante tareas motoras que demandan atención

INTRODUCTION: ADHD probably affects more than 50% of schoolchildren, yet although characteristics such as inattention and/or hyperactivity and impulsiveness are clear, electrophysiological brain behavior during motor activity is not fully understood. OBJECTIVE: To investigate alpha, beta, and SMR band patterns on the EEG in children with Attention Deficit Hyperactivity Disorder (ADHD) during attention-demanding motor skills tasks. METHODS: Fourteen children with a mean age of 9.64±1.74 years divided into diagnosed and undiagnosed with ADHD underwent an EEG at rest and during task performance with attentional demand. Alpha, SMR and beta waves were observed on the EEG. Data were evaluated using the Shapiro-Wilk test in order to determine data normality. ONE WAY ANOVA and Tukey's post hoc tests were used to determine intragroup and intergroup differences, and the Pearson (r) and Spearman (p) correlations were used to determine correlations. All treatments had a significance of 5%. RESULTS: The ADHD and N-ADHD groups showed no difference in cortical alpha, beta and SMR bands at rest, but there were differences in cortical behavior during activity. The cortical activity correlation coefficient (0.30) differed from undiagnosed children (0.70). CONCLUSION: The ADHD group had a low correlation coefficient between rest and activity, contrary to the N-ADHD group. In the intergroup comparison, ADHD had higher alpha, beta and SMR band output power during the same high attentional task when compared with N-ADHD. Level of Evidence III.

INTRODUÇÃO: O TDAH afeta, provavelmente, mais de 50% crianças em idade escolar, porém, embora características como falta de atenção e/ou hiperatividade e impulsividade sejam claras, o comportamento eletrofisiológico do cérebro durante atividades motoras não é bem entendido. OBJETIVO: Investigar o padrão das bandas Alfa, Beta e SMR no EEG de crianças com transtorno do déficit de atenção com hiperatividade (TDAH), durante tarefas motrizes com alta demanda de atenção. MÉTODOS: Catorze crianças com média de idade de 9,64 ± 1,74 anos, divididas nos grupos diagnosticadas e não diagnosticadas com TDAH, realizaram EEG em repouso e durante o desempenho de tarefa com demanda de atenção. As ondas Alfa, SMR e Beta foram observadas no EEG. Os dados foram avaliados pelo teste de Shapiro-Wilk para determinar a normalidade dos dados. Os teste ANOVA one-way e post hoc de Tukey foram usados para determinar as diferenças intragrupo e intergrupo, e a correlação de Pearson (r) e Spearman (p) foram usadas para determinar as correlações. Todos os tratamentos tiveram significância de 5%. RESULTADOS: Os grupos TDAH e N-TDAH não apresentaram diferença na banda cortical Alfa, Beta e SMR em repouso, porém, durante a atividade, constataram-se diferenças do comportamento cortical. O índice de correlação da atividade cortical (0,30) foi diferente nas crianças não diagnosticadas (0,70). CONCLUSÃO: O grupo TDAH apresentou baixo índice de correlação entre repouso e atividade, diferentemente do grupo N-TDAH. Na comparação intergrupos, o TDAH apresentou maior potência de saída da banda Alfa, Beta e SMR durante a mesma tarefa de alta atenção em comparação com o N-TDAH. Nível de Evidência III.

INTRODUCCIÓN: El TDAH afecta probablemente a más del 50% de los escolares, pero aunque las características como la falta de atención y/o la hiperactividad e impulsividad sean entendidas como comportamiento electrofisiológico del cerebro durante las actividades motoras, esto no es bien entendido. OBJETIVO: investigar el patrón de las franjas de Alfa, Beta y SMR en el EEG en niños con trastorno de déficit de atención y de Hiperactividad (TDAH), durante tareas motrices con altas demandas de atención. MÉTODOS: catorce niños con promedio de edad de 9,64 ± 1,74 años, divididos en diagnosticados y no diagnosticados con TDAH, realizaron EEG durante el reposo y desempeño de la tarea motriz con alta demanda de atención. Las ondas Alfa, SMR y Beta se observaron en el EEG. Los datos fueron evaluados por el test de Shapiro-Wilk para determinar la normalidad. ANOVA ONE WAY y el test de Tukey fueron utilizados para determinar las diferencias intragrupo e intergrupo, así como también la correlación de Pearson (r) y Spearman (p) fueron usadas para determinar las correlaciones. Todos los tratamientos tuvieron un nivel de significancia del 5%. RESULTADOS: El TDAH y el N-TDAH no presentaron diferencias en la Franja Cortical Alfa, Beta y SMR durante el reposo, no obstante, al estar en actividad, el comportamiento cortical presentó diferencias. El índice de correlación de la actividad cortical (0,30) fue diferente de niños no diagnosticados (0,70). CONCLUSIONES: El TDAH presentó un bajo índice de correlación entre reposo y actividad, a diferencia del N-TDAH. En la comparación intergrupos, el TDAH presentó mayor potencia de salida de la franja Alfa, Beta y SMR durante la misma tarea de alta atención, en comparación con el N-TDAH. Nivel de Evidencia III.

