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[pt] EFEITOS DA EXPOSIÇÃO PRÉ-NATAL AO ÁLCOOL DURANTE O DESENVOLVIMENTO DO SISTEMA NERVOSO CENTRAL: FOCO EM ESTUDOS PRÉCLÍNICOS E CLÍNICOS / [en] EFFECTS OF PRENATAL ALCOHOL EXPOSURE DURING THE DEVELOPMENT OF THE CENTRAL NERVOUS SYSTEM: FOCUS ON PRECLINICAL AND CLINICAL STUDIESMARTINA VIRAG KOVACS 28 April 2023 (has links)
[pt] O consumo de álcool durante gravidez pode alterar o desenvolvimento neural do feto,
causando defeitos ao longo da vida. As consequências são diversas e compõe o termo
coletivo: Transtorno do Espectro Alcoólico Fetal (TEAF). Esse transtorno é considerado
a causa mais comum de deficiência cognitiva evitável no mundo. Estimativas apontam
que no Brasil entre 1 e 1,5% das crianças nascem com alterações no sistema nervoso
devido à exposição ao álcool in útero. O consumo do álcool é frequente entre mulheres
grávidas muitas vezes por desconhecimento dos seus efeitos adversos no
desenvolvimento do feto. Outra droga comumente utilizada por mulheres grávidas é a
maconha com intuito de amenizar o enjoo durante a gestação. A presente dissertação
explora os efeitos da exposição pré-natal ao álcool no feto (em conjunto ou não do uso da
maconha) em estudos pré-clínicos e clínicos. Dois artigos foram gerados para a realização
deste trabalho. O primeiro artigo relata os mecanismos e as consequências do consumo
simultâneo de álcool e maconha durante gravidez, cujo efeito é ainda mais nocivo ao
desenvolvimento do feto do que apenas a exposição ao álcool. Dados recentes
demonstram a interação do etanol e da maconha com o sistema Endocanabinoide, que
tem um papel importante no neurodesenvolvimento. Depois do fechamento do tubo
neural, que acontece durante a terceira semana da gestação humana, os olhos e o cérebro
se desenvolvem do neuroepitélio. Ambos, o álcool e maconha interferem sinergicamente
nesse processo via receptores canabinóides, alterando assim a sinalização “sonichedgehog”,
que por sua vez, resulta em alterações morfológicas e comportamentais em
modelos animais. Além disso, o artigo relata os mais recentes achados de estudos clínicos
sobre a combinação da dose e tipo de constituintes químicos da machonha, bem como os
desfechos morfológicos e neurocomportamentais da exposição conjunta do álcool e da
maconha. O segundo artigo é uma revisão sistemática que investiga as pesquisas
realizadas no Brasil sobre o TEAF, com ênfase nos instrumentos usados para a avaliação
neuropsicológica de indivíduos com TEAF. Enquanto países desenvolvidos têm décadas
de pesquisa sobre o TEAF, no Brasil, inúmeros fatores comprometem o progresso nesta e outras áreas de pesquisa. Entre esses fatores podemos citar, divergências
socioeconômicas, culturais e geopolíticas, que dificultam o desenvolvimento, adaptação
e validação de instrumentos utilizados no diagnóstico e na avaliação neuropsicológica do
TEAF. Além disso, vale ressaltar que a vulnerabilidade socioeconômica da população
brasileira é um fator importante no aumento da ocorrência de formas mais graves de
TEAF. A revisão sistemática aponta para a necessidade da validação das ferramentas
neuropsicológicas de diagnóstico e avaliação cognitiva de pessoas com TEAF e da
participação de uma equipe multidisciplinar no diagnóstico do TEAF. / [en] Alcohol consumption during pregnancy may damage the development of the fetus, resulting
in the most common preventable cause of neurodevelopmental disability in the world: Fetal
Alcohol Spectrum Disorders (FASD). The present dissertation aims to discuss the effects of
alcohol on the developing CNS through two articles. The first article elucidates the
mechanisms and outcomes of the combined alcohol and cannabis exposure in the offspring
through preclinical studies. Alcohol teratogenesis is more potent when administered with
cannabis and has more negative effects on the fetus than alcohol alone. Recent data
demonstrate the interaction of ethanol and cannabis with the Endocannabinoid system,
which plays an important role in neurodevelopment and explains the morphological and
behavioral changes seen in preclinical studies. The second article is a systematic review that
investigates Brazilian research on FASD, focusing on the instruments used for the
neuropsychological assessment of individuals with FASD. While developed countries have
decades of research on FASD, in Brazil numerous factors slow down the progress of in this
and other areas of research. Socioeconomic status, cultural, and geopolitical divergences are
some of these factors, which hinder the development, adaptation, and validation of
instruments used in the diagnosis and neuropsychological assessment of FASD. In addition,
it is worth noting that the socioeconomic vulnerability of the Brazilian population is an
important factor in the increase in the occurrence of more severe forms of FASD. The
systematic review points to the need to validate neuropsychological tools for the diagnosis
and cognitive assessment of individuals with FASD in Brazil, and the participation of a
multidisciplinary team in the diagnosis of FASD.
