A Esclerose Múltipla (EM) é uma doença inflamatória autoimune caracterizada por desmielinização e degeneração do sistema nervoso central (SNC) duas a três vezes mais frequente em mulheres. A etiologia da EM é dividida em dois subtipos principais: o tipo remitente-recorrente (EMRR) mais comum, caracterizado por dois ou mais episódios de agravamento dos sintomas que envolvem diferentes locais do SNC, separados por pelo menos 1 mês e remisão dos sintomas e o tipo progressivo é a forma menos comum, caracterizada por um contínuo agravamento dos sintomas desde o início geralmente sem recaídas claras ou remissões. A presente pesquisa teve por objetivo avaliar o comprometimento da visão de cores e de sua relação com perdas de atenção, memória visual imediata, memória visual tardia, memória operacional e funções executivas dos portadores de esclerose múltipla tipo remitente recorrente. Método: participaram 41 pacientes com esclerose múltipla de idades entre 20 e 58 anos (35,4±12,2) e 37 controles com idade (34,7±12,1) e escolaridade semelhante. A discriminação de cores foi avaliada com o Cambridge Colour Test (CCT) e a avaliação de funções neuropsicológicas foram utilizados subtestes da bateria Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task e Rapid Information Processing; Escalas de Depressão e Ansiedade de Beck e Escala de Determinação Funcional da Qualidade de vida (DEFU). Resultados: A visão de cores está prejudicada de forma difusa em 24% dos pacientes com esclerose múltipla, tanto em pacientes com histórico de neurite óptica quando em pacientes que não tiveram neurite óptica. Na parte cognitiva, os pacientes demonstraram lentidão em executar as tarefas, comprometimento na atenção, na memória visual de curto e longo prazo, na memória operacional, na memória visuoespacial, além de lentidão no processamento de informações. Há uma relação entre alterações na visão de cores e alterações de memória visual somente em testes em que os estímulos são complexos e com inúmeros detalhes / Multiple sclerosis (MS) is an autoimmune inflammatory disease characterized by demyelination and central nervous system (CNS) degeneration. It is two times more frequent in women. It can be presented in two subtypes: the relapsing-remitting (RR), most common type, characterized by two or more episodes of focal disorders in different sites of the CNS, and remission of the symptoms; and the progressive subtype, less common, characterized by a continuous worsening of the symptoms, since the beginning, usually with no remissions. The present research evaluated color vision impairment and its relationship to attention loss, short-term memory, long-term memory, working memory and executive function in patients with the relapsing-remitting MS type. Methods: 41 patients with multiple sclerosis (20 to 58 years, 35.4 ± 12.2 in average) and 37 controls matched to age (34.7 ± 12.1 in average) and years of education participated of the study. Color vision was tested using the Cambridge Colour Test (CCT) and the neuropsychological assessment was performed using tests of the Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task, Rapid Information Processing the Beck Depression and Anxiety Inventories and the Functional Assessment of Multiple Sclerosis quality of life instrument. Results: Color vision was diffusely impaired in 24% of the MS patients, with or with no history of optic neuritis. Patients also showed a delay during the tasks execution, impairment in attention, short and long-term visual memory and working memory, and slowness in the information processing. There was a relationship between color vision loss and visual memory impairment, but only in tests with complex and highly detailed stimuli

Insomni och depression är psykiatriska åkommor som idag drabbar många människor. Forskning har visat att det råder en stor samsjuklighet mellan diagnoserna där många drabbade lider av samtidig insomni och depression vilket utgör en stor belastning för den enskilde individen. Patienter rapporterar ofta en negativ påverkan på kognitiva funktioner, bland annat minnessvårigheter och problem med koncentration och uppmärksamhet. Inom forskningen råder det i dagsläget en osäkerhet kring vilka kognitiva nedsättningar som karakteriserar personer med dessa diagnoser och på vilka sätt de skiljer sig åt. Det finns också ett behov av att undersöka vilken roll kognitiv förmåga spelar för människors möjlighet att tillgodogöra sig psykologisk behandling. I föreliggande studie var syftet att undersöka dessa båda områden. Resultaten visade inte på några signifikanta skillnader mellan personer med insomni, personer med depression och personer med det komorbida tillståndet avseende kognitiva funktioner, när det mättes genom test av uppmärksamhet, arbetsminne och exekutiva funktioner. Däremot framkom vissa samband mellan arbetsminne och förbättring av upplevda sömnbesvär, liksom mellan förmåga till bibehållen uppmärksamhet och förbättring av depressionssymtom. Vidare forskning med större och jämnare urvalsgrupper behövs för att undersöka stabiliteten i dessa fynd.

