Bien qu’il y ait de plus en plus d’études sur le soutien maternel à l’autonomie, de nombreuses questions restent à éclaircir dans le domaine. Notamment, on en sait très peu sur ses relations avec le développement cognitif de l’enfant, sa stabilité temporelle et les antécédents de celle-ci. La thèse est composée de trois articles empiriques. Le premier explore le rôle médiateur du langage dans la relation entre le soutien maternel à l'autonomie et les fonctions exécutives de l'enfant. Le deuxième examine la stabilité relative et absolue du soutien maternel à l'autonomie entre la petite enfance et l’âge préscolaire en fonction des représentations d'attachement de la mère, des évènements de vie stressants et du sexe de l'enfant. Le troisième article se penche sur le rôle du soutien maternel à l’autonomie mesuré à la petite enfance et à l’âge préscolaire dans la prédiction des fonctions exécutives de l’enfant, ainsi que sur l’impact de différents patrons de stabilité du soutien maternel à l’autonomie sur les fonctions exécutives. 70 dyades mère-enfant ont participé à 5 visites à domicile. Lorsque l’enfant était âgé de 7-8 mois, les représentations d’attachement de la mère ont été mesurées à l’aide de l’entrevue d’attachement à l’âge adulte (George, Kaplan, & Main, 1996). Le soutien maternel à l’autonomie a été mesuré à 15 mois et à 3 ans à l’aide du système de codification de Whipple, Bernier, et Mageau (2011). Les évènements de vie stressants ont été mesurés à 3 reprises entre l’âge de 15 mois et 3 ans à l’aide de l’inventaire des expériences de vie (Sarason, Johnson, & Siegel, 1978). À 2 ans, le langage de l’enfant a été évalué à l’aide des inventaires MacArthur du développement de la communication (Dionne, Tremblay, Boivin, Laplante, & Pérusse, 2003). Les fonctions exécutives de l’enfant ont quant à elles été mesurées à l’âge de 3 ans à l’aide d’une batterie de tâches (Carlson, 2005). Les résultats du premier article indiquent que le langage de l’enfant joue un rôle médiateur dans la relation entre le soutien maternel à l’autonomie et une composante des fonctions exécutives de l’enfant, l’inhibition volontaire. Les résultats du deuxième article démontrent que le soutien maternel à l’autonomie est stable de façon relative, mais non absolue. Les résultats démontrent aussi que les mères qui ont une fille, qui ont vécu peu d’évènements de vie stressants ou qui ont des représentations d’attachement sécurisées sont plus stables dans leur degré de soutien à l’autonomie. Le troisième article démontre d’abord que la moyenne de soutien maternel à l’autonomie entre 15 mois et 3 ans est un prédicteur plus efficace des fonctions exécutives de l’enfant que ne l’est le soutien à l’autonomie à 15 mois ou à 3 ans pris séparément. De plus, les enfants dont les mères conservent un degré élevé de soutien à l’autonomie entre 15 mois et 3 ans performent mieux aux tâches d’inhibition que les enfants dont les mères conservent un faible degré de soutien à l’autonomie. Les résultats présentés dans les articles sont discutés ainsi que leurs implications. / Despite growing empirical support for the idea that maternal autonomy support plays an important role in child development, many questions remained to be investigated. Especially, little is known about its temporal stability, its antecedents, and its relations with child cognitive development. The first article aims to examine the potential mediating role of child language in the prospective relation between maternal autonomy support and child executive functioning (EF). The second article aims to examine (a) the relative and absolute stability of maternal autonomy support between infancy and preschool age and (b) the moderating role of child gender, maternal attachment state of mind, and stressful life events. The goal of the third article is to examine the role of early and ongoing maternal autonomy support, and of its stability over time, in predicting child EF. 70 mother-infant dyads took part in five assessments. At 7-8 months, the Adult Attachment Interview (George, Kaplan, & Main, 1996) was administered to assess mothers’ state of mind with respect to attachment. Maternal autonomy support was rated at 15 months and 3 years with Whipple, Bernier, and Mageau’s (2011) coding scheme, based on observations performed during a mother-child problem-solving task (15 months) and a clean-up task (3 years). Stressful life events were measured at 18 months, 2 and 3 years with the Life Experiences Survey (Sarason, Johnson, & Siegel, 1978) completed by mothers. At 2 years, mothers were asked to complete the MacArthur Communicative Development Inventory (Dionne, Tremblay, Boivin, Laplante, & Pérusse, 2003) to measure child language ability. Finally, child EF was assessed with a battery of tasks chosen based on Carlson’s (2005) measurement guidelines. The results of the first paper suggested that child language played a mediating role in the relation between maternal autonomy support and child performance on EF tasks entailing a strong impulse control component. The results of the second article revealed that maternal autonomy support is stable in relative terms, but that its mean level decreases over time. Moreover, there was significant relative stability only for mothers of girls, mothers who showed greater coherence of mind with respect to attachment, and mothers who experienced fewer stressful life events. The results of the last article showed that the average level of autonomy support displayed by mothers between infancy and preschool years was a more consistent predictor of child Impulse Control and Conflict-EF (two aspects of EF) than either early or current autonomy support in isolation, and that children of mothers who displayed high autonomy support at both 15 months and 3 years performed the best on impulse control. The results presented in the articles are discussed, along with their implications.

