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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
521

Perfil de exossomos periféricos nas fases aguda e crônica do acidente vascular encefálico

Magalhães, Amanda de Souza January 2016 (has links)
O acidente vascular encefálico (AVE) é uma doença comum e de grande impacto para a saúde da população, uma vez que é considerado a principal causa de incapacidades neurológicas, principalmente motora e cognitiva. Considerando que os exossomos e o seu conteúdo podem ser marcadores prognóstico de demência em pacientes com Doença de Alzheimer, avaliamos o perfil exossomal circulante em pacientes pós AVE isquêmico com e sem comprometimento cognitivo. Ainda, é de conhecimento que os pacientes tratados com trombolíticos apresentam redução na dependência funcional a longo prazo, assim é de interesse avaliar os exossomos periféricos destes pacientes. Este trabalho visou investigar o perfil de exossomos circulantes em pacientes após diagnóstico de AVE isquêmico (AVEI) nas fases aguda e crônica. Foram determinados o conteúdo de proteína total e a atividade da acetilcolinesterase (AChE), marcadores de exossomos, além de correlacionar escores de comprometimento neurológico com os parâmetros bioquímicos. Ainda, considerando que o estresse oxidativo tem um papel central na fisiopatologia da isquemia cerebral, determinamos o conteúdo de espécies reativas e a atividade da enzima superóxido dismutase (SOD) em exossomos circulantes. Os fatores comprometimento cognitivo e o uso do trombolítico na fase aguda da doença não mostraram ter influência sobre os parâmetros estudados. Os resultados sugerem que uma diminuição de exossomos circulantes, já que houve uma redução na quantificação de proteínas totais na fase crônica, pode sugerir um prejuízo no sistema de remoção de materiais tóxicos levando ao acúmulo de materiais indesejados disso, o estado oxidativo exossomal, representado pelos níveis de espécies reativas e a atividade da SOD, foi alterado na fase crônica quando comparado com a fase aguda. Estes resultados sugerem que há uma alteração do perfil dos exossomos ao longo do tempo nos pacientes com AVE isquêmico. Nossos dados indicam que os níveis de espécies reativas na fase aguda podem predizer alterações no perfil dos exossomos na fase crônica de pacientes com comprometimento cognitivo, especificamente nas atividades das enzimas SOD e AChE e na concentração de proteínas totais. Estas associações não foram observadas em pacientes sem comprometimento cognitivo. Correlacionamos os parâmetros bioquímicos com as escalas de déficit neurológico, os escores do Mini-Exame do Estado Mental (MEEM) foram inversamente proporcionais aos níveis de AChE naqueles pacientes que não receberam o tratamento trombolítico na fase aguda. Assim, nossos dados demonstram que o prejuízo cognitivo (menores escores de MEEM) está associado a maiores níveis de atividade da AChE em exossomos circulantes. O papel dosexossomos na fisiopatologia da isquemia cerebral, assim como na predição de diagnóstico de comprometimento cognitivo precisa ser melhor investigado. / Stroke is a common disease and has a major impact on the public health, since it is considered the main cause of neurological disabilities, mainly motor and cognitive impairment. Considering that exosomes’ content may be prognostic markers of dementia in patients with Alzheimer's disease we evaluated the circulating exosomal profile in patients with ischemic stroke with and without cognitive impairment. Furthermore, it is known that thrombolytic therapy reduces long-term disability, so it is interesting to evaluate the peripheral exosomes of these patients. This work aimed to investigate the profile of circulating exosomes in patients after diagnosis of ischemic stroke in the acute and chronic phases. Total protein content and acetylcholinesterase activity (AChE), markers of exosomes were determined, also it was correlated the scores of cognitive function tests with biochemical parameters. Considering that oxidative stress plays a central role in the pathophysiology of cerebral ischemia, we determined the content of reactive species and the activity of the superoxide dismutase enzyme (SOD) in circulating exosomes. The factors cognitive impairment and the use of thrombolytic in the acute phase of the disease did not show influence on the studied parameters. The results suggest that a decrease in circulating exosomes, since there was a reduction in the quantification of total proteins in the chronic phase, may suggest a damage in the system of removal of toxic materials leading to the accumulation of unwanted materials. The exosomal oxidative state, represented by the reactive species levels and the SOD activity, was altered in the chronic phase when compared to the acute phase These results suggest that the profile of the exosomes is altered over time in patients with ischemic stroke. Our data indicate that reactive species levels in the acute phase may predict changes in the exosome profile in the chronic phase of patients with cognitive impairment, specifically in the activities of SOD and AChE enzymes and in the concentration of total proteins. These associations were not observed in patients without cognitive impairment. We correlated the biochemical parameters with the the scores of the assessment of cognitive function tests, the Mini-Mental State Examination (MMSE) scores were inversely proportional to the AChE levels in those patients who did not receive the thrombolytic treatment in the acute phase. Thus, our data demonstrate that cognitive impairment (lower MMSE scores) is associated with higher levels of AChE activity in circulating exosomes. The role of exosomes in the pathophysiology of cerebral ischemia, as well as in the prediction of diagnosis of cognitive impairment, needs to be better investigated.
522

