It is necessary to assess the intellectual functioning of dementia patients. However, psychometric instruments such as the Wechsler Adult Intelligence Scale - revised (WAIS-R) are often too demanding for dementia patients, precluding its utility. Clinicians and researchers have indirectly estimated a dementia patient's IQ from the Mini-Mental State Examination (MMSE). This measure is an eleven item screen instrument of global cognitive functioning. Fairly accurate estimates of IQ have been predicted using the MMSE total score.The purpose of the present study was to determine if it is possible to more accurately predict intellectual functioning when the individual MMSE items were used to predict Full Scale, Verbal, and Performance IQ using multiple regression analyses. Forty elderly dementia patients were administered both the MMSE and the WAIS-R. The MMSE total score was entered into a simple linear regression to predict FSIQ. In addition, the eleven item scores of the MMSE were entered into separate stepwise regressions to predict FSIQ, VIQ, and PIQ. The increment in the amount of variance accounted for in the FSIQ between the simple and multiple regression equations were evaluated for statistical significance.The results of these investigations revealed that while the multiple regression equations using MMSE item scores predicted a significant amount of the variance in IQ, they were not statistically superior to using the MMSE total score alone. The MMSE total score was found to account for 76.2% of the variance in Full Scale IQ. The MMSE items that were found to add significantly to the variance in intellectual level accounted for 80.9 %, 75.1 %, and 73.4 % of FSIQ, VIQ, and PIQ respectively. The results of the present study replicated other research that found the MMSE total score to accurately predict intellectual functioning in dementia patients. / Department of Counseling Psychology and Guidance Services

In the current study children 3-5 years of age (N = 75) participated in a mental state task to investigate the effect of action saliency on young children's appreciation of mental states during pretend play activities. They also engaged in a parent-child interaction period, including storybook reading and pretend play activities, in order to examine the relation between mental state term utterances and performance on the mental state task. Two actors appeared side-by-side on a television screen, either in motion or as static images; one actor had knowledge of the animal he was pretending to be; the other actor did not have the same knowledge. The actors' behaviors were identical and related to the behavior of the animal, identical and unrelated, or the knowledgeable actor behaved contradictory to the animal's behavior while the unknowledgeable actor behaved appropriately for that animal. Children were asked to select the actor who was pretending to be the animal. Children selected the appropriate knowledgeable actor significantly more often than a non-knowledgeable actor. Older children performed better than younger children. Children's performance was unaffected by whether actors were shown in motion as compared to simply a static image. Children performed most successfully on trials where actors were both engaged in behaviors unrelated to the animal's behavior and poorest when the actor's behavior was contradictory to his knowledge. The mental state utterances of parents and children were correlated with the children's performance on the mental state task. Hierarchical regression analyses revealed parent's mental state utterances used during the parent-child interactions - specifically cognitive terms and modulations of assertion - were predictive of their children's performance on the mental state task. The current study's results support an understanding of the mind in pretend play activities by some children younger than five years of age and this understanding may be influenced by their parents' use of mental state language. Children who do not do well in appreciating that the mind is essential during pretense activities may have difficulty inhibiting responding to action, thus interfering with their ability to maintain focus on the mental state of the pretender.

