Darbo tikslas: įvertinti ankstyva Parkinsono liga (PL) be demencijos sergančių asmenų pažinimo funkcijas naudojant Kembridžo kompiuterinės neuropsichologinio ištyrimo sistemos testų rinkinį, palyginti rezultatus su kontrolinės grupės asmenų duomenimis bei nustatyti kognityvinių rodiklių ryšius su biologiniais žymenimis ir klinikiniais nekognityviniais PL simptomais. Darbo uždaviniai: ištirti ankstyva PL sergančių asmenų dėmesio, atminties, regos erdvinę ir vykdomąsias funkcijas, naudojant kompiuterizuotų testų rinkinį CANTAB eclipse 3.0.0, ir palyginti juos su kontrolinių asmenų duomenimis; nustatyti pacientų kognityvinių funkcijų ryšį su UPLVS skale įvertintu ligos sunkumu, transkranijinės sonografijos (TKS) metodu nustatytu juodosios medžiagos (JM) echogeniškumu, presinapsinio dopamine transporterio koncentracija dryžuotame kūne, nustatyta radionuklidinės kompiuterinės tomografijos (RKT) su I¹²³-FP-CIT būdu, miego, nuovargio bei demografiniais veiksniais, gyvenimo kokybės rodikliais, PL gydyti skiriamų vaistų vartojimu; išanalizuoti kompiuterizuotais testais įvertintų kognityvinių funkcijų diagnostinę vertę sergant ankstyva PL. Metodai. Tyrimas atliktas Vilniaus universiteto ligoninės Santariškių klinikų Neurologijos centre. Atrinkta 115 pacientų, sergančių ankstyva kliniškai tikėtina PL, kurie atitiko įtraukimo kriterijus bei nebuvo neįtraukimo kriterijų, ir 42 pagal amžių, lytį, mokymosi trukmę atrinkti kontroliniai tiriamieji, kurie nesirgo PL ar kitomis... [toliau žr. visą tekstą] / The aim of the study: to evaluate the cognitive functions of patients with early-stage Parkinson‘s disease (PD) without dementia using Cambridge Neuropsychological Test Automated Battery (CANTAB Eclipse 3.0.0), to compare the obtained results with the data of control subjects, to determine the associations of the variables of cognitive testing with biological markers and clinical non-cognitive symptoms of PD. Objectives: to examine attention, memory, visuospatial and executive functions of patients with early-stage PD without dementia using CANTAB Eclipse 3.0.0 and to compare the obtained results with the data of control subjects; to investigate the relationship between the cognitive functions of patients with early-stage PD and the severity of disease measured by UPDRS score, the echogenic properties of brainstem nigral substance (SN) examined by transcranial sonography (TCS), the striatal binding of presinaptic dopamine transporter determined by single-photon emission computed tomography (SPECT) with I¹²³-FP-CIT, sleep, fatigue, demographic factors and quality of life scores, the usage of medications for early-stage PD; to analize the diagnostic characteristics of particular computerised tests for evaluation of cognitive function in patients with early-stage PD. Methods. The study was performed at the Department of Neurology of Vilnius University Hospital Santariškių Klinikos. 115 patients diagnosed with clinically probable early-stage PD who met inclusion criteria and... [to full text]

