INTRODUÇÃO: A dependência de cocaína/crack está associada a prejuízos neuropsicológicos, principalmente nas funções executivas, estas gerenciadas predominantemente pelo córtex préfrontal do cérebro. O jogo de xadrez é uma atividade que recruta funções executivas e tem sido empregado na reabilitação de pacientes com outros transtornos psiquiátricos; porém, nenhum estudo, até hoje, avaliou o impacto deste jogo em pacientes com dependência química. OBJETIVO: Investigar a viabilidade e o impacto de uma abordagem inovadora, o Xadrez Motivacional, com foco na estimulação das funções executivas, especialmente em memória de trabalho, planejamento e tomada de decisões. MÉTODOS: Foram selecionados 72 pacientes entre 18 e 45 anos que estavam internados na Enfermaria do Comportamento Impulsivo (ECIM) do IPq-HC-FMUSP com diagnóstico de dependência de cocaína/crack. Os pacientes foram divididos em dois grupos, o Grupo Intervenção (n=42), submetido ao Xadrez Motivacional (intervenções por meio de estratégias de Entrevista Motivacional e jogo de xadrez) e o Grupo Controle, (n=30) submetido a atividades recreativas. Os pacientes foram avaliados pré e pós intervenção (aproximadamente um mês de abstinência) através de testes neuropsicológicos e escalas de autopreenchimento. RESULTADOS: Foi observada melhoria significativa na maioria das funções avaliadas, em ambos os grupos (intervenção e controle), porém a participação no Grupo Intervenção associou-se com uma melhoria mais significativa em memória de trabalho verbal. CONCLUSÃO: Estes resultados são promissores por demonstrarem a viabilidade do Xadrez Motivacional nesta população e, principalmente, por auxiliar significativamente na melhoria da memória de trabalho no Grupo Intervenção / INTRODUCTION: Crack cocaine dependence is associated with neuropsychological impairments, mainly in executive functions, managed predominantly by the prefrontal cortex. The game of chess is an activity that recruits executive functions and has been used in the rehabilitation of patients with other psychiatric disorders, but no study to date has evaluated the impact of this game on patients with substance dependency. OBJECTIVE: To investigate the feasibility and impact of an innovative approach, Motivational Chess, focusing on executive function stimulation, especially in working memory, planning and decision making. METHODS: The study enrolled 72 patients between 18 and 45 years who were admitted in the Impulsive Behavior Ward (ECIM) of IPq-HC-FMUSP diagnosed with crack/cocaine dependence. Patients were divided into two groups, the intervention group (n=42) underwent Motivational Chess (interventions using Motivational Interviewing strategies and chess game) and the control group (n=30) was submitted to recreational activities. Patients were assessed pre and post intervention (approximately one month of abstinence) using neuropsychological tests and self-report scales. RESULTS: We found significant improvement in most of the functions evaluated in both groups (control and intervention), but participation in the intervention group was associated with a more significant improvement in verbal working memory. CONCLUSION: These results are promising to show the feasibility of this approach of cognitive stimulation in this population and mainly to aid significantly improve of working memory

Personer med kognitiva nedsättningar tillhör en av de största grupperna av funktionsnedsatta personer. Premium Comai är ett hjälpmedel för att hjälpa personer med kognitiva nedsättningar att bli mer självständiga i deras vardag. Denna målgrupp har framförallt svårigheter med de exekutiva funktionerna så till exempel att minnas saker de ska genomföra eller att uppfatta hur lång tid aktiviteter tar. Denna studie undersöker hur användandet av en digital kalender som hjälpmedel för personer med kognitiva nedsättningar ser ut och hur användare av upplever hjälpmedlet, om de upplever att det hjälper dem planera sin tid och att komma ihåg. För att undersöka detta intervjuades användare av Premium Comai, där intervjutekniken var semistrukturerade intervjuer. Användare upplever att hjälpmedlet är enkelt att använda och att det hjälper dem planera sin tid. Premium Comai skapar trygghet. / People with cognitive impairments belong to one of the largest groups of disabled persons. Premium Comai is a tool to help people with cognitive impairments to become more independent in their daily lives. These peoples have particular difficulties with the executive functions such as remembering things or to perceive the time an activity will take. This study examines how the use of a digital calendar that is accessible for people with cognitive impairments, how users perceive the means, if they feel it helps them manage their time and to remember. To examine this, users of Premium Comai were interviewed, using semi-structured interviews. Users perceive that the device is easy to use and it helps them to plan their time. Premium Comai makes users feel safe.