Habilidades sociais comunicativas em crianças com distúrbio específico de linguagem / Social communication skills in children with specific language impairment

Manoel, Daniela de Oliveira 06 September 2013 (has links)
Crianças com Distúrbio Específico de Linguagem (DEL) podem apresentar dificuldades de recepção e emissão da linguagem que podem trazer prejuízos na sua interação com outras crianças, familiares e sociedade uma vez que estudos relatam a importância social da comunicação como um veículo de extensas redes de trocas sociais, pelas quais se forma e se transforma a cultura e, em consequência a própria realidade social. O objetivo deste estudo foi investigar as habilidades comunicativas de seis crianças com DEL, na faixa etária entre sete e oito anos e onze meses e comparar com crianças com desenvolvimento típico pertencentes ao grupo controle (GC), pareado por idade e gênero. A investigação compreendeu: (i) a avaliação do período da narrativa oral com quatro figuras de sequência lógico temporal e (ii) avaliação do desempenho em habilidades sociais comunicativas (HSC) por meio da analise de filmagens de situações estruturadas entre cada criança com DEL e seu respectivo par do GC e entre cada criança com DEL e um adulto do gênero feminino. Como resultado, todas as crianças com DEL apresentaram déficits nas HSC tanto nas interações com seus pares quanto com o adulto e cinco delas mostraram desempenho narrativo abaixo do esperado em relação ao GC, o que evidencia prejuízo nas interações sociais desses indivíduos. O estudo permitiu caracterizar e identificar necessidades especiais relacionadas ao repertório social e comportamental, mas são necessários novos estudos sobre protocolos de avaliação e intervenção que tenham como meta tanto a melhoria nos aspectos de fala e linguagem quanto nas relações interpessoais das crianças com DEL. / Children with Specific Language Impairment ( SLI ) may present difficulties in receiving and issuing of language that can bring harm in their interaction with other children , family and society as social studies report the importance of communication as a vehicle for extensive exchange networks social and shape by which the culture is transformed and therefore social reality . The aim of this study was to investigate the communicative abilities of six children with SLI , aged between seven and eight years and eleven months and compared with typically developing children in the control group ( CG) , matched for age and gender . The investigation included: ( i ) assessing the period of oral narrative with four figures logical temporal sequence and ( ii ) assessing performance in communicative social skills ( HSC ) through the analysis of shooting situations structured between each child with SLI and its respective pair of the GC and between each child with SLI and an adult female . As a result , all children with SLI showed deficits in HSC both in interactions with their peers and with adult and five of them showed narrative performance below expectations compared to GC , which show impaired social interactions of these individuals . The study allowed us to characterize and identify special needs related to social and behavioral repertoire , but further studies are needed on protocols for assessment and intervention that have as a goal the improvement in both aspects of speech and language and interpersonal relationships of children with SLI .
523

Is language laterality related to language abilities?