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A Preliminary Investigation of the Validity of Time-Based Measures of Sustained Attention for ChildrenKulfan, Michael R. 14 August 2013 (has links)
No description available.
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The neuropsychological profiles of learners with Asperger SyndromeThijsse, Lynette Joan 08 1900 (has links)
A qualitative case study research design is used to investigate the results of a
neuropsychological test battery, collated and used with four individual cases. A
literature study consisting of research with respect to AS as well as
neuropsychological assessments provides the theoretical framework from which
existing theory is tested and expanded on. The cases are analysed individually and
then by cross case analysis to ascertain any patterns of strength and weaknesses
which could result in a "typical" profile of a learner with AS.
Findings conclude confusions with respect to diagnostic criteria for AS and a
distinction of DSM-IV-TR criteria is used. The neuropsychological test battery
includes questionnaires (personal history, Gilliam Asperger's disorder scale,
Conners' parent and teacher questionnaire, Dunn's sensory profile) interviews
(parents, teachers), observations (classroom and playground) and formal testing
(intelligence, motor functions, academic achievement, theory of mind and executive
functions).
Findings from the literature show similarities between AS children and children with
non verbal learning disabilities. Evidence of AS differing from individuals with high
functioning autism is conclusive in all previous research using theory of mind tests.
Evidence from the literature shows many children had been given another diagnosis,
typically ADHD, before being given the diagnosis of AS. Additional disorders such as
anxiety and depression were also given. AS children had consistent difficulties with
social interaction.
A typical neuropsychological profile of AS is not identified, but rather a "personality
type" that is dominated by anxiety and individual "quirks" of personality which affects
responses to the formal test battery - thereby influencing the scores obtained. Two of the cases presented with an academic profile similar to that of a non verbal
learning disability and one presented with similarities with a semantic pragmatic
disorder. The thesis concludes with a proposed differentiating model of behavioural,
communication and learning disorders in which AS is defined in terms of that
originally described by Hans Asperger himself, and specifically treated within the
education environment. / Educational Studies / D.Ed. (Psychology of Education)
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La représentation auditive motrice reflétée par la négativité de discordance chez l’enfant présentant un trouble du spectre de l’autismeLortie, Mélissa 09 1900 (has links)
Il est maintenant bien établi que le cerveau humain est doté d’un système de neurones qui
s’active tant à la perception qu’à l’exécution d’une action. Les neurones miroirs, ainsi que le
système qu’ils forment avec des structures adjacentes appelées système neurones miroirs
(SNM), ont été relié à la compréhension d’action et pourrait être impliqué dans les fonctions
sociales de haut niveau tel que l’empathie et l’imitation. Dans la foulée spéculative reliant le
SNM à la sphère sociale, le dysfonctionnement de ce système a rapidement gagné intérêt dans
la genèse des anomalies du domaine social chez les personnes présentant le Trouble du spectre
de l’autisme (TSA). Néanmoins, l’hypothèse voulant que le dysfonctionnement social des
TSA repose sur une atteinte du SNM est controversée. En effet, les études soutenant cette
hypothèse nécessitent des fonctions cognitives et sociales qui peuvent contribuer à l’obtention
de résultats atypiques, telles que la compréhension des consignes, l’attention sur des stimuli
sociaux ou la réalisation d’acte moteur. Récemment, un protocole auditif de négativité de
discordance (MMN) utilisant des stimuli reliés à l’action humaine a été utilisé pour mesurer
l’activité du SNM. Cette technique semble prometteuse dans la mesure où elle ne nécessite pas
de capacités attentionnelles ou langagières, elle est brève et demande un montage minimal
d’électrodes. Le premier article avait comme objectif principal de mesurer la validité de
convergence du protocole MMN relié à l’action avec celui du rythme mu, le protocole le plus
utilisé pour enregistrer l’activité miroir à l’aide de l’électroencéphalographie (EEG). Les
modes de stimulation ont été délivrées en bloc successif à un groupe de 12 adultes en santé.