Abstract Background: Childhood brain tumors (CBTs) are the most common solid tumors in childhood. CBT survivors have a high risk of several late-effects, including cerebrovascular disease (CVD), neurocognitive impairment, secondary neoplasms, and low bone mineral density; however, only a few studies have clinically investigated the late-sequelae in young-adult CBT survivors. Aim: To determine the prevalence of CVD, neurocognitive impairment, secondary neoplasms, and bone mineral density in a national cohort of radiotherapy-treated long-term survivors of CBT. Subjects and Methods: Radiotherapy-treated CBT survivors diagnosed between 1970–2008 were selected based on the following inclusion criteria: follow-up ≥5 years since the cessation of therapy and age of ≥16 years at the time of the study. Survivors were clinically and neuropsychologically examined, and investigated by magnetic resonance imaging (MRI), bone mineral densitometry, and laboratory analysis. Results: We included 74 survivors after a mean follow-up time of 18.9 ± 6.1 years. The mean age at follow-up was 28.4 ± 6.8 years and at diagnosis 8.3 ± 4.3 years. At the 20-year follow-up, the cumulative prevalence of CVD, along with small- and large-vessel disease was 52%, 38%, and 16%, respectively. Ischemic infarcts or transient ischemic attacks were diagnosed in 11% of the survivors, lacunar infarcts in 10%, and cerebral hemorrhage in 3%. White matter lesions (WMLs) were noted in 49% of the survivors. Higher blood pressure was associated with CVD, large-vessel disease, WMLs, and lacunar infarcts. Survivors had lower cognitive performance in all neuropsychological domains than controls. Mean verbal intelligence quotient was 89 ± 14 and mean performance intelligence quotient 87 ± 19. Executive functions (Z-score -5.0 ± 5.3 SD) and processing speed (Z-score -4.3 ± 5.4 SD) were extensively impaired. Executive functions and processing speed were associated with everyday life skills. Cumulative incidence of secondary meningiomas was 10.2% at the 25-year follow-up using the clinical data, and that of secondary neoplasms was 2.4% using the Finnish Cancer Registry data. We observed low bone mineral density in 23.6% of the survivors, which was associated with fractures in long bones. Conclusions: Young adult CBT survivors experienced late-consequences typically associated with ageing. / Tiivistelmä Taustaa: Suomessa sairastuu vuosittain 46-60 lasta aivokasvaimeen, joka on lapsuusiän yleisin, kiinteä kasvain. Selviytyneillä on todettu lisääntynyt hoitojen myöhäisvaikutuksien riski. Kuitenkin nuorten aikuisten haittavaikutuksia on toistaiseksi tutkittu melko vähän. Tutkimuksen tarkoitus: Tarkoituksena oli selvittää sädehoidon jälkihaittoina esiintyvien sairauksien, kuten aivoverisuonisairauksien, älyllisten ongelmien, sekundaaristen kasvainten ja luustonhaurastumisen yleisyyttä ja riskitekijöitä suomalaisessa, kansallisessa kohortissa. Aineisto ja Menetelmät: Tutkimukseen kutsuttiin kaikki Suomessa lapsuusiällä aivokasvaimen sairastaneet aikuiset, jotka oli hoidettu sädehoidolla vuosina 1970-2008. Tutkittavat olivat yli 16-vuotiaita ja hoitojen päättymisestä oli yli 5 vuotta. Osallistuneille tehtiin kliininen ja neuropsykologinen tutkimus, pään magneettikuvaus, luustontiheysmittaus ja laboratoriotutkimuksia. Tulokset: Tutkimukseemme osallistui 74 nuorta aikuista 18,9 ± 6,1 vuotta hoitojen päättymisen jälkeen. Tutkittavat olivat iältään 28,4 ± 6,8 -vuotiaita osallistuessaan, ja 8,3 ± 4,3 -vuotiaita diagnoosihetkellä. Aivoverisuonisairaus todettiin 52% tutkimukseen osallistuneella 20 vuoden seurannan jälkeen, pienten suonten tauti oli 38 %:lla ja suurten suonten tauti 16 %:lla. Aivoinfarktin oli sairastanut 9 % tutkituista, lakuunainfarktin 10 % ja aivoverenvuodon 3 % tutkituista. Valkean aivoaineen muutoksia todettiin 49 %:lla magneettikuvauksessa. Korkea verenpaine lisäsi aivoverisuonisairauden, suurten suonten taudin, valkoisen aivoaineen muutoksien sekä lakuunainfarktien riskiä. Selviytyjien keskimääräinen kielellinen älykkyysosamäärä oli 89 ± 14 ja ei-kielellinen 87 ± 19. Suurimmat vaikeudet todettiin toiminnanohjauksessa (Z-luku -5,0 ± 5,3 SD) ja prosessointinopeudessa (Z-luku -4,3 ± 5,4 SD). Toiminnanohjauksen ja prosessointinopeuden vaikeudet olivat yhteydessä arkielämän haasteisiin. Sekundaaristen aivokalvokasvainten kumulatiivinen esiintyvyys oli 25 vuoden seuranta-aikana 10,2 % kliinisessä tutkimuksessa ja sekundaaristen kasvainten 2,4 % Syöpärekisteriaineistossa. Matala luustontiheys todettiin 23,6%:lla selviytyneistä. Johtopäätökset: Nuorilla aikuisilla, jotka ovat lapsena aivokasvaimen vuoksi saaneet sädehoitoa, esiintyy useita sellaisia jälkihaittoja, jotka yleensä liittyvät ikääntymiseen.