This thesis is broadly about the structure of propositional knowledge and the ways in which an individual knower can have such knowledge. More specifically, it is about the epistemology of factive psychological attitudes and the view that knowing is a purely mental state. I take such a view as being not so much a theory of knowledge, but rather an accounting of how we know, or the ways in which we know. In arguing for this view I offer a different interpretation of certain epistemic conditions, like seeing and remembering and try to show how understanding the metaphysics of mental states and events clarifies the relation between such conditions and the factive psychological attitudes implicit in them. Part one of the thesis is occupied with a discussion about a form of externalism popular in contemporary philosophy of mind, content externalism and a form of externalism popularized by Timothy Williamson which I refer to in the thesis as attitude externalism. I argue that content externalism in the style of Tyler Burge, arguably one of its most prominent advocates, faces a rather serious dilemma when it comes to the role that mental states and specific mental events are meant to play in psychological explanation. The view endorsed by Timothy Williamson, which says that some psychological attitudes, factive attitudes like ‘seeing that’, can be thought of as broad prime conditions is offered as a way in which the content externalist can avoid this dilemma and retain a causal-psychological explanatory thesis about mental states and events. The second part of the thesis is concerned with the epistemology of factive psychological attitudes and I focus carefully on two paradigmatic cases – seeing and remembering. I dedicate a chapter to each and offer a series of arguments to the effect that seeing and remembering though they may be thought of as ways of having propositional knowledge, it is not necessary that they entail knowing nor that they be stative to do so. In this sense, there is a strong and important divergence in the dialectic of the thesis from the view offered by Timothy Williamson, on which many points in this thesis there is agreement. I conclude the thesis with a discussion on what I take to be a fundamental epistemological principle, which I call the multiformity principle. The argument there is that when a subject knows that p, there is always a specific way in which that subject knows. I further take this principle to reveal the fact that propositional knowledge is an intrinsically disjunctive phenomenon.

京都大学 / 0048 / 新制・課程博士 / 博士(情報学) / 甲第20024号 / 情博第619号 / 新制||情||108(附属図書館) / 33120 / 京都大学大学院情報学研究科知能情報学専攻 / (主査)教授 松山 隆司, 教授 熊田 孝恒, 准教授 川嶋 宏彰 / 学位規則第4条第1項該当 / Doctor of Informatics / Kyoto University / DFAM

No description available.

Bakgrund: Andelen äldre över 60 år ökar och förväntas öka ytterligare framöver. Kognitiv svikt är en av de vanligaste åkommorna samt ett hälsoproblem över hela världen. En viktig riskfaktor för kognitiv svikt är åldrande. Ett annat tillstånd hos äldre som lätt förbises är ortostatisk hypotension (OH). Det finns studier som påvisar samband mellan OH och kognitiv svikt, likväl studier som inte påvisar något samband, vilket gör att det råder delade meningar. Ytterligare kunskap behövs för att stärka det vetenskapliga underlaget till distriktssköterskans hälsofrämjande arbete när det gäller patientutbildning och egenvårdsråd. Syfte: Syftet med studien var att undersöka om ortostatisk hypotension har ett samband med kognitiv svikt hos yngre äldre för att bidra med vetenskapligt underlag till distriktssköterskans hälsofrämjande arbete. Metod: Designen var en kvantitativ studie i samarbete med Swedish National Study on Aging and Care – Blekinge. Urvalet inkluderade yngre äldre (60-78år). Variabler som kön, ålder, utbildning, blodtrycksvärden samt resultat på Mini-Mental State Examination (MMSE) valdes ut. Analysen gjordes i statistikprogrammet SPSS och började med deskriptiv statistik. För att se signifikant skillnad genomfördes Mann-Whitney U-test och Chi-2. Till sist utfördes en logistisk regression för att undersöka vad som påverkade den kognitiva förmågan mest. Resultat: Hos yngre äldre påvisades ingen statistisk signifikans när det gäller sambandet mellan OH och kognitiv svikt. Däremot sågs en tendens som pekade på att av de som har kognitiv svikt så var det fler som hade OH. 72-åringarna hade lägst medelvärde på MMSE. Kvinnor hade i högre utsträckning både kognitiv svikt och låg utbildning än män. Lågutbildning var en riskfaktor för kognitiv svikt. Det sågs en markant ökning av OH där 14% av 60-åringarna hade OH och 36,7% av 72-åringarna. Generellt hade män i högre utsträckning OH än kvinnor.  Slutsats: Inget samband påvisades mellan OH och kognitiv svikt, däremot sågs en visuellt synlig skillnad i alla grupper utom 60 år. Prevalensen av OH ökade efter 60 år. Låg utbildningsnivå var en riskfaktor för kognitiv svikt. Genom ökad kunskap kan distriktssköterskan ge egenvårdsråd och säker hälsovägledning till patienter och närstående för att främja hälsan hos äldre individer

No description available.