L’intérêt marqué et simultané de plusieurs champs de recherche pour le développement des fonctions exécutives (FE) a permis de mettre en lumière le rôle primordial de ces fonctions dans plusieurs sphères du développement de la petite enfance jusqu’à l’âge adulte. Les mécanismes développementaux associés aux différences individuelles restent par ailleurs encore peu étudiés. Les deux articles empiriques qui constituent la thèse visent à documenter le rôle des comportements maternels observés en bas âge dans la prédiction des FE mesurées à l’âge préscolaire. Les deux articles s’inscrivent dans la foulée des travaux qui, selon une approche écologique (Bronfenbrenner, 1979), considèrent les effets d’interaction entre différents facteurs explicatifs pour mieux comprendre les mécanismes impliqués dans le développement de l’enfant. En ce sens, le premier article examine les interactions possibles entre le statut socioéconomique (SSE) de la famille et différentes dimensions du concept de sensibilité maternelle, dans la prédiction de deux dimensions des FE, soit les FE-conflit et les FE-inhibition. Dans le cadre de cette étude, 114 dyades mères-enfants ont participé à trois visites à domicile. Le SSE a été mesuré par questionnaire dans le cadre d’une première visite dans la famille lorsque les enfants avaient six mois, la sensibilité maternelle a été évaluée à 12 mois à partir du Tri de cartes de comportements maternels (Pederson & Moran, 1995) et les FE à 36 mois à partir d’une batterie de tâches choisie sur la base des orientations proposées par Carlson (2005). Le deuxième article explore, en se basant sur postulats de la Théorie de la susceptibilité différentielle (TSD), les possibles interactions entre différentes dimensions du concept de sensibilité maternelle et le tempérament de l’enfant, et ce également dans la prédiction des FE. Pour ce faire, 72 dyades ont également participé à trois visites à domicile. La sensibilité maternelle a été évaluée à 12 mois à partir du Tri de cartes de comportements maternels (Pederson & Moran, 1995), le tempérament à 15 mois à l’aide d’un questionnaire rempli par la mère (ICQ; Bates, Freeland, & Lounsbury, 1979) et les FE à 36 mois à partir de la même batterie de tâche (Carlson, 2005). Les résultats du premier article révèlent des interactions significatives entre le statut socioéconomique et certaines dimensions de comportements maternels, de telle sorte que des comportements maternels de meilleure qualité sont prédicteurs d’une meilleure performance aux tâches de FE, mais seulement chez les enfants provenant de familles relativement désavantagées sur le plan socioéconomique et essentiellement en ce qui concerne les FE-inhibition. Quant aux résultats du deuxième article, ils confirment les hypothèses de la Théorie de la susceptibilité différentielle, en révélant que les enfants ayant un tempérament difficile sont plus affectés par des comportements maternels hostiles, de même que par l’absence de comportements positifs et bénéficient davantage de la présence de comportements positifs et de l’absence de comportements négatifs, et ceci également au regard des FE-inhibition. / The simultaneous and marked interest of many fields of research for the notion of executive functioning (EF) has allowed for the primordial role of these functions in many spheres of development to be identified. However, the developmental mechanisms associated with individual differences in EF are still under studied. The two empirical articles constituting this dissertation aim at documenting the role of maternal behaviors in the prediction of EF in the preschool period. Using an ecological approach (Bronfenbrenner, 1979), interaction effects between different explanatory factors are considered, with the goal of reaching a better understanding of the mechanisms underlying early EF development. To do so, the first article examines the interactions between family socioeconomic status (SES) and different dimensions of maternal behavior in the prediction of two specific components of EF, namely, conflict-EF and impulse control. 114 mother-child dyads participated in three home visits. SES was measured by a questionnaire filled by mothers during the first visit when their child was six months old and maternal behavior was observed in a second visit when the child was 12 months old, using the Maternal Behavior Q-Sort (MBQS; Pederson & Moran, 1995). Finally, child EF was assessed at 3 years with a battery of tasks chosen based on Carlson’s (2005) measurement guidelines. The second article explores, based on Differential Susceptibility Theory (DST), the interactions between different dimensions of maternal behavior and child temperament in the prediction of child EF. Seventy-two mother-child dyads participated in three home visits. Maternal sensitivity was observed when children were 12 months old, using the MBQS, child temperament was assessed at 15 months using a maternal report (ICQ; Bates, Freeland, & Lounsbury, 1979), and child EF was assessed with the same battery of tasks as in the first article. The results of the first article showed significant interactions between family SES and the quality of maternal behaviors in the prediction EF, such that maternal behavior was related to EF only for children in the lower end of the SES spectrum and those relations were found especially for impulse control. The results of the second article confirmed the hypothesis put forward by DST, revealing that children with difficult temperaments were more affected by hostile maternal behavior and the absence of positive behavior, and that these same children benefit more than their easier peers from the presence of positive behaviors, but only in the prediction of impulse control.