A Esclerose Múltipla (EM) é uma doença inflamatória autoimune caracterizada por desmielinização e degeneração do sistema nervoso central (SNC) duas a três vezes mais frequente em mulheres. A etiologia da EM é dividida em dois subtipos principais: o tipo remitente-recorrente (EMRR) mais comum, caracterizado por dois ou mais episódios de agravamento dos sintomas que envolvem diferentes locais do SNC, separados por pelo menos 1 mês e remisão dos sintomas e o tipo progressivo é a forma menos comum, caracterizada por um contínuo agravamento dos sintomas desde o início geralmente sem recaídas claras ou remissões. A presente pesquisa teve por objetivo avaliar o comprometimento da visão de cores e de sua relação com perdas de atenção, memória visual imediata, memória visual tardia, memória operacional e funções executivas dos portadores de esclerose múltipla tipo remitente recorrente. Método: participaram 41 pacientes com esclerose múltipla de idades entre 20 e 58 anos (35,4±12,2) e 37 controles com idade (34,7±12,1) e escolaridade semelhante. A discriminação de cores foi avaliada com o Cambridge Colour Test (CCT) e a avaliação de funções neuropsicológicas foram utilizados subtestes da bateria Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task e Rapid Information Processing; Escalas de Depressão e Ansiedade de Beck e Escala de Determinação Funcional da Qualidade de vida (DEFU). Resultados: A visão de cores está prejudicada de forma difusa em 24% dos pacientes com esclerose múltipla, tanto em pacientes com histórico de neurite óptica quando em pacientes que não tiveram neurite óptica. Na parte cognitiva, os pacientes demonstraram lentidão em executar as tarefas, comprometimento na atenção, na memória visual de curto e longo prazo, na memória operacional, na memória visuoespacial, além de lentidão no processamento de informações. Há uma relação entre alterações na visão de cores e alterações de memória visual somente em testes em que os estímulos são complexos e com inúmeros detalhes / Multiple sclerosis (MS) is an autoimmune inflammatory disease characterized by demyelination and central nervous system (CNS) degeneration. It is two times more frequent in women. It can be presented in two subtypes: the relapsing-remitting (RR), most common type, characterized by two or more episodes of focal disorders in different sites of the CNS, and remission of the symptoms; and the progressive subtype, less common, characterized by a continuous worsening of the symptoms, since the beginning, usually with no remissions. The present research evaluated color vision impairment and its relationship to attention loss, short-term memory, long-term memory, working memory and executive function in patients with the relapsing-remitting MS type. Methods: 41 patients with multiple sclerosis (20 to 58 years, 35.4 ± 12.2 in average) and 37 controls matched to age (34.7 ± 12.1 in average) and years of education participated of the study. Color vision was tested using the Cambridge Colour Test (CCT) and the neuropsychological assessment was performed using tests of the Cambridge Neuropsychological Testing Automated Battery (CANTAB) - Pattern Recognition Memory, Spatial Span, Spatial Recognition Memory, Information Sampling Task, Stop Signal Task, Rapid Information Processing the Beck Depression and Anxiety Inventories and the Functional Assessment of Multiple Sclerosis quality of life instrument. Results: Color vision was diffusely impaired in 24% of the MS patients, with or with no history of optic neuritis. Patients also showed a delay during the tasks execution, impairment in attention, short and long-term visual memory and working memory, and slowness in the information processing. There was a relationship between color vision loss and visual memory impairment, but only in tests with complex and highly detailed stimuli