The past years have seen an incredible increase in the quality and success rates of treatments in pediatric medicine. One of the resulting major challenges refers to the management of primary or secondary residual executive function deficits in affected children. These deficits lead to problems in the ability to acquire, understand, and apply abstract and complex knowledge and to plan, direct, and control actions. Executive functions deficits are important to consider because they are highly predictive of functioning in social and academic aspects of daily life. We argue that current clinical practice does not sufficiently account for the complex cognitive processes in this population. This is because widely applied pharmacological interventions only rarely account for the complexity of the underlying neuronal mechanisms and do not fit well into possibly powerful “individualized medicine” approaches. Novel treatment approaches targeting deficits in executive functions in seriously ill children could focus on neuronal oscillations, as these have some specific relations to different aspects of executive function. Importantly, such treatment approaches can be individually tailored to the individuals’ deficits and can be transferred into home-treatment or e-health solutions. These approaches are easy-to-use, can be easily integrated into daily life, and are becoming increasingly cost-effective.

In Attention Deficit Hyperactivity Disorder (AD(H)D), treatments using methylphenidate (MPH) and behavioralinterventions like neurofeedback (NF) reflect major therapeutic options. These treatments also ameliorate ex-ecutive dysfunctions in AD(H)D. However, the mechanisms underlying effects of MPH and NF on executivefunctions in AD(H)D (e.g. the ability to inhibit prepotent responses) are far from understood. It is particularlyunclear whether these interventions affect similar or dissociable neural mechanisms and associated functionalneuroanatomical structures. This, however, is important when aiming to further improve these treatments. Wecompared the neurophysiological mechanisms of MPH and theta/beta NF treatments on inhibitory control on the basis of EEG recordings and source localization analyses. The data show that MPH and theta/beta NF bothincrease the ability to inhibit pre-potent responses to a similar extent. However, the data suggest that MPH andNF target different neurophysiological mechanisms, especially when it comes to functional neuroanatomicalstructures associated with these effects. Both treatments seem to affect neurophysiological correlates of a‘braking function’ in medial frontal areas. However, in case of the NF intervention, inferior parietal areas are alsoinvolved. This likely reflects the updating and stabilisation of efficient internal representations in order to in-itiate appropriate actions. No effects were seen in correlates of perceptual and attentional selection processes.Notably, reliable effects were only obtained after accounting for intra-individual variability in the neurophy-siological data, which may also explain the diversity of findings in studies on treatment effects in AD(H)D,especially concerning neurofeedback.

The monitoring of cognitive functions is central to the assessment and consecutive management of multiple sclerosis (MS). Though, especially cognitive processes that are central to everyday behavior like dual-tasking are often neglected. We examined dual-task performance using a psychological-refractory period (PRP) task in N = 21 patients and healthy controls and conducted standard neuropsychological tests. In dual-tasking, MS patients committed more erroneous responses when dual-tasking was difficult. In easier conditions, performance of MS patients did not differ to controls. Interestingly, the response times were generally not affected by the difficulty of the dual task, showing that the deficits observed do not reflect simple motor deficits or deficits in information processing speed but point out deficits in executive control functions and response selection in particular. Effect sizes were considerably large with d∼0.80 in mild affected patients and the achieved power was above 99%. There are cognitive control and dual tasking deficits in MS that are not attributable to simple motor speed deficits. Scaling of the difficulty of dual-tasking makes the test applied suitable for a wide variety of MS-patients and may complement neuropsychological assessments in clinical care and research setting.

