Memory and language risk assessment with Wada test in patients candidates for epilepsy surgery. / Evaluación de la memoria y el lenguaje mediante el test de Wada en pacientes candidatos a cirugía de epilepsia.

AIM: To determine post-surgical cognitive risk and associated factors according to lesion location in a sample of patients evaluated for epilepsy surgery with Wada test at the Fundacion Instituto Neurologico de Colombia. MATERIALS AND METHODS: An observational, retrospective, analytical study was completed in patients with drug-resistant temporal lobe epilepsy candidates for epilepsy surgery treated from 2001 to 2021, who completed the Wada test as part of the pre-surgical evaluation. A descriptive analysis of sociodemographic, clinical, imaging and neuropsychological variables was completed; a multivariate logistic regression was performed analyzing factors associated with resection risk in patients with left lesions. RESULTS A total of 369 patients were included, 54.74% of the cases were women, with a median age of seizure onset of 11 years. 92.66% of the cases had lesional epilepsy and 68.56% were secondary to hippocampal sclerosis. Left hemisphere was the most frequently affected (65.68%) being dominant for memory and language in most of the patients with a proportion of 42.82% and 81.3%, respectively. The median functional adequacy was 43.75 (IQR 0-75) and the functional reserve was 75 (IQR 25 -93.75). In 104 patients, the Wada test determined a resection risk. In patients with a left lesion, it was found that functional reserve (PRadjusted 0.99, CI 95% 0.9997-0.9998) and having a right hemispheric dominance for memory (PRadjusted 0.92, CI 95% 0.547-0.999) were protective factors for post-surgical resection risk. CONCLUSION: Wada test is a useful tool for surgical decision-making in patients with drug-resistant temporal lobe epilepsy. When considering cognitive risk, components such as memory dominance and functional reserve should be considered as protective factors for postsurgical cognitive function preservation in patients with left lesions.

TITLE: Evaluación de la memoria y el lenguaje mediante el test de Wada en pacientes candidatos a cirugía de epilepsia.Objetivo. Determinar el riesgo cognitivo posquirúrgico y factores asociados según la localización de la lesión en una muestra de pacientes evaluados para cirugía de epilepsia con el test de Wada en la Fundación Instituto Neurológico de Colombia. Materiales y métodos. Se realizó un estudio observacional, retrospectivo y analítico en pacientes con epilepsia farmacorresistente del lóbulo temporal candidatos a cirugía de epilepsia tratados entre 2001 y 2021, que completaron el test de Wada como parte de la evaluación prequirúrgica. Se realizó un análisis descriptivo de variables sociodemográficas, clínicas, imagenológicas y neuropsicológicas. Se realizó una regresión logística multivariada analizando factores asociados al riesgo de resección en pacientes con lesiones izquierdas. Resultados. Se incluyó a 369 pacientes, el 54,74% de los casos fueron mujeres, con una mediana de edad de inicio de las convulsiones de 11 años. El 92,66% de los casos presentó epilepsia lesional; de éstos, el 68,56% fue secundario a esclerosis hipocampal. El hemisferio izquierdo fue el más frecuentemente afectado (65,68%), y éste fue dominante para la memoria y el lenguaje en la mayoría de los pacientes, con una proporción del 42,82 y el 81,3%, respectivamente. La mediana de adecuación funcional fue de 43,75 (rango intercuartílico: 0-75) y la reserva funcional de 75 (rango intercuartílico: 25-93,75). En 104 pacientes, el test de Wada determinó un riesgo de resección. En pacientes con lesiones izquierdas se encontró que la reserva funcional (razón de prevalencia ajustada: 0,99; intervalo de confianza al 95%: 0,9997-0,9998) y tener dominancia del hemisferio derecho para la memoria (razón de prevalencia ajustada: 0,92; intervalo de confianza al 95%: 0,547-0,999) fueron factores asociados para determinar el riesgo de resección posquirúrgico en el test de Wada. Conclusión. El test de Wada es una herramienta útil para la toma de decisiones quirúrgicas en pacientes con epilepsia del lóbulo temporal farmacorresistente. Componentes como la dominancia de la memoria y la reserva funcional en el test de Wada deben considerarse como factores que se deben tener en cuenta en la predicción de la preservación de la función cognitiva posquirúrgica en pacientes con lesiones izquierdas.

[Specific impaired language development: a selective or generalised cognition problem]. / Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición.

INTRODUCTION: Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. AIM: To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. SUBJECTS AND METHODS: The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. RESULTS: Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of -1.31 and -1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. CONCLUSION: These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions.

Trastorno específico del desarrollo del lenguaje: problema selectivo o generalizado de la cognición / Specific impaired language development: a selective or generalised cognition problem

Introducción. El trastorno específico del desarrollo del lenguaje (TEDL) es una entidad diagnóstica en la que se espera que el lenguaje sea la única función cognitiva afectada. Sin embargo, es posible que se puedan presentar dificultades en otras funciones cognitivas, sea porque la alteración lingüística es expresión de una afección de base o porque el retraso lingüístico lleve a falencias cognitivas en general. Objetivo. Determinar si existen diferencias en el rendimiento cognitivo de niños con TEDL respecto a niños con un desarrollo normal. Sujetos y métodos. Participaron 51 niños con TEDL, con edades entre los 6 y 16 años, y 49 niños de un grupo control, pareados por edad cronológica, sexo y estrato socioeconómico. Se evaluó la capacidad cognitiva verbal, atención, memoria, praxia visuoconstruccional y función ejecutiva. Resultados. Se encontraron diferencias estadística y clínicamente significativas en las habilidades de tipo verbal, como son la comprensión lingüística y la capacidad cognitiva verbal, las cuales tuvieron un tamaño de efecto de –1,31 y –1,33, respectivamente. En las demás funciones evaluadas el rendimiento del grupo con TEDL fue levemente menor que el del grupo control, sin mostrar una diferencia clínicamente significativa. Conclusión. Estos hallazgos muestran que el grupo de niños con TEDL está muy bien seleccionado, ya que los dos grupos sólo se diferencian en aspectos lingüísticos; además, es una evidencia que apoya la concepción de que el lenguaje y otras funciones cognitivas son relativamente independientes, y que una alteración lingüística sólo generaría un efecto general inespecífico en las demás funciones cognitivas

