[Screening for mild cognitive impairment: usefulness of the 7-Minute Screen Test]. / Detección de deterioro cognitivo leve en asistencia primaria. Utilidad del Test de los Siete Minutos.

INTRODUCTION: The <<7- Minute Screen>> is a neurocognitive screening test for the detection of Alzheimer's disease (AD) patients in primary care settings. It consists of 4 brief subtests (orientation, memory, visuoconstruction and verbal fluency) and provides a broader neuropsychological profile than other widely used screening tests, The aim of the present study was to study the usefulness of this screening test for the detection of Mild Cognitive Impairment (MCI). METHODS: Thirty-two patients with probable AD (NINCDS-ADRDA criteria), 25 patients with MCI, and 35 healthy control subjects, matched for age and education, underwent a comprehensive neuropsychological battery and the Rio-de-la-Plata version of the 7-Minute Screen. RESULTS. This test showed 93 % sensitivity and 97% specificity in detecting mild-moderate Alzheimer's disease MMSE<24), but it exhibited a substantially decreased sensitivity (28 %) in its ability to detect MCI in AD (MMSE >2 4 ). CONCLUSION: The screening batteries do not replace a m o re compre h e n s i ve neuro psychological assessment. Th ey are useful in detecting patients with mild dementia, but caution must be the rule when considering a diagnosis of MCI.

[Attention systems and unilateral neglect]. / Sistemas atencionales y negligencia unilateral.

Unilateral neglect can be defined as an impairment to detect, refer, orient or respond to stimuli presented contralaterally to a cerebral lesion, without any impairments in sensory-motor elementary functions. Development. The first descriptions were those of Hughlings Jackson (1876) and Anton (1893). The most important feature of the syndrome is a lateralization bias, which is directional in nature independently of the visual fields. It can be classified in: 1. Attentional (sensory neglect). 2. Intentional (motor neglect). The lesions that may be responsible for the neglect syndromes are usually found in the inferior parietal cortex of the right cerebral hemisphere (superior parietal when optic ataxia is prominent), and the right frontal lobe. Extinction is more frequently related to subcortical lesions (right lenticular nucleus, anterior aspects of peri-ventricular white matter). Unilateral neglect comprises a set of features that may coexist or be isolated traits: 1. Attentional neglect: hemi-inattention, allesthesia, allochiria, anosognosia (with/without somato-paraphrenia or misoplegia), and anoso-diaphoria, sensory extinction. 2. Intentional neglect: hemi-akinesia, directional hypokinesia, motor impersistence, motor extinction. Different theories try to explain the patho-physiology of these phenomena: the attentional-intentional model, the neural network model, the vectorial model, the representational model, and the premotor model, among others.

Subcortical anarthria: a case report.

A 56-year-old right-handed male with a history of hypertension and diabetes presented two episodes of stroke: The first affected territory was the left anterior coroidal artery (capsular and paracapsular infarcts at the level of the genu and posterior arm of the internal capsule) and the second was the right thalamus, due to a hematoma. Following the first stroke, the patient developed severe dysarthria and after the second stroke remained anarthric. The pathophysiology of the disorder is discussed, and the role of the left and right thalamus as far as speech is concerned is reviewed.

Vascular dementia: the Latin American perspective.

Population aging is a process that is especially accelerated in some parts of the world. One example is in Latin America. As with other developing regions, Latin America has to confront population "graying" in the context of an emerging economy. As a result of this and of their health history, the prevalence and incidence of age-related pathologies are different than those in the developed world. The burden of dementia is significant for patients, families, health systems, and public health. The aim of this paper was to summarize data from the scarce dementia epidemiological studies available in Latin America, the diagnostic criteria used in most countries and the most widely used diagnostic tools and neuropsychological assessment instruments (some of them translated, validated, and harmonized). Reference is made to the approval process and availability in Argentina of dementia and cognitive decline-related drugs.

Akinetic mutism: a report of three cases.

OBJECTIVES: To report 3 new cases of akinetic mutism, a clinical syndrome defined by silent immobility with preserved visual alertness not accountable by lesion of the areas and/or effector pathways of speech and voluntary movements. MATERIAL AND METHODS: Anatomopathological studies were performed in Cases 1 and 2; clinical follow-up, EEG, angiography and CT scans in Case 3. RESULTS: Case 1: Bipallidal necrosis; Case 2: Left pallidal necrosis with right frontoparietal cortico-subcortical infarction; Case 3: Striato-capsular infarction on the left side, involving the caudate nucleus and the anterior arm of the internal capsule, together with obstructive hydrocephalus. CONCLUSION: The roles of both globus pallidus and prefrontostriatal circuits in the onset of voluntary movements are discussed.