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O teste do desenho do relogio no rastreio diagnostico da demencia de Alzheimer em idosos no Brasil / The clock drawing test in diagnostic screening of Alzheimer's disease in Brazil elderlyAprahamian, Ivan 12 August 2018 (has links)
Orientador: Monica Sanches Yassuda / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-12T04:01:55Z (GMT). No. of bitstreams: 1
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Previous issue date: 2008 / Resumo: O Teste do Desenho do Relógio (TDR) é o segundo teste mais utilizado no mundo para o rastreio das demências. Contudo, há ainda dúvida sobre seu papel no processo diagnóstico da demência em termos de sensibilidade, especificidade, forma de aplicação e análise. OBJETIVOS: avaliar o desempenho do TDR no processo diagnóstico de uma amostra de idosos brasileiros portadores e não portadores da doença de Alzheimer (DA). Avaliar a sensibilidade (S) e a especificidade (E) do TDR, segundo as escalas de Shulman, Mendez e Sunderland, com as do Mini-Exame do Estado Mental (MEEM) e do Cambridge Cognitive Examination (CAMCOG), a bateria neuropsicométrica do Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). METODOLOGIA: Estudo retrospectivo no qual foram analisados prontuários de pacientes idosos, 121 com DA e 99 controles normais, submetidos ao CAMDEX entre os anos de 2002 e 2007 dentro do Instituto de Geriatria e Gerontologia de Jundiaí seguindo protocolo padronizado. Todos os pacientes avaliados neste estudo passaram por avaliação médica detalhada anterior à realização do CAMDEX, incluindo exames laboratoriais e de neuroimagem. O CAMDEX apresenta duração média de duas horas, incluindo o CAMCOG, a bateria neuropsicométrica, que possui o MEEM e o TDR em sua avaliação. O TDR foi analisado separadamente utilizando-se três escalas comumente utilizadas na literatura (Shulman, Mendez e Sunderland). Os resultados do TDR foram comparados com os do CAMCOG e do MEEM. RESULTADOS: Encontrou-se correlação significativa entre os resultados do TDR com os do MEEM (0,700 - 0,730; p < 0,001) e do CAMCOG (0,753 - 0,779; p < 0,001). As três escalas de TDR utilizadas apresentam resultados semelhantes, sendo a melhor a escala de Shulman (S = 74,2 - 84,8%; E = 66,7 - 89,9%). A utilização conjunta do TDR com o MEEM melhora a sensibilidade e especificidade no rastreio cognitivo dos pacientes (S = 89,2 - 90%; E = 71,7 - 79,8%). Houve aumento da S e E do TDR com a baixa escolaridade. CONCLUSÃO: O TDR é um bom teste de rastreio quando comparado com o MEEM e o CAMCOG, independente da escala de interpretação utilizada. A combinação do TDR com o MEEM melhora seu rendimento. A influência da escolaridade merece estudo posterior. / Abstract: The Clock Drawing test (CDT) is the second most used test in the world for the screening of dementia. Although, there is still doubt over its paper in the diagnostic process of dementia in terms of sensitivity, specificity, application and interpretation. OBJECTIVES: evaluate the performance of the CDT in diagnostic process of a Brazilian elderly sample with and without Alzheimer's disease (AD). Evaluate the sensitivity (SE) and specificity (SP) of CDT, according to Shulman, Mendez and Sunderland, with the Mini-Mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG), the neuropsychiatric battery of the Cambridge Examination for Mental Disorder of the Elderly (CAMDEX). METHODS: Retrospective study of 121 AD and 99 elderly controls medical charts that were submitted to the CAMDEX following a standardized protocol between 2002 and 2007 at the Jundiai's Geriatric and Gerontology Institute. All subjects were clinically evaluated and submitted to laboratory and neuroimaging studies. The CAMDEX has a mean time of two hours, including the CAMCOG, a neuropsychiatric battery that has the MMSE and the CDT in its evaluation. The CDT were analyzed separately using three common scales ((Shulman, Mendez and Sunderland). The results of the CDT were compared with the CAMCOG and the MMSE. RESULTS: There were significant correlation between the results of the CDT and the MMSE (0,700 - 0,730; p < 0,001) and between the CDT and the CAMCOG (0,753 - 0,779; p < 0,001). The three CDT scales showed similar results, but the Shulman's scales was slightly better (SE = 74,2 - 84,8%; SP = 66,7 - 89,9%). The combination between the CDT and the MMSE improved sensitivity and specificity in the cognitive screening of the subjects (SE = 89,2 - 90%; SP = 71,7 - 79,8%). There was improvement of sensitivity and specificity in patients with low level of formal education. CONCLUSION: The CDT is a good screening test when compared with the MMSE or the CAMCOG, independently of the scale used for its interpretation. The combination with the MMSE improves its performance significantly. The influence of education in the CDT deserves further studies. / Mestrado / Mestre em Gerontologia
