The investigation of semantic memory deficit in chronic tinnitus: a behavioral report / Investigação do déficit de memória semântica no zumbido crônico: um relato comportamental

Abstract Introduction: Tinnitus is a central auditory disorder in which different processing systems are involved as a network. One of these networks is memory. Previous studies have demonstrated some deficits in various types of memory in chronic tinnitus. Objectives: The main purpose of the present study was to investigate the semantic memory, which is not yet investigated in the tinnitus population. Methods: In this case-control study, 15 subjects with chronic tinnitus and 16 matched healthy controls were included. 40 semantically related and 40 semantically unrelated word pairs were presented to the participants in a counter-balanced fashion. They were asked to make decision about their semantic relatedness. Then the participants' reaction times and the accuracy of responses were calculated. Results: Mean of reaction times were significantly longer in the tinnitus group (M = 1034 ms, SD = 0.31) compared to the control group (Mean = 1016 ms, SD = 0.13), p < 0.05. However, no significant difference was found for the mean percentage of correct responses between the two groups. Conclusion: The current study provided behavioral evidence that chronic tinnitus can affect the semantic memory. Such behavioral outcomes may provide new insights into more research activities in the field of electrophysiology and neuroimaging in the tinnitus population.

Resumo Introdução: O zumbido é um distúrbio auditivo central, no qual diferentes sistemas de processamento estão envolvidos como em uma rede. Uma dessas redes é a memória. Estudos anteriores demonstraram alguns déficits em vários tipos de memória no zumbido crônico. Objetivos: Investigar a memória semântica, que ainda não foi investigada na população com zumbido. Método: Neste estudo de caso-controle, 15 indivíduos com zumbido crônico e 16 controles saudáveis pareados foram incluídos; 40 pares de palavras semanticamente relacionados e 40 semanticamente não relacionados foram apresentados aos participantes de forma contrabalançada. Eles foram instruídos a tomar decisões sobre sua relação semântica. Em seguida, os tempos de reação dos participantes e a precisão das respostas foram calculados. Resultados: A média dos tempos de reação foi significativamente maior no grupo com zumbido (M = 1,034 ms, DP = 0,31) em comparação ao grupo controle (média = 1,016 ms, DP = 0,13), p< 0,05. Entretanto, nenhuma diferença significante foi encontrada para a porcentagem média de respostas corretas entre os dois grupos. Conclusão: O presente estudo forneceu evidências comportamentais de que o zumbido crônico pode afetar a memória semântica. Tais resultados comportamentais podem levar a novas percepções em mais atividades de pesquisa no campo da eletrofisiologia e neuroimagem na população com zumbido.

Fatores associados à demência em idosos / Factors associated with dementia in elderly

Resumo Analisar os fatores associados à demência em idosos atendidos em um ambulatório de memória da Universidade do Sul de Santa Catarina (Unisul). Estudo transversal com análise de dados de prontuário no período de 01/2013 a 04/2016. O desfecho foi o diagnóstico clínico de demência. As variáveis de controle foram: nível sérico de vitamina D na época do diagnóstico, sexo, cor da pele, escolaridade, idade, diabetes tipo 2, hipertensão arterial e depressão. Foi realizada análise bruta e ajustada com regressão logística. Amostra de 287 idosos, com predominância de idade entre 60 e 69 anos (48,78%), sexo feminino (79,09%), cor da pele branca (92,33%). A média de anos de estudo foi de 6,95 anos (DP ± 4,95) e da vitamina D 26,09 ng/mL (DP ± 9,20). A prevalência de idosos com demência foi de 16,72%. Dentre as morbidades a depressão foi a de maior prevalência seguida pela hipertensão arterial. Estiveram independentemente associadas à demência: vitamina D (OR = 0,92 IC 95% 0,88;0,97), depressão (OR = 4,09 IC95% 1,87;8,94), hipertensão arterial (OR = 2,65 IC95% 1,15;6,08) e indivíduos com idade igual e maior que 80 anos. A prevalência de demência foi alta, e houve associação de níveis mais baixos de vitamina D com diagnóstico de demência. Sendo a vitamina D um fator modificável, abrindo importantes perspectivas para políticas de saúde pública.