Introduction. Specific developmental language disorder (SDLD) is a diagnostic entity in which language is expected to be the only cognitive function that is affected. Nevertheless, difficulties in other cognitive functions may also appear, either because the language disorder is an expression of an underlying condition or because the retarded language development gives rise to cognitive deficits in general. Aim. To determine whether there are any differences in the cognitive performance of children with SDLD and that of children who have developed normally. Subjects and methods. The study involved a sample of 51 children with SDLD, aged between 6 and 16 years, and 49 children in a control group, who were paired by chronological age, sex and socioeconomic level. Verbal cognitive capacity, attention, memory, visual-constructional and executive functioning were all evaluated. Results. Statistically and clinically significant differences were found in the verbal-type skills, such as language comprehension and verbal cognitive capacity, which showed effect sizes of –1.31 and –1.33, respectively. In the other functions that were assessed, the performance of the SDLD group was slightly lower than that of the control group, but with no clinically significant differences. Conclusion. These findings show that the group of children with SDLD was well selected, since the only differences between the two groups involve linguistic aspects; moreover, this evidence supports the idea that language and other cognitive functions are relatively independent and that a language disorder would only generate an unspecific general effect in the other cognitive functions

[A description of semantic memory performance in a sample of the Antioquian population]. / Descripción del desempeño en memoria semántica en una muestra de la población antioqueña.

INTRODUCTION: Available treatments for Alzheimer disease allow that early diagnosis become an important issue, because treatment only are useful during the earliest stage, especially during the mild cognitive impairment (MCI), when the most of the cognitive function is preserved. AIM: To observe the performance on a shortened version of a Semantic Cue Recall Memory Test (SCRMT) from a group of adult aged over 50 years old, living in Medellin city and with dementia of Alzheimer type (DAT). SUBJECTS AND METHODS: The sample was constituted by 30 patients with DAT, 30 with MCI, and 59 healthy controls, which were matched by socio economic strata and school achievement. The SCRMT was administered to the sample. For the analyses two groups of age (50-69 and over 70 years) were conformed. RESULTS: Comparisons statistically significant differences between the groups (p < 0.05). The scores were not significant affected by age. A combination of low scores with the presence of intrusions on the free, immediate cue, and delay cue recalls suggested the diagnosis of DAT, which allow recommending a complete neuropsychological assessment. Statistically significant differences were preserved when the groups were divided by age. The effect of the gender could not determine because the small size of the male sample. CONCLUSION: The shortened version of the SCMRT would appear be useful for the DAT diagnosis.

Descripción del desempeño en memoria semántica en una muestra de la población antioqueña / A description of semantic memory performance in a sample of the antioquian population

Introducción. La existencia de tratamientos para retardar la evolución de la demencia tipo Alzheimer (DTA) hace que la detección temprana sea importante, ya que estos tratamientos son efectivos si se inician cuando la mayoría de las funciones cognitivas aún están preservadas, o en la etapa de deterioro cognitivo leve (DCL). Objetivo. Observar la ejecución en la versión abreviada de la prueba de memoria semántica con clave (MSC), para el diagnóstico de demencias de un grupo de adultos mayores de 50 años del área metropolitana de Medellín. Sujetos y métodos. La muestra estuvo formada por 30 pacientes con DTA, 30 con DCL y 59 controles; se emparejaron por estrato socioeconómico y escolaridad. Se les aplicó la prueba abreviada de MSC, y se formaron dos subgrupos: uno de 50 a 69 años, y otro de 70 años en adelante. Resultados. La comparación de las puntuaciones en la prueba entre los tres grupos arrojó diferencias estadísticamente significativas (p < 0,05). El desempeño no se modificó con la edad. La combinación de bajas puntuaciones con la presencia de intrusiones en la evocación libre, diferida y con clave sugiere el diagnóstico de DTA, lo que justificaría una evaluación neuropsicológica detallada. Al estratificar la muestra por edad las diferencias continuaron siendo significativas. El efecto del sexo no se pudo observar por el bajo número de participantes de sexo masculino (AU)

Introduction. Available treatments for Alzheimer disease allow that early diagnosis become an important issue, because treatment only are useful during the earliest stage, especially during the mild cognitive impairment (MCI), when the most of the cognitive function is preserved. Aim. To observe the performance on a shortened version of a Semantic Cue Recall Memory Test (SCRMT) from a group of adult aged over 50 years old, living in Medellín city and with dementia of Alzheimer type (DAT). Subjects and methods. The sample was constituted by 30 patients with DAT, 30 with MCI, and 59 healthy controls, which were matched by socio economic strata and school achievement. The SCRMT was administered to the sample. For the analyses two groups of age (50-69 and over 70 years) were conformed. Results. Comparisons statistically significant differences between the groups (p < 0.05). The scores were not significant affected by age. A combination of low scores with the presence of intrusions on the free, immediate cue, and delay cue recalls suggested the diagnosis of DAT, which allow recommending a complete neuropsychological assessment. Statistically significant differences were preserved when the groups were divided by age. The effect of the gender could not determine because the small size of the male sample. Conclusion. The shortened version of the SCMRT would appear be useful for the DAT diagnosis (AU)