Diplomová práce Hodnocení krátkodobého efektu aplikace rázové vlny na MTrP Abstract This thesis concerns the application of radial extracorporeal shockwave therapy into muscular trigger points. It's location is derived from the descending part of trapezius muscle on the side of the dominant upper extremity. The performance analysis is based on using partially double-blind placebo-controlled, randomized clinical trial. The effects of the therapy were investigated in 28 subjects divided into experimental and control groups and objectively manifested by measuring the pressure pain threshold. Furthermore, the measuring of the active range of motion of the cervical spine, and the measuring of the maximal voluntary wrist and third finger flexion (measured before and after the therapy). After the therapy, the pressure pain threshold value of the trigger point located in trapezius muscle increased on average from 199 to 295 kPa (p = 0,025). The cervical spine lateral flexion increased on average by 3 degrees towards to the side of non-dominant upper extremity (p = 0,045). This study also investigates the pressure pain threshold value changes of 7 reference points placed remotely from the area of the application. After the shockwave therapy, the pressure pain threshold values of these reference points increased on...

Mindreading is the capacity to attribute psychological states to others and to use those attributions to explain, predict, and understand others’ behaviors. In the past thirty years, mindreading has become the topic of substantial interdisciplinary research and theorizing, with philosophers, psychologists and, more recently, neuroscientists, all contributing to the debate about the nature of the neuropsychological mechanisms that constitute the capacity for mindreading. In this thesis I push this debate forward by using recent results from developmental psychology as the basis for critiques of two prominent views of mindreading. First, I argue that the developmental studies provide evidence of infant mindreading and therefore expose a flaw in José Bermúdez’s view that certain forms of mindreading require language possession. Second, I argue that the evidence of infant mindreading can also be used to undermine Alvin Goldman’s version of Simulation Theory.

[pt] Esta dissertação se insere na área da Psicolinguística, em articulação com a Neuropsicologia. A pesquisa se voltou para a investigação, em idosos hígidos, do processamento sintático de sentenças envolvendo ambiguidade temporária (ex.: Enquanto o homem cozinhava a batata era comprada no mercado), as quais induzem ao efeito labirinto (garden-path effect). O objetivo deste trabalho foi compreender em que medida um declínio de funções executivas com o avanço da idade poderia afetar o processamento desse tipo de estrutura sintática, a qual apresenta alta demanda para a memória de trabalho e parece requerer inibição de uma representação mental inicialmente possível. A pesquisa consistiu na aplicação de um experimento psicolinguístico de compreensão por leitura e testes de avaliação neuropsicológica (Span de Digítos, Stroop e Miniexame do Estado Mental, este último aplicado apenas aos idosos). No experimento psicolinguístico, foram tomadas como variáveis intrassujeitos plausibilidade e extensão da região ambígua entre o sintagma nominal crítico (a batata) e o ponto de desambiguização da sentença (era comprada). Foram testados 40 participantes (20 idosos e 20 jovens). Houve um efeito principal de plausibilidade e extensão da região ambígua e um efeito de interação entre grupo e plausibilidade, tendo os idosos apresentado maior dificuldade, nas condições plausíveis, para inibir a estrutura sintática equivocada construída inicialmente. Também observamos uma correlação entre plausibilidade e o teste Stroop. Os resultados são discutidos em termos da abordagem Good-Enough da compreensão da linguagem e de questões pertinentes às relações entre linguagem e outros domínios da cognição, em especial o papel de funções executivas no processamento sintático. / [en] This master s thesis is situated within the area of psycholinguistics, in conjunction with neuropsychology, and investigates syntactic processing of temporarily ambiguous sentences in the elderly (While the man cooked the potatoes were bought at the supermarket.). These structures induce the garden-path effect. The purpose of the work was to analyze to what extent a decline in executive functions with advancing age could affect syntactic processing of syntactic ambiguity, which presents a high demand for working memory and seems to require inhibition of an initially possible mental representation. The research consisted in the application of a psycholinguistic experiment (a reading comprehension task) and neuropsychological evaluation tests (Digit Span, Stroop and Mini-Mental State Examination; the latter was only applied to the group of older participants). In the psycholinguistic experiment, plausibility and the distance between the critical noun phrase (the potato) and the point of disambiguation of the sentence (was bought) were taken as within-subjects variables. Forty participants (20 older adults and 20 young adults) were tested. A main effect of plausibility and distance and an interaction effect between group and plausibility were observed. The elderly showed more difficulty in inhibiting the initial misinterpretation when the sentence was plausible. There was also a correlation between plausibility and the Stroop test. The results are discussed in terms of the Good-Enough Approach to language comprehension and the relationship between language and other domains of cognition, especially the role of executive functions in syntactic processing.

