Influence of the Craniocervical Posture on Tongue Strength and Endurance.

Tongue strength has an important role in the swallowing process, and previous research has suggested that tongue position, concerning the craniomandibular region, could affect the oral function. This study aimed to evaluate the strength and endurance of three areas of the tongue in three experimentally induced craniocervical postures. A cross-sectional study with a nonprobabilistic sample of 37 participants (mean age: 3.85 ± 3.64 years; 20 men, 17 women) was performed. Tongue strength and endurance were assessed using a pressure device entitled Iowa Oral Performance Instrument (IOPI), in three different craniocervical positions: neutral head position (NHP), anterior head translation-or forward head position (FHP), and posterior head translation-or retracted head position (RHP). Measurements taken using the IOPI system showed significant differences in tongue strength for the anterior (p = 0.015) and middle areas of the tongue (p = 0.01). Significant differences were observed in analysis of variance (ANOVA) in the FHP (p = 0.02) and NHP (p = 0.009). The results of tongue endurance measurements showed statistically significant differences for FHP (p = 0.001), NHP (p = 0.00), and RHP (p = 0.007). The craniocervical position influences tongue strength, especially in the anterior and middle tongue areas, concerning the posterior, and, in the anterior and neutral head posture, regarding the retracted position. No differences were found in tongue resistance between the various craniocervical positions, but differences were found in resistance between the different tongue areas.

Alexithymia in Alzheimer's Disease.

Alexithymia is widely recognized as the inability to identify and express emotions. It is a construct which consists of four cognitive traits such as difficulty in identifying feelings, describing feelings to others, externally oriented thinking, and limited imaginative capacity. Several studies have linked alexithymia to cognitive functioning, observing greater alexithymia scores associated with poorer cognitive abilities. Despite Alzheimer's disease (AD) being a neurodegenerative pathology characterized by cognitive troubles from the early stages, associated to behavioral and emotional disturbances, very few investigations have studied the alexithymia in AD. These studies have shown that alexithymia scores-assessed with Toronto Alexithymia Scale (TAS)-were greater in AD patients than healthy participants. The objective of the study was to investigate if the alexithymia was present in patients with mild AD. We hypothesized that the AD group would show more alexithymia features than the control group. We evaluated 54 subjects, including 27 patients diagnosed with mild AD and 27 normal healthy controls, using the Shalling Sifneos Psychosomatic Scale (SSPS-R) and a neuropsychological test battery. Using non-parametric statistical analyses-Wilcoxon and Mann-Whitney U tests-we observed that the SSPS-R scores were similar in the AD and control groups. All participants showed SSPS-R scores below to 10 points, which means no-alexithymia. We did not find significant correlations between SSPS-R scores and cognitive variables in both groups (p > 0.22), but we observed a negative association between name abilities and alexithymia, but it does not reach to significance (p = 0.07). However, a significant correlation between SSPS-R score and mood state, assessed using Zerssen Rating Scale, was found in both groups (p = 0.01). Because we did not find a significant difference in the alexithymia assessment between both subject groups, pot hoc analyses were computed for each item of the SSPS-R. We made comparisons of alexithymic responses percentages in each SSPS-R item between AD and control groups, using Fisher's test. We observed that AD patients produced more alexithymic responses in some items of SSPS-R test than the control group, particularly about difficulties to find the words to describe feelings, as well as difficulties of imagination capacity and externally oriented thinking. The present results do not confirm our hypothesis and they do not support the results of previous studies revealing great alexithymia in AD.

Orofacial sensorimotor behaviour in unilateral chewing: A comparative analysis in asymptomatic population.