Revisión teórica del proceso de atención sostenida en la infancia y adolescencia / A theoretical review of sustained attention in childhood and adolescence

El estudio de la atención sostenida, entendida como la capacidad a través de la cual mantenemos nuestro estado de alerta para seleccionar determinados estímulos durante un período prolongado de tiempo, ha tenido grandes avances en las últimas décadas. Así, se han publicado diversos trabajos vinculados con la atención en adultos y cambios relacionados con la edad. Sin embargo, la investigación en población infantil y adolescentes es reducida y se ha reportado poco acerca de la influencia de otras variables que pueden estar relacionadas a la trayectoria de desarrollo de este proceso. Objetivo. Analizar el contenido, método y aportaciones de un grupo de artículos que reportan una relación entre ciertas variables y el proceso de atención sostenida en la infancia y adolescencia. Método. Se realizó una revisión literaria de 17 artículos, utilizando la V de Gowin como metodología para el análisis de los objetivos, conceptos clave, modelos teóricos, metodología de los estudios, resultados de los factores asociados y recomendaciones de los autores. Resultados. Los artículos analizados reportan relación entre la atención y diferentes variables como edad, sexo, inteligencia, agresión, ansiedad, oposicionismo, hiperactividad, reactividad emocional, hábitos de sueño, ambiente familiar y nivel socioeconómico. Discusión. En este apartado se indica que es importante tener en cuenta los factores relacionados con la atención sostenida para aumentar la comprensión y dimensionar la complejidad de este proceso cognitivo. Además, se sugiere considerar los factores en procesos de evaluación y rehabilitación de la atención sostenida.

The study of sustained attention, understood as the ability through which we maintain alertness to select stimuli during a long period of time, has encountered great development in the last decades. This has led to the publication of diverse studies related to attention in adults and its changes regarding age. Nevertheless, research on child population is limited, especially regarding the influence of factors that may determine developmental trajectories of sustained attention. Objective. To analyze the content, method and contributions of a group of studies which report a relation of different variables with sustained attention in childhood and adolescence. Method. A literary review of 17 papers on the subject was conducted using the V of Gowin as an instrument of analysis of objectives, keywords, theoretical models, methodology, results from the associated factors and authors' recommendations. Results. The analyzed papers report that age, sex, intelligence, aggression, anxiety, oppositionism, hyperactivity, emotional reactivity, sleep habits, family environment and socioeconomic level, were all considered factors related to the development of sustained attention in childhood and adolescence. Discussion. In this chapter, the focus relies on the importance of acknowledging the factors related to the performance of sustained attention. This will increase the comprehension on the topic and will help to dimension the complexity of this cognitive process. Moreover, the consideration of these factors is suggested in the process of evaluation and rehabilitation of sustained attention.

Perfil neuropsicológico y efectos de la rehabilitación cognitiva en la leucemia linfoblástica aguda: a propósito de un caso / Neuropsychological profile and cognitive rehabilitation training effects on acute lymphoblastic leukaemia: a case study

La Leucemia Linfoblástica Aguda (LLA) infantil es el cáncer pediátrico más frecuente. Actualmente cuenta con un alto porcentaje de supervivencia, pero dichos pacientes presentan secuelas cognitivas secundarias a la enfermedad debidas, principalmente, al tratamiento médico recibido para evitar la recidiva del cáncer. Por lo tanto, resulta necesaria la implementación de programas de rehabilitación cognitiva específicos para este tipo de población. Es por ello que el objetivo del presente estudio fue describir los déficits cognitivos en un varón de 17 años que fue diagnosticado con LLA a los 9 años. Tras la valoración neuropsicológica inicial se desarrolló un programa de rehabilitación cognitiva intensivo durante dos años consecutivos. Realizamos un estudio pre-post en el que administramos el Conners Continuous Performance Test (CPT-II) y la Escala de Inteligencia de Wechsler para niños (WISC-IV). Los resultados, antes de la intervención, mostraron que el paciente manifestaba una menor velocidad de procesamiento y dificultades de atención sostenida y alternante, comprensión verbal y razonamiento perceptivo. Además, también presentó un número considerable de errores perseverativos, signo de dificultades de flexibilidad cognitiva y control inhibitorio. Dichos déficits mejoraron notablemente tras el programa de rehabilitación cognitiva. En conclusión, nuestro estudio pone de manifiesto la necesidad de aplicar programas de rehabilitación cognitiva tempranos para paliar las secuelas cognitivas derivadas de la LLA y de su tratamiento médico, así como mejorar la calidad de vida del paciente, ya que las mejoras cognitivas redundarán en su rendimiento académico y en su funcionamiento cotidiano.