This thesis investigates the effect of normal ageing on the strategies adopted during episodic memory retrieval, using a combination of neuropsychological profiling and neuroimaging data measured during performance on a source memory exclusion task. The exclusion task is a type of source memory task where participants distinguish between targets (studied items from one source e.g. female voice), non-targets (studied items from another source e.g. male voice) and new items. Unlike a source memory task where three separate buttons are pressed for each item at test, in the exclusion task one button is pressed for targets and a second for non-target and new items. As this task is more complex than a normal source memory paradigm and also allows participants to perform the task in more than one way, it places high emphasis on the use of strategies to facilitate retrieval and is therefore ideal for investigating strategic retrieval. Previous source memory studies have shown that while older adults are reasonably good at recognising whether items are old or new, they show marked impairments at remembering the source in which items were presented at study. Dual process theories propose that the age-related decline in source memory occurs because recollection becomes impaired with ageing whereas familiarity remains relatively spared. The results reported in this thesis support dual process theory. Experiment 2a showed that, behaviourally, as expected, the young outperformed the elderly. Event-related potentials (ERPs), recorded while a source memory exclusion test was performed, revealed that both young and older adults showed bilateral frontal and left parietal old/new effects, thought to index familiarity and recollection respectively. Importantly, the magnitude of the left parietal effect was significantly reduced in the older adults. The ERP findings also suggested that dual process theories represent an oversimplification of episodic memory decline with age. In Experiment 1a, three temporally and topographically distinct late frontal old/new effects were present in the younger adults: a bilateral anterior frontal effect (450-900ms post stimulus), a right prefrontal effect (900-1300ms) and a right frontal effect (1300-2000ms). Significant positive correlations between the magnitude of these effects and performance on neuropsychological tests of executive functioning in Experiment 1b, revealed that the bilateral anterior frontal effect was related to working memory, strategy use and planning; the right prefrontal effect was related to working memory and planning while the right frontal effect was related to planning. By contrast, the older adults in Experiment 2a only produced the right frontal effect, which correlated with planning across all three time windows in Experiment 2c. Post-retrieval monitoring in older adults therefore appeared to be qualitatively different than their younger counterparts. Performance on the neuropsychological tests in Experiment 2b, revealed that the older adults’ working memory and strategy use was impaired compared to the young, whereas planning was relatively intact, suggesting that age-related differences in post retrieval processing may be due to reduced executive functioning in older adults. Identifying distinct late frontal effects and demonstrating a relationship between these effects and specific executive functions is a novel finding. The presence of a left parietal target greater than non-target difference in the young adults from Experiment 1a and 2a was interpreted as the young reducing recollection of irrelevant non-target information. The modulation did not differ in magnitude for targets and non-targets in the elderly adults from Experiment 2a, suggesting they were less able to reduce activation of goal irrelevant non-target information. The results in the young adults from Experiment 1a also highlight the importance of considering the context of source information on the processes engaged at retrieval. The bilateral frontal effect was significant for the retrieval of the intrinsic context (source information inherent to the studied item), but not the extrinsic context (source information not inherent to the studied item). This finding was interpreted within a unitisation framework, where the intrinsic context became unitised with the item and enhanced familiarity based remembering. The findings also highlight that in order to fully understand post retrieval processing in both young and old adults, focus should move away from examining quantitative differences in the right frontal effect over long time periods and instead identify qualitatively distinct late frontal effects that may reflect the engagement of various executive functions over time.