The main aim of the present study was to evaluate the presence of differences in motor, somatosensory and laterality recognise variables between individuals with unilateral chewing (UC) versus bilateral chewing (BC). A cross-sectional study with a nonprobabilistic sample was conducted. Seventy asymptomatic individuals were grouped as UC or BC to assess differences in motor, somatosensory, and laterality recognise variables. The recorded variables were range of motion (ROM), electromyographic (EMG) activity, lip grip force, 2-point discrimination (2-PD), pain pressure threshold (PPT), and laterality recognition. Significant differences in EMG activity of the masseter and temporal muscles were found in group*side (p<.005). Significant changes in group*side (p<.005) were found in lip strength and 2-PD in the maxillary and mandibular branch. For laterality, significant between-group differences in accuracy were found (p=.037). Individuals with UC showed unilateral sensorimotor modifications compared with those with BC. Although the relationship between type of mastication and temporomandibular disorder (TMD) cannot be established, neurophysiological changes in UC could affect biomechanics and temporomandibular joint function and could predispose individuals to the onset, development, and maintenance of TMD because patients with TMD usually present an impairment in orofacial motor and sensory functions, with recruitment abnormalities of the masseter and temporal muscles during chewing.

Consciencia del otro en patologías neurodegenerativas / Consciousness of others and neurodegenerative diseases

Resumen Hemos elaborado una revisión del estado actual del concepto emergente denominado consciencia del otro en la enfermedad de Alzheimer y la demencia frontotemporal de variante frontal. La consciencia del otro es la consciencia que uno mismo tiene de los otros congéneres y podría considerarse clave para la comprensión de las alteraciones del comportamiento en patologías neurodegenerativas tales como la enfermedad de Alzheimer y las demencias frontotemporales. La consciencia del otro es multifactorial e incluye los siguientes componentes: reconocimiento emocional del rostro, prosodia emocional, pragmática del lenguaje, mentalización, empatía y razonamiento social. Los distintos tipos de demencias afectan de forma heterogénea a los diferentes componentes de la consciencia del otro. En general, los estudios con pacientes de demencia frontotemporal de variante frontal observan más alteraciones de la consciencia del otro que los de los enfermos de Alzheimer. En concreto, en estos últimos se encuentran mayores dificultades en el componente de la pragmática del lenguaje, asociándolo a la severidad de su deterioro cognitivo, pero que no les impide tener un adecuado sentido social. Sin embargo, los estudios con pacientes con demencia frontotemporal de variante frontal observan importantes dificultades en cada uno de los componentes de la consciencia del otro y muestran graves problemas para regular adecuadamente su conducta social. Se necesitarían más estudios para comprender las relaciones de los distintos componentes de la consciencia del otro en las demencias para comprender sus trastornos del comportamiento.

Abstract This review presents data about an emerging concept called «Consciousness of others¼ in Alzheimer's disease and behavioral variant frontotemporal dementia. Consciousness of others is the awareness that one has of others, and it could be considered key in the understanding of behavioral problems in neurodegenerative diseases, such as Alzheimer's disease and frontotemporal dementia. Consciousness of others is multifactorial and it includes the following aspects: emotional face recognition, emotional prosody, pragmatic of language, mentalization, empathy, and social reasoning. Subtypes of dementias heterogeneously affect the different aspects of consciousness of others. In general, patients with a behavioral variant of frontotemporal dementia presented with more problems of consciousness of others than those with Alzheimer's disease. , patients with Alzheimer's disease showed more difficulties in the aspect of language pragmatic, which was associated with the severity of cognitive impairment, but they could maintain a good social sense. However, patients with frontal variant frontotemporal dementia showed problems in every component of the consciousness of others, thus having important problems to properly regulate their social behavior. Further studies are needed for a better knowledge of the complex relationship between different aspects of consciousness of others in dementias for a better understanding of behavioral troubles.

[Proceeding memory in Alzheimer's disease]. / Memoria procedimental en pacientes con enfermedad de Alzheimer.

Procedural learning can acquire or develop skills through performance and repetition of a task unconsciously or unintentionally. Procedural skills are considered as the cornerstone in the neuropsychological rehabilitation to promote the autonomy of patients with brain damage, as those with Alzheimer's disease. This review presents data about procedural skills in Alzheimer's disease. Over the past three decades, we have found 40 articles studying various procedural skills in the Alzheimer's disease: motor, perceptual-motor, cognitive, perceptual-cognitive and those developed through serial reaction-time paradigm. We analyzed every study evaluating a procedural skill, indicating the used task and preservation or no preservation of procedural learning. Overall, most of the papers published describe conservation of learning procedures or relatively conserved in Alzheimer's disease, which could be used to promote patient autonomy.