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Avaliação neuropsicológica de crianças e adolescentes com hiperfenilalaninemias / Neuropsychological evaluation of children and adolescents with hyperphenylalaninaemiaDutra, Vivian de Freitas, 1985- 23 August 2018 (has links)
Orientadores: Maria Augusta Santos Montenegro, Catarina Abraão Guimarães / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-23T02:13:36Z (GMT). No. of bitstreams: 1
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Previous issue date: 2013 / Resumo: A fenilcetonúria é um erro inato do metabolismo, com incidência entre 1:10000 e 1:15000 nascidos vivos. Trata-se de uma doença de herança autossômica recessiva, caracterizada pela deficiência da enzima hepática fenilalanina hidroxilase ou de seu co-fator tetraidrobiopterina, que, na rota metabólica normal, são responsáveis por converter a fenilalanina em tirosina. O acúmulo de fenilalanina é tóxico ao Sistema Nervoso Central. O défict nos níveis de tirosina leva ao desequilíbrio metabólico que pode causar hipotonia, irritabilidade, letargia, tonturas, microcefalia, características autistas, défict cognitivo e atraso de desenvolvimento. O tratamento é baseado na dieta restrita em fenilalanina. Quando a dieta é iniciada precocemente, o prognóstico cognitivo é bom e os pacientes apresentam QI dentro da média. Embora não haja rebaixamento de QI, alguns estudos mostram que os resultados de avaliação neuropsicológica dos pacientes são piores do que irmãos e pares sem a doença, especialmente com relação a funções executivas. O objetivo deste trabalho foi avaliar e comparar o desempenho de crianças e adolescentes com fenilcetonúria tratados em um Serviço de Referência no Brasil em provas neuropsicológicas de memória e funções executivas, e comparar com aquele apresentado por pares sem a doença. Participaram do estudo 12 crianças e adolescentes com fenilcetonúria leve, oito com hiperfenilalaninemia permanentemente e uma com fenilcetonúria clássica. A idade do grupo caso índice variou entre seis e 15 anos (m=9,52±2,82). O grupo controle foi formado por 21 crianças e adolescentes com idade entre seis e 14 anos (m=9,19±2,84), recrutados em uma escola de rede municipal. Como instrumento para a avaliação neuropsicológica foi utilizada a Escala de Inteligência Wechsler para crianças (WISC-III, 2002) e uma bateria para avaliação de funções executivas, incluindo o Teste de Trilhas, Teste de aprendizagem verbal de Rey, Teste de aprendizagem visual de Rey, teste de fluência verbal FAS e categoria "animais", teste de Stroop e Torre de Hanói. Os dados foram armazenados e analisados com programa estatístico SPSS - Statistic Package for Social Sciences, versão 13.5, considerando o nível de significância de 5%. Não foram encontradas diferenças significativas entre o desempenho do grupo de pacientes e o grupo controle, para nenhum dos achados neuropsicológicos. Apenas uma criança neste estudo apresentou diagnóstico de PKU clássica, a forma da doença com pior prognostico cognitivo. A média de idade de diagnóstico dos participantes foi de 35 dias e 75% dos participantes apresentaram resultados de exame de PHE<8,0 no ano anterior à avaliação neuropsicológica. Os achados concordam com a literatura que indica a importância do tratamento para garantir um bom desenvolvimento cognitivo. Futuros estudos podem avaliar também funções não executivas, e estudos colaborativos entre diferentes centros de tratamento podem fornecer uma amostra mais significativa da população estudada / Abstract: Phenylketonuria is an autossomal recessive metabolic disease caused by a mutation in the gene for the hepatic enzyme phenylalanine hydroxylase which makes it nonfunctional. It is one of the most common inborn errors of metabolism, with an incidence of 1:10000 to 1:15000 live births. Accumulation of PHE is toxic to the central nervous system. Low levels of tyrosine add to the metabolic abnormality and patients may present hypotonia, irritability, lethargy, dizziness, microcephaly, autistic features, cognitive impairment and developmental delay. The standard treatment is based on a lifelong diet with low levels of phenylalanine. When PKU restricted diet is started early in life, the cognitive outcome is excellent, and patients have normal IQ. Although there is no cognitive impairment, some studies showed that their neuropsychological scores might be lower than the ones of their peers and siblings, especially regarding executive functions. The objective of this study was to evaluate the neuropsychological performance of children and adolescents with the different types of hyperphenylalaninemia treated at a tertiary center in Brazil and compare with a control group with similar age and socioeconomic level. 