Les dysfonctions attentionnelles suivant un traumatisme craniocérébral (TCC) compliquent souvent la reprise des activités de la vie quotidienne et influencent négativement le pronostic de réinsertion socio-académique et professionnelle. Or, les cliniciens de réadaptation disposent d’un nombre limité d’outils de remédiation cognitive dont l’efficacité est démontrée et qui sont adaptés à une population francophone. Cette étude vise à démontrer l’efficacité d’un protocole d’entrainement intensif des fonctions attentionnelles : « Attention! Prêt? On s’enTraine! » (Séguin, Lahaie & Beauchamp, 2012), basé sur une adaptation française de l’« Attention Process Training-I » (APT-I; Sohlberg & Mateer, 1987). Dix-sept participants ayant subi un TCC et présentant des déficits attentionnels ont reçu 15 séances d’entrainement attentionnel avec le programme « Attention! Prêt? On s’enTraine! » (n = 8) ou de l’aide aux devoirs (n = 9). Suite à l’intervention, les participants du groupe expérimental ont amélioré leur rendement dans plusieurs fonctions ciblées par l’intervention attentionnelle, notamment au niveau du balayage visuel, de l’attention sélective et de l’alternance attentionnelle. De plus, les gains se sont généralisés à des fonctions connexes, puisqu’une meilleure performance a été retrouvée dans des tâches de mémoire de travail, d’inhibition, de flexibilité cognitive et de planification visuoconstructive. La démonstration de l’effet positif d’un entrainement intensif sur le rendement attentionnel pourrait inciter les cliniciens et chercheurs à développer et à valider d’autres protocoles de remédiation cognitive francophones, pour les fonctions attentionnelles ou d’autres sphères de la cognition. Par le fait même, le pronostic fonctionnel de la clientèle pédiatrique en traumatologie en sera potentialisé. / Attention dysfunctions following traumatic brain injury (TBI) frequently complicate the return to activities of daily living and negatively influence professional and socioacademic reintegration. Yet, clinicians in rehabilitation settings have limited access to cognitive remediation protocols for which efficacy has been demonstrated and that are adapted to French populations. Thus, the aim of this study is to evaluate the effectiveness of the intensive attention process training program « Attention! Prêt? On s’enTraine! » (Séguin, Lahaie & Beauchamp, 2012) based on a French adaptation of the « Attention Process Training-I » program (APT-I; Sohlberg & Mateer, 1987). Over five weeks, 17 participants who sustained TBI and demonstrated attention deficits received either the attention process training intervention (n = 8) or homework assistance (n = 9). Following the intervention, the experimental group improved on functions targeted by the « Attention! Prêt? On s’enTraine! » program, specifically, visual scanning, visual selective attention and attentional shifting. They also showed significant transfer gains on related tasks including measures of working memory, inhibition, mental flexibility and visuoconstructive planning. The demonstration of a positive effect of an intensive attention training program on attentional performances after TBI is likely to support and reinforce the development and validation of French cognitive remediation protocols, ultimately leading to improvements in the prognosis for individuals with TBI.

Introduction et objectifs : Alors que l'effet moteur de la lévodopa (L-dopa) dans la maladie de Parkinson (MP) est clair et établi, son effet sur la cognition demeure incertain. Les troubles cognitifs ont un impact important sur la qualité de vie et les études évaluant l'effet cognitif de ce médicament donnent des résultats encore divergents. L’objectif primaire de cette étude pilote est d’observer l’impact des doses cliniques de lévodopa sur la cognition. Un second objectif sera d'établir une courbe dose-réponse pour observer les différences potentielles. Méthodes : Cinq patients avec MP ont été évalués à l’aide de 2 tests cognitifs (CPT-II et Stroop) et 2 tests moteurs (Finger Tapping et UPDRS-III) en OFF (sevrage minimal de 12 heures) et en ON avec des doses croissantes de lévodopa (commençant à 50mg avec une augmentation de dose de 50mg par visite) jusqu’à l'observation d'une performance cognitive optimale ou d'effets secondaires. Une administration répétée des tests cognitifs a été faite à la première visite pour limiter l’effet d’apprentissage. Résultats : Le temps de réaction (RT) mesuré en millisecondes au CPT-II a augmenté (médiane 3.03%) après la prise de médicament alors que les erreurs ont légèrement diminué (médiane -9.92%). Au Stroop, l’effet d’interférence évalué selon les changements au temps d’inhibition mesuré en secondes était légèrement moindre sans changement dans les erreurs. Avec les doses prescrites, le RT a augmenté de 3,50% et le nombre d’erreurs est resté stable alors que les doses inférieures ont eu une moindre augmentation du RT tout en diminuant les erreurs. Dans le Stroop, les doses faibles ont amélioré le temps de près de 19% alors que les doses prescrites ont quant à elles diminué les erreurs. Malgré une certaine variabilité, la courbe dose-réponse indique que les erreurs diminuaient aux doses faibles et fortes dans le CPT-II alors que le RT augmentait généralement, ce qui pourrait indiquer un style de performance plus prudent. L’effet de la lévodopa sur l’interférence dans le Stroop variait légèrement sans tendances fixes mis à part le bénéfice observé par les doses faibles. Une importante variabilité a été observée dans les évaluations motrices entre les sujets ainsi qu'au sein du même sujet. Conclusion : Ces résultats indiquent qu’en général, le médicament ne semble pas avoir d’effet néfaste important sur l’attention et les fonctions exécutives évaluées auprès de ce groupe de patients parkinsoniens. L'effet cognitif des doses plus faibles semble leur être bénéfique et meilleur que les doses cliniquement prescrites. La relation dose-réponse démontre un effet cognitif variable de la lévodopa entre les doses, n'indiquant toutefois pas de tendances claires. / Background and objectives: While levodopa’s effect on motor symptoms in Parkinson’s disease (PD) has been largely characterized, its cognitive effect still remains without definite conclusion. Since cognitive impairment is an important feature of PD that impacts patients’ quality of life, it is important to establish levodopa’s effect on cognitive functions. Multiple studies regarding this subject remained without specific consensus. The main goal pursued in this study is to observe the effect of clinical doses of levodopa on attention and executive functions. A dose-response curve is also made with the escalating doses evaluated. Methods: Five PD patients were investigated OFF (minimal withdrawal of 12 hours) and ON levodopa (starting dose of 50mg escalating by 50mg per visit) with 2 cognitive (CPT-II and Stroop) and 2 motor (finger tapping and UPDRS-III) tests until reaching an optimal cognitive performance or showing signs of side effects. Practice sessions of the cognitive tests were done at the first visit. Results: While reaction time (RT) in milliseconds increased (median 3.03%), errors slightly decreased (median -9.92%) after medication intake in the CPT-II. Errors however did not change in the Stroop while time evaluated in seconds decreased. The CPT-II showed slowing at the prescribed doses of levodopa (3.5%) while lower doses improved errors with less increase of the RT. These small doses also improved the performance in the Stroop test with a 19% reduction in time while the prescribed doses improved errors instead. The dose-response curve indicates a reduction of errors in the CPT-II for low and high doses while time usually increased, showing a more cautious style. Besides the beneficial effect of low doses, the dose-response curve for the Stroop test did not show any specific tendencies in levodopa’s effect on interference. An important variability was observed in motor evaluations between and within subjects. Conclusion: These results indicate that levodopa does not seem to have an important deleterious effect on attention and executive functions evaluated in this group of parkinsonian patients and that low doses seem to even be beneficial and better than the ones usually taken by the patients. The dose-response curve showed that the cognitive effect of levodopa for these patients varies between the different doses without being clear on the tendencies.

