Estrategias de evocación en la prueba de fluidez verbal en pacientes con esclerosis múltiple / Recall strategies for the verbal fluency test in patients with multiple sclerosis

La esclerosis múltiple (EM) es un padecimiento neurodegenerativo caracterizado por inflamación y desmielinización y que conduce a un cambio irreversible de la mielina, lo que conlleva a la presencia de alteraciones físicas y cognitivas. La prueba de fluidez verbal (FV) ha demostrado ser sensible para evidenciar deterioro cognitivo en estos pacientes. Objetivo: Comparar aspectos cuantitativos y cualitativos del desempeño en pruebas de fluidez semántica y fonológica en pacientes con EM y sujetos sanos, mediante el análisis del total de palabras producidas y de las estrategias utilizadas (agrupaciones y saltos). Método: Se evaluaron 46 pacientes con EM y 33 sujetos sanos mediante la prueba de FV. Resultados: En la FV semántica no hubo diferencia estadística entre los grupos. En la FV fonológica los pacientes presentaron menor producción de palabras (F [77] = 2.286; p < 0,001) con una deficiente estrategia de agrupación, por lo tanto mayor número de saltos (F [77] = 3.808; p< 0,005). Conclusiones: Estos resultados apoyan la realización de un análisis cualitativo de las estrategias de evocación, al aportar datos sobre los componentes de la tarea que se ven alterados por el daño cerebral. Las agrupaciones dependen de la integridad de la memoria semántica, mientras que los saltos del desarrollo de una estrategia de búsqueda eficaz, de flexibilidad cognitiva y de la capacidad para modificar la respuesta. En la EM se ha reportado daño del lóbulo frontal, lo que concuerda con los resultados obtenidos en la prueba de FV fonológica (AU)

Multiple sclerosis (MS) is a neurodegenerative disease characterised by inflammation and demyelination. It generates irreversible myelin changes, which in turn give rise to physical and cognitive disorders. The verbal fluency test (VF) has been shown to be a sensitive tool for detecting cognitive impairment in these patients. Objective: To compare quantitative and qualitative aspects of performance on semantic and phonological fluency tests between MS patients and healthy controls by analysing total words produced and strategies used (clusters and switching). Method: We evaluated 46 patients with MS and 33 healthy controls using the VF test. Results:The semantic VF task revealed no significant differences between groups; for the phonological task, the patients demonstrated reduced word production (F [77] = 2.286 P < 0.001) and poorer use of grouping strategies, resulting in more frequent switching (F [77] = 3.808 P < 0.005). Conclusions: These results support using qualitative analysis for recall strategies, since the technique provides data about which components of the task are affected by brain damage. Clusters depend on the integrity of semantic memory, while switching has to do with developing effective search strategies, cognitive flexibility, and the ability to modify responses. Frontal lobe damage has been reported in MS, and this is consistent with results from the phonological VF test

Recall strategies for the verbal fluency test in patients with multiple sclerosis.

UNLABELLED: Multiple sclerosis (MS) is a neurodegenerative disease characterised by inflammation and demyelination. It generates irreversible myelin changes, which in turn give rise to physical and cognitive disorders. The verbal fluency test (VF) has been shown to be a sensitive tool for detecting cognitive impairment in these patients. OBJECTIVE: To compare quantitative and qualitative aspects of performance on semantic and phonological fluency tests between MS patients and healthy controls by analysing total words produced and strategies used (clusters and switching). METHOD: We evaluated 46 patients with MS and 33 healthy controls using the VF test. RESULTS: The semantic VF task revealed no significant differences between groups; for the phonological task, patients demonstrated reduced word production (F [77]=2.286 P<.001) and poorer use of grouping strategies, resulting in more frequent switching (F [77]=3.808 P<.005). CONCLUSIONS: These results support using qualitative analysis for recall strategies, since the technique provides data about which components of the task are affected by brain damage. Clusters depend on the integrity of semantic memory, while switching has to do with developing effective search strategies, cognitive flexibility, and the ability to modify responses. Frontal lobe damage has been reported in MS, and this is consistent with results from the phonological VF test.