Abstract We analyzed the factors associated with dementia in the elderly attended at a memory outpatient clinic of the University of Southern Santa Catarina (UNISUL). This is a cross-sectional study with data analysis of medical records from January 2013 to April 2016. The outcome was the clinical diagnosis of dementia. The control variables were: serum vitamin D level at the time of diagnosis, gender, skin color, schooling, age, type 2 diabetes, hypertension, and depression. We performed a crude and adjusted analysis with logistic regression. The sample consisted of 287 elderly, with the predominance of age between 60 and 69 years (48.78%), female (79.09%) and white (92.33%). The mean number of years of study was 6.95 years (SD ± 4.95) and mean vitamin D was 26.09 ng/mL (SD ± 9,20). The prevalence of elderly with dementia was 16.72%. Depression was the most prevalent (42.50%) among the morbidities, followed by hypertension (31.71%). The following were independently associated with dementia: vitamin D (OR = 0.92, 95%CI, 0.88;0.97), depression (OR = 4.09, 95%CI, 1.87;8.94), hypertension (OR = 2.65, 95%CI, 1.15;6.08) and individuals aged 80 years and over (OR = 3.97 95%CI, 1.59;9.91). Dementia prevalence was high and diagnosed dementia was associated with lower levels of vitamin D. Vitamin D is a modifiable factor, opening up essential perspectives for public health policies.

Cognitive function among older adults: ELSI-Brazil results / Função cognitiva entre adultos mais velhos: resultados do ELSI-Brasil

ABSTRACT OBJECTIVE To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older. METHODS Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding RESULTS Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency. CONCLUSIONS There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.

RESUMO OBJETIVO Investigar as variações macrorregionais da função cognitiva em amostra nacional representativa da população brasileira com 50 anos ou mais. MÉTODOS Foram utilizados dados da linha de base do Estudo Longitudinal dos Idosos Brasileiros (ELSI-Brasil), coletados entre 2015 e 2016. A memória foi aferida por meio de lista de 10 palavras e a função executiva, pela fluência verbal semântica, baseada na nomeação de animais. Como potenciais variáveis de confusão, incluímos: sexo, idade, escolaridade e residência rural ou urbana. RESULTADOS Entre os 9.412 participantes do ELSI-Brasil, 9.085 foram incluídos na análise; 53,9% eram mulheres e a média de idade foi 63,0 (0,42) anos. Após ajustes por potenciais variáveis de confusão, os escores médios para memória e fluência verbal foram menores na região Nordeste e maiores no Centro-Oeste e Sudeste, respectivamente. Na região Sul, foram encontrados maiores escores para memória imediata e combinada. Em todas as regiões, participantes mais velhos e com menor escolaridade apresentaram piores escores para memória e fluência verbal. CONCLUSÕES Existem diferenças na função cognitiva entre adultos mais velhos nas distintas macrorregiões, que são independentes da idade, sexo, escolaridade e residência rural ou urbana.

Queixa subjetiva de memória e a relação com a fluência verbal em idosos ativos / Subjective memory complaints and their relation with verbal fluency in active older people

RESUMO Objetivo Verificar a queixa subjetiva de memória relacionada com a fluência verbal em idosos participantes de grupos de convivência. Método Trata-se de um estudo epidemiológico, quantitativo, realizado em grupos de convivência de idosos do município de Florianópolis, Estado de Santa Catarina. Os dados foram coletados por meio de entrevista estruturada utilizando-se o Questionário de Queixas de Memória (MAC-Q) e o Teste de Fluência Verbal (TFV) por categorias semânticas animais/minuto. Para a análise descritiva inferencial, consideraram-se os dados com p < 5%. Resultados Foi encontrada a queixa de memória autodeclarada em 35,7% da amostra. Não houve associação e correlação do TFV com a percepção da memória obtida pelo MAC-Q bem como com o seu escore. A análise do TFV com os indivíduos que referiram percepção negativa de memória apresentou significância estatística. Salienta-se que foi encontrada associação significativa entre a percepção (escore do MAC-Q) e a presença da queixa de memória (referida pelos idosos em questão acrescida ao questionário). Conclusão Não houve relação entre a queixa subjetiva de memória e a fluência verbal de idosos ativos, sendo as queixas mnemônicas correlacionadas à percepção negativa da memória e ao tempo de queixa apresentada. Porém a queixa subjetiva da memória se mostrou um indicativo para aqueles indivíduos com percepção negativa da memória, sendo um aspecto que deve ser considerado na fala dos idosos ao se investigar um possível declínio cognitivo. Tais dados podem auxiliar no direcionamento das ações de políticas públicas de assistência às pessoas idosas no município, salientando-se a importância em se verificar a queixa subjetiva de memória dos idosos.

