Rasmussen syndrome (RS) is a rare encephalitis characterized by inflammation of one cerebral hemisphere that causes atrophy, neurological and cognitive impairment. We present a 42-year-old female patient, with no significant previous history and diagnosed with epilepsy since she was 24 years old, epileptic seizures are reported in different time windows with temporary cessation, but with constant reinstallations of acute and drug-resistant episodes. Neurological examination revealed hyperkinesia of the extremities, with persistent flexion and extension movements. The neuropsychological evaluation carried out with the MoCA test, Rey’s complex figure and Token test, shows severe cognitive impairment with psychiatric symptoms. In addition, electroencephalogram results show unilateral hemispheric slowing with unilateral focal onset and MRI evidence of generalized atrophy of the left hemisphere, elements supporting the diagnosis of late-onset RS. Finally, information is offered about the associated neuropsychological manifestations.
neuropsychology
Análisis neuropsicológico en un caso de Afasia Global. Neuropsychological analysis in a case of Global Aphasia.
Acquired brain damage generates a series of neuropsychological alterations, among which we can highlight aphasia. This syndrome is characterized by language impairment, with its main features being deficits in fluency, comprehension, repetition, naming, reading, writing and calculation. In this article we present the case of a patient suffering from global aphasia, who presents severe linguistic alterations. The state of the disease and its neuropsychological condition are analyzed. Finally, we close this analysis, highlighting the need for a correct neuropsychological approach at the level of diagnosis and rehabilitation which can help the patient.
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Asociación entre Inflamación y Desempeño Cognitivo en Adultos: Revisión Sistemática en PubMed 2017-2022. Association Between Inflammation And Cognitive Performance In Adults: Systematic Review In Pubmed 2017-2022.
Introduction: The decline of cognitive functions is one of the main negative changes associated with aging. In recent years, interest has grown in determining whether inflammation affects cognitive decline and to what extent. The objective was to review the literature for studies that investigated the association between inflammation and performance in specific cognitive domains (example, memory, attention, or language), and in adults of all ages.
Methods: The PubMed database was consulted between 2017-2022. A systematic review was carried out according to the PRISMA statement and 27 scientific articles were selected.
Results: 26 out of 27 articles warned that greater inflammation is associated with poorer performance in attention, memory, executive functions, language, and processing speed, among the main cognitive domains. The evidence includes adults of various ages with and without a history of inflammatory or neuropsychiatric disease. Eight longitudinal studies indicated that inflammation is an important predictor of cognitive decline.
Conclusion: The reviewed studies suggest that a higher level of inflammation is associated with worse performance in specific cognitive domains, with evidence for adults of different ages, with and without a history of disease. Some methodological recommendations are offered to improve the comparability between studies.
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Análisis neuropsicológico de un caso de daño talámico. ¿Por qué el paciente presenta una nueva holgazanería y una ingenuidad adquirida?. Neuropsychological analysis of a case of thalamic damage. Why does he present a new laziness and acquired naiveté?.
Acquired brain damage is a topic of central interest in neuropsychology, since it allows us to understand the relationship between cognition, behavior and emotion with pathological brain functioning. On this occasion, we present a case with a cerebrovascular disease that, as a result of damage at the thalamic level, presents executive, emotional, linguistic, and memory disorders. This is a 52-year-old patient who presents signs and symptoms such as personal insouciance, lack of motivation to seek employment, problems regulating his behavior, among others. We analyze the case regarding the role of the thalamus in global brain functioning and the need to carry out a correct follow-up with the patient.
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Propiedades psicométricas del test de evaluación neuropsicológica – Neuropsi en población peruana. Psychometric properties of the neuropsychological evaluation test – Neuropsi in peruvian population
This research aims to estimate the psychometric properties of the neuropsychological assessment instrument – Neuropsi in patients treated in the Neurology area of a public hospital in Peru. The study is of a technological, psychometric type, of a non-experimental and cross-sectional design and is oriented through a quantitative approach. We worked with a non-probabilistic sample of 432 medical records of elderly patients who were diagnosed with or without cognitive disorders or dementia, to whom the brief neuropsychological assessment instrument in Spanish – Neuropsi was applied. A factor analysis was found that reports a good fit in a 6-factor model with X2 = 2.825, CFI = 0.990, GFI = 0.986, PNFI = 0.460, AIC = 47.774, SRMR = 0.0196, RMSEA = 0.065 and the Cognitive performance differs according to the age range of the patient. In addition, it has a Cronbach’s alpha reliability of .863. These findings suggest that the instrument is valid, short, accurate, and adequate for measuring cognitive performance.