Des études récentes ont rapporté que les individus âgés avec un trouble cognitif léger (TCL) ont de plus grandes activations en lien avec la réalisation d’une tâche cognitive que des personnes âgées saines. Des auteurs ont proposé que ces hyperactivations pourraient refléter des processus de plasticité cérébrale compensatoires ayant lieu pendant la phase précoce de la maladie d’Alzheimer. Des processus de compensations fonctionnelles pourraient émerger en réponse à une perte d’intégrité structurelle dans les régions du cerveau normalement requises pour compléter une tâche. Dans ce mémoire, j’ai évalué cette hypothèse chez des personnes avec TCL en faisant appel à une tâche de mémoire de travail comportant plusieurs niveaux de difficulté ainsi qu’aux techniques d’imagerie par résonnance magnétique (IRM) structurelle et fonctionnelle. Des analyses de régression multiples ont été utilisées afin d’identifier les régions cérébrales dont l’activité variait en fonction de l’intégrité neuronale telle que définie par le volume de l’hippocampe. Les valeurs estimées des paramètres du signal de ces régions furent ensuite extraites afin de procéder à des analyses corrélationnelles sur la performance ainsi que sur le volume de différentes structures cérébrales. Les résultats indiquent des hyperactivations dans les régions frontales droites chez les participants TCL souffrant d’une plus grande atteinte neuronale. De plus, le niveau d’activation est négativement corrélé au volume de structures frontales et pariétales. Ces résultats indique la présence d’une hyperactivation compensatoire dans la phase du TCL associée à la réalisation d’une tâche de mémoire de travail. / Recent studies have shown greater task-related activation in individuals with mild cognitive impairment (MCI) compared to healthy older adults. It has been suggested that these hyperactivations reflect compensatory processes of brain plasticity in the early phase of Alzheimer’s disease (AD). Functional compensation processes could emerge in response to a loss of structural integrity in brain regions typically required for the task. In this masters dissertation, I examined this hypothesis in MCI using a working memory task that incorporated a parametrical variation of difficulty level as well as functional and structural magnetic resonance imaging (MRI). Multiple regression analyses were used to identify areas of the brain in MCI in which functional activation varied as a function of neural injury as measured by hippocampal volume. Parameter estimates from these areas were then extracted and used for further correlational analyses with performance and structural volumes. Results indicate that MCI participants with high neural injury hyperactivated a subset of regions in the right frontal lobe. Furthermore, the level of activation was negatively correlated with the volume of frontal and parietal regions. These results indicate the presence of compensatory hyperactivations associated with a working memory task in persons with MCI.

Dans les dernières années, les études sur les maladies neurodégénératives telles que la maladie d’Alzheimer (MA) et la maladie de Parkinson sans démence (MP) et avec démence (MPD) ont été nombreuses, mais la différenciation de ces patients sur la base de leur profil cognitif doit être encore améliorée. Effectivement, l’évaluation clinique peut s’avérer difficile en raison du peu de spécificité dans la présentation de leurs déficits neuropsychologiques. Ceci s’explique par la variabilité et le chevauchement des processus cliniques et pathologiques affectant essentiellement les mêmes régions/fonctions, soit celles liées aux lobes temporaux médians (LTM)/Mémoire (fonction LTM/Mémoire) et aux lobes frontaux (LF)/Fonctions exécutives (fonction LF/Exécutive). Toutefois, il existerait une distinction critique au niveau de l’intégrité relative de ces fonctions dans ces maladies neurodégénératives, ce qui permettrait d’identifier des déficits cognitifs spécifiques à la MA, la MP et la MPD. La présente thèse s’inscrit dans cette volonté de caractériser les profils cognitifs propres à la MA, la MP et la MPD, plus précisément par l’étude novatrice de la mémoire de source et des faux souvenirs. Les quatre chapitres qui composent cette thèse servent donc à documenter la nature de ces mécanismes mnésiques, leurs patrons de performance spécifiques dans la MA, la MP et la MPD, et leur sensibilité aux atteintes des fonctions LTM/Mémoire et LF/Exécutive. Ainsi, le Chapitre I démontre la pertinence d’étudier la mémoire de source et les faux souvenirs dans la MA, la MP et la MPD, en décrivant leurs interactions avec les fonctions LTM/Mémoire et LF/Exécutive, toutes les deux atteintes dans ces maladies. Le Chapitre II, présenté sous forme d’article, révèle des déficits en mémoire de source chez des patients MP, mais seulement dans l’une des tâches employées. Également, malgré des atteintes des fonctions LF/Exécutive et LTM/Mémoire, il est démontré que seule la fonction LTM/Mémoire est liée à l’altération de la mémoire de source chez les patients MP. Le Chapitre III, également sous forme d’article, illustre un taux anormal de faux souvenirs chez des patients MA, tandis que chez des patients MP et MPD, il est démontré qu’ils ont un taux de faux souvenirs comparable à celui des participants contrôles. Il est également rapporté que malgré l’atteinte de la fonction LF/Exécutive chez les patients MA, MP et MPD, elle est seulement liée à l’augmentation des faux souvenirs chez les patients MA. Finalement, dans le dernier Chapitre (IV), les résultats obtenus sont discutés dans leur ensemble à la lumière des prédictions et connaissances actuelles, tout en identifiant les limites afin d’orienter les perspectives de recherche. / In the last years, there have been numerous studies on neurodegenerative diseases such as Alzheimer’s disease (AD), Parkinson’s disease without dementia (PD) and with dementia (PDD), but differentiation of these patients based on their cognitive profile