[Development and validation of a short battery of tests for the assessment of aphasia: 'bedside assessment of language'. Its use in a rehabilitation centre]. / Desarrollo y validación de una batería corta de evaluación de la afasia: 'bedside de lenguaje'. Utilización en un centro de rehabilitación.

INTRODUCTION: A formal and complete language assessment requires too much time and also tires the patient out during the first recovery stages after brain injury. The aim of this paper is to introduce a bedside screening, short and sensitive to diagnose aphasias in patients with brain injury. PATIENTS AND METHODS: The results of the Bedside Assessment of Language (BAL) was studied in 121 aphasic patients and in 77 dysarthric patients after brain injury. The five linguistic areas assessed in this short battery are: spontaneous language, comprehension, repetition, writing and reading. Each area has a maximum of 5 points, and the test has a total score of 25. Statistics tests used were: median test, Kruskal-Wallis test, Fisher's exact test, receiver operating characteristics curves and correlation coefficient. RESULTS: The BAL showed an excellent internal consistency reliability (Cronbach's alpha coefficient: 0.9419); sensitivity was of 79.3% and specificity of 84.4%. CONCLUSIONS: These results indicate that the BAL has been a potentially useful tool for the diagnose of the type of aphasia and it has been sensitive to evolutionary changes in sub-acute stages of language disorders.

[Validity of the Spanish version of the Addenbrooke's Cognitive Examination for the diagnosis of dementia and to differentiate Alzheimer's disease and frontotemporal dementia]. / El Addenbrooke's Cognitive Examination en español para el diagnóstico de demencia y para la diferenciación entre enfermedad de Alzheimer y demencia frontotemporal.

INTRODUCTION: The Addenbrooke's Cognitive Examination (ACE) is a brief bedside test battery to detect mild dementia and differentiate frontotemporal dementia (FTD) from Alzheimer's disease (AD). AIM: To validate the ACE in Spanish. PATIENTS AND METHODS: The study evaluated the Spanish version of ACE on 128 subjects consisting in two groups a patient group (n = 76) and a control subjects group (n = 52). The patient group was divided in AD (n = 54) based on the NINCDS-ADRDA criteria and FTD (n = 22) based on the Lund y Manchester criteria. All patients underwent clinical, neuropsychological, radiologic (MRI, CT, and SPECT), and laboratory evaluations. Group's differences were evaluated using ANOVA. The internal consistency of the Spanish version of the ACE was measured using the Cronbach's alpha coefficient. The discriminative capability of the Spanish version of the ACE was examined by the receiver operating characteristic (ROC) analysis. RESULTS: The cut-off score of 86 showed a sensitivity of 92% (CI 95% = 83.6-97.0) and a specificity of 96.2% (CI 95% = 86.8-99.4). The ROC curve showed higher sensitivity and specificity of the ACE than the Mini-Mental State Examination in discriminating the dementia and control group. The VLOM ratio (verbal fluency + language)/(orientation + memory) of < 1.82 discriminated for FTD and > 4.87 discriminated for AD. CONCLUSION: The Spanish version of ACE is a brief and reliable instrument for early detection of dementia in highly educated people and offers a simple objective index to differentiate AD and FTD. More studies in less educated people are warranted.

Autobiographical amnesia and accelerated forgetting in transient epileptic amnesia.

BACKGROUND: Recurrent brief isolated episodes of amnesia associated with epileptiform discharges on EEG recordings have been interpreted as a distinct entity termed transient epileptic amnesia (TEA). Patients with TEA often complain of autobiographical amnesia for recent and remote events, but show normal anterograde memory. OBJECTIVE: To investigate (a) accelerated long term forgetting and (b) autobiographical memory in a group of patients with TEA. METHODS: Seven patients with TEA and seven age matched controls were evaluated on a range of anterograde memory tasks in two sessions separated by 6 weeks and by the Galton-Crovitz test of cued autobiographical memory. RESULTS: Patients with TEA showed abnormal long term forgetting of verbal material, with virtually no recall after 6 weeks. In addition, there was impaired recall of autobiographical memories from the time periods 1985-89 and 1990-94 but not from 1995-1999. CONCLUSIONS: TEA is associated with accelerated loss of new information and impaired remote autobiographical memory. There are a number of possible explanations including ongoing subclinical ictal activity, medial temporal lobe damage as a result of seizure, or subtle ischaemic pathology. Future analyses should seek to clarify the relationship between aetiology, seizure frequency, and degree of memory impairment.