The aim of the study: to evaluate the cognitive functions of patients with early-stage Parkinson‘s disease (PD) without dementia using Cambridge Neuropsychological Test Automated Battery (CANTAB Eclipse 3.0.0), to compare the obtained results with the data of control subjects, to determine the associations of the variables of cognitive testing with biological markers and clinical non-cognitive symptoms of PD. Objectives: to examine attention, memory, visuospatial and executive functions of patients with early-stage PD without dementia using CANTAB Eclipse 3.0.0 and to compare the obtained results with the data of control subjects; to investigate the relationship between the cognitive functions of patients with early-stage PD and the severity of disease measured by UPDRS score, the echogenic properties of brainstem nigral substance (SN) examined by transcranial sonography (TCS), the striatal binding of presinaptic dopamine transporter determined by single-photon emission computed tomography (SPECT) with I¹²³-FP-CIT, sleep, fatigue, demographic factors and quality of life scores, the usage of medications for early-stage PD; to analize the diagnostic characteristics of particular computerised tests for evaluation of cognitive function in patients with early-stage PD. Methods. The study was performed at the Department of Neurology of Vilnius University Hospital Santariškių Klinikos. 115 patients diagnosed with clinically probable early-stage PD who met inclusion criteria and... [to full text] / Darbo tikslas: įvertinti ankstyva Parkinsono liga (PL) be demencijos sergančių asmenų pažinimo funkcijas naudojant Kembridžo kompiuterinės neuropsichologinio ištyrimo sistemos testų rinkinį, palyginti rezultatus su kontrolinės grupės asmenų duomenimis bei nustatyti kognityvinių rodiklių ryšius su biologiniais žymenimis ir klinikiniais nekognityviniais PL simptomais. Darbo uždaviniai: ištirti ankstyva PL sergančių asmenų dėmesio, atminties, regos erdvinę ir vykdomąsias funkcijas, naudojant kompiuterizuotų testų rinkinį CANTAB eclipse 3.0.0, ir palyginti juos su kontrolinių asmenų duomenimis; nustatyti pacientų kognityvinių funkcijų ryšį su UPLVS skale įvertintu ligos sunkumu, transkranijinės sonografijos (TKS) metodu nustatytu juodosios medžiagos (JM) echogeniškumu, presinapsinio dopamine transporterio koncentracija dryžuotame kūne, nustatyta radionuklidinės kompiuterinės tomografijos (RKT) su I¹²³-FP-CIT būdu, miego, nuovargio bei demografiniais veiksniais, gyvenimo kokybės rodikliais, PL gydyti skiriamų vaistų vartojimu; išanalizuoti kompiuterizuotais testais įvertintų kognityvinių funkcijų diagnostinę vertę sergant ankstyva PL. Metodai. Tyrimas atliktas Vilniaus universiteto ligoninės Santariškių klinikų Neurologijos centre. Atrinkta 115 pacientų, sergančių ankstyva kliniškai tikėtina PL, kurie atitiko įtraukimo kriterijus bei nebuvo neįtraukimo kriterijų, ir 42 pagal amžių, lytį, mokymosi trukmę atrinkti kontroliniai tiriamieji, kurie nesirgo PL ar kitomis... [toliau žr. visą tekstą]