Bruckert, Lisa January 2016 (has links)
It is well known that language processing depends on specialized areas in the left side of the brain in the majority of the population. A popular view is that developmental language disorders result from a poorly lateralized brain, but evidence in support of this has been weak and inconsistent. In this thesis, I investigated language-related asymmetries in brain structure and function, and their behavioural relevance in both individuals with specific language impairment (SLI) and typically developing adults. Combining different brain imaging techniques, I looked at group-level as well as individual estimates of language laterality and its relationship to language abilities. The aim of my first two studies was to investigate the neural underpinnings of SLI in terms of white matter microstructure and functional organization associated with auditory processing. For this, diffusion and functional MRI data was obtained in a small number of families with a history of SLI and in control families. Compared with neurotypical controls, children with SLI had lower white matter integrity in the corpus callosum, and in white matter areas corresponding to the dorsal and ventral language pathways. The expected functional lateralization for auditory processing was not observed in either group. In the second half of my thesis, I assessed language laterality in 215 neurotypical adults. I demonstrated that functional transcranial Doppler (FTCD) ultrasonography could reliably assess functional lateralization across different language processes. From this large group, I identified 16 individuals with atypical language lateralization and compared them to a group of 16 typically lateralized individuals using a combination of FTCD, MRI and behavioural measures of language laterality and language abilities. The two groups differed significantly in terms of lateralization assessed by functional MRI and diffusion imaging. The atypical group had lower left and greater right hemisphere activation compared with the typical group, and lacked the leftwards asymmetry in the ventral language tract seen in the typical group. The groups did not differ in terms of cognitive measures. Different functional laterality assessments were concordant in the typically lateralized individuals but were inconsistent in the individuals assessed as atypical by FTCD. In brief, my findings suggest that for some individuals language lateralization may be unstable and varies depending on task or other factors. Even so, such differences do not appear to have consequences for language or other cognitive development.
524

Ökad nivå av earnings management när företag upplever pressade resultat : – Finns detta samband på Stockholmsbörsen?

Hjalmarsson, Eric, Jansson, Andreas January 2014 (has links)
Earnings management är ett fenomen som enligt studier har ökat i omfattning under senare tid tack vare förändringar av redovisningsprinciper. Detta har gett företag möjligheten att med ökad subjektivitet bedöma värdet på sina tillgångar, vilket kan utnyttjas för att manipulera redovisning och justera resultat i önskad riktning. Den här studien syftar primärt till att undersöka om det finns ett samband mellan variablerna earnings management och pressade resultat bland de noterade bolagen på Nasdaq OMX Stockholm, även kallad “Stockholmsbörsen”. Det sekundära syftet är att undersöka om detta eventuella samband är vanligare förekommande bland mindre företag samt om någon bransch är överrepresenterad. En kvantitativ metod har använts där data från bolagens årsredovisningar har hämtats och sedan granskats. Efter det har en analytisk generalisering gjorts av resultaten som visar på att företag i större utsträckning tenderar att bedriva earnings management under perioder där de upplever pressade resultat, i motsats till perioder där de upplever normala resultat. Studien visar också att detta inte är vanligare förekommande på någon speciell börslista eller inom någon specifik bransch, utan att företagen är representerade i likvärdig utsträckning. I studien visade det sig att ett vanligt verktyg för att bedriva earnings management är att göra stora engångsnedskrivningar av goodwill. Detta möjliggjordes år 2005 då IFRS 13 infördes i EU, vilket resulterade i att goodwillposten årligen nedskrivningsprövas istället för att som tidigare avskrivas planmässigt. En kritisk diskussion förs med slutsatsen att resultaten är delvis applicerbara på den studerade populationen och säger något om närliggande fall. Slutligen diskuteras studiens bidrag där konklusionen är att resultaten adderar till samt stärker tidigare forskning. / Earnings management is a phenomenon whose scope of usage has expanded in recent time due to changes in accounting principles, according to studies. These changes have given companies the possibility to use subjective judgment to a higher degree when valuing their assets. This can be utilized to manipulate accounts and tweak results in desired direction. The purpose of this study is primarily to investigate if there is a connection between the variables earnings management and pressured results among the listed companies on Nasdaq OMX Stockholm, also knowned as “Stockholmsbörsen”. The secondary purpose is to investigate if this possible connection is more common among smaller companies and if there is any industry that is overrepresented. A quantitative method has been used where data has been collected from the companies’ websites and later reviewed. An analytic generalization has then been applied on the results that show that companies tend to engage in earnings management in greater magnitude when they are experiencing times with pressured results, in contrary to when they experience times with normal results. The study also shows that it’s not more commonly practiced on any particular stock market list or in some particular industry. The companies are rather equivalently represented along the scope of industries and stock market lists. The study shows that a common tool to engage in earnings management is to make big one time impairments of goodwill. This was made possible 2005 when IFRS 13 was implemented in the EU, which resulted in that the goodwill account where to be impairment tested every year instead of the former principle that used linear depreciation. A critical discussion is held with the conclusion that the results of the study are partly applicable on the studied population and says something about nearby cases. Finally there is a discussion about the contribution of the study with the conclusion that the findings adds something to and strengthens past findings.
525