ABSTRACT Purpose To verify subjective memory complaints and their relation to verbal fluency in older people participating in community groups. Methods An epidemiological quantitative study performed in community groups for older people in Florianópolis, state of Santa Catarina, Brazil. Data were collected by structured interview using the Memory Complaint Questionnaire (MAC-Q) and the Verbal Fluency Test (VFT) by semantic categories “animals/minute”. For an inferential descriptive analysis, data with p < 5% were considered. Results Self-reported memory complaints were found in 35.7% of the sample. No association or correlation of VFT with the perception of memory obtained by MAC-Q, nor with its score was found. The VFT analysis of in individuals who reported negative perception of memory presented statistical significance. We found significant association between the perception (MAC-Q score) and presence of memory lapses (reported by the older people in question and added to the questionnaire). Conclusion We found no relation between subjective memory complaints and verbal fluency of active older people. Mnemonic complaints were correlated to the negative perception of memory and to the duration of the complaint. However, subjective memory complaints were an indicator for those individuals with negative perception of memory, being one aspect that must be considered in older people’s speech when investigating a possible cognitive deterioration. Such data can assist in formulating public health care policies aimed at older people in the city, which emphasizes the importance of verifying subjective memory complaints in this population.

Cognitive performance and psychosocial functioning in patients with bipolar disorder, unaffected siblings, and healthy controls

Objective: To assess cognitive performance and psychosocial functioning in patients with bipolar disorder (BD), in unaffected siblings, and in healthy controls. Methods: Subjects were patients with BD (n=36), unaffected siblings (n=35), and healthy controls (n=44). Psychosocial functioning was accessed using the Functioning Assessment Short Test (FAST). A sub-group of patients with BD (n=21), unaffected siblings (n=14), and healthy controls (n=22) also underwent a battery of neuropsychological tests: California Verbal Learning Test (CVLT), Stroop Color and Word Test, and Wisconsin Card Sorting Test (WCST). Clinical and sociodemographic characteristics were analyzed using one-way analysis of variance or the chi-square test; multivariate analysis of covariance was used to examine differences in neuropsychological variables. Results: Patients with BD showed higher FAST total scores (23.90±11.35) than healthy controls (5.86±5.47; p < 0.001) and siblings (12.60±11.83; p 0.001). Siblings and healthy controls also showed statistically significant differences in FAST total scores (p = 0.008). Patients performed worse than healthy controls on all CVLT sub-tests (p < 0.030) and in the number of correctly completed categories on WCST (p = 0.030). Siblings did not differ from healthy controls in cognitive tests. Conclusion: Unaffected siblings of patients with BD may show poorer functional performance compared to healthy controls. FAST scores may contribute to the development of markers of vulnerability and endophenotypic traits in at-risk populations.

Awareness of memory deficits is useful to distinguish between depression and mild cognitive impairment in the elderly

Objective: To investigate whether the level of awareness of memory deficits is useful for discriminating between major depressive disorder (MDD) and mild cognitive impairment (MCI) in the elderly. Methods: Sixty-three consecutively referred patients (38 women and 25 men) with memory concerns comprising three groups (clinical control, MDD and MCI) underwent a memory test (Rey Auditory Verbal Learning Test [RAVLT]) and completed the Memory Assessment Complaints-Questionnaire (MAC-Q). Level of awareness was estimated by the difference between the MAC-Q score and the score on the fifth presentation of the RAVLT. Memory performance, Mini-Mental State Examination (MMSE) and depressive symptoms (Geriatric Depression Scale [GDS]) were also assessed. Results: The control (n=25), MDD (n=16), and MCI (n=22) groups were similar in age, educational level, and MMSE (p > 0.05). Among the groups, the MDD group had the most memory complaints, whereas the MCI group had the worst objective memory performance. Level of awareness was capable of discriminating between MDD and MCI (p < 0.05), but not between MDD and clinical controls (p > 0.05). MDD subjects tended to underestimate their memory functioning as compared to controls (p < 0.05). Conclusion: Level of awareness of memory deficits was significantly useful to discriminate between MCI and MDD, which is a common difficulty faced by clinicians. Future studies with larger samples are needed to confirm these findings.

Normative data of Fuld Object Memory Evaluation test for brazilian elderly population / Dados normativos do teste Fuld Object Memory Evaluation para a população de idosos brasileiros

ABSTRACT Objective This study aims to present normative data for Fuld Object Memory Evaluation test stratified by sex, gender, age, and education for the Brazilian elderly population. Method We evaluated 2.132 healthy elderly both genders, with a mean age of 70.30 years (± 7.28) from two community-based samples in Brazil drawn from different economic areas who were screened with cognitive and functional tests and the memory test. Statistical analyses were performed by independent t-test, one-way analysis of variance and multiple linear regression. Results Statistical analyses showed that memory scores tend to improve significantly with increasing years of education and decrease significantly as age increased. Conclusion We conclude that gender, education and age had effect on the Fuld Object Memory Evaluation performance in this Brazilian community-based sample.

