The Mini-Mental Examination for Children (MMC): Evidence of validity for children with learning difficulties / Mini-exame do estado mental para crianças (mmc): evidência de validade para crianças com dificuldades de aprendizagem

ABSTRACT The Mini-Mental Examination for Children (MMC) is a widely used tool for assessing global cognitive deficits, however,is still unknown whether MMC is sensitive for investigating cognitive profiles associated with learning difficulties (LD). Objective: Here we investigate the feasibility of using the MMC for screening school-aged children with learning difficulties in spelling and math. Methods: The MMC and other neurophysiological tests were administered to a sample of 168 children, aged 7 to 12 years. The sample was subdivided into a Control group and LD group (Math Difficulties, Spelling Difficulties, Math and Spelling Difficulties). Diagnostic accuracy was assessed with ROC analysis. Convergent and divergent validity was assessed using correlation analysis. Results: Performance on the MMC was associated with nonverbal intelligence, age and school achievement. The LD group had significantly lower performance on the MMC than the Control group. Performance on the MMC discriminated LD children with a global accuracy of around 0.80. Associations between the MMC and the other neuropsychological variables were higher for finger gnosis (r=0.40) and generally higher for early elementary school grades. The MMC proved satisfactory for identifying LD children with good accuracy. Nonverbal intelligence, and perceptual/motor abilities play an important role in MMC performance. Conclusion: The MMC could be a useful instrument for screening children with LD.

RESUMO Mini-exame mental para crianças (MMC) é uma ferramenta amplamente utilizada para avaliar déficits cognitivos globais, no entanto, ainda é desconhecido se a MMC é sensível para investigar perfis cognitivos associados a dificuldades de aprendizagem. Objetivo: Aqui nós investigamos a viabilidade de usar MMC para triagem de crianças em idade escolar com dificuldades de aprendizagem em ortografia e matemática. Métodos: MMC e outros testes neuropsicológicos foram administrados em uma amostra de 168 crianças de 7 a 12 anos de idade. A amostra foi subdividida em um Grupo Controle e um grupo LD (dificuldade na matemática, na escrita, ou na escrita e na matemática). A acurácia diagnóstica foi analisada através de uma análise de curva ROC. A validade convergente e divergente foi investigada através de análises de correlações. Resultados: A performance no MMC foi associada com a inteligência não verbal, idade e desempenho escolar. O grupo LD apresentou desempenho significativamente inferior ao Grupo Controle no MMC. A performance no MMC pôde identificar crianças LD com uma acurácia global em torno de 0.80. As associações entre MMC e outras variáveis neuropsicológicas foram maiores para gnosias digitais (r=0.40) e em geral, mais altas nas séries iniciais. O MMC se mostrou satisfatório para identificar crianças LD com uma boa acurácia. A inteligência não verbal, habilidades perceptivas/motoras tem um importante papel na performance no MMC. Conclusão: O MMC pode ser um instrumento útil para o rastreamento de crianças com LD.

Improvement of Visuo-spatial Function Assessed by Raven’s Colored Progressive Matrices in Dementia with Lewy Bodies by Donepezil Treatment

OBJECTIVE: Donepezil is used to improve cognitive impairment of dementia with Lewy bodies (DLB). Visuo-spatial dysfunction is a well-known symptom of DLB. Non-verbal Raven’s Colored Progressive Matrices (RCPM) were used to assess both visual perception and reasoning ability in DLB subjects treated with donepezil. METHODS: Twenty-one DLB patients (mean age, 78.7±4.5 years) were enrolled. RCPM assessment was performed at the time of starting donepezil and within one year after starting donepezil. RESULTS: There were significant improvements of RCPM in the total scores between one year donepezil treatment (p=0.013), in both Set A score (p=0.002) and Set AB score (p=0.015), but trend in the Set B score (p=0.083). CONCLUSION: Donepezil is useful for improving visuo-spatial impairment in DLB, but not for problem-solving impairment.