Ressonância magnética quantitativa das alterações estruturais do corpo caloso na doença de Alzheimer e no comprometimento cognitivo leve / Quantitative MRI of strutural changes of the corpus callosum in Alzheimer\'s disease and mild cognitive impairment

Santos, Breno William Corrêa dos 12 June 2017 (has links)
Objetivo: Avaliar a atrofia do corpo caloso (CC) em pacientes com doença de Alzheimer (DA) e comprometimento cognitivo leve (CCL) e quantificar quais regiões dessa estrutura são mais acometidas nessa doença como uso de técnicas quantitativas de ressonância magnética. Metodologia: O estudo contou com a participação de 75 indivíduos sendo 22 controles normais (CN), 30 com CCL e 23 com DA. O volume total do corpo caloso e suas 3 diferentes sub regiões foram delimitadas em cortes sagitais de imagem de ressonância magnética. Os volumes obtidos foram corrigidos para a variação de volume intracraniano. As mascaras foram co-registradas a mapas de relaxometria e transferência de magnetização para analise quantitativa. Resultados: Encontramos atrofia e redução dos valores de relaxometria e transferência de magnetização nos pacientes do grupo DA. As tres sub regiões do corpo caloso apresentaram redução de volume na doença sendo que a atrofia foi maior nas regiões anteriores. Não encontramos diferença significativa nos parâmetros estudados entre CCL e CN. Conclusões: Embora o corpo caloso esteja envolvido no processo de desconexão cortical presente na doença de Alzheimer seu envolvimento não é precoce. / Objective: To evaluate the atrophy of the corpus callosum (CC) in patients with Alzheimer disease (AD) and mild cognitive impairment (CCL) and quantify which regions of this structure are most affected in this disease as using quantitative MRI techniques. Methodology: The study counted on the participation of 75 individuals being 22 normal controls (CN), 30 with CCL and 23 with AI). The total volume of the corpus callosum and its v 3 different sub regions were delimited in sagittal sections of magnetic resonance imaging. The volumes obtained were corrected for intracranial volume variation. The masks were recorded with maps of relaxometry and transfer of magnetization for quantitative analysis. Results: We found atrophy and reduced values of relaxometry and magnetization transfer in patients in the AD group. The three sub regions of the corpus callosum showed volume reduction in the disease, with atrophy being greater in the anterior region. We found no significant difference in the parameters studied between CCL and CN fit .Conclusions: Although the corpus callosum is involved in the process of cortical detachment present in Alzheimer\'s disease, its involvement is late.
526