remains to be better understood. Indeed, clinical diagnosis remains difficult given that their neuropsychological deficits lack specificity. An explanation lies in the variability and overlap in terms of both clinical and neuroanatomical signs affecting similar brain regions/functions, which are those linked to medial temporal lobes (MTL)/Memory (MTL/Memory function) and to frontal lobes (FL)/Executive functions (FL/Executive function). However, a critical distinction lies in the relative integrity of both functions across AD, PD and PDD patients, which likely allows the capture of diagnosis-specific patterns of performance. This thesis addresses the need to describe the cognitive deficits more precisely by using novel measures of source memory and false memory. In the next four chapters of this thesis, the mechanisms underlying these forms of memory will be described as well as specific patterns of performance in AD, PD and PDD in source memory and false memory and their link to MTL/Memory and FL/Executive dysfunction. In Chapter I, the relevance of studying source memory and false memory in AD, PD and PDD, is explained by describing their interaction with MTL/Memory and FL/Executive functions, both impaired in these diseases. In Chapter II, a first study found source memory deficits in PD patients but only on one of the tasks that were used. Also, despite impaired MTL/Memory and FL/Executive functions, only MTL/Memory function is linked to impaired source memory in PD. In Chapter III, a second study found abnormal false memory rates in AD patients while in PD and PDD patients, false memory rates are comparable to those of healthy controls. It is also reported that despite impaired FL/Executive functions in AD, PD and PDD patients FL/Executive function is only linked to an increase in false memory rates in AD patients. Finally, in the last Chapter (IV), results of this thesis as a whole are discussed in light of predictions and the current literature and future research perspectives are discussed.

Bei altersbedingt abnehmender kognitiver Funktion stellt das steigende Renteneintrittsalter Arbeitgeber und -nehmer vor wachsende Herausforderungen. Der Aufbau der kognitiven Reserve (CR) durch geistig stimulierende Aktivitäten verspricht eine Resilienz gegenüber neuropathologisch bedingten kognitiven Defiziten. In der vorliegenden Arbeit wird die Rolle der CR in Bezug auf die kognitive Leistungsfähigkeit und die neuronale Informationsverarbeitung gesunder Erwachsener im Berufsalter untersucht. Unter Ableitung des Elektroenzephalogramms bearbeiteten Probanden mittleren und hohen Erwerbsalters (34-45 J. und 46-62 J.) im 2-Jahres-Abstand Aufgaben zu drei Domänen exekutiver Funktionen: Arbeitsgedächtnis (AG), kognitive Flexibilität und Inhibitionskontrolle. Hoch-CR-Probanden wiesen aufgabenübergreifend schnellere Reaktionen und geringere Fehlerraten auf. Reduzierte Leistung ließ sich in der Gering-CR-Gruppe tendenziell bei älteren Probanden und in anspruchsvollen Aufgabenbedingungen beobachten. Nach 2 Jahren zeigten Gering-CR-Ältere eine numerisch abnehmende AG-Kapazität, während Hoch-CR-Ältere ihre hohe Leistung steigern konnten. Die P3-Amplitude variierte in Abhängigkeit von der CR und dem Alter. Hoch-CR-Jüngere wiesen im Vergleich zu Gering-CR-Jüngeren höhere P3-Amplituden auf, während Hoch-CR-Ältere im Gegensatz zu Gering-CR-Älteren kleinere P3-Amplituden generierten. Zudem legten kürzere P3-Latenzen in der Hoch-CR-Gruppe eine schnellere neuronale Verarbeitungsgeschwindigkeit nahe. In der Aufgabe zur kognitiven Flexibilität ließ sich bei Gering-CR-Probanden ein Anterior-Shift der P3 beobachten. Die Untersuchungsergebnisse konnten nach 2 Jahren repliziert werden. Alterungsrelevante Leistungsvariablen und neuronale Informationsverarbeitungsprozesse zeigten sich bereits im Berufsalter sensitiv gegenüber der CR. Das mittlere Erwachsenenalter sollte bei der Erarbeitung und Evaluation CR-basierter Maßnahmen zur Prävention kognitiver Defizite stärker berücksichtigt werden. / The increasing retirement date accompanied by an age-associated decline of cognitive functions poses growing challenges to employers and employees. The cognitive reserve (CR) promises a resilience to brain damage-associated cognitive deficits through intellectually stimulating lifestyle activities. The present study examines the role of CR relating to cognitive performance and neuronal information processing of healthy adults in working age. Using an electroencephalogram, subjects of middle and high working age (34-45 years and 46-62 years of age, respectively) completed tasks on three domains of executive functions: working memory, cognitive flexibility and inhibition control. Follow-up assessments were conducted after two years. High-CR subjects performed better across tasks than Low-CR subjects, with faster reaction times and lower error rates. Reduced performance in the Low-CR group tended to be more common among older participants and during the more challenging task conditions. In addition, after two years, Low-CR older workers showed a decreased working memory capacity while older High-CR individuals improved their higher performance. The P3 amplitude of the event-related brain potential varied systematically as a function of CR and age. High-CR younger individuals revealed higher P3 amplitudes compared to Low-CR younger individuals, while High-CR older individuals generated smaller P3 amplitudes than Low-CR older individuals. The shorter P3 peak-latencies of the High-CR group suggested moreover a difference in neural processing speed. When testing cognitive flexibility an anterior shift of the P3 was observed in older Low-CR subjects. The results were almost completely replicated after two years. Age-related performance variables and neuronal information processes revealed to be sensitive to CR already at working age. These findings recommend more research on early adulthood in the development and evaluation of CR-based programs to prevent cognitive deficits.