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Práctica de la neuropsicología en Ecuador. Practice of neuropsychology in Ecuador
Objectives: To explore the current state of neuropsychology practice in Ecuador through the administration of an online survey.
Methods: A total of 48 professionals working in the field of neuropsychology completed an online survey between August 2018 and December 2019.
Results: The majority of the participants were female (62.5%), with a mean age of 37.23. 87.5% report having received postgraduate neuropsychology training. Most are employed in private practice, universities and/or clinics, and report being satisfied with their work. The most commonly treated diagnoses are Attention Deficit with Hyperactivity Disorder (ADHD), learning disabilities and language disorders. The three main barriers identified for the development of neuropsychology are the lack of academic training programs, the lack of clinical training programs and the lack of willingness to collaborate among professionals.
Conclusions: The practice of neuropsychology in Ecuador is on par with that of Latin America. However, certain changes are needed, such as increasing academic and clinical training programs in the area, formalizing regulations that guarantee quality and standards in practice, and continuing to standardize and validate neuropsychological tests in the country.
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Uso de la Escala de Inteligencia de Adultos de Wechsler-IV para la evaluación neuropsicológicas en Ecuador. The Wechsler Adult Intelligence Scale-IV for use in Neuropsychological Assessments in Ecuador
An important part of cognitive status evaluation is the determination of general cognitive ability. However, the most common tests are not standardized for use in Ecuador. This has limited the extent and accuracy of clinical neuropsychological assessments within the country. We used the 7-subtest Wechsler Adult Intelligence Scale-IV (WAIS-IV) with 155 mainly city-living Ecuadorian adults, recruited from a range of socioeconomic backgrounds around 4 different sites in Ecuador. The sample was matched to the Ecuadorian urban population for gender, education, and ethnicity. We show that this version of the WAIS-IV is a reliable and valid assessment for this context. In addition, we provide a method to adjust standard scores derived from the Spanish population, and used in the WAIS-IV manual, so that they are more appropriate for use in Ecuador. These can potentially be used to calculate full IQ scores. We also describe methods of comparing the Ecuador-adjusted standard scores so that they can be used in clinical neuropsychological evaluations of Ecuadorian adults.
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Estructura Factorial del Funcionamiento Neuropsicológico en la Discapacidad Intelectual Leve en Niños. Factorial Structure Of Neuropsychological Functioning In Mild Intellectual Disability In Children.
An exploratory factor analysis was performed to establish the factor structure of neuropsychological functioning in mild intellectual disability in children. It was a quantitative, descriptive and cross-sectional study. Eighty children with a diagnosis of mild intellectual disability were included. An extensive battery of neuropsychological tests was applied. An Exploratory Factor Analysis was performed to identify the main factors. The results showed that mild intellectual disability in children has a structure in which the neuropsychological functions associated with executive functioning explain 56% of the variance and have a factor priority over 13%, which explains the variables associated with two traditional tests for assess intelligence. Each factor is analyzed and discussed from clinical and experimental neuropsychology. The study findings have theoretical and clinical implications for differential diagnosis.
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Adaptación Lingüística de la Batería de Evaluación Neuropsicológica “BREV” en Una Población de Escolares Ecuatorianos. Linguistic Adaptation Of The Neuropsychological Evaluation Battery “BREV” In A Population Of Ecuadorian Schoolchildren.
This article reports the process followed for the linguistic adaptation of the Neuropsychological Assessment Battery “BREV” in a population of Ecuadorian school children. The translation-back-translation method was used. The final version of the test was applied to a pilot sample of 100 schoolchildren from the city of Cuenca – Ecuador. The piloting revealed results similar to the original version in most of the subtests, however, there are still certain adaptation errors at the level of some terms and stimuli of the test that must be corrected. The statistical results demonstrated a significance of 5% (p <0.05) in the correlations between the performance of each subtest and the age of the Ecuadorian children. It was concluded that the final version of the linguistic adaptation of the Battery “BREV” obtained in this first part of the investigation similar results to the original version; but a statistical analysis by retest is necessary to ensure the equivalence and reliability of the adapted instrument with respect to the original French test.
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Diseño y validación de un paradigma para evaluar la atención selectiva, utilizando el software de código abierto “PsychoPy”, aplicable a la Resonancia Magnética Funcional. Design and validation of a paradigm to evaluate selective attention, using the open source software “PsychoPy”, applicable to Functional Magnetic Resonance.