RESUMO Objetivo Este estudo tem como objetivo apresentar dados normativos para o teste de Fuld Object Memory Evaluation estratificada por sexo, idade e educação para a população idosa brasileira. Método Foram avaliados 2.132 idosos saudáveis de ambos os sexos com idade média de 70,30 anos (± 7,28) a partir de duas amostras de base comunitária no Brasil provenientes de diferentes áreas economicas que foram selecionados com testes cognitivos e funcionais e o teste de memória. Resultados As análises estatísticas mostraram que os escores de memória tendem a melhorar significativamente com o aumento de anos de educação e diminuir significativamente o aumento da idade. Conclusão Conclui-se que gênero , escolaridade e idade tem efeito sobre o desempenho no teste Fuld Object Memory Evaluation nesta amostra da comunidade brasileira.

Gray and White Matter Degenerations in Subjective Memory Impairment: Comparisons with Normal Controls and Mild Cognitive Impairment

Subjective memory impairment (SMI) is now increasingly recognized as a risk factor of progression to dementia. This study investigated gray and white matter changes in the brains of SMI patients compared with normal controls and mild cognitive impairment (MCI) patients. We recruited 28 normal controls, 28 subjects with SMI, and 29 patients with MCI aged 60 or older. We analyzed gray and white matter changes using a voxel-based morphometry (VBM), hippocampal volumetry and regions of interest in diffusion tensor imaging (DTI). DTI parameters of corpus callosum and cingulum in SMI showed more white matter changes compared with those in normal controls, they were similar to those in MCI except in the hippocampus, which showed more degenerations in MCI. In VBM, SMI showed atrophy in the frontal, temporal, and parietal lobes compared with normal controls although it was not as extensive as that in MCI. Patients with SMI showed gray and white matter degenerations, the changes were distinct in white matter structures. SMI might be the first presenting symptom within the Alzheimer's disease continuum when combined with additional risk factors and neurodegenerative changes.

Persistência de imagem de hiperintensidade no hipocampo após episódio de amnésia global transitória / Persistence of hyperintensity image in the hippocampus after an episode of transient global amnesia

A patogenia da amnésia global transitória (AGT) continua obscura. Estudos recentes demonstraram que, em alguns pacientes, a sequência de difusão (DWI) da ressonância magnética pode revelar apresença de sinal pequeno e pontual hipersinal no hipocampo, após a fase aguda do episódio. Esse sinal é principalmente visualizado nas primeiras 6 horas do início do evento, sendo 114 horas o tempo máximo que foi registrado até o momento. Estamos apresentando um caso em que essa imagem persistiu por 11 dias após o episódio. Discutem-se as conhecidas causas, as teorias da patogenia da AGT e a possível conexão entre um efeito vascular e a depressão alastrante, como relatada na enxaqueca com aura.

The pathogenesis of transient global amnesia (TGA) remains obscure.Recent studies revealed that small and punctate signal on diffusion-weighted imaging (DWI) in the hippocampus after the post-acute phase. This signal is mainly seen in the first 6 hours of the onset of the event, and so far the maximum time registered was 114 hours. We present one case where this image persisted for 11 days after the episode. Known causes, theories on pathogenesis of TGA and a possible relation between a vascular mechanism and the spreading depression, as reported in migraine with aura, are discussed.

Relations between memory complaints, depressive symptoms and cognitive performance among community dwelling elderly / Relações entre queixas de memória, sintomas depressivos e desempenho cognitivo em idosos residentes na comunidade

Backgroun: Memory complaints are quite common among the elderly; yet, the clinical relevance of these complaints to diagnose cognitive decline is debatable, since several different factors could be associated with them. Objective: The present paper examined the correlations between memory complaints, depressive symptoms and cognitive performance in a group of 301 elderly individuals who lived in the district of Ermelino Matarazzo, São Paulo, and who participated in the population-based survey entitled Profiles of Frailty in Elderly Brazilians by the FIBRA Network. Methods: Cognitive performance was assessed with the memorization test involving 10 common pictures, the Mini Mental State Examination (MMSE), the Verbal Fluency (VF) test, and the Clock Drawing Test, which comprise the Brief Cognitive Screening Battery (BCSB). Memory complaints were assessed with the Memory Complaint Questionnaire (MAC-Q), and depressive symptoms with the Geriatric Depression Scale (GDS). Results: Female participants had higher rates of memory complaints when compared to male participants (p = 0.013). Subjects with less years of schooling had more severe memory complaints and poorer cognitive performance than those with more years of schooling (p < 0.003). The presence of depressive symptoms was associated with poorer memory assessment scores (r = 0.39, p < 0.001). Discussion: Memory complaints were correlated with sex, schooling and depressive symptoms among elderly individuals residing in the community. No correlation was found between complaints and cognitive performance.