The dissertation thesis addresses the topic of mathematical tasks processing in students with autism spectrum disorder (ASD) and problematic points of their solution. The aim of this work is to delineate methods that ASD students use to approach these tasks and solve them. We focus primarily on whether it is possible to identify different procedures than those used by typically developing students, and whether these procedures show specifics corresponding to distinct cognitive processes. In the theoretical part we provide a theoretical background for the study. Firstly, we create a frame to understand the complexity of autism, furthermore we deal with psychological theories examining the topic, and describe specifics of development of ASD students during their adolescence. Thereafter, we reflect on studies addressing mathematical skills of ASD students. Mathematics is considered as their great strength, however is not sufficiently scrutinized, as highlighted by various international studies (for example Oswald et al., 2016). The empiric part is based on qualitative methodology and pursues comparisons of mathematical tasks processing between six ASD students and typically developing peers. We strive to document differences and common points in solutions as well as to analyze cognitive processes of...

Syftet med studien var att undersöka om regelbunden fysisk aktivitet respektive kognitiv aktivitet hade samband med kognitiva funktioner i åldersgruppen 65+. Mer specifikt har sambandet mellan regelbunden fysisk aktivitet i termer av total träningsmängd, träningsintensitet (mycket/måttligt ansträngande och promenader) samt total tid stillasittande och de kognitiva funktionerna; exekutiva funktioner, bearbetningshastighet och analytiskt tänkande studerats. 28 individer i åldrarna 65–85 (M = 75.52, SD = 5.15) deltog i studien, varav 14 var kvinnor och 14 var män. Deltagarna rekryterades på lokala gym samt öppna mötesplatser och besvarade ett frågeformulär med bakgrundsfrågor (kön, ålder, utbildningsnivå), deras fysiska aktivitetsvanor (International Physical Activities Questionnaire, IPAQ) samt kognitionsvanor (Florida Cognitive Activities Scale, FCAS). Efter att ha besvarat frågorna genomförde deltagarna kognitiva test som mäter tre olika kognitiva funktioner; exekutiv funktion (via Trail Making Test B, TMT B), bearbetningshastighet (via Trail Making Test A, TMT A, samt Symbol Digit Modalities Test, SDMT) och analytiskt tänkande (via Cognitive Reflection Test, CRT). Modell 2 med prediktorerna total fysisk aktivitet och kognitiv aktivitet var signifikant och förklarade 36% av variansen i TMT A. Modell 3 med prediktorn mycket ansträngande fysisk aktivitet var signifikant och förklarade 11% av variansen i CRT rätt. Modell 7 med prediktorerna mycket ansträngande fysisk aktivitet, måttligt ansträngande fysisk aktivitet och promenader var signifikant och förklarade 25% av variansen i CRT rätt. Positivt signifikanta samband hittades för kognitiv aktivitet och bearbetningshastighet, samt för promenader och analytiskt tänkande. Negativt signifikant samband hittades mellan mycket ansträngande fysisk aktivitet och analytiskt tänkande. Inga signifikanta resultat hittades för de exekutiva funktionerna. Resultaten från föreliggande studie tyder på att en högre grad av kognitiv aktivitet är relaterat till bättre bearbetningshastighet, mer promenader är relaterat till bättre förmåga till analytiskt tänkande, samt att en högre grad av mycket ansträngande fysisk aktivitet är relaterat till sämre förmåga till analytiskt tänkande. / The purpose of the study was to examine the association between regular physical and cognitive activity and cognitive functioning in an older population. More specifically the association between regular physical activity in terms of total amount of exercise, exercise intensity (vigorous / moderate strenuous and walks), plus total amount of time spent sitting during a day and the cognitive functions; executive function, processing speed and analytical thinking. Twenty-eight participants between 65-85 years of age (MD = 75.52, SD = 5.15) partook in the present study, of which 14 were women and 14 were men. The participants were recruited at local gyms and public meeting places and answered a questionnaire including background questions (gender, age, educational level), their physical activity habits (International Physical Activities Questionnaire, IPAQ) and cognitive activity habits (Florida Cognitive Activities Scale, FCAS). After answering the questions, the participants performed cognitive tests to measure the three cognitive functions; executive function (through Trail Making Test B, TMT B), processing speed (through Trail Making Test A, TMT A, and Symbol Digit Modalities Test, SDMT) and analytical thinking (through Cognitive Reflection Test, CRT). Model 2 with the predictors' total physical activity and cognitive activity was significant and explained 36% of the variance in TMT A. Model 3 with the predictor vigorous strenuous physical activity was significant and explained 11% of the variance in CRT Correct. Model 7 with the predictors' vigorous strenuous physical activity, moderate strenuous physical activity and walks was significant and explained 25% of the variance in CRT Correct. Positive significant associations were found between cognitive activity and processing speed, as well as between walks and analytical thinking. Finally negative significant associations between vigorous strenuous activity and analytical thinking was found. No significant results were found for executive functions in the present study. The results from the current study suggests that higher degrees of cognitive activity is related to better processing speed, more walks are related to better analytical thinking, and that a higher degree of vigorous physical activity is related to poorer ability of analytical thinking.