12 children and teenagers with mild PKU, eight with HPA and one with classic PKU were evaluated. Age ranged between six and 15 years (m=9,52±2,82). Control group were formed by 21 non-pku children and teenagers with ages between six and 14 years (m=9,19±2,84), recruited in a public school. Neuropsychological evaluation was performed using the Wechsler Inteligence Scale for Children-III (WISC-III, Stroop Test, Rey Auditive Verbal Learning Test (RAVLT), Rey Visual Design Learning Test (RVDLT),Trail Making Test (TMT), Verbal Fluency Test (categorie: animals and letters F,A,S) and Hanoi Tower. This study was approved by the Ethical Committee of our institution. Statistical analysis was performed using the Statistical Package for Social Sciences for Personal Computer (SPSS/PC), Version 13.5; with a level of significance of 0.05. There was no difference regarding the neuropsychological findings between both the hyperphenylalaninemia and mild phenylketonuria groups and control group. One children in this study had classic PKU. Mean diagnostic age was 35 days and 75% of participant's present PHE concentrations < 8,0 mg/dl. These findings are in concordance to literature that indicates the importance of dietetic treatment for an adequate cognitive outcome. Further research could also evaluate non-executive functions and collaborative studies between different centers could provide a larger sample size / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas
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The neurocognitive effects of immunosupression in the AIDS dementia complexKirkby, Lana 18 February 2014 (has links)
M.Sc. (Research Psychology) / Please refer to full text to view abstract
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A Quantitative Analysis of Cognitive Impairments Following Breast Cancer TreatmentOuimet, Lea Ann Maria January 2011 (has links)
One in nine North American women will be diagnosed with breast cancer in their lifetime and most will receive chemotherapy as part of their treatment. Although advances in treatment have increased survivorship, some research suggests chemotherapy results in cognitive deficits in a subset of recipients, a condition known as chemo-fog, thereby compromising quality of life. However, inconsistencies in methodology and neuropsychological assessment have complicated comparison of findings. The first objective of this thesis was to review the methodological issues with an emphasis on the quantitative techniques typically employed. A comparison of group and individual based analyses found negligible effects for both univariate and multivariate approaches while individual based analyses identified severe declines in function in a subset of participants. A standardized-regression based (SRB) approach was recommended as the method of choice. Furthermore, it was recommended that the number of tests be limited since comprehensive batteries can complicate identification due to increased risk of misclassification. Therefore, the second goal of the thesis was to evaluate the sensitivity of a reduced battery to the declines associated with chemo-fog. A comprehensive neuropsychological battery comprising 23 tests was compared to a subset of nine tests. SRB analyses demonstrated that a more selective battery was equally useful and may be appropriate for identification of chemo-fog. Given the variability in the composition of neuropsychological test batteries, the final aim of this thesis was to compare the structure of the theoretical cognitive domains with ones identified through exploratory factor analyses (principle axis factoring) to evaluate the convergence between the two. The results demonstrated there is statistical support for the conceptual framework that underlies the composition of the domains. The contributions of this thesis include providing methodological guidelines for those conducting future research in this area to ensure that results are comparable across studies and are meaningful, and evaluating the utility of a screening battery to facilitate identification of chemo-fog. In addition, it was demonstrated that despite the lack of professional guidelines informing the selection and construction of neuropsychological test batteries, there is statistical evidence to support the practice of grouping tests into domains based on theoretical grounds.