El papel del cuerpo calloso en el procesamiento visoespacial / The role of the corpus callosum in the visuospatial processing

El procesamiento visoespacial es una función adaptativa del organismo que permite su interacción con los elementos que se encuentran en su medio ambiente. Se considera una función superior, ya que involucra sistemas de reconocimiento y de memoria, entre otros. Hasta el momento se ha descrito la participación de diversas estructuras cerebrales en el procesamiento de información visoespacial, por ejemplo, tradicionalmente se considera una especialización funcional por parte del hemisferio derecho; sin embargo aún existen muchas controversias con respecto a la participación de diversas áreas cerebrales tanto ipsilaterales como contralaterales en estás funciones visoespaciales. En el presente trabajo se discute el papel de la comunicación interhemisferica, y específicamente del papel que juega el cuerpo calloso en el procesamiento visoespacial. Se inicia con una descripción de las vías de procesamiento visoespacial desde el ojo hasta la corteza V1 y las conexiones anatómicas funcionales que se establecen a partir de ésta. Posteriormente se resume la estructura-función del cuerpo calloso y se revisan los trabajos que han reportado relaciones entre éste y la función visoespacial. Por último, se revisan algunas de las patologías neurológicas que cursan con afectación del cuerpo calloso y que se ha reportado en la literatura que afectan a la función visoespacial...

The visuospatial processing is an adaptive function of the organism that allows it to interact with the elements that are in their environment. It is considered a high-order function as it involves recognition systems, memory, among others. So far described the participation of various brain structures in processing visuospatial information, for example, is traditionally considered a functional specialization by the right hemisphere, but there are still many controversies regarding the participation of various brain areas, both ipsilateral and contralateral in the visuospatial functions. In this paper we discuss the role of interhemispheric communication, and specifically the role of the corpus callosum in visuospatial processing. It begins with a description of visuospatial processing pathways from the eye to the cortex V1 and the anatomical-functional connections are established from this. Later summarizes the structure-function of the corpus callosum and reviews the studies that have reported relationships between this and visuospatial function. Finally we review some of the neurological disorders that present with involvement of the corpus callosum and it has been reported in the literature that affect visuospatial function...

Language-specific Dysgraphia in Korean Patients with Right Brain Stroke: Influence of Unilateral Spatial Neglect

The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke.

Language-specific Dysgraphia in Korean Patients with Right Brain Stroke: Influence of Unilateral Spatial Neglect

The purpose of the present study was to investigate the relationship between Korean language-specific dysgraphia and unilateral spatial neglect in 31 right brain stroke patients. All patients were tested for writing errors in spontaneous writing, dictation, and copying tests. The dysgraphia was classified into visuospatial omission, visuospatial destruction, syllabic tilting, stroke omission, stroke addition, and stroke tilting. Twenty-three (77.4%) of the 31 patients made dysgraphia and 18 (58.1%) demonstrated unilateral spatial neglect. The visuospatial omission was the most common dysgraphia followed by stroke addition and omission errors. The highest number of errors was made in the copying and the least was in the spontaneous writing test. Patients with unilateral spatial neglect made a significantly higher number of dysgraphia in the copying test than those without. We identified specific dysgraphia features such as a right side space omission and a vertical stroke addition in Korean right brain stroke patients. In conclusion, unilateral spatial neglect influences copy writing system of Korean language in patients with right brain stroke.

Sinais comportamentais dos Transtornos do Déficit de Atenção com Hiperatividade e do Processamento Auditivo: a impressão de profissionais brasileiros / Behavioral signs of Attention Deficit Hyperactivity Disorder and Central Auditory Processing Disorder: impressions of Brazilian professionals