Le début de la scolarisation implique de nombreuses contraintes, qui ne sont pas toujours adaptées à de jeunes enfants, notamment quant aux attentes attentionnelles irréalistes. Dans une optique préventive, il importe d’outiller les jeunes apprenants à faire face aux différents défis qu’ils rencontrent à leur entrée à l’école. Le yoga semble des plus bénéfiques pour étayer les élèves à cet égard puisque cette discipline permet de développer une aptitude permettant de demeurer dans l’instant présent, en ne se laissant plus distraire par les pensées ou stimuli externes, ce qui soutiendrait ainsi les enfants à s’engager dans leurs apprentissages. L’intervention mise en œuvre dans ce mémoire s’appuie sur l’ensemble des branches du yoga définies par Patanjali, sans omettre l’aspect éthique de cette pratique ancestrale travaillé grâce à la littérature jeunesse, élément fréquemment délaissé dans l’occidentalisation du yoga qui ne retient souvent que les postures physiques. Le modèle du Bucheton et Soulé (2009) a servi de bases pour appréhender la pratique enseignante, dans une optique réflexive de l’action enseignante, de manière à peaufiner l’intervention. L’approche retenue est principalement qualitative, bien que certains outils quantitatifs aient été retenus. Ces derniers ne se sont pas avérés significatifs étant donné la brève durée de l’intervention de 3 mois. Pour examiner l’impact sur l’attention et la régulation émotionnelle, des études de cas ont été réalisées. Il en ressort que l’intervention s’est révélée efficace pour l’ensemble des participants (N=8) de manière variable selon leur tempérament et leurs besoins prioritaires. Les retombées des résultats ont conduit à énoncer 16 recommandations pour une pratique du yoga en contexte de classe. / The beginning of schooling involves many constraints, which are not always suitable for young children, notably in regard to unrealistic attention expectations. From a preventive perspective, it is essential to tool young learners to face the different challenges they encounter upon entering school. Yoga seems to be most beneficial for supporting students. Since this discipline allows them to develop an ability to remain in the present moment, by not being distracted by external thoughts or stimuli, which would thus support children to engage in their learning. The intervention implemented in this thesis is based on the branches of yoga defined by Patanjali, without omitting the ethical aspect of this ancestral practice developed through children’s literature, an element often neglected in the westernization of yoga, who often only retains physical postures. The Bucheton and Soulé model (2009) served as the basis to grasp the teaching practice, from a reflective perspective of the teaching action, so to refine the intervention. The approach adopted is mainly qualitative, although certain quantitative tools have been retained. The latter were not found to be significant given the short duration of the 3 months intervention. To examine the impact on attention and emotional regulation, case studies were carried out. It turns out that the intervention was effective for all participants (N=8) in varying ways depending on their temperament and their priority needs. The impact of the results led to the formulation of 16 recommendations for a yoga practice in the classroom context.

The present study examined attachment disorganization and executive function as predictors of adolescent risky behavior. Additionally, the present study examined how attachment disorganization and executive function may differentially predict adolescent risky behavior for males and females. Measures of executive function, mother-infant attachment, adolescent risky behavior, family income, and gender were obtained from adolescent participants of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD-SECCYD). Data was analyzed through structural equation modeling (SEM). Executive function, attachment, and risky behavior were unrelated in the study sample. Income was a significant predictor of attachment for females, but not males. Income was an equal and significant predictor of executive function for both males and females. Income was also a significant predictor of risky behavior for males and females, though a stronger predictor for females. Limitations and ideas for future research were discussed.