El aprendizaje procedimental permite adquirir o desarrollar habilidades mediante la ejecución y repetición de una tarea de manera no consciente o no intencional. Las habilidades procedimentales están siendo consideradas ejes centrales en la rehabilitación neuropsicológica para fomentar la autonomía de los pacientes con daño cerebral. En este artículo se hace una revisión del estado actual de las investigaciones que analizan los aprendizajes procedimentales en la enfermedad de Alzheimer. De las últimas tres décadas se identificaron 40 investigaciones relativas a las habilidades procedimentales en la enfermedad de Alzheimer: motoras, perceptivo-motoras, cognitivas, perceptivo-cognitivas y las desarrolladas mediante el paradigma del tiempo de reacción serial. En cada una se han analizado los estudios que evalúan la habilidad, el tipo de tarea utilizada y los resultados que reflejan la preservación o el deterioro del aprendizaje procedimental. Los aprendizajes procedimentales preservados o relativamente preservados en los pacientes con enfermedad de Alzheimer podrían ser utilizados para fomentar la autonomía de estos.

Técnicas de rehabilitación neuropsicológica en demencias: hacia la ciber-rehabilitación neuropsicológica / Neuropsychological rehabilitation techniques in dementias: towards neuropsychological cyber-rehabilitation

Las técnicas de rehabilitación neuropsicológica están destinadas a paliar el deterioro cognitivo de pacientes que sufren una demencia de severidad leve, sin el uso de psicofármacos. Actualmente, la mayoría de estos programas de intervención cognitiva en demencias está siendo mejorada, a través de la incorporación de los avances en el campo de la Tecnología de la Información y Comunicación (TIC). El objetivo del presente trabajo es la revisión de los avances más recientes en este campo. Describiremos las técnicas de rehabilitación neuropsicológica desde las más clásicas (Terapia de Orientación a la Realidad y la Terapia de Reminiscencias), pasando por las más actuales, como las técnicas para la facilitación de la re-codificación, las técnicas de acondicionamiento del entorno y para el aprendizaje de nueva información (Recuperación Espaciada, Difuminación de los Indicios de Recuperación, Aprendizaje sin Errores y Procedimentalización de Tareas). Esta revisión finaliza con las técnicas ciber-neuropsicológicas, las cuales aplican las últimas novedades de las TIC como la realidad virtual a la rehabilitación neuropsicológica.

Neuropsychological rehabilitation techniques are aimed at palliating the cognitive deterioration of patients suffering from non-severe dementia, without the use of psychotropics. Currently, most such cognitive intervention programs in dementia are being improved through the use of advances in the field of information and communication technology (ICTs). The aim of this paper is to offer a review of the most recent advances in this area. We shall describe Neuropsychological Rehabilitation techniques ranging from the most classical (Reality Orientation Therapy and Reminiscence Therapy), to more updated techniques such as those for facilitating re-encoding, techniques for conditioning the environment and techniques for learning new information (Spaced Retrieval, Vanishing Cues, Errorless learning and procedural techniques). This review ends with cyber-neuropsychological techniques, which apply the latest introductions to ICTs, such as virtual reality.

As técnicas de Reabilitação Neuropsicológica estão destinadas a diminuir, sem o uso de psicofármacos, a disfunção cognitiva de pacientes que sofrem uma demência de severidade leve. Atualmente, a maioria de estes programas de intervenção cognitiva em demências estão sendo melhorados, a través da incorporação dos avances no campo da tecnologia da informação e comunicação (TIC). O escopo do presente trabalho é revisar os avances mais novos neste campo. São descritas as técnicas de Reabilitação Neuropsicológica desde as mais clássicas (Terapia de Orientação à Realidade e a Terapia de Reminiscências), passando pelas técnicas mais atuais como a facilidade da recodificação, as técnicas de acondicionamento do entorno e as técnicas para a aprendizagem de nova informação (Recuperação Espaçada, Difuminação dos Indícios de Recuperação, Aprendizagem sem erros e Procedimentalização de tarefas). Esta revisão termina com as técnicas ciber-neuropsicológicas, as quais aplicam as últimas novidades das TICs como a realidade virtual à reabilitação neuropsicológica.

