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Introducción: La relación entre el TDAH y la epilepsia, aunque muy frecuente, no es clara. Los estudios clínicos en neuropsicología y neurología (neuropsiquiatría) pueden ofrecer información valiosa para la evaluación, la intervención y el tratamiento. Método: Se realizó un estudio con diseño no experimental, enfoque cuantitativo, nivel descriptivo y corte transversal con el objetivo de comparar el funcionamiento ejecutivo de un grupo de niños con TDAH y un grupo de niños con TDHA y EBPCT. Se conformó una muestra por conveniencia de 40 niños emparejados (todos hombres) agrupados en dos grupos de 20 con edades entre los 7 y los 13 años. Para realizar la evaluación del funcionamiento ejecutivo se aplicaron algunas pruebas de la Batería Neuropsicológica de Funciones Ejecutivas y Lóbulos Frontales - BANFE. Resultados: De acuerdo con los valores de la significancia asintótica bilateral, se encontraron diferencias estadísticamente significativas en las variables Stroop A - Aciertos, Stroop B - Aciertos, Señalamiento autodirigido (Aciertos, Planeación y Tiempo), y Memoria de Trabajo Visoespacial (Nivel máximo, Perseveraciones y Errores de orden). Conclusiones: Los resultados del presente estudio coinciden con los fallos en el control inhibitorio y los problemas de atención sostenida reportados en la literatura. Los niños con EBPCT y TDAH tienen un perfil de funcionamiento ejecutivo diferente y más deteriorado que los niños con TDAH solo.
Introduction: The relationship between ADHD and epilepsy, although very frequent, is not clear. Clinical studies in neuropsychology and neurology (neuropsychiatry) can provide valuable information for assessment, intervention and treatment. Method: A non-experimental design, quantitative approach, descriptive level and cross-sectional study was carried out with the aim of comparing the executive functioning of a group of children with ADHD and a group of children with ADHD and CPSDD. A convenience sample of 40 matched children (all males) grouped in two groups of 20 children between 7 and 13 years of age was formed. In order to evaluate executive functioning, some tests of the Neuropsychological Battery of Executive Functions and Frontal Lobes - BANFE were applied. Results: According to the bilateral asymptotic significance values, statistically significant differences were found in the variables Stroop A - Hits, Stroop B - Hits, Self-directed Signaling (Hits, Planning and Time), and Visuospatial Working Memory (Maximum Level, Perseverations and Order Errors). Conclusions: The results of the present study coincide with the failures in inhibitory control and sustained attention problems reported in the literature. Children with EBPCT and ADHD have a different and more impaired executive functioning profile than children with ADHD alone.
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Objective:To explore the effects of game addiction disorders on brain cognitive control functions based on near-infrared spectroscopy.Methods:Thirteen subjects were screened according to the Online Game Addiction (OGA) Scale. The experimental paradigm was the stop-signal task. The relative concentration levels of oxyhemoglobin (HbO 2) and deoxyhemoglobin (Hb) in the prefrontal region of the brain during cognitive activity were collected using near-infrared spectroscopy to assess the cognitive control function of the subjects. Results:The game-addicted patients had lower keystroke accuracy in the stop-signal task than healthy subjects, and the difference was statistically significant ( P<0.05). Compared to healthy subjects, game-addicted patients had less activation in prefrontal areas and showed uncontrolled behavior and brain activity. Conclusions:Game addiction disorders impair brain cognitive control, which in turn triggers a weakening of cognitive control. The results of this study provide a reference for the prevention and treatment of game addiction.
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Objective To study the clinical therapeutic effect of combination of Naodekang capsule and western medicine for treatment of patients with mental disorders after bilateral cerebral frontal lobes contusion and laceration.Methods A prospective study was conducted. Sixty-two patients with mental disorders after bilateral frontal lobes contusion and laceration hospitalized from June 2012 to January 2014 in the Department of Neurosurgery in Liangzhou Hospital, Wuwei City, Gansu Province were enrolled. According to random principle, they were divided into combined traditional Chinese and western medicine treatment group (32 cases) and western medicine treatment control group (30 cases). Conventional symptomatic therapy was given to both groups. In the western medicine control group, based on the above conventional treatment, antipsychotic drug risperdal (risperidone) was given, the beginning dosage was 4 mg daily and gradually reduced to 1 mg daily. In combined traditional Chinese and western medicine group, beside the conventional therapy, oral Naodekang capsules and oral risperdal were given. The ingredients of the capsule included: Astragalus 60 g, Radix Paeoniae Rubra 15 g, Rhizoma Chuanxiong 25 g, Angelica 15 g, Earthworm 10 g, Semen Persicae 10 g, Safflower 15 g, Salvia miltiorrhiza 15 g, Rhizoma Gastrodiae 15 g, Uncaria 10 g, Bupleurum 20 g, Pueraria 15 g, Rhizoma Acori Tatarinowii 15 g; the patients took once 3 capsules, three times a day, and risperdal 2 mg per day at the beginning and gradually reduced to 1 mg daily. Before treatment and after treatment for 2, 6 and 12 weeks, the brief psychiatric rating scale (BPRS) score was applied to evaluate the clinical therapeutic effect on the situation of patients' improvement of symptoms; in the two groups, the clinical curative effects were observed and when the psychiatric symptoms were controlled, the mean dosage of antipsychotic western medicine used daily in each patient was calculated.Results After treatment, the BPRS scores in the two groups were lower than those before treatment, from 6 weeks after treatment, the degree of descent in the BPRS score in the combined treatment group was more significant than that in the western medicine group (38.68±7.81 vs. 54.05±6.75,P < 0.05), and the descent was persistent until 12 weeks after treatment (15.46±8.51 vs. 23.98±8.03,P < 0.05). The cure rate of the combined group was markedly higher than that in western medicine group [84.4% (27/32) vs. 76.6% (23/30),P < 0.05]. When the psychiatric symptoms were controlled, the dosage of antipsychotic western drug used in each patient in the combined group was less than that in western medicine group (mg/d: 1.5±0.1 vs. 2.8±0.2,P < 0.05).Conclusion The westernconventional therapy combined with traditional Chinese medicine Naodekang capsule for treatment of mental disorders after bilateral cerebral frontal lobes contusion and laceration has relatively good therapeutic effect.