Considéré pendant très longtemps uniquement pour son rôle moteur, dans les deux dernières décennies le noyau subthalamique (NST) a fait l'objet d'études portant sur son rôle dans les processus cognitifs et motivationnels. Nous avons étudié les effets de la lésion du NST sur la prise de décision et le jeu pathologique. Nous avons observé, que la lésion du NST diminuait la prise de risque lors de choix incertain ou lors du jeu pathologique. Nous avons trouvé que la lésion du NST diminuait les comportements compulsifs lorsqu’un choix était mis en jeu. Enfin, nous avons observé que la lésion de la zona incerta avait des effets opposés à celle du NST sur la prise de risque. Nous avons montré que la SHF du NST bloquait le processus de ré-escalade de prise de d’héroïne. Dans un troisième temps, nous avons effectué des enregistrements électrophysiologiques dans une tâche comportementale. Nous avons montré que différentes populations de neurones codaient les différentes récompenses, quel que soit leur nombre ou leur nature. De plus, nous avons montré que : lors du remplacement d'une récompense, les neurones du NST se réorganisaient pour coder différemment une même récompense en fonction du contexte, répondaient spécifiquement aux erreurs dans la réalisation de la tâche spécifiques de la récompense attendue et enfin que les neurones du NST étaient capables de coder l’omission de la récompense. L'ensemble de ce travail apporte un éclairage sur l'implication du NST dans les processus motivationnels et décisionnels en en faisant notamment une cible potentielle dans le traitement de la dépendance aux drogues d’abus, au jeu pathologique et des troubles obsessionnels compulsifs. / Considered for a long time only for his motor role in the last two decades the subthalamic nucleus (STN) has been studied for its role in cognitive and motivational processes. We studied the effects of the STN lesion in decision making and pathological gambling. We observed that the lesion of STN decreased risk taking during uncertain when choosing or pathological gambling. We found that the lesion of STN decreased compulsive behaviors when a choice was put in. Finally, we observed that the lesion of shingles incerta had the opposite effect to that of the STN on risk taking. We have shown that STN HFS blocking the process of re-escalation of taking heroin. Thirdly, we performed electrophysiological recordings in a behavioral task. We showed that different populations of neurons encode different rewards, regardless of their number or nature. In addition, we showed that: when replacing a reward, the STN neurons reorganized differently to encode the same reward depending on the context, specifically meet the errors in the implementation of the specific task of the expected reward and finally STN neurons were capable of encoding the omission of reward. This work highlights the involvement of the STN in motivational and decision making process in particular a potential target in the treatment of addiction to drugs of abuse, pathological gambling and obsessive compulsive disorder.