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The psychometric assessment of the re-employability (on a labourer level) of the brain-damagedErasmus, Cindy 05 September 2012 (has links)
M.A. / Certain topics almost have an interdicted status surrounding them. Avoidance of the unknown is a common reaction displayed by people especially when it involves a condition that strips another of normality. One such topic is brain damage. This study was undertaken to provide an alternative method of viewing a condition that is known to affect many individuals. Brain damage may be acquired by anyone at any point in time as a result of the forces of nature, such as illnesses or intervention of mankind, such as motor vehicle accidents. It seems more valuable to research the issue and provide some resolve, than to ignore or avoid it. To ensure that a well-founded study was accomplished one dimension of daily living affected by head injuries, was focused upon. Re-employability of labourers following mild to moderate brain damage was the area selected for this study. To achieve this objective, a psychometric battery which assesses the capabilities of an unskilled or semiskilled labourer with brain damage, has been designed. In order to assess the validity of the battery, it was administered to two groups of individuals. The first group constituted 25 brain-damaged labourers and the second group consisted of 100 normal labourers. By comparing the performance of the two groups, it became possible to determine whether the battery was feasible as an instrument of skill disparity. The data accumulated by the study showed that the battery does have the capability of distinguishing between the groups. A significant result of this study is that there now appears to be a method of differentiating between the jobrelated skills retained by brain-damaged labourers as opposed to normal labourers. This infers that the instrument has the capacity to assess how close to normal the skill competencies of injured persons are. In this setting this invariably implies an evaluation of the reemployability status of a person. Brain-damaged individuals are thereby given some recourse to determine their future work prospects and are provided with some clarity on one dimension of their functioning.
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Psychological characteristics contributing to performance on neuropsychological tests and effort testing.Hilborn, Robert Scott 08 1900 (has links)
The issue of effortful patient performance has been an area of clinical interest in individuals with minor traumatic brain injury (mTBI). Clinical attention to this area has increased largely because of an increase in the number of worker's compensation claims, injury-related lawsuits and/or insanity defense pleas. As patients are presented with the opportunity for secondary gain, the issue of optimum performance on neuropsychological measures becomes salient. In addition to neurocognitive deficits, there are psychological characteristics associated with mTBI including depression, emotional disturbance, personality changes, and other psychopathology. This study utilized the MSVT, a set of standard neuropsychological instruments, and the Minnesota Multiphasic Inventory-2 (MMPI-2) to investigate the relationships between effort, psychological characteristics, and neuropsychological functioning in individuals with minor traumatic brain injuries. The first objective of this study was to determine which psychological factors were related to effort in mTBI. The second objective was to determine if there were differences between groups that performed poorly on effort testing and groups that performed adequately on effort testing, based on relevant psychological characteristics. The results of the analyses supported the first hypothesis. Hysteria was inversely related to effort, and Mania was positively related to effort on one of five measures of effort. The second hypothesis was not supported.