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Una forma de entender la estructura de las Funciones Ejecutivas (FE), es su estudio en el desarrollo temprano y el uso de métodos estadísticos avanzados que permiten entender la interrelación de los distintos componentes. Los hallazgos en la etapa adulta, apoyan la idea multifactorial de componentes relacionados, pero separables; mientras que evidencias recientes, en la etapa preescolar sugieren que la estructura de las FE, puede ser descrita por un solo factor. La estructura de las FE fue examinada en 128 niños de 3 a 6 años de edad, usando un análisis factorial confirmatorio. Los preescolares completaron una batería de tareas de FE, que evaluaban procesos de inhibición y memoria de trabajo, con sensibilidad adecuada para la edad. En la edad preescolar la estructura del funcionamiento ejecutivo puede ser diferenciada en dos procesos relacionados pero independientes: memoria de trabajo e inhibición. Las relaciones entre los componentes parecen cambiar en el desarrollo. La unidad estructural de las FE en edades muy tempranas, cambia a través del desarrollo, siendo cada vez más multifacética, que se relaciona con la maduración e integración de diferentes circuitos frontosubcorticales.
One way to understand the structure of executive functions (EF) is their study in early development and use of advanced statistical methods that allow us to understand the interrelationship of various components. The findings in the adult age, support the idea multifactorial of related components, but separable, while recent evidence in the preschool years suggest that the structure of the FE, can be described by a single factor. The structure of the EF was examined in 128 children aged 3 to 6 years of age, using a confirmatory factor analysis. Preschoolers completed a battery of EF tasks, assessing processes of inhibition and working memory with age-appropriate sensitivity. In the preschool the structure of executive functioning can be differentiated into two related but independent processes: working memory and inhibition. The relationships between the components seem to change in development. The structural unit of the FE at very early ages, it changes through the development, becoming more multifaceted, which is associated with the maturation and integration of different frontal-subcortical circuits.
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Una persona transexual se define como aquella que presenta una incongruencia entre el fenotipo físico y la identidad de género. Existen transexuales nacidos hombres pero con identidad de género de mujer. Se ha propuesto que uno de los orígenes de esta condición radica en los efectos que las hormonas esteroides sexuales tienen sobre el desarrollo cerebral a nivel prenatal y es posible que afecten las funciones cognitivas como las funciones ejecutivas. El objetivo fue evaluar funciones ejecutivas en transexuales hombre a mujer. Con la batería de lóbulos Frontales y Funciones Ejecutivas, se encontró que las Transexuales tuvieron una menor ejecución comparadas con los hombres en los puntajes totales de funciones ejecutivas y en los totales de corteza prefrontal orbitomedial. En las subpruebas de inhibición (Stroop) y Toma de decisiones (Juego de cartas del IOWA) las transexuales obtuvieron menores puntajes que los hombres y las mujeres. Estos resultados apoyan las evidencias que indican que las TH-M presentan una ejecución cognitiva lejana a su sexo de nacimiento y se propone un perfil cognitivo en las TH-M diferente al de los hombres y las mujeres.
Transsexualism is characterized by the development of a gender identity that is at variance with morphology of genitals and secondary sex characteristics. The origin of the transsexualism is not very clear, although some biological indicators as the prenatal androgenization seems to be one of the causes that predispose to the development of the sexual identity, as well as the cerebral anatomical differences between transsexuals and non transsexuals. Mental functions including executive functions are susceptible to be affected by sexual steroids hormones during development. The aim was to evaluate the cognitive profile in male to female transsexuals (M-FT) in absence of hormonal treatment with estrogens. With the battery of Frontal lobes and Executive Functions, transsexuals had a smaller execution compared with the men in the totals of executive functions and the totals of orbitomedial prefrontal cortex. In the sub-tests of inhibition (Stroop) and Decision making (letter Game of the IOWA) group transsexual had minor's scores than men and women. These results support the evidences that they indicate that the transsexuals display a distant mental execution to their sex of birth. We propose a cognitive profile in our transsexual group different from men and the women sets out.
