Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

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Music therapy intervention for memory, attention, and language in children with dyslalia. Intervención musicoterapéutica para mejorar la memoria, atención y lenguaje in niños con dislalia

Dyslalia is a language disorder that is present in a wide percentage of children. This work proposes an intervention protocol in music therapy to improve attention, memory, and language for children with the dyslalia disorder. A confirmatory mixed-method design composed of two studies was conducted: the first included a quantitative and pre-experimental design with a sample of 20 children aged between 5 and 8 years (Mage=6.45, SD=1.23) diagnosed with dyslalia. The second study used a qualitative confirmatory methodology, where participants’ parents and therapists participated. Wepman’s and the initial Luria pre- and post-tests measurements were applied. The results of the pre-experiment found statistically significant improvements in verbal regulation t(19)=-5.03, p=<.001, d=.76, attention t(19)=-5.05, p=<.001, d=.76, and memory t(19)=-2.88, p=.009, d=.55. In the qualitative phase, narratives were found that affirmed the positive results of the pre-experiment. Moreover, data surrounding the benefits of the music therapy intervention protocol in the improvement of cognitive processes and the relationship with previous literature that found positive results with this type of intervention are discussed.

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La evaluación neuropsicológica en la Cirugía de Epilepsia.

Since the decade of the sixties objective systems of evaluation of the superior functions have been developed with the purpose of being able to establish the cognitive state from the patients candidates to epilepsy surgery, for that, the neuropsychological evaluation is made by means of the use of suitable instruments that allows to identify the cerebral dysfunction and taking into account the following aspects: a) to establish the global cognitive state, b) to guide in the lateralization of the cerebral dysfunction, c) to predict the risk of deterioration or cognitive improvement, with base in the preserved functions and in the altered functions, and d) after the surgery, to describe the patient’s cognitive state by means of periodic evaluations, with the purpose of having an evolutionary control of the neuropsychological functioning, providing in a precise and integrated way the effects that the surgical intervention produces in the cognitive functioning of the patients. The neuropsychological evaluation is an integrated process that requires of several hours to be completed, for that, it is important that this is carried out without the previous knowledge of the discoveries of image and/or electroencephalographic methods, since this could slant the exploration and the results, when it is not possible the identification of other possible cognitive alterations, or, one runs the risk of supposing the existence of cerebral pathology where there is not. In this article the theoretical-methodological aspects of the neuropsychological exploration are described in the area of epilepsy surgery.

 

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Una propuesta para la evaluación de la Prueba de Wada en pacientes analfabetos: Presentación de un caso.

In the preoperative neuropsychological evaluation of certain patients with epilepsy it is important to determine the hemispheric dominance; particularly in those of doubtful laterality, due to the high postoperative risks of affectation of the language and the memory. The test of Wada allows guiding the neurosurgeon about the possible impact of the surgical procedure in the hemispheric areas related to the language and the memory. Although it is well-known that the execution in diagnostic neuropsychological tests is under the influence of an important series of variables, as the culture and the educational level, until now there are not specific protocols for this kind of exploration in illiterate patients. In this study we describe the experience in the test of WADA of an illiterate patient with epilepsy diagnosis and cerebral congenital left hemiatrophy, of left-handed manual laterality. With base in the protocol of Trenerry and Loring the language tasks and memory were implemented according to the patient’s cultural context. It was found a right hemispheric representation for the language and the memory. These results confirm the effects of the cerebral plasticity in the reorganization and /or compensation of the cognitive functions, as the language and the memory in the cerebral hemisphere not affected.

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Aspectos Moleculares de los Trastornos Cognitivos Ligados al Cromosoma X que Conllevan una Disfunción del Lenguaje.

Molecular characterization of X-linked cognitive disorders in which language impairment is a prominent symptom decisively contributes to a better understanding of the genetic programme involved in the development of the language organ. Proteins encoded by genes mutated in these disorders are structurally and functionally diverse: (i) helicases, (ii) homebox proteins, (iii) transcriptional regulators, (iv) translational regulators, (v) posttranslational regulators, and (vi) phosphoproteins. These proteins ultimately modulateneural development and function, as far as they seem to be involved in the regulation of (i) neural migration, (ii) neural identity, (iii) axonal growth, (iv) dendritic proliferation, (v) synaptogenesis, (vi) myelinization, (vii) neural plasticity, (viii) long-term potentiation and (ix) neural survival, but also in the modulation of basic cellular processes, like (x) chromosome segregation. Though these genes clearly make up the genetic programmes responsible for the emergence of different cognitive modules, they should be taken necessarily into account for an accurate molecular characterization of the language organ, since it is only programmes, but not genes, that should be properly regarded as idiosyncratic (i.e. most genes cannot reasonably be characterized as “linguistic”, unlike the programme itself related to the language organ).

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Aspectos moleculares de las enfermedades metabólicas que conllevan trastornos del lenguaje.

 

Molecular characterization of metabolic diseases in which language impairment is a prominent symptom decisively contributes to a better understanding of the molecular effects and ontogenetic context on the development of the language organ. Main etiological feature in these diseases is actually diverse, as it may be disturbed in: 1) hormone homeostasis; 2) sugar, creatine, carnitine, lipid, sulphur, organic acid, or aminoacid metabolism; 3) different cellular processes (lysosomal storage and mitochondrial function). Metabolic disturbances ultimately lead to structural and functional anomalies in different brain regions, which positively correlate with the linguistic and cognitive impairments. Functional cloning has greatly helped to identify genes involved in such metabolic diseases, and so to a better understanding of the innate programme involved in the development of the linguistic module.

 

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