The thesis deals with the evaluation of the influence of foam rolling on selected parameters of somatosensory perception (pressure-algic threshold, vibrotactile sensation). The theoretical part discusses fascial tissue, summarizes the current knowledge of foam rolling and focuses on the mechanisms of pain and vibrotactile sensation. The research part consists of a randomized blind study on a group of 15 healthy probands (11 women, 4 men), which evaluates the effect of foam rolling. The effect is objectivized by pressure algometry and vibrametry on the m. rectus femoris and m. biceps femoris of both lower limbs (measured before and after therapy). The value of the pressure pain threshold (PPT) increased after foam rolling. Vibrotactile threshold (VT) was lower after foam rolling than before its use, which means that vibrotactile sensitivity was increased. The results show that these changes do not occur only in the interventioned m. rectus femoris, but some changes in parameters can be found in other muscles as well. Keywords fascial tissues, foam rolling, pressure algometry, pressure pain treshold, PPT, vibrametry, somatosensory system, nociception, diffuse noxious inhibitory control, DNIC

Les fonctions exécutives (FE), et en particulier le Contrôle Inhibiteur (CI), jouent un rôle très important dans la réussite académique et professionnelle ainsi que dans la physiopathologie de nombreux troubles psychiatriques. L'adolescence est une période critique du développement du CI, ce dernier étant sous-tendu en particulier par la maturation tardive du cortex préfrontal jusqu’au début de l'âge adulte. Le premier objectif de cette thèse a été de cartographier les bases neurales du CI durant le développement et d'en évaluer leurs spécificités en les comparant avec celles de la mémoire de travail (MdT), une autre composante clef des FE. À partir d'une méta-analyse des études en IRMf du CI et de la MdT incluant 845 enfants, 1377 adolescents et 10235 adultes, nous avons identifié des modifications de l'activité fonctionnelle, à savoir le passage d'un réseau diffus à un réseau focal plus spécialisé avec l'âge, en accord avec un modèle dynamique du développement cérébral. Un large recouvrement de régions fronto-pariétales pour le CI et la MdT a également été détecté, ce qui soulève la question de la spécificité des processus et des tâches de ces deux FE. Par la suite, nous avons analysé l'effet à long terme du neuro-développement précoce sur le CI à partir de l'étude de la morphologie sulcale, un paramètre anatomique du cerveau déterminé lors de la vie fœtale. Dans un premier temps, nous avons montré, d'après une analyse longitudinale de 243 IRM, la stabilité du motif des sillons durant le développement. Nous avons par la suite établi que les polymorphismes sulcaux du cortex cingulaire antérieur et du sillon frontal inférieur contribuaient, de manière complémentaire, à l'efficience du CI chez l'enfant et également chez l'adulte. Enfin, nous nous sommes intéressés à l’entraînement cognitif au CI à l'adolescence, une période de très grande plasticité cérébrale et de sensibilité à l'environnement. Nous avons étudié chez 49 adolescents de 16-17 ans l'effet d'un entraînement intensif sur tablette tactile (25 sessions de 15 minutes par jour) au CI versus Contrôle Actif aux niveaux cognitif et cérébral (IRMf : tâches de stop-signal, de matrice de points, du réseau attentionnel et de gratification retardée). Nous avons en particulier évalué l'effet des facteurs neurodéveloppementaux précoces sur la réceptivité à l’entraînement au CI. Ces travaux s'inscrivent dans un nouveau champ de recherche interdisciplinaire à l'interface entre les neurosciences et la psychologie. Dans une perspective translationnelle éducative et thérapeutique, il vise à évaluer le plus finement possible, grâce à l'imagerie cérébrale anatomique et fonctionnelle, quelles interventions pédagogiques et thérapeutiques sont susceptibles d'aider au mieux le cerveau à surmonter des difficultés d'ordre cognitif. / Executive functions (EF), including Inhibitory Control (IC), play a major role in academic and professional achievement, as well as in the pathophysiology of many psychiatric disorders. Adolescence is a critical period in IC development as it is underlain by the protracted maturation of prefrontal cortex until early adulthood. The first objective of this thesis was to examine the neural bases of IC during development and to evaluate their specificities by comparing them with the working memory (WM), another key component of EF. Based on a meta-analysis of IC and WM fMRI studies including 845 children, 1377 adolescents and 10235 adults, we identified changes in functional activity with a shift from a diffuse to a more focal and specialized network with age. These results support the model of dynamic neurofunctional development. Moreover, a large overlap of fronto-parietal regions was found for IC and WM, which raises issues regarding the specificities of IC and WM processes and tasks. Second, we analyzed the long-term effect of early neurodevelopment on IC based on the sulcus morphology, an anatomical brain feature determined during fetal life. We showed, using a longitudinal analysis of 243 MRIs, that folding patterns are fixed from childhood to adulthood. Subsequently, we established that the sulcal polymorphisms of the anterior cingulate cortex and the inferior frontal sulcus complementary contributed to IC efficiency in both children and adults. Finally, we studied IC training in adolescence, a period of high brain plasticity and environmental sensitivity. We examined the effects of an intensive IC training (25 sessions of 15 minutes per day) versus active control training group on touchscreens in 49 adolescents (16-17 years-old) on cognitive and brain levels (fMRI: stop-signal, dot matrix, attentional network and delayed gratification tasks). We also assessed the effect of early neurodevelopmental factors on IC training receptivity. This thesis is part of a new field of interdisciplinary research, at the interface between neurosciences and psychology. It includes translational educational and therapeutic perspectives, with aims at evaluating as finely as possible, using anatomical and functional brain imaging, what pedagogical and therapeutic interventions are likely to help the brain to overcome cognitive difficulties.