Alors que les deux techniques ont modulé efficacement les régions fronto-centrales et
centrales respectivement, mais ne sont pas corrélées, nous avons conclu qu’il est possible
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qu’elles mesurent des aspects différents du SNM. Le deuxième article avait comme objectif
principal de mesurer l’activité du SNM à l’aide du protocole MMN relié à l’action chez 10
enfants présentant un TSA ainsi que chez 12 enfants neurotypiques dans la même tranche
d’âge (5-7ans). Chez les enfants TSA, nous avons montré un patron de latence inversée,
comparativement aux enfants du groupe contrôle; ils traitaient plus rapidement les sons
contrôles que les sons reliés à l’action humaine, alors que la tendance inverse était observée
chez les contrôles. De plus, bien que les deux groupes différaient quant aux sons d’action, ils
ne différaient pas quant aux sons contrôles. Quant à l’amplitude, les enfants TSA se
distinguaient du groupe contrôle par une amplitude restreinte du son d’action provenant de la
bouche. Par ailleurs, les mesures neurophysiologiques et neuropsychologiques n’étaient pas
corrélées. En sommes, basé sur la prémisse que ce protocole MMN pourrait mesurer l’activité
du SNM, cette thèse a comme but d’améliorer les connaissances quant à son utilisation chez
l’adulte et l’enfant neurotypique ainsi que chez l’enfant TSA. Celui-ci pourrait ultimement
être utilisé comme un biomarqueur potentiel du TSA. / Mirror-neuron system (NMS) has been suggested to underlie action understanding, which is
believed to be involved in higher social functions such as empathy and imitation. Numerous
studies have also provided indirect evidence supporting the existence of a MNS in the human
brain using functional magnetic resonance imaging, transcranial magnetic stimulation,
magnetoenceophalography and electroencephalography (EEG). As evidence relating MNS
function with social cognition accumulated, its dysfunction was proposed to underlie social
impairments in Autism Spectrum Disorder (ASD). Although some studies have reported
structural and/or functional data supporting this hypothesis, it remains controversial. Indeed,
the techniques used to probe MNS activity often require the participant to understand the task,
display sustained attention and present spared visual cognitive functions, which could be
altered in ASD population. This, in turn, could partly explain differences in MNS activity
found between invididuals with ASD and neurotypical participants. The auditory mismatch
negativity (MMN) protocol has recently been proposed as a viable tool to assess MNS activity
using action-related sounds. This relatively short oddball paradigm does not require visual,
attentional or language skills and can be performed with minimal electrode installation
(minimal use of 4 electrodes). This action-related MMN may therefore be well-suited to
investigate MNS function in very young children or populations with mental disabilities, such
as ASD. The first article of this thesis assessed the convergent validity of the action-related
MMN protocol with a mu rhythm suppression paradigm, which is the most commonly used
EEG measure of MNS activity. To do so, both protocols were consecutively administered in
healthy adults in the same experimental session. While both techniques successfully
4
modulated the fronto-central and central brain regions using action-related stimuli, they did
not correlate significantly. This suggests that the two techniques may not probe the same
aspects of MNS function. The second article aimed at investigating MNS activity in children
with ASD using the action-related MMN protocol. Data were compared to age-matched
typically developing children. We show that children with ASD present an opposite pattern to
that of control children : whereas MMN latencies are shorter for action-related sounds
compared to control sounds in neurotypical children, the opposite pattern is observed in
children with ASD. Furthermore, although the two groups present different response patterns
with regards to action-related sounds, they repond similarly to control sounds. For amplitude
measurements, children with ASD display reduced amplitude to action-related sounds
produced by the mouth compared to neurotypical children. In summary, this thesis aimed at
determining whether and action-related MMN protocol could be used to measure MNS
activity in neurotypical adults and children, as well as in ASD children. The action-related
MMN could potentially be used as a biological biomarker of ASD pending further studies.