Childhood Acute Lymphoblastic Leukemia (ALL) is the most common pediatric cancer. It currently has a high survival rate, but these patients have cognitive sequelae secondary to the disease, mainly due to the medical treatment received to prevent cancer recurrence. Therefore, it is necessary to implement specific cognitive rehabilitation programs for this type of population. Hence, the main objective of this study was to describe cognitive deficits in a 17-year-old male who was diagnosed with ALL when he was 9 years old. After the initial neuropsychological evaluation, an intensive cognitive rehabilitation program was developed during two consecutive years. We conducted a pre-post study in which we administered the Conners Continuous Performance Test (CPT-II) and the Wechsler Intelligence Scale for Children (WISC-IV). Results, before the intervention, showed that the patient presented a lower processing speed and difficulties of sustained and alternating attention, verbal comprehension and perceptive reasoning; in addition to a large number of perseverative errors, sign of self-monitoring difficulties and inhibitory control. These deficits improved markedly after a program of cognitive rehabilitation. In conclusion, our study highlights the need to apply early cognitive rehabilitation programs to alleviate the cognitive sequelae derived from ALL and its medical treatment. In addition, any improvement in their cognitive capabilities will have a positive impact in their academic performance and quality of life.

Capacidad física y reserva cognitiva como factores protectores de las funciones atencionales en adultos mayores / Physical activity and cognitive reserve as protective factors for attentional functioning in older people

Background: Attention is considered a central control mechanism in cognitive processing systems. Attention deficits contribute to the symptomatic profile of Alzheimer's disease (AD). Physical exercise and cognitive reserve, could delay cognitive impairment and constitute a protective factor against clinical manifestations of AD. Aim: To relate the functionality of the attentional networks with physical activity and cognitive reserve. Material and Methods: Three groups of 20 older adults each (control, physical activity and with osteoarthritis) were studied. The Functional capacity assessment test, Cognitive Reserve Questionnaire and the Attention Networks Test - for Interactions and Vigilance or ANTI-V were applied to participants. Results: Significant differences were observed in the response times of the alert, orientation and executive network, and the percentage of success in the network orientation and executive network. No differences between groups were observed for the different indicators of vigilance. Conclusions: These results confirm the benefits of physical exercise as a protective factor for attentional functioning.

Driving and visual deficits in stroke patients / Direção de automóveis e déficits visuais em pacientes com AVC

ABSTRACT Objective: The aim of the present study was to conduct an exploratory assessment of visual impairment following stroke, and to discuss the possibilities of reintroducing patients to the activity of driving. Methods: The Useful Field of View test was used to assess visual processing and visual attention. Results: A total of 18 patients were included in the study, and were assigned to either the drive group (n = 9) or the intention group (n = 9). In the drive group, one patient was categorized as moderate-to-high risk; whereas, in the intention group, one patient was categorized as low-to-moderate risk. Additionally, two patients in the intention group were categorized as high risk. The patients did not perceive their visual deficits as a limitation. Conclusion: Visual attention is an interference factor in terms of the safe performance of driving after a stroke. All patients showed a high level of interest for the independence provided through being able to drive.

RESUMO Objetivo: O objeto deste estudo foi realizar uma avaliação exploratória de déficits visuais decorrentes do AVC e discutir possibilidades de retorno à direção de automóveis. Métodos: Estudo descritivo e observacional. O software UFOV foi utilizado para avaliar o processamento visual e atenção visual. Resultados: Um total de 18 pacientes foram incluídos no estudo, classificados em Grupo Direção - GD (n = 9) e Grupo Pretensão - GP (n = 9). No GD, um paciente foi classificado em moderado a alto risco de acidentes, e um paciente do GP em baixo a moderado risco. Especificamente, no grupo GP dois pacientes foram classificados em alto risco de acidentes. Pacientes não reconhecem os déficits visuais como dificuldades. Conclusão: Atenção visual é um fator de interferência no desempenho seguro da direção após o AVC. Todos os pacientes mostraram alto interesse na independência oferecida pela direção de automóveis.