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The Contribution of Bilingualism to Cognitive Functioning and Biological Markers in the Progression of Normal and Abnormal AgingUnknown Date (has links)
Controversy surrounds the idea that bilingualism leads to enhanced executive function (EF) and brain volume changes, potentially leading to delays in cognitive decline and dementia onset. The purpose of this research was to explore these claims in a sample of elderly monolinguals and bilinguals. This study explored gray matter volume (GMV) in 214 monolinguals and bilinguals (Mage = 71.21, SD = 7.53) who were cognitively normal (CN) or diagnosed with Mild Cognitive Impairment (MCI) or dementia. Neuropsychological performance was also examined between CN and MCI monolinguals and bilinguals (N = 153) across two visits. Scores from the Digit Span Backwards, Stroop interference, Trail Making Test A minus Trail Making Test B, and category fluency average scores were used. Magnetic Resonance Imaging (MRI) brain regions associated with memory, language, and EF were selected. Additionally, the study examined how a Bilingualism Index (BI) and the age of acquisition of English could predict GMV and EF in Spanish/English bilinguals whose native language was Spanish.
Lastly, the initial age of cognitive decline across language groups was compared. Results suggested higher GMV in language and EF regions in bilinguals, but differences were not found in memory regions. Furthermore, neuropsychological performance over time did not vary across language groups; however, bilinguals exhibited reduced Stroop interference as well as lower scores on Digit Span Backwards and category fluency. The age of acquisition of English did not predict GMV or EF scores, while the BI predicted category fluency, with lower scores associated with a higher degree of balanced bilingualism. Overall, the influence of bilingualism appears to be reflected in increased GMV in specific language and EF regions relative to neuropsychological performance. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection
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Provisional formulation of normative data for semi and unskilled black and coloured workers on the Trail making TestDaly, Nigel January 1988 (has links)
Includes bibliography. / This study provides a provisional normative range of performance for the South African semi- and unskilled black and coloured population groups on the Trail Making Test. One hundred and six black and coloured semi- and unskilled workers from the Groote Schuur Hospital in Cape Town, satisfying the criteria of 8 years or less of formal education, with no neurological impairment or psychopathology, and some degree of literacy, were randomly selected. Parts A and B of the Trail Making Test were then administered and scored, and the scores reported in tabular form, broken up in terms of race, age and education. A statistical analysis (multiple linear regression) was applied to the data and additional information on the effects of age, education and sex on test performance briefly discussed in terms of previous research findings. The results of this study add weight to Dugmore's (1987) assertion that existing norms currently in use for the Trail making Test are invalid for these population groups. Limitations of the study and suggestions for further research were also briefly discussed.
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Driving Performance and Its Correlation with Neuropsychological Tests in Senior Drivers with Cognitive Impairment in Japan / 日本の認知障害のある高齢ドライバーにおける運転技能と神経心理学的検査との相関Peng, Zhouyuan 23 March 2021 (has links)
京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第23129号 / 人健博第91号 / 新制||人健||6(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 澤本 伸克, 教授 十一 元三, 教授 髙橋 良輔 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM
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Neuropsychological Sequelae of Adult Subjects with Retinopathy of Prematurity Compared to Other Blind PopulationsO'Brien, Eugene Patrick 08 1900 (has links)
The blind have generally been considered to be a homogeneous population whose deficits arise from an interaction of loss of vision, age of onset and socialization. Sequelae are posited to exist merely due to the limiting effects of blindness on experience. This is believed to affect all blind persons equally regardless of cause of blindness provided that independent secondary disabilities do not exist. This study investigated the possibility that different causes of blindness are related to specific neuropsychological deficits which cannot be explained by the mere presence of blindness. It was found that neuropsychological differences existed among specific sub-populations of blind persons. These results suggested that the cause of blindness may be a marker for specific Central Nervous System involvement.
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