Alteraciones en el procesamiento visual de formas: clasificación clínica integradora / Visual form-processing deficits: a global clinical classification

Introducción: Los pacientes que presentan dificultades para el reconocimiento visual de formas estimulares son considerados habitualmente como pacientes con agnosia visual. No obstante, estudios recientes permiten identificar diferentes manifestaciones clínicas que podrían corresponderse con entidades diagnósticas que reflejan déficits diferenciados a lo largo del continuo del procesamiento visual cortical de las formas. Desarrollo: Revisamos diferentes casos clínicos publicados en la literatura científica así como propuestas de clasificación de este déficit con la finalidad de dar una visión integradora del mismo. Exponemos los principales hallazgos en cuanto a las bases neuroanatómicas del procesamiento visual de formas y discutimos acerca de los criterios para evaluar dicho procesamiento cuando pueda estar alterado. Asimismo, presentamos un esquema de los déficits de procesamiento visual de formas que pretende integrar los distintos casos clínicos descritos en la literatura científica. Finalmente, proponemos un árbol de decisión que puede ser útil para guiar el proceso diagnóstico de estos casos. Conclusiones: Existe un amplio consenso en cuanto a las áreas corticales y circuitos neuronales que participan en el procesamiento visual, aunque futuros estudios con las nuevas técnicas de neuroimagen funcional permitirán profundizar en este aspecto. Una evaluación estructurada y exhaustiva de las diferentes etapas del procesamiento visual realizada a partir de una visión integradora del déficit nos facilitara un diagnóstico más objetivo, lo que nos permitirá conocer mejor el pronóstico y será de utilidad para guiar el diseño de estrategias individualizadas de psicoestimulación o rehabilitación

Introduction: Patients who have difficulties recognising visual form stimuli are usually labelled as having visual agnosia. However, recent studies let us identify different clinical manifestations corresponding to discrete diagnostic entities which reflect a variety of deficits along the continuum of cortical visual processing. Development: We reviewed different clinical cases published in medical literature as well as proposals for classifying deficits in order to provide a global perspective of the subject. Here, we present the main findings on the neuroanatomical basis of visual form processing and discuss the criteria for evaluating processing which may be abnormal. We also include an inclusive diagram of visual form processing deficits which represents the different clinical cases described in the literature. Lastly, we propose a boosted decision tree to serve as a guide in the process of diagnosing such cases. Conclusions: Although the medical community largely agrees on which cortical areas and neuronal circuits are involved in visual processing, future studies making use of new functional neuroimaging techniques will provide more in-depth information. A well-structured and exhaustive assessment of the different stages of visual processing, designed with a global view of the deficit in mind, will give a better idea of the prognosis and serve as a basis for planning personalised psychostimulation and rehabilitation strategies

Visual form-processing deficits: a global clinical classification.

INTRODUCTION: Patients who have difficulties recognising visual form stimuli are usually labelled as having visual agnosia. However, recent studies let us identify different clinical manifestations corresponding to discrete diagnostic entities which reflect a variety of deficits along the continuum of cortical visual processing. DEVELOPMENT: We reviewed different clinical cases published in medical literature as well as proposals for classifying deficits in order to provide a global perspective of the subject. Here, we present the main findings on the neuroanatomical basis of visual form processing and discuss the criteria for evaluating processing which may be abnormal. We also include an inclusive diagram of visual form processing deficits which represents the different clinical cases described in the literature. Lastly, we propose a boosted decision tree to serve as a guide in the process of diagnosing such cases. CONCLUSIONS: Although the medical community largely agrees on which cortical areas and neuronal circuits are involved in visual processing, future studies making use of new functional neuroimaging techniques will provide more in-depth information. A well-structured and exhaustive assessment of the different stages of visual processing, designed with a global view of the deficit in mind, will give a better idea of the prognosis and serve as a basis for planning personalised psychostimulation and rehabilitation strategies.

[Mild cognitive impairment: early detection and new perspectives]. / Deterioro cognitivo leve: deteccion temprana y nuevas perspectivas.

INTRODUCTION. Along past years, interest in mild cognitive impairment (MCI) research and its early detection has been increased. Unlike first theories, international current proposals suggest that MCI is a syndrome characterized by an impairment in one or more cognitive functions without interfering in daily functional abilities and it is also accompanied by a concern because of the cognitive change. Although early MCI detection is usually made by cognitive screening tests, most of them do not seem to correctly detect MCI, but dementia. AIM. To expose an analysis of the cognitive screening tests more suitable for clinical MCI detection, according to current researches. DEVELOPMENT AND CONCLUSIONS. There are three kind of cognitive screening tests: general cognitive screening tests, specific cognitive screening tests and MCI-subtype cognitive screening test. We observe that most of the tests don't follow current MCI criteria. In this respect we propose to jointly apply tests, as well as the necessity of a carefully test choice to effectively detect MCI in clinical practice.