Visual, musculoskeletal, and balance symptoms in people with visual impairments

Zetterlund, Christina January 2017 (has links)
Background: Worldwide, about 300 million people have some kind of visual impairment (VI). Most people with VI are in the older age range, as visual deficits increase with age. It is not unusual that people with VI suffer both from neck pain or scapular area symptoms and reduced balance, which they consider to be symptoms of old age. However, their symptoms may not be attributable to age, but rather to poor vision. Aims: First, to identify associations between visual, musculoskeletal and balance symptoms in people engaging in near work every day and in people with VI. Second, to design and validate a suitable instrument for gathering information about visual, musculoskeletal and balance symptoms in people with VI. Third, to explore differences in perceived symptoms between VI patients and people with normal vision in cross-sectional studies and by following a group of age-related macular degeneration (AMD) patients in a longitudinal study. Fourth, to identify the most specific predictors of higher levels of visual, musculoskeletal and balance symptoms. Methods: A specific instrument was developed: the Visual, Musculoskeletal and Balance symptoms (VMB) questionnaire. Patients with VI were compared to an age-matched reference group with normal vision in three different studies in order to detect differences in self-reported symptoms between the groups. In addition, a follow-up was conducted in a group of AMD patients. Results: Patients with VI reported higher levels of VMB symptoms than controls, and this increased over time. Visual deficits and the need for visual enhancement increased the risk of VMB symptoms. Conclusion: People with VI run a potentially higher risk of VMB symptoms than age-matched controls.
527

Ovlivňování motoriky ve vztahu k prostorové orientaci u žáků 1. a 2 stupně základní školy pro zrakově postižené / Influence upon Mobility in Relation to Spatial Orientation of Pupils in Primary and Upper Primary Schools for the Visually Impaired

Koubová, Lenka January 2012 (has links)
The thesis is focused on spatial orientation and independent movement of visually impaired people. The aim of the thesis is to evaluate the extent of straight direction deviations concerning visually impaired pupils of primary and lower secondary schools. After analysis of specialized literature a description of current educational system for visually impaired pupils in the Czech Republic follows in the theoretical part. Specific needs related to the field of education of this target group are mentioned. Functional limitation of the visual analyzer influences spatial orientation and independent movement of the visually impaired individual. Therefore the thesis deals with the above mentioned topic and characterises education of the subject called spatial orientation and independent movement. Troubles in the field of motoric movement occur in the group of visually impaired people. This is apparent especially in incorrect walking technique and in deviation from the required straight direction. The research part of the thesis analyses deviations from the straight direction of the visually impaired and intact pupils.
528

Habilidades sociais comunicativas em crianças com distúrbio específico de linguagem / Social communication skills in children with specific language impairment

Daniela de Oliveira Manoel 06 September 2013 (has links)
Crianças com Distúrbio Específico de Linguagem (DEL) podem apresentar dificuldades de recepção e emissão da linguagem que podem trazer prejuízos na sua interação com outras crianças, familiares e sociedade uma vez que estudos relatam a importância social da comunicação como um veículo de extensas redes de trocas sociais, pelas quais se forma e se transforma a cultura e, em consequência a própria realidade social. O objetivo deste estudo foi investigar as habilidades comunicativas de seis crianças com DEL, na faixa etária entre sete e oito anos e onze meses e comparar com crianças com desenvolvimento típico pertencentes ao grupo controle (GC), pareado por idade e gênero. A investigação compreendeu: (i) a avaliação do período da narrativa oral com quatro figuras de sequência lógico temporal e (ii) avaliação do desempenho em habilidades sociais comunicativas (HSC) por meio da analise de filmagens de situações estruturadas entre cada criança com DEL e seu respectivo par do GC e entre cada criança com DEL e um adulto do gênero feminino. Como resultado, todas as crianças com DEL apresentaram déficits nas HSC tanto nas interações com seus pares quanto com o adulto e cinco delas mostraram desempenho narrativo abaixo do esperado em relação ao GC, o que evidencia prejuízo nas interações sociais desses indivíduos. O estudo permitiu caracterizar e identificar necessidades especiais relacionadas ao repertório social e comportamental, mas são necessários novos estudos sobre protocolos de avaliação e intervenção que tenham como meta tanto a melhoria nos aspectos de fala e linguagem quanto nas relações interpessoais das crianças com DEL. / Children with Specific Language Impairment ( SLI ) may present difficulties in receiving and issuing of language that can bring harm in their interaction with other children , family and society as social studies report the importance of communication as a vehicle for extensive exchange networks social and shape by which the culture is transformed and therefore social reality . The aim of this study was to investigate the communicative abilities of six children with SLI , aged between seven and eight years and eleven months and compared with typically developing children in the control group ( CG) , matched for age and gender . The investigation included: ( i ) assessing the period of oral narrative with four figures logical temporal sequence and ( ii ) assessing performance in communicative social skills ( HSC ) through the analysis of shooting situations structured between each child with SLI and its respective pair of the GC and between each child with SLI and an adult female . As a result , all children with SLI showed deficits in HSC both in interactions with their peers and with adult and five of them showed narrative performance below expectations compared to GC , which show impaired social interactions of these individuals . The study allowed us to characterize and identify special needs related to social and behavioral repertoire , but further studies are needed on protocols for assessment and intervention that have as a goal the improvement in both aspects of speech and language and interpersonal relationships of children with SLI .
529