Introduction: Selective attention is a neuropsychological function involved in carrying out activities, from the simplest to the most complex, guiding us towards the search for relevant elements for the achievement of proposed tasks and inhibiting other responses.
Objective: Design and validation of the paradigm to evaluate selective attention.
Methodology: Quantitative study, exploratory-descriptive, experimental. The instrument was designed in three stages: 1) elaboration of the paradigm, 2) validation of the construct and content, 3) Field test and data analysis applied to 18 healthy adults, selected in a non-probabilistic way, between 18 and 30 years old. The paradigm was developed virtually in “PsychoPy”, based on the d2 test and adapted for the Magnetic Resonator.
Results: High scores were found in the evaluation of selective attention and the average time of correct answers is adequate in relation to the amount of work. When analyzing the influence of age and sex with the frequency of correct answers, no statistically significant differences were found.
Conclusions: The selective attention paradigm is a complementary prognostic tool, useful to assess this function, because it has construct and content validity; being a safe, free and easy-to-apply instrument.
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Modelos de Organización Cerebral: un recorrido neuropsicológico. Brain Organization Models: a neuropsychological journey
There has always been an interest in understanding how the human brain functions in relation to behavior and cognition. An approach that seeks to solve this intrigue lies in the proposal of models of brain organization that try to explain how the work of the brain mass is. In this sense, this article proposes a theoretical review of the main models. Jackson proposes a theory where three levels of brain structure are considered: lower or medullary level, middle level, and higher level. McLean postulates the existence of three brains: reptile, paloemamiferous / limbic and neocortex. The Wernicke-Geswind model manifests the interaction of language structures in favor of brain function. Luria’s model of brain organization highlights the interactive role of three functional units: first, in charge of regulating tone and wakefulness; second, it receives, processes and stores the information; and the third, plans, monitors and verifies mental and behavioral activity. This review highlights the high complexity involved in the work of the human brain. This article closes highlighting the need to carry out research that can generate empirical evidence in favor of understanding the efficacy of each of the models described in this work.
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Cerebelo: No Sólo Función Motora – A Propósito de un Caso. Cerebellum: Not Just Motor Function – About A Case.
The cerebellum constitutes a nervous structure with multiple bidirectional connections with the prefrontal cortex. This relationship allows us to understand its importance on neurocognitive processes. Multidisciplinary evaluation of neurological conditions allows us to study in depth its impact on the emotional and cognitive sphere.
Present case study aims to analyze the neurological and neuropsychological characteristics of a 64-year-old patient with cerebellar degeneration (novo progressive cerebellar atrophy) , which has 15 years of evolution but evaluated by the neuropsychology area the last four years.
After clinical evaluation carried out in two stages, and after check standardized neurocognitive tests, significant qualitative data are observed. A progressive decline in the patient’s neurocognitive sphere is evident, mainly in executive processes, such as bradypsychia, attention deficit, cognitive rigidity, foresight deficit, and categorical evocation.
The results suggest deterioration evidenced probably related to underlying cerebellar disorder, and evidence of cortex-cerebellar circuits, such dysfunction will influence on neurocognitive processes of executive type.
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Análisis neurofutbolístico de Loris Karius: de la gloria al infierno. Loris Karius neurofutbolistic analysis: from glory to hell.
In the soccer context there have been huge errors that have cost the teams dearly. Sometimes they occur due to nerves or deconcentration, however, according to our clinical eye, sometimes the brain plays a trick and its malfunction, the product of traumatic brain injury that occurred in the same game, is what determines the score of an encounter. This is what happened to the Liverpool goalkeeper in the final of the 2018 Champions League, who, from our neuro-soccer reflection, had errors that cost him the match, due to an affectation of the cerebral magnocellular pathway that allows processing spatial visual perceptual information. In the featured article, we reflect on his brain state before and after the trauma suffered and highlight that a footballer who is awake and expressing that he can continue, is not necessarily an individual with his brain preserved, since it may be only a part of his brain mass speaking, but, as seen in Karius, however, other silencers may have been altered. We close the work by highlighting the need to incorporate neuropsychological knowledge to understand the effect of trauma on the playfield, since this work confirms that humans do not play soccer with their legs or hands, they do so with your brain.
