Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review

This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.

Development and applications of the SWAN rating scale for assessment of attention deficit hyperactivity disorder: a literature review.

This study reviewed the use of the Strengths and Weaknesses of Attention-Deficit/Hyperactivity-symptoms and Normal-behaviors (SWAN) rating scale in diagnostic and evolutive approaches to attention deficit hyperactivity disorder (ADHD) and in correlational studies of the disorder. A review of articles published in indexed journals from electronic databases was conducted and 61 articles on the SWAN scale were analyzed. From these, 27 were selected to a) examine use of SWAN in research on attention disorders and b) verify evidence of its usefulness in the areas of genetics, neuropsychology, diagnostics, psychiatric comorbidities, neuroimaging, pharmacotherapy, and to examine its statistical reliability and validity in studies of diverse populations. This review of articles indicated a growing use of the SWAN scale for diagnostic purposes, for therapy, and in research on areas other than ADHD, especially when compared with other reliable scales. Use of the scale in ADHD diagnosis requires further statistical testing to define its psychometric properties.

Study of candidate genes for dyslexia in Brazilian individuals.

Dyslexia or reading disability (RD) is the most common childhood learning disorder and a significantly heritable trait. Many recent studies have investigated the genetic basis of dyslexia, and several candidate genes have been proposed. Among these, DCDC2 and KIAA0319 have emerged as the strongest candidate genes for dyslexia; however studies have not provided uniformly supportive results. The aim of this study was to assess the contribution of proposed candidate genes to the molecular etiology of dyslexia in a Brazilian sample. Large deletions and duplications in the candidate genes DCDC2, KIAA0319, and ROBO1 were investigated in 51 dyslexic subjects. Furthermore, a family-based association study was performed to investigate whether associations observed in other populations with variants in the DCDC2 and KIAA0319 genes were reproducible in Brazilian dyslexic individuals. Our analysis did not detect any deletions or duplications in the genes studied, and we found no evidence that the allelic variants in the two candidate genes were significantly associated with RD in our sample. Our data do not support a role of the DCDC2/KIAA0319 locus in influencing dyslexia as a categorical trait. Given the genetic complexity of dyslexia, it is plausible that both genes contribute to an increased risk, but the relative influence of these 2 genes on RD varies in different study samples, and/or depends on analytical approaches.

Hemiparetic cerebral palsy: clinical data compared with neuroimaging

OBJETIVO: Este estudo correlacionou o desempenho da função motora fina (FMF) e Sensorial (FS) na paralisia cerebral hemiparética (PC-H) à classificação da ressonância magnética (RM). MÉTODO: Utilizaram-se os protocolos específicos para avaliar FMF, FS e lesões encefálicas quanto à sua extensão e localização no hemisfério. Foram avaliados 46 sujeitos sendo 23 com PC-H, grupo 1, e 23 crianças normais, grupo 2. A idade variou entre 07 a 16 anos, idade média de 12 anos e 8 meses. RESULTADOS:O desempenho das FMF e FS demonstrou ser significantemente pior no grupo 1 quando comparado ao grupo controle. PC-H que apresentavam lesões atingindo uma única estrutura encefálica demonstraram melhores resultados que aqueles com comprometimento atingindo duas estruturas maiores que 10 mm. O desempenho dos sujeitos com comprometimento cortical e subcortical, uni ou bilateral, foi inferior quando comparados aos com lesões subcorticais.CONCLUSÃO: As disfunções motoras e sensoriais necessitam ser identificadas e compreendidas para prover melhor treinamento de rotina e cuidados especiais a essas crianças.

Doença cerebrovascular: aquisição de linguagem em pré-escolares / Cerebrovascular disease: language acquisition in preschool children

We describe ten children, aging 5 years and 1 month until 5 years and 11 months, when the phonoaudiological assessment was conducted. They are divided according to cerebrovascular disease, in CVD group (CVD-G) and control group (cG). Children were seen and CVD was confirmed in the acute phase at UNICAMP hospital. Audiologic assessment, protocol for Infant language assessment, and Peabody picture vocabulary test were used in the evaluations. The qualitative analysis of the subjects from a phonoaudiological and neurological point of view has shown the recovery of acquired language disorder (ALD) with no influence whatsoever in the development of 2 subjects and subtle language and/or learning process alterations for 3 subjects. The cases study has revealed that all aspects of language development in preschool children should be analyzed in an individual, quantitative, and qualitative basis to lead to conclusive findings.