Prevalência de alterações cognitivas e funcionais em idosos da comunidade quilombola kalunga / Prevalence of cognitive and functional impairment of elderly slave’s descendent of a community called Kalunga

Lopes, Danielly Bandeira 08 March 2012 (has links)
Submitted by Marlene Santos (marlene.bc.ufg@gmail.com) on 2016-08-09T20:18:47Z No. of bitstreams: 2 Dissertação - Danielly Bandeira Lopes - 2012.pdf: 1745388 bytes, checksum: a72368b4ae4637fc530aad20797968ed (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2016-08-10T11:16:24Z (GMT) No. of bitstreams: 2 Dissertação - Danielly Bandeira Lopes - 2012.pdf: 1745388 bytes, checksum: a72368b4ae4637fc530aad20797968ed (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2016-08-10T11:16:24Z (GMT). No. of bitstreams: 2 Dissertação - Danielly Bandeira Lopes - 2012.pdf: 1745388 bytes, checksum: a72368b4ae4637fc530aad20797968ed (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2012-03-08 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / This study was to estimate the prevalence of cognitive and functional elderly residents of the isolated community, remaining Quilombo, located in the northeastern state of Goias, called Kalunga. Cross-sectional study with noninvasive methods, based on primary data of cognitive and functional elderly aged above 60 years of quilombo Kalunga, the northeastern state of Goiás were collected and analyzed data to identify (age, sex), socio-demographic factors (education, place), cultural and previous morbidities (hypertension, diabetes) participants through semi-structured questionnaire. Data on cognitive and functional assessment were obtained by applying the Mini-Mental State Examination (MMSE) and the Questionnaire of Daily Living (QAVD), respectively. A total of 65 elderly patients were evaluated. . Most were male (52.3%), married (58.5%), illiterate (93.8%) and mean age of 71.58 years, ranging between 60 and 93 years. The prevalence of individuals with cognitive and functional change was 9.2% (n = 6), and the functional change (18.5%) was more prevalent than cognitive (12.3%). The prevalence rate of cognitive and functional changes detected in this study was low compared to other studies conducted in Brazil, but were similar to studies in other populations. / Este trabalho propôs estimar a prevalência de alterações cognitivas e funcionais em idosos residentes em comunidade isolada, remanescente de quilombo, localizada no nordeste do estado de Goiás, denominada Kalunga. Realizado estudo transversal, com métodos não invasivos, baseado em dados primários, das alterações cognitivas e funcionais de idosos, com idade igual ou maior que 60 anos, da comunidade quilombola Kalunga, do nordeste do estado de Goiás. Foram coletados e analisados dados de identificação (idade, gênero), sócio-demográficos (escolaridade, procedência), culturais e de morbidades prévias (hipertensão arterial, diabetes) dos participantes por meio de questionário semi-estruturado. Os dados de avaliação cognitiva e funcional foram obtidos por meio da aplicação do Mini Exame do Estado Mental (MEEM) e do Questionário de Atividades de Vida Diária (QAVD), respectivamente. No total foram avaliados 65 idosos. . A maioria era do gênero masculino (52,3%), casada (58,5%), analfabeta (93,8%) e com idade média de 71,58 anos, variando entre 60 e 93 anos. A prevalência de indivíduos com alteração cognitiva e funcional foi de 9,2% (n=6), sendo que a alteração funcional (18,5%) foi mais prevalente que a cognitiva (12,3%). A taxa de prevalência de alteração cognitiva e funcional detectada neste trabalho foi baixa em relação a outros estudos realizados no Brasil, mas equivalente a estudos realizados em outras populações.
530