Contexto: A queixa de memória é comum entre pessoas idosas, entretanto sua relevância clínica para o diagnóstico de alterações cognitivas é questionável, visto que diversos fatores podem se associar às queixas. Objetivo: O presente estudo avaliou a relação entre queixas de memória, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Objetivo: O presente estudo avaliou a relação entre queixas de memória, sintomas depressivos e desempenho cognitivo em 301 idosos residentes em Ermelino Matarazzo que participaram da pesquisa de base populacional Perfis de Fragilidade em Idosos Brasileiros da Rede FIBRA. Métodos: O desempenho cognitivo foi avaliado por meio dos testes de memorização de 10 figuras comuns, Miniexame do Estado Mental (MEEM), Fluência Verbal (FV) e Teste do Desenho do Relógio, que compõem a Bateria Breve de Rastreio Cognitivo (BBRC). As queixas de memória foram avaliadas pelo Questionário de Queixas de Memória (MAC-Q) e os sintomas depressivos, pela Escala de Depressão Geriátrica (EDG). Resultados: Participantes do sexo feminino apresentaram maior índice de queixas de memória, comparado ao dos homens (p = 0,013). Idosos menos escolarizados apresentaram queixas de memória mais intensas e pior desempenho cognitivo, comparados aos de maior escolaridade (p < 0,003). A presença de sintomas depressivos associou-se à pior avaliação da memória (r = 0,39, p < 0,001). Conclusão: As queixas de memória se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Não houve associação entre queixas e desempenho cognitivo. Conclusão: As queixas de memória se associaram a sexo, escolaridade e sintomas depressivos, entre idosos residentes na comunidade. Não houve associação entre queixas e desempenho cognitivo.

Subjective memory complaints in the elderly: a sign of cognitive impairment?

OBJECTIVES: Cognitive impairment in the elderly is frequently overlooked by general practitioners. The use of subjective memory complaints as a sign of cognitive impairment by the general practice is controversial. METHODS: Elderly individuals (N = 248) were asked whether they had memory complaints and underwent a cognitive impairment screening. Subjects classified as exhibiting “probable cognitive impairment” underwent a complete cognitive evaluation, and the final diagnoses were established by expert consensus. RESULTS: A total of 147 patients presented with subjective memory complaints, and 43 were further classified as demented or “cognitively impaired not demented”. Subjective memory complaints presented a sensitivity of 100% and a negative predictive value of 100%. CONCLUSION: Subjective memory complaints are an indicator for cognitive impairment screening. .

Utilidad clínica del Memory Impairment Screen (MIS): análisis del instrumento como prueba de tamizaje de memoria / Clinical utility of Memory Impairment Screen (MIS): analysis of the instrument as a screening test memory

Introducción. Se ha insistido en la necesidad de seleccionar apropiadamente las pruebas neuropsicológicas más sencillas y precisas en el diagnóstico precoz de deterioro cognitivo y demencia. Objetivo. Comparar la utilidad clínica del MIS (Memory Impairment Screen) con otras pruebas breves de cribado cognitivo en una población mayor de 60 años que consultó específicamente por quejas de memoria. Pacientes y Método. Estudio prospectivo, muestra de 142 pacientes mayores de 60 años, derivados a evaluación neuropsicológica por quejas de memoria al policlínico de Neuropsicología de la Sección de Geriatría del Hospital Clínico de la Universidad Chile. Se aplicaron MIS, Mini-Cog, Test del Reloj (CDT) y Recuerdo libre y selectivamente facilitado (FCSRT). La validez de MIS,Mini-Cog y CDT fue evaluada contra FCSRT como gold standard. Resultados. El 70.4 por ciento eran mujeres, con promedios de edad 75.9+/-7 años, escolaridad 9.5+/-4.7 años y MMSE (Mini Mental State Examination) 25+/-3.7 puntos. MIS presentó los valores más altos de sensibilidad (82 por ciento), especificidad (75 por ciento), Valor Predictivo Positivo (61 por ciento) y Valor Predictivo Negativo (90 por ciento). En un 31.7 por ciento de los pacientes se detectó deterioro según FCSRT, mientras que con MIS fue de 43 por ciento, Mini-Cog 47.2 por ciento y CDT 45.2 por ciento. Por otra parte, el 35.6 por ciento de los pacientes con déficit de memoria según MIS serían falsos positivos, es decir, fueron incorrectamente diagnosticados como sanos. Conclusiones: La detección precoz del déficit de memoria mediante el MIS sería superior a otras pruebas simples de tamizaje, sin embargo FCSRT permite optimizar la evaluación de la memoria constituyendo un instrumento clínico que no podría ser sustituido por MIS.