Adaptación y validación del test Evaluación Rápida de las Funciones Cognitivas(Gil et al, 1986). Primera versión en castellano con una muestra geriátrica (AU) / First Spanish version of the French test Rapid Assessment of Cognitive Functions (Gil et al, 1986). Adaptation and validation in a geriatric sample

Objetivo: Adaptación y validación de la primera versión en castellano del test Evaluación Rápida de las Funciones Cognitivas (ERFC) de Gil et al (1986). Sujetos y Métodos: Se examinó una muestra de 369 personas mayores sin deterioro mental de tres comunidades autónomas de España. Se utilizaron los siguientes instrumentos de evaluación: ERFC.es (versión en castellano del ERFC francés) y versiones españolas del Mini-Examen Cognoscitivo 30, el test de Ansiedad y Depresión de Goldberg, el Geriatric Mental State, el History and Aetiology Schedule, así como los criterios de demencia del DSM-IV. Los datos normativos se obtuvieron para tres grupos de edad (63-69, 70-75 y > 75 años) y cuatro niveles de escolaridad (analfabetos, estudios primarios, bachillerato y estudios universitarios). Resultados: El ERFC.es cumple criterios de fiabilidad test-retest (r = 0,38), validez de contenido (70%), según la prueba de Morillama por acuerdo entre jueces, validez de constructo (MEC = 0,82 y ERFC = 0,9) y consistencia interna (alfa de Cronbach = 0,8). Obtiene una sensibilidad del 0,92% y una especificidad del 0,86% con el punto de corte de 51/56. Además, las puntuaciones totales del ERFC.es son similares al ERFC, una vez eliminados los ítems nuevos introducidos en nuestra versión. Se observa un efecto mayor de las variables edad y nivel escolar en las puntuaciones del ERFC.es que en la versión original francesa. Conclusiones: Se confirma la validez y la fiabilidad del ERFC.es en una muestra geriátrica sana. Puede considerarse como un instrumento útil para la evaluación rápida de las capacidades cognitivas (AU)

Aim: To adapt and validate the first Spanish version of the French test Rapid Assessment of Cognitive Functions (RACF) (Gil et al, 1986). Subjects and methods: A sample of 369 elderly people without cognitive impairment from three autonomous communities in Spain was evaluated. The following instruments were used: the Spanish version of the French RACF (RACF.sp ) and the Spanish versions of the Mini-Mental State Examination (MMSE), Goldberg’s anxiety and depression scale, the Geriatric Mental State Examination, the History and Etiology Schedule, and the DSM-IV criteria for a diagnosis of dementia. Normative data were obtained for three age groups (63-69, 70-75 and > 75 years) and four educational levels (illiterate, primary school, high school and college/university). Results: The RACF.sp fulfilled the criteria of testretest reliability (r = 0.88), content validity (70%), according to Morillama’s method of inter-rater agreement, construct validity (MMSE = 0.82; RACF = 0.9) and internal consistency reliability (Cronbach’s alpha = 0.8). The sensitivity of the RACF.sp was 0.92% and specificity was 0.86% with a cut-off point of 51/56. RACF.sp scores were similar to those of the RACF, when the new items introduced into the RACF. sp were eliminated. A greater effect of age and educational level was observed in RACF.sp scores than in those of the original RACF. Conclusions: This study confirms the reliability and validity of the RACF.sp in a healthy geriatric sample. The RACF.sp can be considered a useful tool for the rapid assessment of cognitive functions (AU)