OBJETIVO: Caracterizar os sinais comportamentais do Transtorno do Déficit de Atenção com Hiperatividade (TDAH) e do Transtorno do Processamento Auditivo (TPA), segundo a visão de profissionais que atuam no diagnóstico e intervenção relacionados a estes transtornos no Brasil. MÉTODOS: Participaram 42 profissionais (médicos, fonoaudiólogos, psicólogos e pedagogos). Todos responderam a um questionário contendo 58 sinais comportamentais de TDAH e TPA. Cada participante foi orientado a classificar os comportamentos de acordo com a frequência de ocorrência, elencando-os em categorias de 1 (nunca) a 5 (sempre). Os valores da média geral deste estudo foram comparados aos valores da média apresentados em estudo norte americano similar. RESULTADOS: Verificou-se que alguns sinais comportamentais foram mais citados do que outros em ambos os transtornos. No TDAH os sinais comportamentais mais evidentes foram: dificuldade em brincar silenciosamente, distraído, desorganizado, desatento, hiperativo, irrequieto, muda de um trabalho incompleto para o outro, pouco autocontrole, falta de persistência e apressado ou impulsivo. No TPA os sinais comportamentais mais evidentes foram: déficit na atenção auditiva dividida, déficit na atenção auditiva seletiva, dificuldade em seguir instruções orais, habilidade de associação auditiva ruim, dificuldade de ouvir em ambiente ruidoso, déficit na atenção auditiva sustentada, dificuldade em discriminar fala e taxa reduzida de processamento da informação auditiva. CONCLUSÃO: Foi possível concluir que os profissionais classificaram determinados sinais comportamentais como mais evidentes no TDAH e outros mais evidentes no TPA.

PURPOSE: To characterize the behavioral signs of attention deficit hyperactivity disorder (ADHD) and central auditory processing disorder (CAPD) from the perspective of the professionals who diagnose and manage these conditions in Brazil. METHODS: Forty-two health professionals in Brazil (medical doctors, speech therapists, psychologists, and pedagogues) participated in this study, and they responded to a questionnaire listing 58 behavioral signs of ADHD and CAPD. The participants were asked to score the listed behavioral signs according to the frequency with which they occurred, from 1 (never) to 5 (always). The average values were compared to the results of a similar study conducted in North America. RESULTS: Some of the listed behavioral signs were indicated more often than others, depending on the disorder. In the case of ADHD, the behavioral signs most often mentioned were difficulty playing quietly, distraction, disorganization, inattentiveness, hyperactivity, restlessness, shifting from one incomplete task to another, poor self-control, lack of persistence, and hastiness or impulsiveness. The most evident behavioral signs of CAPD were auditory divided attention deficit, auditory selective attention deficit, difficulty following instructions given orally, poor auditory association skills, difficulty hearing in a noisy environment, auditory sustained attention deficit, difficulty discriminating speech, and reduced auditory information processing rate. CONCLUSION: The health professionals identified some behavioral signs as being more evident in ADHD and other signs as more evident in CAPD.

Localização de áreas de monitoramento telemétrico em ambientes aquáticos da Amazônia / Location of telemetric monitoring sites in Amazon floodplain lakes

O presente trabalho demonstra a aplicabilidade de imagens de sensoriamento remoto e de métodos de processamento de imagens digitais para definição de locais adequados à instalação de sistemas telemétricos de monitoramento de variáveis ambientais em sistemas aquáticos, localizados em regiões de difícil acesso. A técnica consiste essencialmente da aplicação de operações Booleanas entre mapas da pluma do Rio Amazonas e de zonas inundadas do Lago de Curuai em diferentes etapas do ciclo hidrológico. A localização exata para o sistema de monitoramento telemétrico será vital para o desenvolvimento de modelos de troca de gases traço entre a planície de inundação Amazônica e a atmosfera.

The present work illustrates the application of remote sensing and image processing methods to define appropriate sites for installing buoy moored telemetric systems at the surface of Amazon floodplain lakes for long-term limnologic-micrometeorologic monitoring. The technique consists essentially of Boolean operations over Amazon plume maps and historic inundation of the Curuai Lake at distinct stages of the hydrologic cycle. The precise location for the long-term monitoring is vital to the development of models concerning air-water trace gas exchange in the Amazon floodplains.