No / The aim of this chapter is to provide an overview of ASC arising from varied origins. This chapter includes case studies of altered conscious states which aid in linking theory to clinical practice. In the first section we introduce the concept of consciousness and elaborate further on altered states of consciousness. In the second section physiologically induced ASC will be outlined and discussed with reference to situations that nurses may frequently encounter. The third section will focus on psychosis, hallucinations and delusions. These are considered exemplars of ASC, here we explore and evaluate cognitive psychology’s contribution to accounting for the complex phenomenology of the unusual experiences of psychosis. The final section focuses of ASC that result from intention, i.e. as a consequence of alcohol or drug use. Psychological theories, associated psychological issues, and supportive evidence based interventions will be discussed.

Introdução: O comprometimento cognitivo (CC) na Esclerose Múltipla (EM) possui taxas de prevalência de 43% a 70% e pode surgir desde a Síndrome Clinicamente Isolada (CIS) aos estágios iniciais da EM. O CC na EM pode evoluir independentemente dos sinais e sintomas motores, dos resultados do EDSS e ausência de lesões ativas (captantes) na Ressonância Magnética. Neste contexto, o Multiple Sclerosis National Questionaire (MSNQ) e o protocolo Brief International Cognitive Assesment for Multiple Sclerosis (BICAMS) são instrumentos internacionais empregados para a triagem e o monitoramento nos centros de atendimento para os pacientes com EM. Estudos posteriores e reuniões do mesmo comitê concluíram que o MSNQ possui várias limitações por ser uma medida não objetiva e a triagem única pelo Symbol Digit Modalities Test (SDMT) por si só não é capaz de acessar outras áreas que podem estar comprometidas na EM. Com a segunda revisão do MMSE, e na falta de instrumentos de triagem objetivos capazes de triar os pacientes que precisassem ser melhor acompanhados pelo BICAMS, buscou-se no presente estudo criar a partir do BICAMS e do MMSE-2 uma medida rápida para triagem, que tivesse medidas de memória episódica, velocidade de processamento, atenção e memória operacional. Objetivo: Para obter uma ferramenta de triagem para este propósito (MMSE-MS) foram conduzidos estudos de adaptação segundo o estímulo: estudo de protótipos, estudo de adaptação, propriedades psicométricas e normas do MMSE-2 (como a nossa ferramenta experimental) e estudo preliminar de desenvolvimento de uma ferramenta objetiva de triagem para EM, com base no MMSE-3. Métodos: Todos os estudos de tradução e adaptação foram conduzidos seguindo um mesmo método, já amplamente utilizado pela literatura. O primeiro estudo consistiu no estudo convencional e de protótipos para verificar qual possuía melhor estimativa de equivalência entre as culturas. O segundo estudo consistiu em adaptar, verificar as propriedades psicométricas e estabelecer normas para o MMSE-2. Similarmente ao estudo anterior, um juiz internacional discutiu os resultados do estudo de adaptação para estabelecimento dos parâmetros de transculturalidade. O último estudo foi realizado com o objetivo de obter uma ferramenta com estimativas de sensibilidade e especificidade similares ao BICAMS, mas que fosse designada à triagem dos pacientes que são elegíveis para ser acompanhados pelo BICAMS. Para tal participaram do primeiro estudo, 374 voluntários da comunidade e 25 pacientes com EM. No segundo e terceiro estudo, participaram 128 pacientes com EM e 602 voluntários saudáveis. Todos os estudos clínicos e com as amostras da comunidade foram realizados no período de 2013 à 2015 e contaram com a parceria em pesquisa do Instituto Brasileiro de Neuropsicologia (IBNeuro) e do Laboratório de Instrumentação e Avaliação Psicológica (LABIAP). A coleta de pacientes foi realizada no Ambulatório de Neuroimunologia do Hospital das clínicas da Faculdade de Medicina de Ribeirão Perto (FMRP-USP). Resultados: No primeiro estudo, foram mantidas 5 palavras das 15 da versão original. A razão para as modificações na lista Brasileira foram as diferenças entre a divisão silábica, extensão das palavras e presença de protótipos. Verificou-se ainda que até a quarta palavra evocada na nossa cultura em cada categoria semântica foram as mesmas que foram evocadas na língua nativa do instrumento, mas a ordem da frequência variou dentro de cada categoria, mostrando que embora existam