Introduction. It has emphasized the need for appropriately selected neuropsychological testing simple and accurate early diagnosis of cognitive impairment and dementia. Objective. To compare the clinical utility of MIS (Memory Impairment Screen) with other brief cognitive screening test in a population older than 60 years who consulted specifically for memory complaints. Patients and Method. Prospective study sample of 142 patients over 60 years, referred for neuropsychological assessment of memory complaints to the polyclinic of Neuropsychology, Section of Geriatric Hospital of the University of Chile. MIS were applied, Mini-Cog, Clock Test (CDT) and selectively facilitated free recall (FCSRT). The validity of MIS, Mini-Cog and CDT was evaluated against FCSRT as gold standard. Results. 70.4 percent were women, with mean age 75.9 +/- 7 years, education 9.5 +/- 4.7 years and MMSE (Mini Mental State Examination) 25 +/- 3.7 points. MY presented the highest values of sensitivity (82 percent, specificity (75 percent), positive predictive value (61 percent) and negative predictive value (90 percent). In 31.7 percent of patients according FCSRT deterioration detected while MIS was 43 percent, Mini-Cog CDT 47.2 percent and 45.2 percent. On the other hand, 35.6 percent of patients with memory deficits as MIS would be false positives, ie, were incorrectly diagnosed as healthy. Conclusions. The early detection of memory deficits by MIS would be simpler than other screening tests, however FCSRT optimizes memory assessment forming a clinical instrument that could not be replaced by MIS.

Memória evocativa em pacientes não dementes com doença de Parkinson / Evocative memory in not demented patients with Parkinson disease

INTRODUÇÃO: A doença de Parkinson (DP) é uma moléstia neuro-psiquiátrica caracterizada principalmente por manifestação motora - tremor de repouso, bradicinesia, rigidez e alterações do equilíbrio. No fim do século XIX, observou-se também comprometimento cognitivo na DP. Entre as alterações cognitivas, estão relacionados o déficit executivo e os distúrbios de memória, que podem ser a principal manifestação da demência de Parkinson. OBJETIVOS: Identificar alterações da memória evocativa em doentes de Parkinson não dementes, relacionando o estadiamento motor da doença com essas alterações. MÉTODOS: Foi utilizado o Protocolo para Diagnóstico e Tratamento da Demência de Alzheimer para caracterizar a memória evocativa de 11 pacientes assistidos no Hospital de Clínicas de Uberlândia, principalmente por meio dos testes "Reconhecimento de figuras" e "Lista de palavras". O estadiamento motor foi avaliado pela escala de Hoehn e Yahr. RESULTADOS: Formaram-se dois grupos de pacientes conforme os resultados obtidos. As variáveis Idade, Percepção visual, Memória incidental, Pontuação na primeira, segunda e terceira tentativa e Memória evocativa no teste Lista de Palavras não apresentaram diferença significativa entre os grupos. Já as variáveis Estádios da Doença de Parkinson segundo a Escala de Hoehne Yahr, Memória imediata 1, Memória imediata 2 e Evocação de 5 minutos apresentaram diferença significativa, e no grupo 2 estas variáveis foram menores. CONCLUSÃO: Não se estabeleceu relação entre a deterioração da memória global do portador da doença de Parkinson com seus prejuízos motores e a memória imediata não teve distinção da memória evocativa com a evolução da doença.

