Neuropsychology of epilepsy surgery and theory-based practice: an opinion review / Neuropsicologia da cirurgia de epilepsia e prática teórica: uma revisão de opinião

Abstract The present review attempts to discuss how some of the central concepts from the Lurian corpus of theories are relevant to the modern neuropsychology of epilepsy and epilepsy surgery. Through the lenses of the main Lurian concepts (such as the qualitative syndrome analysis), we discuss the barriers to clinical reasoning imposed by quadrant-based views of the brain, or even atheoretical, statistically-based and data-driven approaches. We further advice towards a systemic view inspired by Luria's clinical work and theorizing, given their importance towards our clinical practice, by contrasting it to the modular views when appropriate. Luria provided theory-guided methods of assessment and rehabilitation of higher cortical functions. Although his work did not specifically address epilepsy, his theory and clinical approaches actually apply to the whole neuropathology spectrum and accounting for the whole panorama of neurocognition. This holistic and systemic approach to the brain is consistent with the network approach of the neuroimaging era. As to epilepsy, the logic of cognitive functions organized into complex functional systems, contrary to modular views of the brain, heralds current knowledge of epilepsy as a network disease, as well as the concept of the functional deficit zone.

Resumo A presente revisão tenta discutir como alguns dos conceitos centrais do corpus de teorias lurianas são relevantes para a moderna neuropsicologia da epilepsia e cirurgia da epilepsia. Através das lentes dos principais conceitos lurianos (como a análise qualitativa de síndromes), discutimos as barreiras ao raciocínio clínico impostas por visões do cérebro baseadas em quadrantes, ou mesmo abordagens ateóricas, baseadas em estatísticas e orientadas por dados. Aconselhamos ainda uma visão sistêmica inspirada na clínica e na teorização de Luria, dada sua importância para nossa prática clínica, contrastando-a com as visões modulares quando apropriado. Luria forneceu métodos teóricos de avaliação e reabilitação de funções corticais superiores. Embora seu trabalho não abordasse especificamente a epilepsia, sua teoria e abordagens clínicas na verdade se aplicam a todo o espectro da neuropatologia e respondem por todo o panorama da neurocognição. Essa abordagem holística e sistêmica do cérebro é consistente com a abordagem de rede da era da neuroimagem. Quanto à epilepsia, a lógica das funções cognitivas organizadas em sistemas funcionais complexos, ao contrário das visões modulares do cérebro, anuncia o conhecimento atual da epilepsia como uma doença em rede, bem como o conceito de zona de déficit funcional.

Aplicación de la prueba Luria Inicial en el niño preescolar con desviaciones del neurodesarrollo en Cuba / Application of Initial Luria test in preschool children with neurodevelopmental deviations in Cuba

Fundamento: La aplicación de instrumentos neurosicológicos en la edad preescolar es una necesidad a favor de conocer e intervenir en las habilidades previas a la etapa escolar. El bajo peso al nacer, los desórdenes metabólicos, los antecedentes de hipoxia perinatal, los signos neurológicos menores y los trastornos de hiperactividad son desviaciones del neurodesarrollo que tienen un perfil cognitivo deficitario en la edad preescolar. Objetivo: Ofrecer una revisión sobre el estado de las funciones mentales superiores con la prueba Luria Inicial en el niño preescolar con desviaciones del neurodesarrollo en Cuba. Desarrollo: Se reflexiona a partir de los resultados de la prueba Luria Inicial en el niño preescolar en diferentes desviaciones del neurodesarrollo de interés en la comunidad internacional como, el bajo peso al nacer, los desórdenes metabólicos, los antecedentes de hipoxia perinatal, los signos neurológicos menores y los trastornos de hiperactividad. Conclusiones: Los niños con alteraciones del neurodesarrollo en la edad preescolar presentan un patrón cognitivo deficitario en común. Independiente a la alteración neurológica que tengan los niños, la función reguladora del lenguaje, la habilidad viso espacial, el acto motor voluntario y el razonamiento verbal y matemático, son sensibles a no establecerse en tiempo.

Background: The application of neuropsychological instruments in preschool ages is a necessity for knowing and intervening in the pre-school stage skills. The low birth weight, metabolic disorders, history of perinatal hypoxia, minor neurological signs and hyperactivity disorders are neurodevelopmental deviations that have a cognitive deficit profile in preschool ages. Objective: To provide a review on the state of higher mental functions with Initial Luria test in preschool children with neurodevelopmental deviations in Cuba. Development: There is a reflection based on the results of the Initial Luria test in the preschool child in different neurodevelopmental deviations of interest for the international community, such as low birth weight, metabolic disorders, history of perinatal hypoxia, minor neurological signs and hyperactivity disorders. Conclusions: Children with neurodevelopmental disorders in preschool ages have a common cognitive deficit pattern. Despite of the neurological disorder children may have, the regulatory function of language, the visuo spatial ability, voluntary motor act and verbal and mathematical reasoning, are sensitive to not settle in time.

Effects of Total Sleep Deprivation on the Cognitive Function in the Normal Adult Male Subjects / 신경정신의학

OBJECTIVES: This study was carried out to evaluate the effect of acute sleep deprivation of 36 hours on cognitive functions, and investigate which region of brain would dysfunction by sleep deprivation. METHODS: We carried out sleep deprivation in the 18 healthy and right handed males in their 20's. We also administered to them Luria-Nebraska Neuropsychological Battery and Calculation and Digit Span task of K-WAIS in order to examine cognitive functions before and after sleep deprivations. RESULTS: There were no differences in freedom from distractability, tactile function, visual function, reading, writing, calculation, and intellectual process function. However, motor function, rhythm, receptive speech, expressive speech, memory, and complex verbal arithmetic function decreased after sleep deprivation. In motor function, delayed speed and high fail rate in complex forms of praxis and selectivity of motor acts were observed. In area of receptive speech and expressive speech, understanding of logical and grammatical structure, spontaneous speech, sequencing and filling in items which are grammatically accurate decreased. All these functions related with dysfunction in right hemisphere anterior region. Also in localization scales, the fail rates of right frontal dysfunction scale and right temporal dysfunction scale increased after sleep deprivation. CONCLUSIONS: From these results, we suggest that sleep deprivation has negative effect on the cognitive functions. Especially, sleep deprivation might be associated with dysfunction of anterior region in right hemisphere or subcortical dysfunction.