No description available.

L’impulsivité est une séquelle fréquente suite à un traumatisme cranio-cérébral (TCC) à laquelle sont associées de nombreuses conséquences néfastes et qui nécessite un investissement considérable de ressources. En ce sens, une évaluation adéquate de l’impulsivité est de mise dans un contexte de réadaptation. Par contre, malgré son importance, il n’existe pas de définition consensuelle de l’impulsivité post-TCC ni de mesure spécifique permettant de l’évaluer. Il est généralement admis, dans la littérature récente, que l’impulsivité est un construit multidimensionnel. Notamment, le modèle UPPS-P de l’impulsivité gagne un appui significatif et pourrait permettre une compréhension plus spécifique de l’impulsivité post-TCC. Selon ce modèle, il existe quatre dimensions à l’impulsivité soit l’urgence (tendance à agir ses impulsions dans un contexte d’émotions intenses), le manque de persévérance (difficulté au niveau du maintien de l’attention sur une tâche complexe et ennuyante et une susceptibilité à l’ennui), le manque de préméditation (difficulté de prévoir les conséquences d’un comportement avant de le poser) et la recherche de sensations (tendance à préconiser des activités jugées excitantes et l’ouverture à essayer de nouvelles expériences qui peuvent ou non, être dangereuses). Il a été proposé que l’urgence, le manque de persévérance et le manque de préméditation sont associés à des difficultés à inhiber la réponse automatique, à résister à l’interférence proactive et de la prise de décision, respectivement (Bechara et Van der Linden, 2005). Une telle conceptualisation offre une avenue prometteuse quant à l’évaluation de l’impulsivité post-TCC. Le présent projet vise à clarifier le construit de l’impulsivité post-TCC, à déterminer si les mêmes mécanismes cognitifs sont en lien avec les dimensions de l’impulsivité dans un contexte de réadaptation fonctionnelle intensive puis de déterminer quelles tâches de performance prédisent le mieux les comportements impulsifs dans ce milieu. D’abord, une recension des écrits portant sur l’impulsivité post-TCC donne un appui à la conceptualisation multidimensionnelle de l’impulsivité et fait ressortir les obstacles qui nuisent à l’étude de l’impulsivité post-TCC. Ensuite, l’utilisation de diverses tâches de performance permet d’évaluer le lien entre les dimensions de l’UPPS-P et les mécanismes cognitifs. Les résultats indiquent des atteintes sur les mécanismes liés à l’inhibition de la réponse automatique, à la résistance à l’interférence proactive ainsi qu’à la prise de décision. Toutefois, ils ne permettent pas de supporter les propositions de Bechara et Van der Linden quant aux mécanismes sous-jacents aux dimensions de l’impulsivité post-TCC chez les patients en réadaptation intensive. Finalement, les résultats permettent de faire ressortir la pertinence des tâches de performance écologiques dans la prédiction de comportements impulsifs dans la vie quotidienne. Les portées théoriques et cliniques des résultats sont discutées. / Impulsivity is a common sequela following traumatic brain injury (TBI) to which are associated many negative consequences and necessitates important resources. A thorough assessment of impulsivity is therefore necessary in a rehabilitation setting. However, there is no consensual definition of post TBI impulsivity nor is there a specific measure allowing its assessment. It is generally acknowledged, in recent literature, that impulsivity is a multidimensional construct. The UPPS-P model is gaining a significant amount of support and could allow a better understanding of post-TBI impulsivity. According to this model, there are four dimensions to impulsivity, namely urgency (tendency to experience and act on strong impulses frequently under conditions of strong affect), lack of perseverance (inability to remain focused on a task that may be boring or difficult), lack of premeditation (inability to think and reflect on the consequences of an act before engaging in that act) and sensation seeking (tendency to enjoy activities that are exciting and a willingness to try new experiences). It has been suggested that urgency, lack of perseverance and lack of premeditation are linked to impairments on prepotent response inhibition, on resistance to proactive interference and on decision making, respectively (Bechara and Van der Linden, 2005). This conceptualisation offers a promising avenue as to the assessment of post-TBI impulsivity. This project aims to clarify the construct of post-TBI impulsivity, to determine whether the same cognitive mechanisms come into play in the different dimensions of impulsivity in an intensive functional rehabilitation setting and to determine which performance tasks allow the prediction of impulsive behaviors in that setting. Firstly, a literature review among studies on post-TBI impulsivity gives support to a multidimensional conceptualisation of impulsivity and allows to bring out the obstacles which make the study of post-TBI impulsivity more complicated. Secondly, the use of different performance tasks is used to assess the links between UPPS-P dimensions and cognitive mechanisms. Results indicate impairments on the mechanisms linked to prepotent response inhibition, to resistance to proactive interference and to decision making. However, they do not support Bechara and Van der Linden’s (2005) propositions as to the underlying mechanisms to the dimensions of post-TBI impulsivity in an acute rehabilitation setting. Thirdly, the results show the relevance of ecological performance tasks as to the prediction of impulsive behaviors in everyday life. The theoretical and clinical implications of the results are discussed.