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The neuropsychological profiles of learners with Asperger SyndromeThijsse, Lynette Joan 08 1900 (has links)
A qualitative case study research design is used to investigate the results of a
neuropsychological test battery, collated and used with four individual cases. A
literature study consisting of research with respect to AS as well as
neuropsychological assessments provides the theoretical framework from which
existing theory is tested and expanded on. The cases are analysed individually and
then by cross case analysis to ascertain any patterns of strength and weaknesses
which could result in a "typical" profile of a learner with AS.
Findings conclude confusions with respect to diagnostic criteria for AS and a
distinction of DSM-IV-TR criteria is used. The neuropsychological test battery
includes questionnaires (personal history, Gilliam Asperger's disorder scale,
Conners' parent and teacher questionnaire, Dunn's sensory profile) interviews
(parents, teachers), observations (classroom and playground) and formal testing
(intelligence, motor functions, academic achievement, theory of mind and executive
functions).
Findings from the literature show similarities between AS children and children with
non verbal learning disabilities. Evidence of AS differing from individuals with high
functioning autism is conclusive in all previous research using theory of mind tests.
Evidence from the literature shows many children had been given another diagnosis,
typically ADHD, before being given the diagnosis of AS. Additional disorders such as
anxiety and depression were also given. AS children had consistent difficulties with
social interaction.
A typical neuropsychological profile of AS is not identified, but rather a "personality
type" that is dominated by anxiety and individual "quirks" of personality which affects
responses to the formal test battery - thereby influencing the scores obtained. Two of the cases presented with an academic profile similar to that of a non verbal
learning disability and one presented with similarities with a semantic pragmatic
disorder. The thesis concludes with a proposed differentiating model of behavioural,
communication and learning disorders in which AS is defined in terms of that
originally described by Hans Asperger himself, and specifically treated within the
education environment. / Educational Studies / D.Ed. (Psychology of Education)
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Neuropsychological assessment of executive functions in substance dependence populations: a systematic reviewJansen van Vuuren, Jacques 11 1900 (has links)
The role of executive functioning in substance dependence and addiction has received
increased attention in recent years; however, the findings of empirical studies are at times
contradictory and difficult to compare at face value. To address the current state of
fragmentation and to delineate the current body of knowledge a systematic review of
existing studies was conducted. The synthesis of the findings from these studies confirmed
that lower neuropsychological performance scores of executive functioning are observed
in substance dependent populations. Furthermore, the synthesis of the components of these
studies provided a comprehensive overview and revealed a number of critical gaps in the
current body of knowledge. The gaps include limitations concerning specific
demographics of the samples studied (under-representation of females, adolescents, the
elderly, individuals with limited education, and individuals from Africa, Oceania, Asia,
Latin America and the Caribbean), as well as the scarce number of studies investigating
specific substances; insufficient longitudinal studies; and the fragmentation of executive
functioning as a theoretical construct. / Psychology / M.A. (Psychology)
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