palavras que são prototípicas às duas culturas na classificação semântica global, o contexto cultural interfere muito quando partimos para as especificidades dentro de cada classificação e categoria semântica. O MMSE-2 também apresentou estimativas de validade e precisão comum às duas culturas. No quarto estudo, as medidas do MMSE-2 que tiveram melhor relação com o BICAMS e índices de sensibilidade e especificidade parecidos foram as medidas da tarefa de evocação, atenção e cálculo, memória de histórias e codificação dígitos-símbolos. As correlações selecionadas foram aquelas classificadas em moderadas e fortes. Como segundo critério, as medidas do MMSE-2 foram comparadas às medidas do BICAMS pela curva ROC. As medidas do MMSE- 2 que tiveram especificidade e sensibilidade significativas (p<0,001) foram as elegíveis para compor o teste de triagem. Como a tarefa de codificação dígitos-símbolos é susceptível à demanda motora, optou-se pelo uso da forma oral do SDMT em conjunto. Deste modo, no nosso instrumento de triagem, normas para este instrumento foram criadas a partir da soma dos itens do MMSE-MS com o SDMT oral. Conclusão: A integração de dados desses diversos estudos evidencia cautela quanto aos procedimentos de adaptação empregados para adaptação transcultural das tarefas que são de origem verbal e semântica. Há também evidências da necessidade de instrumentos capazes de triar esses pacientes. Para tal, o MMSE-EM mostrou-se válido, preciso, com índices de sensibilidade e especificidade similares ao BICAMS, com normas ajustadas ao contexto Brasileiro. / Background: The cognitive impairment (CI) in Multiple Sclerosis (MS) has the prevalence rate from 43% to 70% and may occur from the Clinically Isolated Syndrome (CIS) to the early stages of MS. The CI in MS can advance independently of motor signs and symptoms, EDSS scores and MRI stable. In this context, the National Multiple Sclerosis Questionnaire (MSNQ) and the International Brief Cognitive Assesment for Multiple Sclerosis (BICAMS) are international tools used to screening and monitoring MS patients in care centers. Further studies and meetings provided by same committee alluded that MSNQ has several limitations for being a non-objective measure and the screening using the Symbol Digit Modalities Test (SDMT) alone is not effective because other areas that may be impaired in MS is not screened. With the second revision of the MMSE, and the lack of objective screening tools to quikly screening MS patients that needed to be monitored by BICAMS, we aimed in the presente study to create a fast measurement to screening the episodic memory, processing speed, attention and working memory from BICAMS and MMSE-2. Objective: To obtain brief a screening tool for MS (MMSE-MS) were conducted four studies using different tools: first the prototype study to development of CVLT-2 lists, adaptation, psychometric properties and normative data of BICAMS to the Braziliam context (as our gold standard), Cross cultural adaptation, psychometric properties, and normative data of MMSE-2 (the experimental tool) and the preliminary study of development of MMSE-MS. Methods: All translation and adaptation studies were conducted following the same method, as widely used in the literature. The first study consisted of conventional adaptation and prototypical norms, aiming to see which had the best estimates of equivalence between the cultures. The second study with BICAMS protocol show that MS scored significantly lower on all BICAMS tests. At the end of the study, the results were discussed with a member of the international committee to confirm the evidences of transculturality between the original and Brazilian versions. The third study consisted of Adapt, to investigate the psychometric properties and stablish normative data to the MMSE-2. Similarly to the previous study, an international judge discussed the results of the study of adaptation to identify the estimatives of transculturality. The fourth and last study was conducted in order to obtain a tool with sensitivity and similar specificity estimates BICAMS, but it was designed to screen patients who are eligible to be accompanied by BICAMS. Participated of the first study, 374 healthy volunteers and 25 patients with MS. In the second and third study participated 128 MS patients and 602 healthy volunteers. All clinical studies and community samples were carried out from 2013 to 2015 and had the partnership of the