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Objective To identify the possible alterations of brain function in prefrontal lobes and hippocampus in the first-episode patients with positive symptoms of schizophrenia using magnetic resonance spectroscopy. Methods 20 patients were selected to perform MRI and HMRS examination. Proton multi-voxel spectroscopy imaging(1 H-MRSI)was obtained from two sides of the hippocampus and frontal lobes regions. The metabolites included N-acetylaspartate (NAA), and choline-containing compounds (Cho), creatine and phosphocreatine (Cr).The ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. Results (1)The Cho/Cr ratio was significantly reduced in left frontal white matter of patients compared to right(1. 178 ± 0.210 vs 1.437 ± 0. 337). (2) There was no statistically significant difference in metabolite levels in between left anterior cingulate gray matter and right (N AA. Cr: 1. 339 ± 0.452 vs 1. 748 ± 0. 147;Cho/Cr: 1. 406 ± 0. 394 vs 1. 761 ± 0.362) (P ＜ 0.05). (3) The NAA/Cr, Cho/Cr were significantly reduced in left hippocampus of patients compared to right. Conclusion The results implicate that the metabolic abnormalities might exist in the left hippocampus and frontal lobe of schizophrenic patients with positive symptoms.
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OBJECTIVES: Non-verbal memory deficits, impairments in executive function and deficits in visuospartial functions have been repeatedly reported in subjects with obsessive-compulsive disorder (OCD). The present study aimed to evaluate the frontal lobe function using neuro-psychological test in subjects with OCD and normal control. METHODS: A battery of neuropsychological tests (Wisconsin Card Sorting test, Rey-Osterrieth Complex Figure test, Controlled Oral Word Association test, Trail Making test, Verbal Learning test) reflecting frontal lobe function was administrated to 32 OCD patients and 28 healthy comparison subjects. RESULT: There were no significant differences in age, years of education, or estimated IQ between the groups. Scores in category fluency, immediate recall and delayed recall of Rey-Osterrieth Complex Figure test in OCD subjects were significantly lower than those of healthy comparison subjects (ANCOVA, F=15.07, df=58, p< .001; ANCOVA, F=6.33, df=57, p=0.015; ANCOVA, F=5.53, df=57, p=0.022, respectively). CONCLUSION: OCD patients had selective deficits in task involving non-verbal memory and categorical word fluency relative to healthy comparisons.
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Humanos , Educación , Función Ejecutiva , Lóbulo Frontal , Memoria , Trastornos de la Memoria , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Neuropsicología , Trastorno Obsesivo Compulsivo , Prueba de Secuencia Alfanumérica , Aprendizaje Verbal , Pruebas de Asociación de PalabrasRESUMEN
OBJECTIVE: Functional imaging studies on obsessive-compulsive disorder(OCD) subjects have repeatedly reported increased metabolism in orbitofrontal lobes and caudate nucleus, resulting in the "frontal-subcortical" circuit abnormality theory. Limitations of the previous studies to date include little consideration for the duration of illness, and the use of regions of interest methods, as an image analysis method. Our study objectives are 1) to include the duration of illness as an important study variable, and 2) to use Statistical Parametric Mapping(SPM) method in order to tap relations between the brain function and the psychopathology and symptoms of OCD. METHOD: The [18] fluorodeoxyglucose positron emission tomography(FDG-PET) scans of OCD subjects and normal comparison subjects, as diagnosed by the Structured Clinical Interview for DSM-IV(SCID-IV), were analyzed using SPM. RESULTS: 1) Comparison of OCD and control groups: OCD subjects had significantly decreased metabolism in both parietal lobes and didn't have any areas of increased metabolism in comparison to comparison subjects(p<0.01). Four OCD subjects with the illness duration of 10 years or longer, had significantly increased metabolism in both orbitofrontal lobes(p<0.01). OCD subjects whose illness duration is shorter than 10 years didn't have any areas of increased metabolism and had significantly decreased parietal lobe metabolism, as in the analyses of all subjects(p<0.01). 2) Correlation analysis between areas and symptom severity: Metabolism of both thalamic areas showed significant positive correlation with Yale-Brown Obsessive-Compulsive Scale(Y-BOCS) scores(p<0.01). Metabolism of right parietal area showed significant negative corre-lation with Y-BOCS scores(p<0.01). CONCLUSIONS: The current findings suggest that the increased metabolism in orbitofrontal lobe, previously reported, may be a secondary phenomenon due to the extended illness duration and that decreased metabolism in the parietal lobes are primary abnormality in OCD subjects. Thus Baxter's fronto-subcortical circuit theory should be extended into "fronto-parietal" complex theory, which includes the parietal lobes.