Avaliação neuropsicológica da tomada de decisão no comprometimento cognitivo leve / Neuropsychological assessment of decision-making in the mild cognitive impairment

Rodolfo Santos Flaborea 27 March 2015 (has links)
Introdução: o aumento da população idosa traz uma demanda significativa sobre as ciências da saúde para lidar com os problemas característicos do envelhecimento. Neste contexto, as demências são as desordens neuropsiquiátricas de maior impacto atualmente. Poucas pesquisas acerca do CCL foram dedicadas a analisar a função neuropsicológica da tomada de decisão. Esta é definida como o processo de escolher uma ação específica, dentro de um rol de alternativas possíveis, que produza o resultado mais vantajoso para o sujeito. Logo, ela possui papel clínico fundamental, pois subsidia importante espectro da funcionalidade. Objetivo: avaliar se idosos com CCL amnéstico de múltiplos domínios ou de único domínio apresentam prejuízos na tomada de decisão sob risco, quando comparados a idosos saudáveis. Métodos: foram analisados os desempenhos de 20 sujeitos (9 CCL e 11 controles) no teste de tomada de decisão Cambridge Gambling Task (CGT). Utilizou-se modelo linear geral acompanhado de análise de covariância para idade, anos de escolaridade e escore do Mini Exame do Estado Mental. Resultados: Foi verificado efeito de grupo e da idade sobre a aversão ao atraso, proporção global de aposta e assunção de risco. Conclusão: pacientes com CCL demonstraram maior impulsividade nas escolhas das apostas, além de terem apostado menos ao longo de todo o CGT. O déficit no controle da impulsividade pode ser um indicador de maior risco para conversão para demência, hipótese esta que necessita ser mais investigada. Apostas menores podem constituir estratégia compensatória em reação à impulsividade ou, ainda, ser resultado da menor confiança do paciente com CCL em suas capacidades para lidar com o teste / Introduction: The increase in elderly population brings a significant demand upon the health sciences to deal with aging-specific issues. In this context, dementia is currently the group of neuropsychiatric disorders with the greatest impact. Research on cerebral reserve shows the importance of early treatment in these syndromes, highlighting the need for comprehension about Mild Cognitive Impairment (MCI), classically defined by literature as a prodromic stage for dementia. Few existing studies on MCI aimed at investigating the neuropsychological function of decision-making, which is defined as the process of choosing a specific action among several options in order to achieve the most advantageous outcome. Therefore, this function has a fundamental clinical role, since it grants the basis for the individual functionality. Objective: investigate possible deficits in the decision-making of a sample of elderly patients diagnosed with amnestic MCI of multiple or single domain by comparing their performance with that of healthy ones. Methods: the performances of a sample 20 subjects (9 MCI and 11 controls) in the Cambridge Gambling Task (CGT) were analysed. General linear model with covariance analysis for age, years of schooling and the Mini Mental State Examination scores was used for the statistical analyses. Results: it was found that group and age effect on delay aversion, overall proportion bet, and risk taking. Conclusion: MCI patients showed higher impulsivity on bet choices and made smaller bets throughout the CGT run. The impulsivity control deficit can be an indicator of the conversion risk from MCI to dementia, hypothesis that needs further investigation. Smaller bets may be a compensatory strategy for the increased impulsivity or the result of MCI patients less confidence in their own cognitive ability to deal with the test

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