INTRODUCTION: Parkinson's disease (PD) is a neuropsychiatric disordercharacterized mainly by motor manifestations - resting tremor, bradykinesia, rigidity and balance disorders. In the late 19th century cognitive impairment was also observed in PD. Among the cognitive changes are included primarily executive deficits and memory disorders, which may be the primary manifestation of Parkinson's dementia. OBJECTIVES: To identify changes in evocative memory in not demented PD patients, relating to motor staging of the disease with these changes. METHODS: The protocol for Diagnosis and Treatment of Alzheimer's Disease was used to characterize evocative memory of 11 patients assisted at the Hospital de Clínicas de Uberlândia, mainly through the tests "Recognition of figures" and "Word List". The motor staging of patients was assessed with Hoehn and Yahr scale. RESULTS: Two groups of patients were formed according to the obtained results. The variables Age, Visual perception, Incidental memory score in the 1st, 2nd and 3rd trial and Evocative memory in the test Word List, did not present significant differences between the groups. The variables Stages of Parkinson's disease according to Hoehn and Yahr scale, an Immediate memory 1, Immediate memory 2, and 5 minutes retrieval, showed significant differences between the groups, with lower variables in the group 2. CONCLUSION: No relation was established between the global memory decline in Parkinson's diseasepatients, with their motor impairments, and immediate memory presentedno distinction in relation to the evocative memory with the course of the disease.

Verbal learning on depressive pseudodementia: accentuate impairment of free recall, moderate on learning processes, and spared short-term and recognition memory / Aprendizagem verbal na pseudodemencia depressiva: comprometimento acentuado da evocacao livre, moderado nos processos de aprendizagem e preservacao da memoria de curto prazo e reconhecimento

Objective Depressive pseudodementia (DPD) is a clinical condition characterized by depressive symptoms followed by cognitive and functional impairment characteristics of dementia. Memory complaints are one of the most related cognitive symptoms in DPD. The present study aims to assess the verbal learning profile of elderly patients with DPD. Methods Ninety-six older adults (34 DPD and 62 controls) were assessed by neuropsychological tests including the Rey auditory-verbal learning test (RAVLT). A multivariate general linear model was used to assess group differences and controlled for demographic factors. Results Moderate or large effects were found on all RAVLT components, except for short-term and recognition memory. Conclusion DPD impairs verbal memory, with large effect size on free recall and moderate effect size on the learning. Short-term storage and recognition memory are useful in clinical contexts when the differential diagnosis is required. .

Objetivo A pseudodemência depressiva (PDD) é uma condição clínica onde sintomas depressivos são acompanhados por comprometimento cognitivo e funcional característicos da demência. Queixas de memória são um dos sintomas mais comumente relatados na PDD. O presente estudo almeja investigar a aprendizagem verbal de pacientes idosos com PDD. Método 96 idosos (34 PDD e 62 controles) realizaram testes neuropsicológicos incluindo o Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT). Adotou-se um modelo linear geral multivariado para comparação dos grupos controlando variáveis sociodemográficas. Resultados Pacientes com PDD apresentaram déficits em todo o RAVLT, com exceção no armazenamento de curto-prazo e reconhecimento, com tamanhos de efeito moderados ou altos. Conclusão A PDD compromete a memória verbal mais intensamente na evocação livre e de forma moderada na aprendizagem. A memória de curto-prazo e de reconhecimento são úteis em contextos onde o diagnóstico diferencial é necessário. .

Revisión de dos instrumentos de simulación neurocognitiva y su utilidad en el contexto forense / Review of the neurocognitive malingering instrument and its useful in a forensic contex

Gran parte de la precisión de la evaluación neuropsicológica, depende que los instrumentos que utiliza, sean medidas estandarizadas, válidas y confiables. Sin embargo, la simulación, la exageración y el bajo esfuerzo son aspectos que pueden interferir en los resultados de los test. El objetivo de esta revisión pretende describir y analizar dos instrumentos en el contexto de la Neuropsicología Forense que evalúan simulación de síntomas cognitivos: el Test of Memory Malingering (TOMM) y el Victoria Symptoms Validity Test (VSVT). Se realizó una búsqueda dirigida no exhaustiva, en diversas bases de datos y libros afines. El criterio de inclusión fue la utilización o revisión de los test. Se seleccionaron 68 trabajos publicados. Cada uno de los cuales fue analizado en base a las características técnicas de los instrumentos. La revisión ha demostrado que el TOMM y el VSVT son instrumentos pertinentes para valorar simulación y exageración de sintomatología cognitiva. Estos instrumentos cuentan con un cúmulo de investigaciones que avalan sus propiedades, pero también las limitaciones y restricciones de su utilización.

Most of the accuracy in neuropsychological assessment depends that the instruments used are standardized, valid and reliable measures. However, malingering, exaggeration and poor effort are aspects that can interfere with the interpretation of the results. The aim of this review was to describe and analyze two instruments in the context of forensic neuropsychology that assess malingering of cognitive symptoms: Test of Memory Malingering (TOMM) and Victoria Symptoms ValidityTest (VSVT). Several scientific databases and related books were searched non-exhaustively. The criterion for inclusion in this review was the use of test. We selected 68 documents, each one was analyzed based on the technical characteristics of the instruments. Review showed that the TOMM and VSVT are relevant instruments for assessing malingering and exaggeration of cognitive symptoms. These instruments have several evidence that support their psychometric properties but also limitations and restrictions on their use.