São descritos 10 casos de crianças com idade cronológica entre 5 anos e 1 mês e 5 anos e 11 meses, divididas em grupo de doença cerebrovascular, (G-DCV) e grupo controle (Gc). As crianças do G-DCV apresentaram DCV confirmada na fase aguda através de exame neurológico clínico e de imagem na UNICAMP. Nas avaliações utilizou-se triagem audiológica, protocolo de avaliação da linguagem infantil, teste de vocabulário por imagens Peabody, com o objetivo de avaliar os diversos subsistemas lingüísticos e as noções perceptivo-cognitivas. Na análise qualitativa do G-DCV, do ponto de vista fonoaudiológico e neurológico, quando comparado ao Gc, mostrou recuperação completa do distúrbio adquirido de linguagem (DAL) em 2 crianças e alterações de linguagem em 3. O estudo dos casos revelou que os diversos aspectos que constituem a linguagem em desenvolvimento na criança pré-escolar devem ser analisados de forma individual, quantitativa e qualitativamente para achados conclusivos.

Neuropsychological and phonological evaluation in the Apert's syndrome: study of two cases.

This study evaluated two cases of Apert's syndrome, through phonological, cognitive, and neuropsychological instruments and correlated the results to complementary exams. In short, this study reveals the necessity of application of neuropsychological, cognitive and phonological evaluation and correlation of the results with complementary testings because significant differences can be present in the Apert's syndrome.

[Medical residence in pediatric neurology in Brazil]. / Residência médica em neurologia infantil no Brasil.

We present the results of a research on Medical Residence in Pediatric Neurology, classifying present information on the teaching and training in the several centers of formation in Brazil. It was possible to contact 17 Institutions with organized services, being 6 accredited by CNRM (National Council of Medical residence), 10 non accredited, and one under diligence. The program content is developed in 3 or 4 years, including the pre-qualification, being the annual schedule load variable, from 1900 to 2880 hours / year.

Cerebrovascular disease in newborn infants. Report of three cases with clinical follow-up and brain SPECT imaging.

The clinical and neurological findings of three neonates with the diagnosis of cerebrovascular disease are reported. The neuropsychological evaluation disclosed impairment of fine motor function, coordination, language, perception and behavioral disturbances. Brain SPECT imaging revealed perfusional deficits in the three cases.

[Comparison of the neuropsychological assessment in a girl with bilateral cerebrovascular disease (moyamoya) before and after surgical intervention]. / Comparação das avaliações neuropsicológicas em menina com doença cerebrovascular bilateral (moyamoya) antes e após a intervenção cirúrgica.

Moyamoya is a chronic progressive cerebrovascular disease with characteristic angiographic findings and a clinical picture with episodes of transient ischemic attacks, headache, seizures, hemiparesis, which may resolve after surgical treatment. We describe the case of a girl with the typical findings of the disease, comparing them before and after surgery with the use of neuropsychological tests, neurological examination and laboratory tests.

Fragile X syndrome. Clinical, electroencephalographic and neuroimaging characteristics.

We studied 11 patients (9 males) with cytogenetic diagnosis of fragile X syndrome (FXS) with the purpose of investigating the neural circuitry involved in this condition. The ages ranged from 8 to 19. All the individuals presented large ears, elongated faces and autistic features. Ten patients had severe mental retardation. Attention disorder was found in 10 individuals. Electroencephalographic recordings were abnormal in 6 of 10 patients examined, showing focal epileptiform discharges predominantly in frontal and parietal areas. All patients underwent magnetic resonance imaging studies which were abnormal in 8 of them. The most important abnormalities were reduction of the cerebellar vermis and enlargement of the IV ventricle. Single photon emission computerized tomography (SPECT) was performed in 7 patients and was abnormal in all of them, the most frequent finding being a hypoperfusion of the inferior of the frontal lobes. Based on the clinical picture, neuropsychological findings and functional and structural imaging studies we suggest that FXS presents with a dysfunction involving a large area of the central nervous system: cerebellum-basal frontal regions-parietal lobes. The literature points to a disturbance involving the same neural circuitry in patients with autism.

[Surgical treatment of strabismus by sagittal cutting of the oblique muscles. Apropos of 449 cases]. / Traitement chirurgical du strabisme incomitant par sagittalisation des obliques. A propos de 449 cas.

The theoretical proposals and the therapeutic approach described at the beginning of the sixties by Gobin concerning the treatment of incomitant strabismus have had such positive results as to convince many surgeons to adopt this methodology. The principal merit of Gobin's technique lies in evaluation of all aspects of the strabismus (horizontal, vertical and oblique) searching for the obstacles to ocular movements which cause alteration of binocular vision and removing them. According to the above criteria, we have operated 449 cases of incomitant strabismus due to sagittalization of the oblique muscles. The validity of this technique has been demonstrated by the results obtained in a single operation (a success rate of over 50%). With a second operation the success rate was increased to 70% (orthophoria, heterophoria and esthetic angle < 7 degrees).