Anorexia nervosa und unipolare Affektive Störungen stellen häufige und schwerwiegende kinder- und jugendpsychiatrische Störungsbilder dar, deren Pathogenese bislang nicht vollständig entschlüsselt ist. Verschiedene Studien zeigen bei erwachsenen Patienten gravierende Auffälligkeiten in den kognitiven Funktionen. Dahingegen scheinen bei adoleszenten Patienten lediglich leichtere Einschränkungen in den kognitiven Funktionen vorzuliegen. Die Prävalenz der Anorexia nervosa und unipolaren Affektiven Störung ist mit Beginn der Adoleszenz deutlich erhöht. Es ist anzunehmen, dass kognitive Dysfunktionen, die sich bereits in diesem Alter abzeichnen, den weiteren Krankheitsverlauf bis in das Erwachsenenalter, die Behandlungsergebnisse und die Prognose maßgeblich beeinträchtigen könnten. Zudem ist von einem höheren Chronifizierungsrisiko auszugehen. In der vorliegenden Arbeit wurden daher kognitive Funktionen bei adoleszenten Patientinnen mit Anorexia nervosa sowie Patienten mit unipolaren Affektiven Störungen untersucht. Die Überprüfung der kognitiven Funktionen bei Patientinnen mit Anorexia nervosa erfolgte vor und nach Gewichtszunahme. Weiterhin wurden zugrundeliegende biologische Mechanismen überprüft. Zudem wurde die Spezifität kognitiver Dysfunktionen für beide Störungsbilder untersucht und bei Patienten mit unipolaren Affektiven Störungen geschlechtsbezogene Unterschiede exploriert. Insgesamt gingen 47 Patientinnen mit Anorexia nervosa (mittleres Alter 16,3 + 1,6 Jahre), 39 Patienten mit unipolaren Affektiven Störungen (mittleres Alter 15,5 + 1,3 Jahre) sowie 78 Kontrollprobanden (mittleres Alter 16,5 + 1,3 Jahre) in die Untersuchung ein. Sämtliche Studienteilnehmer durchliefen eine neuropsychologische Testbatterie, bestehend aus Verfahren zur Überprüfung der kognitiven Flexibilität sowie visuellen und psychomotorischen Verarbeitungsgeschwindigkeit. Neben einem Intelligenzscreening wurden zudem das Ausmaß der depressiven Symptomatik sowie die allgemeine psychische Belastung erfasst. Die Ergebnisse legen nahe, dass bei adoleszenten Patientinnen mit Anorexia nervosa, sowohl im akut untergewichtigen Zustand als auch nach Gewichtszunahme, lediglich milde Beeinträchtigungen in den kognitiven Funktionen vorliegen. Im akut untergewichtigen Zustand offenbarten sich deutliche Zusammenhänge zwischen dem appetitregulierenden Peptid Agouti-related Protein und kognitiver Flexibilität, nicht jedoch zwischen Agouti-related Protein und visueller oder psychomotorischer Verarbeitungsgeschwindigkeit. Bei dem Vergleich von Anorexia nervosa und unipolaren Affektiven Störungen prädizierte die Zugehörigkeit zu der Patientengruppe Anorexia nervosa ein Risiko für das Vorliegen kognitiver Dysfunktionen. Es zeigte sich zudem, dass adoleszente Patienten mit unipolaren Affektiven Störungen lediglich in der psychomotorischen Verarbeitungsgeschwindigkeit tendenziell schwächere Leistungen offenbarten als gesunde Kontrollprobanden. Es ergab sich jedoch ein genereller geschlechtsbezogener Vorteil für weibliche Probanden in der visuellen und psychomotorischen Verarbeitungsgeschwindigkeit. Die vorliegenden Befunde unterstreichen die Notwendigkeit der Überprüfung kognitiver Funktionen bei adoleszenten Patienten mit Anorexia nervosa sowie unipolaren Affektiven Störungen in der klinischen Routinediagnostik. Die Patienten könnten von spezifischen Therapieprogrammen profitieren, die Beeinträchtigungen in den kognitiven Funktionen mildern bzw. präventiv behandeln. / Anorexia nervosa and unipolar affective disorders are common and severe psychiatric disorders whose pathogenesis is not fully understood so far. Several studies have revealed serious impairments in cognitive functions among adult patients whereas recent research in adolescent patients shows only subtle cognitive dysfunctions. The prevalence in both disorders increases with the beginning of adolescence. Cognitive impairments that occur during adolescence may exacerbate the course of disease. Early cognitive deficits may also hinder treatment efforts and prognosis to a greater extent than during adulthood. Moreover, there is a higher risk for chronification. In the present study cognitive functions in adolescent patients with anorexia nervosa and unipolar affective disorders were examined. Cognitive functions in patients with anorexia nervosa were assessed before and after weight gain. Furthermore, the underlying biological mechanisms were explored. Moreover, the specificity for these psychiatric diagnoses as well as gender differences in patients with unipolar affective disorders were investigated. 47 patients with anorexia nervosa (mean age 16.3 + 1.6), 39 patients with unipolar affective disorders (mean age 15.5 + 1.3) and 78 healthy adolescents (mean age 16.5 + 1.3) participated in this study. Each of them completed a battery of neuropsychological tests for cognitive functions including tests for assessing cognitive flexibility as well as visual and psychomotor processing speed. Moreover, intelligence, depressive symptoms and psychological stress were explored. The findings revealed only subtle cognitive impairments in adolescent patients with anorexia nervosa, both in underweight condition and after weight gain. Besides, the results showed an association between cognitive flexibility and plasma agouti-related protein levels in female adolescent patients with acute anorexia nervosa, but not for visual or psychomotor speed and plasma agouti-related protein levels. Comparing anorexia nervosa and unipolar affective disorders, the results suggested a higher risk for cognitive dysfunctions when belonging to the anorexia nervosa group. Furthermore, the results only revealed a slightly weaker performance in psychomotor processing speed in adolescent patients with unipolar affective disorders compared to healthy adolescents. Moreover, female subjects generally displayed a better performance in visual and psychomotor processing speed. The present findings underlie the necessity of exploring cognitive functions in adolescent patients with anorexia nervosa and unipolar affective disorders within routine clinical diagnostic. Patients may benefit from specific therapy programs to reduce or prevent cognitive dysfunctions.

This thesis deals with speech therapy for people with acquired brain injury. The theoretical part consists of three chapters that acquaint readers with the theoretical framework necessary to understand the range of problems examined. It approximates the issue of origin and effects of this disease and refers to attitude in therapy that can be realized to people with this impairment. The research part of the work puts a goal to analyze the possibilities of speech therapy of selected persons with aphasia. The resulting data agree on the fact that for effective speech therapy is necessary on the one hand an individual approach but also motivation of patient is very important. The thesis also includes creating a custom set of exercises which has confirmed the effectivness of the development of cognitive functions in persons with aphasia. The empirical part is based on the qualitative research which was realized by techniques of participant observing, interviewing, questionnaire survey, analysing progress and outcomes of activities, documentation and literature.