INTRODUÇÃO: Acometimento em diversos domínios cognitivos (funções executivas, linguagem, memória episódica e semântica) são complicações reconhecidas da epilepsia associada à esclerose mesial temporal (EMT). Também é reconhecido déficit de memória específico para material verbal e não verbal, segundo a lateralidade da lesão. Atividade epileptiforme (ictal e interictal) pode comprometer funções cognitivas. O impacto do envolvimento eletrográfico contralateral nas funções cognitivas em pacientes com EMT unilateral não foi estudado. METÓDOS: Avaliamos o impacto da atividade epileptiforme contralateral em funções cognitivas em 121 pacientes com EMT unilateral (69 EMT esquerda), destros, com QI>70, oito ou mais anos de escolaridade, sem comorbidades, e 39 controles pareados por sexo, idade e escolaridade. Todos os pacientes foram submetidos a monitorização por vídeo-EEG e avaliação neuropsicológica, que incluiu: memória verbal (Rey Auditory Verbal Learning Test, RAVLT), não verbal (Rey Visual Design Learning Test, RVDLT, figura complexa de Rey) funções executivas (Stroop, teste classificação cartões de Wisconsin, repetição de dígitos e fluência verbal - FAS), linguagem (teste nomeação de Boston), escalas de ansiedade e depressão e questionário de queixas de memória. Segundo os achados eletrográficos, classificamos os pacientes com EMT unilateral em direito e esquerdo concordantes (DC, EC), parcialmente concordantes (DPC, EPC) e discordantes (DD, ED), reagrupados, em seguida, por dois critérios: maior discordância (parcialmente concordantes + concordantes) e menor discordância (parcialmente concordantes + discordantes). RESULTADOS: Dados demográficos, características da doença e tratamento não diferiram entre grupos. EC e ED tiveram pior desempenho que controles em memória verbal tardia. Após sete dias, ED tiveram pior desempenho que controles e DC+DPC em evocação livre, em reconhecimento e erros de reconhecimento que os demais grupos. DD apresentaram mais erros no aprendizado no RVDLT que controles. DPC+DD apresentaram rendimento inferior a controles em recordação tardia e após 7 dias da figura complexa de Rey. Ambos os grupos EMT esquerda desempenharam abaixo dos controles em evocação tardia da figura complexa Rey. ED e DPC+DD apresentaram maior quantidade de queixas de memória que controles. Não se observou impacto da discordância sobre funções executivas. DD apresentaram tendência de pior desempenho que controles e DC+- DPC nos testes de linguagem. EPC+ED apresentaram maior pontuação que controles em escala de depressão. CONCLUSÃO: Envolvimento eletrográfico contralateral associa-se a comprometimento mais acentuado de memória verbal no grupo ED, e, menos intensamente, a alteração de memória não verbal para grupo DD+DPC. Observou-se maior quantidade de queixas de memória nos grupos ED e DD+DPC, e tendência de pior desempenho em linguagem no grupo DD. Estes achados contrariam o conceito de dominância hemisférica para memória verbal e não verbal. Propomos um modelo de predominância da memória verbal para o hemisfério dominante e, menos pronunciadamente, predominância de memória não verbal no hemisfério não dominante de linguagem. Especulamos que a cirurgia bem sucedida para epilepsia possa trazer melhora cognitiva nos casos com achados eletrográficos discordantes / INTRODUCTION: Mesial temporal sclerosis (MTS) associated epilepsy leads to cognitive changes in various cognitive domains, including episodic and semantic memory, executive functions, and language. A material-specific model for memory impairment has been proposed. Ictal and interictal epileptiform activity may negatively impact on cognitive functions. The impact of contralateral electrographic involvement on cognitive functions in unilateral MTS has not been studied. METHODS: We retrospectively studied the impact of contralateral interictal and ictal epileptiform activity on cognitive functions in 121 (69 left) right-handed unilateral MTS patients, with an IQ>70, eight or more education years, without comorbidities, and 39 age, gender and education-matched controls. All patients underwent video-EEG monitoring and neuropsychological testing, including verbal (Rey Auditory Verbal Learning Test, RAVLT) and nonverbal memory (Rey Visual Design Learning Test, RVDLT, and Complex-Rey-Osterrieth-Figure), executive functions (Stroop, Wisconsin Card Sorting Task, digit span and verbal fluency - FAS), language (Boston Naming Test) and self- report scales for anxiety, depression, and memory complaints. According to MTS side and EEG findings groups were classified as right or left concordant (RC,LC), partially concordant (RPC, LPC), discordant (RD, LD). Groups were regrouped by two criteria: major discordance (merging partially concordant and concordant groups) and minor discordance (merging partially concordant and discordant groups). RESULTS: Demographic, disease and treatment features did not differ among groups. On verbal memory, LD and LC performed worse than controls on delayed recall. On 7-day recall, LD scored significantly worse than controls and RC+RPC, recognized fewer words and had more recognition errors than all groups. On nonverbal memory, RD had more errors in RVDLT learning than controls, and showed a trend towards worse performance compared to RC+RPC in immediate and delayed