Brazilian Institute of Neuropsychology (IBNeuro) and the Laboratory of Instrumentation and Psychological Assessment (LABIAP). The collection of patients was performed at the Neuroimmunology Outpatient Clinic from Ribeirão Preto Medical School (FMRP-USP). Results: In the first study, were kept 5 words of 15 from the original American version. The reason for these changes in the Brazilian list were the differences between the syllabic division, extension of the words and the presence of prototypicall words. Was also found that until the fourth word evoked in our culture, in each semantic category were the same as those mentioned in the native language, but the order of the frequency varied within each category, indicating that although there are words that are prototypically commom between the two cultures in the overall semantic classification, the cultural context changes when we analyse the specifics prototipically words inside of each classification and semantic categories. To the second study, the BICAMS showed similar estimates of reliability and validity for current use as monitoring tool for MS in the Brazilian contexto, supporting the diagnostic validity of the Brazilian-Portuguese adaptation The normative data were satisfactory (p <0.001) in relation to the vocational status. The third study, with MMSE-2 also provided good estimates of validity and precision to the both cultures. To the fourth study, the MMSE-2 was compared to the BICAMS. The MMSE-2 tasks which had similar sensitivity and specificity to the BICAMS protocol was the recalling, attention and calculation, history memory and processing speed (Symbol Digit-coding). The selected tasks were those classified as moderate and Strong correlations. The second procedure consisted on comparisions among the MMSE-2 measurements and BICAMS using ROC curve. So, the MMSE-2 measures that had significant (p <0.001) specificity and sensitivity and similar area under the curve (ROC) were eligible to composse the screening tool. As the digit-symbol coding task is susceptible to motor demand, we decided to include the oral SDMT to the task. Thus, to get our screening tool, normative data for this instrument were created from the sum of the MMSE-MS items with oral SDMT. Conclusion: The overall of the data from these studies calls attention to the necessity of the caution to the adaptation procedures used in cross-cultural adaptation of the tasks that has verbal and semantic stimuli. There is also the need of tools abel to screening MS patients. For this, these preliminar data for MMSE-MS showed evidences of validation, similar sensitivity and and specificity, with normative data culturally adjusted to the Brazilian context.

Introdução: O comprometimento cognitivo (CC) na Esclerose Múltipla (EM) possui taxas de prevalência de 43% a 70% e pode surgir desde a Síndrome Clinicamente Isolada (CIS) aos estágios iniciais da EM. O CC na EM pode evoluir independentemente dos sinais e sintomas motores, dos resultados do EDSS e ausência de lesões ativas (captantes) na Ressonância Magnética. Neste contexto, o Multiple Sclerosis National Questionaire (MSNQ) e o protocolo Brief International Cognitive Assesment for Multiple Sclerosis (BICAMS) são instrumentos internacionais empregados para a triagem e o monitoramento nos centros de atendimento para os pacientes com EM. Estudos posteriores e reuniões do mesmo comitê concluíram que o MSNQ possui várias limitações por ser uma medida não objetiva e a triagem única pelo Symbol Digit Modalities Test (SDMT) por si só não é capaz de acessar outras áreas que podem estar comprometidas na EM. Com a segunda revisão do MMSE, e na falta de instrumentos de triagem objetivos capazes de triar os pacientes que precisassem ser melhor acompanhados pelo BICAMS, buscou-se no presente estudo criar a partir do BICAMS e do MMSE-2 uma medida rápida para triagem, que tivesse medidas de memória episódica, velocidade de processamento, atenção e memória operacional. Objetivo: Para obter uma ferramenta de triagem para este propósito (MMSE-MS) foram conduzidos estudos de adaptação segundo o estímulo: estudo de protótipos, estudo de adaptação, propriedades psicométricas e normas do MMSE-2 (como a nossa ferramenta experimental) e estudo preliminar de desenvolvimento de uma ferramenta objetiva de triagem para EM, com base no MMSE-3. Métodos: Todos os estudos de tradução e adaptação foram conduzidos seguindo um mesmo método, já amplamente utilizado