Rationale Cognitive deficits are now recognised as a major symptom of schizophrenia with a number of studies reporting profound deficits in cognitive function in both chronic and first episode patients. Recent advances in cognitive remediation therapy have provided the opportunity for patients to improve their cognitive function and therefore improve their functional outcome. Aim The aim of the present study was to investigate cognitive deficits using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in first episode psychosis and chronic schizophrenia patients. In the first episode population the effect of ethnicity on cognition was also examined. In the chronic schizophrenia study comparisons between severity of deficits with first episode psychosis patients were also made. The effects of cognitive remediation therapy were also examined in a sample of first episode patients. Methods A total of 35 patients and 30 healthy controls were recruited into the first episode study, 17 patients and 17 controls into the chronic schizophrenia study and 11 patients into the cognitive remediation study. The first episode psychosis patients were recruited from the Bradford and Airedale Early Intervention Service and the chronic patients from the Leeds Partnership NHS Foundation Trust. The control subjects were matched as closely as possible in terms of intelligence and demographics to the patient groups. The Wechsler Test of Adult Reading (WTAR) was used to estimate subjects pre-morbid IQ. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). All subjects who took part in the study completed a comprehensive battery of neuropsychological tests from the CANTAB®. Patients in the cognitive remediation study participated in group therapy sessions using X-cog®. Results There were no significant differences found between There were no significant differences found between patients and controls in relation to intelligence or demographics in all studies. The effect of ethnicity was shown to be not significant in the first episode study. Results show that patients performed significantly worse than controls across all iv cognitive domains tested in all studies. A correlation between negative symptoms and executive function was found in both first episode and chronic schizophrenia patients. Comparisons between first episode psychosis and chronic schizophrenia patients in cognition showed no significant differences, however significant differences were found in levels of negative symptoms and age between the two groups with chronic patients scoring higher on negative symptoms and being older. In the cognitive remediation study a significant improvement was observed in patients in the domain of executive function and a reduction in negative symptoms following completion of the intervention. Conclusion First episode and chronic schizophrenia patients display significant cognitive deficits across all domains when tested using the CANTAB®. Some of these deficits appear to be independent of the length of the illness but dependent on negative symptoms. This study demonstrates that cognitive deficits exist across all patient groups regardless of age, gender, pre-morbid IQ, years in education and ethnicity. Cognitive remediation therapy has also been shown to be effective in improving cognitive functioning in patients.

Submitted by Hellen Luz (hellencrisluz@gmail.com) on 2018-02-26T19:14:41Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_CorrelacaoMedidasQuantitativas.pdf: 4931104 bytes, checksum: 89eb8efff7aef9a8c3382319a847ac48 (MD5) / Approved for entry into archive by Edisangela Bastos (edisangela@ufpa.br) on 2018-03-08T15:47:29Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_CorrelacaoMedidasQuantitativas.pdf: 4931104 bytes, checksum: 89eb8efff7aef9a8c3382319a847ac48 (MD5) / Made available in DSpace on 2018-03-08T15:47:29Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_CorrelacaoMedidasQuantitativas.pdf: 4931104 bytes, checksum: 89eb8efff7aef9a8c3382319a847ac48 (MD5) Previous issue date: 2017-10-17 / Atualmente, com o aumento na expectativa de vida das populações humanas, as doenças neurodegenerativas, de comum ocorrência com o avançar da idade, tornaram-se fonte de serias preocupações. Deste modo, tem sido fomentado em todo o mundo a investigação de novos meios de diagnóstico precoce de transtornos neurocognitivos associados a doenças como a de Alzheimer e de Parkinson, assim como a melhoria do entendimento dos métodos de diagnóstico clinico neurológico atualmente disponíveis. Neste sentido, este trabalho propõe investigar a existência de possíveis correlações entre os resultados de exames utilizados na investigação clínica neurológica de pacientes diagnosticados com transtorno neurocognitivo associado a essas importantes doenças neurodegenerativas (doenças de Alzheimer e Parkinson). Os resultados mostram que a medida da espessura da camada de fibras nervosas da retina perimacular, realizada