recall. For the Complex- Rey-Osterrieth-Figure, RPC+RD performed significantly worse than controls on delayed and 7-day recall. Both left MTS groups attained lower scores than controls on the Complex-Rey-Osterrieth-Figure delayed recall. LD and RPC+RD had higher scores of memory complaints than controls. No impact of discordance was observed on executive functioning. On language tests, there was a trend towards worse performance for RD compared to controls and RC+-RPC. LPC+LD scored more than controls in depression scale. CONCLUSION: Contralateral EEG involvement was associated with impaired verbal memory for LD group, and, to a lesser extent, with impaired nonverbal memory for the RD+RPC group. These findings were associated with increased memory complaints for LD and RD+RPC groups. We also found a trend towards worse performance on language tests for RD. These findings suggest that verbal and nonverbal memory are not completely lateralized to the dominant and non- dominant hemispheres. We propose a model of language-dominant hemisphere predominance for verbal memory and a less pronounced non-language dominant hemisphere predominance for nonverbal memory. We speculate that memory impairment in patients with discordant EEG data may be partially reversed with successful epilepsy surgery and removal of the at-distance focus. This hypothesis should be tested with appropriately designed studies

Zeit ist ein fundamentaler Aspekt menschlichen Verhaltens. Während Untersuchungen bislang meist nur auf einem der drei Hauptaspekte der Zeit: Dauer, Zeitfolge und individuelle zeitliche Orientierung fokussierten, untersucht diese Dissertation Zusammenhänge zwischen der individuellen zeitlichen Orientierung und der Zeitfolge. Zeit ist nicht direkt wahrnehmbar, sondern an kognitive Abstraktionsprozesse gebunden. Diese benötigen kognitive Ressourcen und werden kognitiven Fähigkeiten beeinflusst. Daher wurden Zusammenhänge zwischen individueller zeitlicher Orientierung und allgemeinen kognitiven Fähigkeiten ebenfalls untersucht. Studie 1 analysiert, wie verschiedene Aspekte individueller zeitlicher Orientierung korreliert sind, und diese Korrelationen von Alter und Geschlecht beeinflusst sind. Studien 2 und 3a analysieren Zusammenhänge zwischen individueller zeitlicher Orientierung und der Zeitfolge. Studie 3b untersucht mittels einer geometrischen Analogieanforderung Korrelationen zwischen individueller zeitlicher Orientierung und höheren fluiden Intelligenzleistungen. Befunde zu Zeitperspektive-Chronotyp- Relationen sowie Zeithorizont-Chronotyp-Relationen werden berichtet, ebenso Zusammenhänge zwischen Zeitperspektive, Zeithorizont und der Zeitfolge. Ausgehend von diesen und früheren Befunden wird ein kognitives Modell vorgestellt, welches alle drei Aspekte psychologischer Zeit (Zeitdauer; Zeitfolge; individuelle zeitliche Orientierung) integriert. Ferner werden als Ergebnis der Studien Zusammenhänge zwischen der Zukunftsperspektive und fluider Intelligenz sowie Chronotyp und verbaler Intelligenz berichtet. Verhaltensdaten und psychophysiologische Daten (Pupillendilation) zeigen ferner Zusammenhänge zwischen individueller zeitlicher Orientierung, analogem Denken, exekutiven Funktionen und Konfliktverarbeitung. So scheinen Zukunftsperspektive und Morgentyp eng mit Konfliktverarbeitung verbunden, der Zeithorizont hingegen eng mit inhibierenden Kontrollprozessen. / Time is a fundamental aspect of human experience. Whilst most research investigated major aspects of psychological time - time duration, time succession, individual temporal orientation - in isolation, this dissertation investigates interrelations between individual temporal orientation and time succession. Since psychological time is bound to cognitive abstraction processes that rely on cognitive resources and functions, interrelations between individual temporal orientation and cognitive capacities were also investigated. Study 1 explored how different levels of individuals’ temporal orientation may be interrelated, and how interrelations may be influenced by age and sex. Interrelations between individual temporal orientation and time succession were explored in a task predominantly requiring crystallized intelligence (Study 2) and in a semantic analogy task requiring crystallized and fluid intelligence (Study 3a). Study 3b investigated interrelations between individual temporal orientation and higher-level fluid intelligence measures by applying a geometric analogy task. Interrelations between time perspective and chronotype as well as between chronotype and temporal depth are reported. Further, both future time perspective and temporal depth are interrelated with time succession. A testable global working memory model of time perception integrating all three aspects of psychological time is proposed. Further, interrelations between individual temporal orientation and cognitive capacities are reported. Future time perspective was related to fluid intelligence, chronotype to verbal intelligence. Behavioral as well as pupillary data suggest that individual temporal orientation is related to analogical reasoning, executive functions and goal management. Whereas future time perspective and morningness appear interrelated with conflict detection, temporal depth appears interrelated with inhibitory control.