pela literatura. O primeiro estudo consistiu no estudo convencional e de protótipos para verificar qual possuía melhor estimativa de equivalência entre as culturas. O segundo estudo consistiu em adaptar, verificar as propriedades psicométricas e estabelecer normas para o MMSE-2. Similarmente ao estudo anterior, um juiz internacional discutiu os resultados do estudo de adaptação para estabelecimento dos parâmetros de transculturalidade. O último estudo foi realizado com o objetivo de obter uma ferramenta com estimativas de sensibilidade e especificidade similares ao BICAMS, mas que fosse designada à triagem dos pacientes que são elegíveis para ser acompanhados pelo BICAMS. Para tal participaram do primeiro estudo, 374 voluntários da comunidade e 25 pacientes com EM. No segundo e terceiro estudo, participaram 128 pacientes com EM e 602 voluntários saudáveis. Todos os estudos clínicos e com as amostras da comunidade foram realizados no período de 2013 à 2015 e contaram com a parceria em pesquisa do Instituto Brasileiro de Neuropsicologia (IBNeuro) e do Laboratório de Instrumentação e Avaliação Psicológica (LABIAP). A coleta de pacientes foi realizada no Ambulatório de Neuroimunologia do Hospital das clínicas da Faculdade de Medicina de Ribeirão Perto (FMRP-USP). Resultados: No primeiro estudo, foram mantidas 5 palavras das 15 da versão original. A razão para as modificações na lista Brasileira foram as diferenças entre a divisão silábica, extensão das palavras e presença de protótipos. Verificou-se ainda que até a quarta palavra evocada na nossa cultura em cada categoria semântica foram as mesmas que foram evocadas na língua nativa do instrumento, mas a ordem da frequência variou dentro de cada categoria, mostrando que embora existam palavras que são prototípicas às duas culturas na classificação semântica global, o contexto cultural interfere muito quando partimos para as especificidades dentro de cada classificação e categoria semântica. O MMSE-2 também apresentou estimativas de validade e precisão comum às duas culturas. No quarto estudo, as medidas do MMSE-2 que tiveram melhor relação com o BICAMS e índices de sensibilidade e especificidade parecidos foram as medidas da tarefa de evocação, atenção e cálculo, memória de histórias e codificação dígitos-símbolos. As correlações selecionadas foram aquelas classificadas em moderadas e fortes. Como segundo critério, as medidas do MMSE-2 foram comparadas às medidas do BICAMS pela curva ROC. As medidas do MMSE- 2 que tiveram especificidade e sensibilidade significativas (p<0,001) foram as elegíveis para compor o teste de triagem. Como a tarefa de codificação dígitos-símbolos é susceptível à demanda motora, optou-se pelo uso da forma oral do SDMT em conjunto. Deste modo, no nosso instrumento de triagem, normas para este instrumento foram criadas a partir da soma dos itens do MMSE-MS com o SDMT oral. Conclusão: A integração de dados desses diversos estudos evidencia cautela quanto aos procedimentos de adaptação empregados para adaptação transcultural das tarefas que são de origem verbal e semântica. Há também evidências da necessidade de instrumentos capazes de triar esses pacientes. Para tal, o MMSE-EM mostrou-se válido, preciso, com índices de sensibilidade e especificidade similares ao BICAMS, com normas ajustadas ao contexto Brasileiro. / Background: The cognitive impairment (CI) in Multiple Sclerosis (MS) has the prevalence rate from 43% to 70% and may occur from the Clinically Isolated Syndrome (CIS) to the early stages of MS. The CI in MS can advance independently of motor signs and symptoms, EDSS scores and MRI stable. In this context, the National Multiple Sclerosis Questionnaire (MSNQ) and the International Brief Cognitive Assesment for Multiple Sclerosis (BICAMS) are international tools used to screening and monitoring MS patients in care centers. Further studies and meetings provided by same committee alluded that MSNQ has several limitations for being a non-objective measure and the screening using the Symbol Digit Modalities Test (SDMT) alone is not effective because other areas that may be impaired in MS is not screened. With the second revision of the MMSE, and the lack of objective screening tools to quikly screening MS patients that needed to be monitored by BICAMS, we aimed in the presente study to create a fast measurement to screening the episodic memory, processing speed, attention and working memory from BICAMS and MMSE-2. Objective: To obtain brief a screening tool for MS (MMSE-MS) were conducted four studies using different tools: first the prototype study to development of CVLT-2 lists, adaptation, psychometric properties and normative data of BICAMS to the Braziliam context (as our gold standard), Cross cultural adaptation, psychometric properties, and normative data of MMSE-2 (the experimental tool) and the preliminary study of development of MMSE-MS. Methods: All translation and adaptation studies were conducted following the same method, as widely used in the literature. The first study consisted of conventional adaptation and prototypical norms, aiming to see which had the best estimates of equivalence between the cultures. The second study with BICAMS protocol show that MS scored significantly lower on all BICAMS tests. At the end of the study, the results were discussed with a member of the international committee to confirm the evidences of transculturality between the original and Brazilian versions. The third study consisted of Adapt, to investigate the psychometric properties and stablish normative data to the MMSE-2. Similarly to the previous study, an international judge discussed the results of the study of adaptation to identify the estimatives of transculturality. The fourth and last study was conducted in order to obtain a tool with sensitivity and similar specificity estimates BICAMS, but it was designed to screen patients who are eligible to be accompanied by BICAMS. Participated of the first study, 374 healthy volunteers and 25 patients with MS. In the second and third study participated 128 MS patients and 602 healthy volunteers. All clinical studies and community samples were carried out from 2013 to 2015 and had the partnership of the Brazilian Institute of Neuropsychology (IBNeuro) and the Laboratory of Instrumentation and Psychological Assessment (LABIAP). The collection of patients was performed at the Neuroimmunology Outpatient Clinic from Ribeirão Preto Medical School (FMRP-USP). Results: In the first study, were kept 5 words of 15 from the original American version. The reason for these changes in the Brazilian list were the differences between the syllabic division, extension of the words and the presence of prototypicall words. Was also found that until the fourth word evoked in our culture, in each semantic category were the same as those mentioned in the native language, but the order of the frequency varied within each category, indicating that although there are words that are prototypically commom between the two cultures in the overall semantic classification, the cultural context changes when we analyse the specifics prototipically words inside of each classification and semantic categories. To the second study, the BICAMS showed similar estimates of reliability and validity for current use as monitoring tool for MS in the Brazilian contexto, supporting the diagnostic validity of the Brazilian-Portuguese adaptation The normative data were satisfactory (p <0.001) in relation to the vocational status. The third study, with MMSE-2 also provided good estimates of validity and precision to the both cultures. To the fourth study, the MMSE-2 was compared to the BICAMS. The MMSE-2 tasks which had similar sensitivity and specificity to the BICAMS protocol was the recalling, attention and calculation, history memory and processing speed (Symbol Digit-coding). The selected tasks were those classified as moderate and Strong correlations. The second procedure consisted on comparisions among the MMSE-2 measurements and BICAMS using ROC curve. So, the MMSE-2 measures that had significant (p <0.001) specificity and sensitivity and similar area under the curve (ROC) were eligible to composse the screening tool. As the digit-symbol coding task is susceptible to motor demand, we decided to include the oral SDMT to the task. Thus, to get our screening tool, normative data for this instrument were created from the sum of the MMSE-MS items with oral SDMT. Conclusion: The overall of the data from these studies calls attention to the necessity of the caution to the adaptation procedures used in cross-cultural adaptation of the tasks that has verbal and semantic stimuli. There is also the need of tools abel to screening MS patients. For this, these preliminar data for MMSE-MS showed evidences of validation, similar sensitivity and and specificity, with normative data culturally adjusted to the Brazilian context.