Propiedades psicométricas del cuestionario multidimensional de memoria en población chilena adulta / Psychometric properties of multifactorial memory questionnaire in chilean adult population

El estudio presenta los datos de confiabilidad, validez convergente, de contenido y validez factorial del multifactorial memory questionnaire [MMQ] en una muestra de 740 participantes correspondientes a población chilena normal, sin problemas de salud, en rangos de edad de 20 a 81 años. El MMQ posee 56 ítems tipo likert, correspondientes a tres dimensiones referidas a confianza en la memoria, capacidad y estrategias o ayudas usadas diariamente para recordar información. A partir del análisis realizado es posible afirmar que el instrumento presenta validez de contenido, validez factorial y confiabilidad de consistencia interna, similar a la reportada en su versión original. Se presenta además, la relación existente con sexo, edad, satisfacción vital y salud subjetiva. El MMQ es un instrumento adecuado para ser usado tanto en contextos clínicos como de investigación para evaluar metamemoria.

The current study presents data on the reliability, convergent, content and factorial validity of the multifactorial memory questionnaire [MMQ] in a Chilean sample of 740 normal and healthy participants aged 20 to 81 years. The MMQ is a 56-item likert scale questionnaire divided into three dimensions: memory contentment, ability, and everyday strategies or aids used to remember information. The analysis indicates that the instrument has content validity, factorial validity and internal reliability, similar to the data reported on the original study of the instrument. Data of the relationship with sex, age, life satisfaction and subjective health are also presented. The MMQ is a useful scale to evaluate metamemory in clinical and research settings.

Memory mood congruency phenomenon in bipolar I disorder and major depression disorder patients

The objective of the present study was to evaluate memory performance in tasks with and without affective content (to confirm the mood congruency phenomenon) in acutely admitted patients with bipolar I disorder (BD) and major depression disorder (MDD) and in healthy participants. Seventy-eight participants (24 BD, 29 MDD, and 25 healthy controls) were evaluated. Three word lists were used as the memory task with affective content (positive, negative and indifferent). Psychiatric symptoms were also evaluated with rating scales (Young Mania Rating Scale for mania and Hamilton Depression Rating Scale for depression). Patients were selected during the first week of hospitalization. BD patients showed higher scores in the word span with positive tone than MDD patients and healthy controls (P = 0.002). No other difference was observed for tests with affective tone. MDD patients presented significantly lower scores in the Mini-Mental State Exam, logical memory test, visual recognition span, and digit span, while BD patients presented lower scores in the visual recognition test and digit span. Mood congruency effect was found for word span with positive tone among BD patients but no similar effect was observed among MDD patients for negative items. MDD patients presented more memory impairment than BD patients, but BD patients also showed memory impairment.

Nuevo objetivo en la mira de la neuropsiquiatría: el síndrome disejecutivo y disejecutividad: hallazgos clínicos neurológicos y psiquiátricos / New target in the sights of neuropsychiatry: dysexecutive and dysexecutive syndrome: neurological and psychiatric clinical findings

Desde el punto de vista sintomatológico, se han descrito numerosos hallazgos neurológicos asociados a lesiones, isquemias que corresponden a un deterioro cognitivo no favorable a la edad de los pacientes estudiados en diferentes investigaciones. Se ha tornado una premisa mundial el enfoque actual neuropsiquiátrico y el uso diagnóstico y terapéutico de herramientas neuropsiquiátricas disponibles en la actualidad, teniéndose consideración de innovadores conceptos como la validez ecológica de tareas, test, y subtest neuropsicológicos. Es por ello que se pretende compartir una revisión bibliográfica desde esta óptica, para identificar las probables lesiones que sean causa de este polémico y reciente objeto de estudio: el síndrome disejecutivo, o recientemente denominado “disejecutividad”.

From the standpoint of symptomatic have been reported numerous findings related to neurological injury, ischemia that corre-spond to unfavorable cognitive impairment at the age of the patients studied in various investigations, has become a global as-sumption the current approach and use neuropsychiatric Diagnosis and treatment of neuropsychiatric tools available today, taking account of innovative concepts such as ecological validity of tasks, tests, and neuropsychological subtests. That is why I intend to share reviews from this standpoint, in order to identify lesions that are likely cause of this controversial and recent area of study: The dysexecutive syndrome, or recently called dysexecutive.