[pt] Diversos estudos apontam o efeito do nível de escolaridade parental no desenvolvimento das funções cognitivas, em especial a linguagem e as funções executivas. Evidenciam a importância da interação entre o cuidador e a criança, a qualidade da estimulação e a promoção de experiências de desenvolvimento, propiciadas a criança, como fundamentais para o desenvolvimento das funções executivas. Há poucos estudos desse efeito no desenvolvimento de crianças brasileiras. O objetivo da dissertação foi investigar o efeito do nível de escolaridade dos pais, separadamente, no desempenho em tarefas de memória de longo prazo, memória de trabalho, controle inibitório e flexibilidade cognitiva de crianças e adolescentes com baixo nível socioeconômico na cidade do Rio de Janeiro. Participaram do estudo 352 crianças entre 7 a 15 anos de escolas privadas com perfil de baixo nível socioeconômico na cidade do Rio de Janeiro. Os instrumentos utilizados foram a Figura Complexa de Rey, a Aprendizagem auditivo verbal de Rey, o paradigma de Stroop e as tarefas de Fluência Verbal fonêmica e semântica. Os resultados mostraram efeitos para a escolaridade de ambos os pais. Resultados sistemáticos aconteceram na fluência verbal, na faixa de 9-10 anos. Não foram encontrados efeitos significativos em controle inibitório e memória de trabalho. O efeito da escolaridade parental apareceu de forma sistemática em funções executivas, mas não em outras funções, em uma amostra homogênea, o que levanta a ideia de que outros fatores como a renda e a cultura, se somam ao efeito ambiental no desenvolvimento cognitivo. / [en] Several studies demonstrated the effect of parents educational level in the development of cognitive functions, especially language and executive functions. Highlight the importance of interaction between the caregiver and the child, the quality of stimulation and promotion of development experiences afforded the child, as fundamental for the development of executive functions. There are few studies of this effect in the development of Brazilian children. The objective of the study is to analyze the effect of the education level of parents, separately, in the cognitive performance of long-term memory, working memory, inhibitory control and cognitive flexibility in children and adolescents living at Rio de Janeiro with low socioeconomic status. The study included 352 children between 7-15 years of private schools with low socioeconomic profile students of city of Rio de Janeiro. The instruments used were the Rey–Osterrieth Complex Figure Test, the Rey Auditory Verbal Learning Test, the Stroop test (Victoria Version) and Verbal Fluency phonemic and semantic. The results showed effects on education of both parents. Systematic results happened in verbal fluency, in the 9-10 year group. There were no significant effects on inhibitory control and working memory. The effect of parental education appeared systematically in executive functions, but not in other functions, raises the idea that other factors such as income and culture add to the environmental effect on cognitive development.