La scolarisation des élèves en situation de handicap sur le plan cognitif, désignés comme handicapés mentaux, connaît en France une forte expansion depuis la loi du 11 février 2005. Le paradigme inclusif, encadré par une législation européenne et internationale, y contribue largement, tout comme l’influence des disability studies. Assurant un accompagnement pédagogique à l’inclusion des élèves dans les classes ordinaires, l’Unité Localisée pour l’Inclusion Scolaire est un dispositif dont les modalités d’organisation, particulièrement en second degré, varient selon les contextes académiques. Si l’inclusion se développe significativement au collège, la présence de ces élèves au lycée professionnel date seulement d’une dizaine d’années et se confronte à des résistances créant des effets de liminalité. À travers un recueil de données ethnographiques (observations, documents de terrain) et l’analyse d’entretiens semi-directifs de type compréhensif réalisés auprès de trente-six élèves et d’une trentaine de professionnels de l’école (coordonnateurs, enseignants, COP, responsables institutionnels), nous analysons les processus en œuvre dans les procédures d’orientation scolaire des élèves du second degré bénéficiant du cadre de l’ULIS. Fondées sur la mise en place du Parcours Avenir, ces pratiques empruntent de nouvelles voies pour des élèves dont l’orientation a été, jusque récemment, majoritairement tournée vers la filière médico-sociale. Notre analyse s’attache à montrer comment l’ULIS peut, dans certaines conditions, fournir les bases d’un environnement socialisant et capacitant afin d’ouvrir des perspectives de formation aux élèves en situation de handicap cognitif. / In France, the education of students with cognitive disorders, labelled as mentally disabled, has been growing since the act of the 11 of February 2005. The inclusion paradigm that is ruled by law at the European and international levels, has greatly influenced this development as well as the disability studies. The ULIS, provide some pedagogical support to include Special Education Needs students into mainstream classrooms. The organization of such a device varies according to context and education areas. If inclusion has significantly increased in lower secondary schools, the attendance of students with cognitive disabilities in vocational schools has started only ten years ago and the process faces liminality challenges. Thanks to the collection of ethnographic data based on observation and documents analysis as well as the completion of semi-directive face-to-face interviews conducted with 36 students and 30 educational professionals (coordinators, teachers, orientation counsellors, management staff), we set out to analyse the undergoing process for the orientation practices of ULIS students in secondary education. Based on the implementation of the Parcours Avenir project, these guidance practices open up new perspectives for these students whose orientation has been mainly guided by socio-therapeutic approaches. We show how the ULIS device, under specific conditions, can offer the basis for a socializing and empowering environment that contributes to open up new training perspectives to students with cognitive disabilities.

The theoretical part of this dissertation presents a current view of functional (psychogenic) movement disorders (FMD) in the current International Classification of Diseases (ICD-10) referred to as dissociative (conversion) motor disorders, which has undergone significant development in the last two decades. It is a heterogeneous group of diseases with a tendency of becoming chronic diseases, which, in addition to motor symptoms, are manifested by a number of comorbid non-motor symptoms (fatigue, pain, anxiety, depression, cognitive difficulties, etc.). Despite the potential reversibility, these disorders still have an unfavorable prognosis and are associated with a low quality of life. Based on our current understanding, abnormalities of attentional processes are among the central phenomena of the development and maintenance of FMD. So far, only a minimum of studies has focused on attentional processes in the context of complex cognitive performance with contradictory findings. The dissertation had two goals. The first of the presented studies focused on the impact of subjectively assessed non-motor symptoms including subjective cognitive complaints and objectively assessed motor symptoms on the quality of life. The aim of the second study was to examine the cognitive profile of patients with FMD...

This diploma thesis focuses on the issue of seniors in transportation and examines the typical causes of traffic accidents caused by the participation of persons of this age category. The theoretical part of the thesis explains the demographic development of the society with regard to the population’s mobility and describes the personality of the person in the transport environment from the traffic psychology point of view focusing on seniors. The empirical part of the thesis focuses on the analysis of traffic accidents with the participation of seniors, defining the causes. It sets out the practical tools that can be used to objectively assess the driver's ability to drive in terms of driver's age and the possibility of reducing the number of traffic accidents caused by the elderly.