Latent class analysis of attention and white matter correlation in children with attention-deficit/hyperactivity disorder

This study aimed to explore attentional patterns among children with inattentive attention-deficit/hyperactivity disorder (ADHD-I) and children with typical development (TD), using a latent class analysis (LCA). Patterns of brain connectivity were also explored. The sample comprised 29 ADHD-I and 29 TD matched children. An LCA was conducted to reclassify subjects according to their attentional performance, considering cognitive measures of attention and behavioral symptoms, regardless of group of origin. The new clusters were then compared in respect to brain white matter measurements (extracted from diffusion tensor imaging). Participants were rearranged in 2 new latent classes, according to their performance in an attention task and the results of behavioral scales, resulting in groups with more homogeneous attentional profiles. A comparison of the 2 new classes using the white matter measurements revealed increased fractional anisotropy in the left inferior fronto-occipital fasciculus and left inferior longitudinal fasciculus for the class composed by participants with a higher risk of attentional problems. The findings indicated that it was possible to observe variability regarding neuropsychological profile, accompanied by underpinning neurobiological differences, even among individuals with the same disorder subtype - inattentive ADHD. This specific data-driven clustering analysis may help to enhance understanding of the pathophysiology of the disorder's phenotypes.

Masking Level Difference em escolares: análises ambientais / Masking Level Difference in schoolchildren: environmental analysis

RESUMO Objetivo Pesquisar a habilidade auditiva de atenção seletiva na população escolar e identificar valores de referência para a faixa etária de sete a dez anos por meio do teste Masking Level Difference, além de identificar se a escolaridade dos pais, bem como a renda familiar, pode influenciar os resultados do teste. Método Participaram do estudo 31 escolares que se encaixaram nos critérios de elegibilidade da pesquisa, sendo 20 do gênero feminino e 11 do gênero masculino. Realizou-se anamnese para questionamento da renda familiar e escolaridade dos pais do escolar, inspeção visual do meato acústico externo, audiometria tonal liminar, logoaudiometria, medidas de imitância acústica, teste Dicótico de Dígitos e teste Masking Level Difference. Resultados A idade média dos indivíduos foi de 8,67 anos. Não foi observada diferença entre os gêneros e entre as idades avaliadas, no desempenho do MLD. Não houve relação entre a escolaridade dos pais e a renda mensal média com o desempenho das crianças no MLD. A média do MLD foi de 7,65 dB, com desvio padrão de 2,51 dB. Conclusão O Masking Level Difference em escolares de sete a dez anos é de 7,65 dB e independe do gênero, do nível de escolaridade dos pais ou da renda mensal média da família do escolar.

ABSTRACT Purpose To investigate the auditory ability of selective attention in the school population and to identify reference values to the age group from seven to ten years old through the Masking Level Difference Test, and to identify if the parents' schooling, as well as the family income can influence the test results. Methods Thirty-one schoolchildren who match the eligibility criteria attended the study, being 20 female and 11 male. An anamnesis was conducted to question the familiar income and the schooling of the children´s parents; we also performed visual inspection of the External Acoustic Meatus, Pure Tone Audiometry, Speech Audiometry, Acoustic Immittance Measures, Dichotic Digits Test and Masking Level Difference test. Results The mean age of the individuals was 8.67 years. There were no observed differences between genders and between the evaluated ages in the MLD performance. There was no relation between the parents' schooling and the average monthly income with the performance of the children in MLD Test. The MLD mean was 7.65 dB and standard deviation of 2.51 dB. Conclusion The Masking Level Difference in schoolchildren from seven to ten years old is 7.65 dB and is independent of the gender, parents' schooling and the average monthly income of the schoolchild.