[pt] O envelhecimento em todo o mundo é um dos maiores desafios da saúde. Nesse contexto, condições clínicas como demências e Comprometimento Cognitivo Leve (CCL) também aumentam suas prevalências. A causa de demência mais frequente e estudada é demência de Alzheimer (DA). Tradicionalmente, DA é caracterizada pelo déficit precoce na memória episódica. Entretanto, estudos atuais mostram que a DA apresenta heterogeneidade neuropsicológica e alguns pacientes apresentam déficits cognitivos precoces não-amnésticos. Essas apresentações são chamadas por alguns autores de DA atípica. Dessa forma, a primeira parte dessa tese dedicou-se a estudar a heterogeneidade neuropsicológica na DA através de dois estudos: uma revisão sistemática sobre heterogeneidade neuropsicológica na DA (publicado) e um estudo de casos sobre perfis típico e atípico na DA (publicado). A revisão sistemática tornou-se necessária já que foi a primeira revisão sistemática publicada sobre o tema. Os achados dos dois estudos mostraram que aspectos atípicos na DA precisam ser mais explorados, já que DA não é uma condição homogênea. Compreender esses perfis cognitivos na DA irá interferir nos métodos diagnósticos e intervenções terapêuticas, seja farmacológica ou comportamental. A segunda parte dessa tese explora esses aspectos atípicos em três amostras: envelhecimento normal, CCL e AD. Assim, um estudo transversal foi realizado para comparar medidas de velocidade de processamento (VP), controle inibitório e automonitoramento nas três amostras. Os resultados desse estudo mostram que medidas de VP podem ser indicadores precoces do declínio cognitivo envelhecimento. Ao comparar CCL com o grupo de envelhecimento saudável, os dados mostram diferença nas medidas de VP e erros cometidos nos testes de VP. Entretanto, as duas amostras não apresentaram diferenças nas medidas de funções executivas (FEs) e nas medidas de funcionalidade. CCL versus AD mostraram diferenças nas medidas de VP, funções executivas e funcionalidade. Dessa forma, esse estudo traz resultados relevantes para o diagnóstico precoce de CCL e novas diretrizes para o cenário clínico e pesquisa. Além disso, na segunda parte desta tese foi realizado um artigo sobre acurácia diagnóstica das medidas de VP nos casos de CCL e AD. A literatura mostra falta de estudos sobre diferenças nas medidas de VP no envelhecimento e parâmetros diagnósticos dos instrumentos de VP. Esse estudo mostrou que medidas de VP apresentam habilidades discriminativas, para DA e CCL. Esses dados são necessários, já que apresentamos um cenário de escassez de instrumentos com elevados parâmetros diagnósticos para medidas de VP no envelhecimento. Esse cenário torna-se ainda mais drástico, quando falamos de Brasil. / [en] Aging is a major healthcare challenge worldwide. With aging, the prevalence of conditions such as dementia and Mild Cognitive Impairment increase. The most frequent and studied cause of dementia is Alzheimer s dementia (AD). Traditionally, AD is characterized by early deficit in episodic memory. However, current studies show that AD presents heterogeneity in clinical manifestations, especially cognitive manifestations. Thus, some patients present a non-amnestic cognitive profile. These profiles are called by some authors as atypical AD. The first part of this thesis was aimed at studying the neuropsychological heterogeneity in AD by means of 2 studies: a systematic review on neuropsychological heterogeneity in AD (published) and cases of study with typical and atypical AD patients (published). The systematic review was necessary, as it was the first published review about the topic. The findings of the two studies show that atypical aspects in AD need to be further explored, since AD is not a homogeneous condition. Understanding these cognitive profiles in AD will interfere in diagnostic methods and therapeutic interventions, either pharmacological or behavioral ones. The second part of this thesis explores atypical aspects in three samples: normal aging, MCI and AD. Thus, a cross-sectional study was conducted to compare measures of processing speed (PS), inhibitory control, working memory and cognitive flexibility in the three samples. The results of this study showed that PS measures may be early indicators of cognition decline in aging. MCI versus normal aging showed differences in PS measures and errors in tests of PS. However, these samples did not show differences in executive function measures (EFs) and functional measures. Nevertheless, MCI versus AD show differences in PS measures, executive functions and functionality. Thus, this study showed relevant results for the diagnosis process of MCI and new guidelines for clinical settings and research. In addition, in the second part of this thesis an article was written on diagnostic accuracy of the PS measures used in cases of MCI and AD. The literature shows a lack of studies on differences in PS measures in aging and diagnostic parameters of PS instruments. This study showed that PS measures present discriminative abilities in AD and MCI. These data are important, as there is a lack of diagnostic tools for PS in aging, especially in the Brazilian scenario.