O Wisconsin Card Sorting Test (WCST), instrumento psicológico freqüentemente utilizado em processos de avaliação neuropsicológica, examina as funções executivas: planejamento, flexibilidade do pensamento, memória de trabalho, monitoração e inibição de perseverações. Destacou-se na literatura internacional na última década, sobretudo em pesquisas aplicadas na clínica neurológica, psiquiátrica e psicológica. Dentro deste contexto, o presente estudo objetivou desenvolver normas avaliativas para adultos da região de Ribeirão Preto (SP) e verificar a validade do WCST no contexto brasileiro. Foram avaliados dois conjuntos de voluntários: um grupo estratificado e representativo de universitários de Ribeirão Preto (SP), composto por 223 estudantes de 23 cursos de ensino superior, de 18 a 30 anos, com boa saúde geral e nível intelectual mediano ou superior. O segundo grupo foi composto por dois subgrupos de idosos: o primeiro com 36 pacientes, em fase inicial da Doença de Alzheimer (DA), de Ribeirão Preto (SP) e, o segundo, com 50 idosos saudáveis da região de Porto Alegre (RS). Todos foram avaliados individualmente pela forma impressa do WCST. Inicialmente foram elaborados referenciais normativos do teste para universitários do contexto sócio-cultural da região de Ribeirão Preto (SP). Comparando-se o desempenho no WCST dos universitários brasileiros com amostra equivalente americana, por meio do Teste t de Student (p 0,05), observou-se desempenho inferior nos estudantes de Ribeirão Preto. As especificidades de desempenho entre estas amostras sugerem interação de fatores sócio-culturais nas habilidades executivas, variável que não pode ser desprezada na interpretação dos resultados. A seguir, examinou-se a validade do WCST, por meio de Análise dos Componentes Principais, no grupo de 223 universitários. Estes resultados foram comparados à estrutura fatorial originalmente descrita com universitários americanos, encontrando-se estruturas e cargas fatoriais dos componentes do teste virtualmente idênticas, confirmando sua validade de construto. Desta forma, o WCST demonstrou estabilidade em sua estrutura interna e em sua capacidade de acessar as funções executivas, de forma segura, também no contexto sócio-cultural brasileiro. Na seqüência das análises, elaborou-se tabela preliminar do desempenho típico no WCST de idosos com DA, permitindo identificar sua condição de maior ou menor prejuízo cognitivo em relação a este grupo de referência. A seguir foi realizada análise comparativa dos desempenhos no WCST dos idosos saudáveis e com DA (validade discriminante). Foi realizada análise multivariada (MANOVA) dos resultados destas duas amostras, encontrando-se diferenças significativas entre eles (valor de Lambda de Wilks = 0,594, F = 3,460, p < 0,001), indicando validade discriminativa do WCST na realidade brasileira. Ultrapassando os objetivos iniciais, foram realizadas análises qualitativas das respostas dos universitários ao WCST, buscando-se identificar possíveis razões de fracasso no teste (não concluir as seis categorias classificatórias) em pessoas com elevado potencial cognitivo. A partir desta análise foram identificados diferentes processos arbitrários de raciocínio e de falhas no funcionamento da atenção em adultos, confirmando evidências da literatura acerca da complexidade das funções executivas, exigindo avaliação qualitativa e ecologicamente orientada para complementar as informações quantitativas do WCST, de modo a subsidiar adequadas hipóteses interpretativas de seus resultados. / The Wisconsin Card Sorting Test (WCST) is a psychological instrument used in neupsychological assessment which examines executive functions: planning, thought flexibility, work memory, monitoring and perseveration inhibiting. This instrument has stood out the last decade, especially in studies on applied, clinical neurology, psychiatry and psychology. Within this context, the present study aimed to develop assessment norms for the WCST in adults from the region of Ribeirão Preto (SP), and verify its validity in the brazilian culture. Two sets of volunteers were assessed: a stratified and representative group of college students from Ribeirão Preto (SP), composed of 223 18-30 years-old, average/superior intellectual-level participants with good health from 23 different graduation courses. The second group comprised two subsets of elderly persons, the first one with 36 patients from Ribeirão Preto (SP) in the initial stage of Alzheimer\'s Disease (AD), and the second subset with 50 healthy, elderly participants from Porto Alegre (RS). All participants were individually assessed using the printed version of the WCST. Initially, normative references were designed for college students from the sociocultural context of Ribeirão Preto region. Comparisons between Brazilian college students and a similar north-American sample using Student\'s t-test (p 0,05) show inferior performance in the Brazilian sample, suggesting the interaction of sociocultural factors in executive functions, which is a variable that cannot be excluded in the interpretation of the results. After this, the validity of the WSCT was assessed in the college students? sample through Principal Component Analysis. These results were compared to the original factorial structure described within the north-American sample, showing virtually identical factorial structures and loads for the components of the test, thus confirming its construct validity. This way, the WCST showed stability in its internal structure, as well as for the ability to safely assess executive functions in the brazilian sociocultural context. In the following analyses, a preliminary table of the AD subset?s typical performance in the WSCT was designed, allowing the identification of bigger or smaller cognitive impairment compared to this reference group. After this, a comparative analysis was performed between the performances of the two subsets of elderly participants (discriminative analysis). A Multivariate Analysis (MANOVA) of those two samples showed significant differences between them (Wilks? Lambda-value = 0,594, F = 3,460, p < 0,001), indicating WCST discriminative validity for the brazilian reality. The initial aims of this study were overcome by performing qualitative analyses of the college students group?s WCST responding, in order to identify possible reasons for test failure (not completing the six classificatory categories) in persons with high cognitive potential. These analyses show different arbitrary processes of thought, as well as attention functioning failures in adults. These results confirm the evidences from the literature about executive functions complexity, which requires qualitative, ecologically-oriented analysis for complementing WCST quantitative information, in order to subsidize adequate interpretative hypotheses of its results.