Efeitos do jogo de câmbio na capacidade funcional e na atenção de idosos / Effects of exchange volleyball game in elderly functional capacity and attention

Objetivo: Investigar os efeitos do jogo de câmbio na capacidade funcional e na atenção de idosos. Método: Trata-se de um estudo quase-experimental, com pré e pós-intervenção, em que participaram 21 idosos com idades entre 62 a 84 anos. Os jogos com duração de 60 minutos foram realizados duas vezes por semana durante 12 semanas. Para a avaliação da aptidão física foi utilizado o Protocolo Senior Fitness Test, que mede os parâmetros de força, flexibilidade, resistência aeróbica, velocidade, agilidade e equilíbrio. Para a avaliação da atenção sustentada e dividida foi utilizado o Teste de Trilhas Coloridas. Todos os participantes foram avaliados no início da intervenção (pré) e após três meses (pós). Na análise dos dados foram utilizados os testes Postos com Sinais de Wilcoxon e Teste t de student para amostras pareadas. As associações entre variáveis numéricas foram avaliadas com o coeficiente de correlação de Pearson com valor de significância p<0,05. Resultados: Após três meses, o Índice de Aptidão Física Geral dos participantes apresentou melhoras significativas da pré para a pós-intervenção (Tcalc=4,5

Objective: To investigate the effects of adapted volleyball on the functional capacity and attention of the elderly. Method: It is a quasi-experimental study, with pre and post-intervention, involving 21 elderly people aged 62 to 84 years. The games were held twice a week for 12 weeks, lasting 60 minutes. The Senior Fitness Test Protocol was used for Physical fitness assessment. It measures the parameters of strength, flexibility, aerobic endurance, speed, agility and balance. For the evaluation of the sustained and divided attention, the Test of Colored Trails was used. All participants were evaluated at the beginning of the intervention (pre) and after three months (post). The Wilcoxon Signal Test and the Student T test for paired samples were used for data analysis. The associations between numerical variables were assessed using Pearson's correlation coefficient with significance value <0.05. Results: After three months, the participants' IAFG showed significant improvements from pre-post-intervention (Tcalc = 4.5< Tcritic=52), which also occurred in the tests that evaluated strength: lift and sit (p = 0.004), forearm flexion (p<0.001); physical mobility: sitting, walking 2.44m and sitting again (p=0.003); and aerobic endurance: walking 6 minutes (p<0.001). In the analysis of attention, the results showed that the game contributed to the improvement in attention, indicating significant differences in the two tests from pre to post-intervention (Form 1 p<0.001 and Form 2 p<0.001). Conclusion: The adapted volleyball was beneficial to the elderly due to the significant improvement in physical fitness and attention after the intervention, which makes it a viable alternative for the maintenance of the functional capacity of the elderly. (AU)

Efectos del ejercicio físico sobre la atención: una revisión de los últimos años / Effects of the physical exercise on the attention: a review of last years

El siguiente trabajo es una revisión de las investigaciones sobre el efecto crónico del ejercicio físico en la atención, basado en el entrenamiento físico-deportivo en estudios de carácter longitudinal, el efecto agudo del ejercicio físico en la atención, basado en situaciones experimentales y la relación entre los niveles de actividad física y condición física con la atención realizado en estudios transversales. La bús-queda se realizó en las bases de datos Dialnet, Scielo y Pubmed. Se encontró un total de 119 artículos, de los cuales 28 cumplían con los criterios de inclusión (publicados entre el 1° de enero del año 2010 y el 31 de diciembre del 2016, idioma español, inglés o portugués, artículos de investigación, estudios realizados en seres humanos y muestras con sujetos sanos). De la revisión más del 70% dan cuenta de los efectos positivos del ejercicio físico sobre la atención, incluyendo trabajos con aplicaciones de una sesión de entrenamiento o de varias semanas/meses. También se observaron relaciones importantes en-tre la práctica de actividad física y esta función cerebral. Algunos trabajos no mostraron influencia del entrenamiento, lo que hace necesario más estudio orientados a determinar las intensidades y tiempos de aplicación mas adecuados para potenciar la atención en diferentes grupos etarios.

The following work is a review of the research carried out on the chronic effects of physical exercise on sustained attention, based on: Physical-sports training in longitudinal studies; chronic effects of physical exercise on sustained attention; experimental situations and the relationship between physical activity levels and physical condition with sustained attention, carried out in cross-sectional studies. The search was conducted in the following databases: Dialnet, Scielo and Pubmed. A total of 119 ar-ticles were found, of which 28 met the criteria of inclusion (published between January 1, 2010 and December 31, 2016, languages Spanish, English or Portuguese, research articles, studies carried out on human beings and healthy subject samples). Based this revision, more than 70% give account of the positive effects of physical exercise on sustained attention, including one session training workouts or after several weeks/months of workouts. Furthermore, important relations were observed between the practice of physical activity and this cerebral activity. Some workouts, however, did not show any influence on the subjects after the training session, which makes it necessary to study this further in order to determine the right intensities and the best times for the workouts in order to boost sustained attention for different age groups.