La prise en charge des personnes âgées présentant une maladie neurodégénérative aboutissant à des troubles cognitifs et une démence représente un enjeu majeur de santé. Il est important de concevoir des outils pour aider les cliniciens à mieux prendre en charge les patients par la stimulation. L’Environnement Enrichi – favorisant les stimulations cognitives, physiques et sociales dans un contexte émotionnel positif – apparait être une puissante stratégie non-médicamenteuse pour réduire ou retarder les évolutions des processus neurodégénératifs et les pertes cognitives. Dans cette approche, l’hypothèse de l’Enrichissement Cognitif stipule que les comportements qu’adopte un individu tout au long de sa vie vont avoir un impact sur le fonctionnement de son cerveau, même à l’âge avancé. C’est dans cette idée que les Jeux Vidéo et les Serious Games à activité physique sont utilisés. X-Torp est un Serious Game d’action conçu pour être accessible et stimulant pour les sujets âgés en bonne santé et présentant une Maladie Neurodégénérative due à un trouble cognitif léger ou une démence de type Alzheimer. Le joueur incarne un sous-marin et est plongé dans un monde quasi maritime où seules quelques îles sont en surface. Il doit ainsi évoluer dans un scénario pour monter en grade à travers la réalisation de missions et d’affrontements en mer. X-Torp est jouable sur Microsoft® Kinect™ pour PC. L’objectif de cette thèse est de présenter l’ensemble des travaux scientifiques entrepris pour (1) concevoir une première version du jeu ; (2) la tester chez les populations cibles et (3) concevoir en conséquence une seconde version commercialisable / The care of elderly people affected by neurodegenerative diseases leading to cognitive impairment and dementia represents a major challenge in the healthcare domain. It is important to design tools that can help clinicians to better treat these patients through stimulation. Enriched Environments - which favor cognitive and physical stimulations in a positive emotional context – look like a powerful non-pharmacological strategy to reduce or delay the evolution of neurodegenerative processes, and the consequent cognitive disorders. Based on this approach, the Enriched Environment hypothesis states that the behavior of an individual during the lifetime, even during old age, affect his brain functioning. Video Games and Serious Games implying physical activity are used in this context. X-Torp is an action Serious Game conceived to be usable and stimulating for healthy elderly people and people with neurodegenerative disorders leading to Mild Cognitive Impairment or to Alzheimer’s’ dementia. The player takes the command of a submarine and is immersed in a sea-world where only a few islands appear on the surface. The player needs to advance in the game scenario to improve his grade position accomplishing missions and battling over the sea. X-Torp is played with Microsoft® Kinect™ for PC. The aim of this thesis is to present the scientific work undergone to (1) conceive and design the first game version; (2) test this version on the target populations, and (3) based on the results, design a second game version ready to be commercialized

5 ABSTRACT Object permanence is a cognitive ability to perceive the continuous existence of objects, even if they cannot be directly observed, respectively perceived by other senses (Piaget 1954). In humans object permanence develops in 6 qualitatively different stages. By using a comparative approach, it was found that the last stage 6 of this ability also occurs in great apes, gibbons and some New World monkeys (capuchin, marmoset and tamarin). In this study, we conducted a study with a series of invisible displacements of an object, in which we investigated whether two rhesus macaques (Macaca mulatta) have fully developed the ability of object permanence and don't rely on simple alternative cognitive strategies, while solving the different tasks. With one test subject, we confirmed that he solved the tasks with stage 6 object permanence abilities. Although the second individual reached significant performance in some sessions, the overall results are ambiguous, because during the testing he had a tendency to use simple alternative strategies. Our study concludes that under certain circumstances macaques have the cognitive capacity for a fully developed ability of object permanence. Key words: Object permanence, rhesus macaque, invisible displacement, cognitive functions

FEUERSTEIN'S INSTRUMENTAL ENRICHMENT PROGRAM FROM THE POINT OF VIEW OF PRIMARY SCHOOL TEACHERS The presented doctoral work covers the programme of cognitive stimulation created by Reuven Feuerstein. It aims to describe the effects that the teachers are triggered with by this programme. The work presents Feuerstein's Instrumental Enrichment (FIE) in context of all the Feuerstein's work. It explains its theoretical grounds in detail, and connects them with broader questions from educational psychology field, that are related to the teaching of thinking skills. There is compared the Feuerstein's theory of Mediated Learning Experience (MLE) with L. S. Vygotsky's theory of mediation in the work. It also refers to the work of J. Piaget in many passages. The research part of the work is based on interviews and two small semantic- differential scales. The research group contained 9 experimental and 6 control teachers from primary schools. The main aim of the carried research was to map what form gain the influences that FIE has on the teachers. We also worked on the teachers' opinions regarding the implementation of this programme at mainstream schools. Besides the description of effects, we were also describing and comparing opinions of both groups on teaching thinking. The closing part of the work is...