por tomografia de coerência óptica, é um parâmetro que pode não diferir de modo relevante entre grupos de pacientes e sujeitos saudáveis. Por outro lado, a medida da amplitude dos sinais espectroscópicos gerados por metabólitos encefálicos, realizada por espectroscopia de prótons em ressonância magnética, revela alterações encefálicas que variam de região para região. Além disso, a medida neuropsicológica de funções cognitivas, realizada pela aplicação da bateria automatizada CANTAB, revela que diversos aspectos dessas funções estão prejudicados nesses pacientes. Finalmente, a Análise de Componente Principal mostra que, considerando o conjunto de variáveis obtidos pelas medidas tomográficas e neuropsicológicas, é possível observar uma correlação entre várias dessas variáveis. Deste modo, conclui-se que correlacionando os resultados obtidos por diferentes abordagens pode agregar potencial na interpretação dessa casuística, o que não seria possível se considerarmos tais dados de modo isolado. / Currently, with the increase in life expectancy of human populations, neurodegenerative diseases, commonly occurring with the advancing age, have become a source of serious concern. Thus, research into new ways of early diagnosis of neurocognitive disorders associated with diseases such as Alzheimer's and Parkinson's, as well as the improvement of the understanding of currently available clinical neurological diagnostic methods, has been promoted throughout the world. In this sense, this work proposes to investigate the existence of possible correlations between the results of exams used in clinical neurological investigation of patients diagnosed with neurocognitive disorder associated with these important neurodegenerative diseases (Alzheimer's and Parkinson's diseases). The results show that the measurement of the thickness of the nerve fiber layer of the perimacular retina, performed by optical coherence tomography, is a parameter that may not differ significantly between groups of patients and healthy subjects. On the other hand, the measurement of the amplitude of the spectroscopic signals generated by encephalic metabolites, performed by magnetic resonance proton spectroscopy, reveals encephalic changes that vary from region to region. In addition, the neuropsychological measure of cognitive functions, performed by the automated CANTAB battery, reveals that several aspects of these functions are impaired in these patients. Finally, Principal Component Analysis shows that, considering the set of variables obtained by tomographic and neuropsychological measurements, it is possible to observe a correlation between several of these variables. Thus, it is concluded that correlating the results obtained by different approaches may add potential in the interpretation of this casuistry, which would not be possible if we consider such data in an isolated way.

Background. Within the South African context there is a large body of research regarding the associations between maternal gestational drinking and diagnosable child FASDs. However, there remains a paucity of local research regarding the impacts of other kinds of maternal drinking behaviours (e.g. past and present maternal drinking) and related socio-demographic factors on developmentally sensitive areas of child neurocognitive functioning, such as executive functioning (EF). Methods. This study was cross-sectional in design, utilising a gender balanced sample of N=464 children between the ages of 9.00 and 15.12 (year.months) in three rural areas within the Western Cape. Information regarding maternal drinking behaviours (before, during and after pregnancy) and related socio-demographic factors was collected via structured interviews with mothers or proxy respondents. Six subtests from the Cambridge Automated Neuropsychological Battery (CANTAB), were used to assess three aspects of child EF namely: (1) processing speed, assessed by the MOT and RTI subtests, (2) attention, assessed by the MTT and RVP subtests and (3) memory, assessed by the SWM and PAL subtests. Findings. For all three maternal alcohol use behaviours examined, there was an apparent non-significant trend whereby children of mothers who reported alcohol use (before, during and after pregnancy) performed worse (on average) than children of mothers reporting non-alcohol use on the EF subtests. Several of the socio-demographic factors were found to act as significant predictors of subtest specific EF performance including child sex (RTI: B=.46, p<. 01; MTT: B=.05, p<.05), child age (RTI: B=.27, p<.05; MTT: B=.11, p<.01), home language (MOT: B=- .13, p<.05), maternal employment (MTT: B=-.04, p<.05) and household size (SWM: B=-1.29, p<.05). Conclusions. These study findings provide initial insights into the impacts of different types of maternal drinking behaviours and related socio-demographic factors on child EF outcomes within the context of an LMIC, South Africa.