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Percepción de Los Padres de Niños Con Déficit Ejecutivos Que Presentan Dificultades en el Aprendizaje de Matemáticas. Parental Perception In Children With Executive Deficits Who Have Learning Difficulties In Mathemathics
The main objective of this research is to describe the executive deficits of children with learning difficulties in mathematics and their relationship with parental perceptions. A sample of 30 children with difficulties in mathematics at ages between 9 and 12 years was studied, they underwent Tower of London test, and to the parents the Children’s Inventory of Executive Functions (CHEXI) was studied. According to the applied tests, the results showed difficulties in working memory, planning, regulation and inhibition. The results showed no correlation between the executive deficits evidenced in children and the perception of parents. However, there is a positive relationship between the perception of parents in the area of working memory and poor academic performance. The results are discussed by the complexity of the evaluated construct and the multiple variables involved at the time of its clinical assessment.
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El Pensamiento Moral Después del Daño Cerebral Adquirido. Moral Thought After Acquired Cerebral Damage.
Introduction. Moral thinking is a mental skill that allows respecting implicit and explicit social norms. One factor that can alter its functioning is acquired brain damage, as is the case of subjects who have suffered a brain injury at the frontal lobe. Aim. To analyze the relationship between the process of moral thinking and brain functioning, through the description of cases that have suffered acquired brain damage, with the purpose of explaining the situation that an individual lives after presenting brain damage and becoming unable to respect social norms. Development. The clinic of patients who have suffered brain damage at the frontal level, such as Phineas Gage, NN and Elliot, is shown, in which it was observed that its state after the traumatic event was characterized by going back to previous stages of thinking moral, unlike a subject who may present brain damage in later structures. Conclusions. We discuss the analysis performed on the role of the frontal lobe in the process of respecting social norms that allow human interaction and how it can be affected by brain damage.
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Evaluación Neuropsicológica de la Atención: Test de Símbolos y Dígitos. Neuropsychological Assessment of Attention: Symbols And Digits Test.
Introduction: The symbol digit modality test is a reactive which provides great support in neuropsychological evaluation. Its execution permits to evaluate brain functions such as visual perception, stimuli recognition, attention (focal, selective and sustained), task supervision, interference control among others. Object: The purpose of the current research study was to analyze the normative percentiles of the execution of the test, to identify the performance activity of the reactive according to age group and gender; applying the test in a sample of college students. Method: The sample included 250 university students,142 (56.8%) males and 108 (43.2%) females. The age range of the participants was between 18 and 34 years old (M=21.53, DE=2.25). A transversal, non-experimental, quantitative research model with a correlational scope was used. Results: The correct answer average for the test was 52.83 (DE=13,60) and for percentile P5 31,55 right answers were found; for percentile P75 60,00 right answers, P25 had 46,00 right answers, and for P95 74,45 right answers were found. No significant differences were found for the mean of errors in the test in terms of age group f(3, 246)=0,67, p=0,57 and gender t(248)=0,68, p=0,49 of the participants as comparison factor. Conclusions: Results were discussed based on prior research pointing out the importance of counting with a first statistical parameter of the test as ground for neuropsychological clinical practice in Ecuador.
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Sistemas de Atención Focalizada, Sostenida y Selectiva en Universitarios de Quito-Ecuador
Introduction. Attention is a neuropsychological function that has threads of targeting, selectivity, sustainability, division and alternation, which enable human beings identify a particular stimulus for cognitive and brain processing. Objective. To analyze the performance of college students in a focused, sustained and selective attention test, considering age group, gender and academic level comparing factors. Method. A quantitative, non experimental, transectional and based on the comparison group research design was used. The sample size was 246 college students (50.8% men and 49.2% women), within17 and 29 years (M = 21.01, SD = 2.35) Results. It was found that targeting attentional processes, sustainability and selectivity are similar between the different age groups, educational level and gender. Conclusions. The basic attentional processes are fully developed in college students. Data are discussed around previous research and theoretical postulates of cognitive neuroscience.
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Intoxicación por Monóxido de Carbono, Presentación de un Caso.
A 35-year-old patient experienced 2 months, low levels of carbon monoxide exposure, produced by the motor of his vehicle. He experienced drowsiness in the morning. Because of drowsiness he had an automotomobile accident with traumatic brain injury. The only symptom at the time of neurological examination was anterograde amnesia. The magnetic resonance (MRI) of the brain revealed bilateral necrosis of the globus pallidus. We present this case for prevention of carbon monoxide poisoning and as an example of the utility of MRI and neuropsychological examinations in detecting central nervous system dysfunction secondary to CO exposure.
