Álvaro Machado Dias

Transcranial Direct Current Stimulation Effects on Athletes’ Cognitive Performance: An Exploratory Proof of Concept Trial

Among the 2016 Olympic and Paralympic Games’ unforgettable moments, one could not overlook performances by Phelps and Bolt, which challenge old premises about the maximum extension of individual supremacism in ultracompetitive modalities and the doping scandals. Different media channels resonated these two trends, with an unseen rise on discussions about traits and practices that may set ultrahigh performance athletes apart from the more ordinary ones. Yet, some key issues remain undebated. This paper aims to add to this debate, with a proof of concept trial, which investigates whether transcranial direct current stimulation (tDCS) may serve as an aid for professional athletes. Ten professional athletes of three different modalities (judo, N = 4 athletes, swimming, N = 3 athletes, and rhythmic gymnastics, N = 3 athletes) received anodal stimulation (2 mA) for 20 min on the left dorsolateral prefrontal cortex for ten consecutive weekdays. We observed a positive effect of tDCS in their cognitive performance, including a significant improvement in alternated, sustained, and divided attention and in memory scores. We also observed a decrease in Beck Depression Inventory scores (4.50 points) in this non-clinical population. These preliminary results suggest that tDCS sessions may translate into competitive advantages for professional athletes and recommend the deepening of the discussion on its ethical use in sports, which is ultimately tied to the wider debate around the risks and opportunities that neuromodulation brings to the table.

Effect of transcranial direct current stimulation (tDCS) over the prefrontal cortex combined with cognitive training for treating schizophrenia: a sham-controlled randomized clinical trial

Introduction: We report a transcranial direct current stimulation (tDCS) protocol over the dorsolateral prefrontal cortex (DLPFC) combined with cognitive training in schizophrenia. Method: We assessed psychotic symptoms in nine patients using the Positive and Negative Syndrome Scale (PANSS). All evaluations were scored at baseline, at the end of the intervention protocol, and during a 4-week follow-up. The tDCS protocol consisted of 10 consecutive sessions over 5-day periods. We placed the cathode over the right and the anode over the left DLPFC. For sham stimulation, we turned the device off after 60 seconds. Cognitive training consisted of the administration of N-back and sequence learning tasks. Results: We performed an analysis of covariance (ANCOVA) to adjust for the dependent variable PANSS, considering the interaction with baseline severity scores (p = 0.619). Mixed analysis of variance (ANOVA) showed no statistical significance between the groups regarding final PANSS scores. Conclusion: The results failed to demonstrate that the concomitant use of tDCS and cognitive training is effective to improve clinical outcomes in patients with schizophrenia. The present findings should be analyzed with care, considering the small sample size. Larger controlled trials on electric/cognitive stimulation should be produced in order to enhance therapeutic strategies in schizophrenia.

Forensic neuropsychological assessment: a review of its scope

Background Issues related to the field of mental health and justice require a multifactorial understanding of the possible causes of such issues. Objective To conduct an integrative literature review of controlled studies describing forensic neuropsychological assessment. Methods The articles were compiled and analyzed in two phases: 1) first, we retrieved all papers in PubMed by the keywords “Forensic Neuropsychology” and generated a growth curve for the subject and a cluster-based thematic distribution of publications. 2) We then conducted a curated analysis of all relevant papers indexed in Medline, PubMed and ISI, between 2000 and 2012. Results The evolution of the field during the last 15 years reveals an unstable growth pattern and three main thematic clusters. In terms of our curated analysis, a total of 390 articles were pre-selected, resulting in the selection of 44 fully-relevant studies, which comprise four main categories: cognitive damage in forensic psychiatric patients; imitation of cognitive damage; civil capacity, penal liability and violence risk; and validation of neuropsychological assessment tools. Discussion Two aspects appeared as the most relevant in this study: growth in the use of neuropsychological assessment as a diagnostic tool in the forensic context; and the necessity to enhance conformity in assessments.

Cognitive impact in children with “benign” childhood focal epilepsy with centrotemporal spikes

Background Cognitive alterations are associated with benign childhood focal epilepsy with centrotemporal spikes (BCECTS) including aspects of executive functions. Objectives This study presents the performance profile on attention and executive function tests of fifty-eight children (BCECTS, n = 30 and controls, n = 28) aged 8-13 years. Methods The following tools were employed: Vocabulary and Block Design subtests from the Wechsler Intelligence Scale for Children III, Stroop Test, Modified Card Sorting Test, Controlled Oral Word Association – FAS and Tower of London. Results Children with BCECTS presented average IQ measure, although their performance was statistically worse when compared to the control group. Children with BCECTS showed significantly lower performance compared to the control group in the following variables: total number of recollected words on the oral fluency test, total number of categories, categorization effect and total number of errors in MCST; and execution time for the Stroop Test Card 1. After controlling for the IQ effect, the total number of errors in the MCST did not show any significant difference between the groups. Discussion Children with BCECTS showed lower performance in attention and executive functions when compared to healthy children. The results suggest that the concept of “benign” BCECTS should be reconsidered.

Neuropsychological correlates of remission in chronic schizophrenia subjects: The role of general and task-specific executive processes

Background Although cognitive deficits have consistently been characterized as core features of schizophrenia, they have not been incorporated into definitions of remission. Furthermore, just a few studies have examined the relationship between cognitive deficits and symptomatic remission. The main aim of the present study is to evaluate the executive functioning of nonremitted schizophrenia patients. Methods 72 remitted and 42 nonremitted schizophrenia patients, and 119 healthy controls were examined. Subjects were tested with a comprehensive battery of cognitive tests, including a measure to assess the general components of executive functioning and individual tasks to tap the three specific executive dimensions assessed in the present study, namely updating, shifting and inhibition. Results Schizophrenia subjects performed poorly on general executive functioning and shifting tasks in comparison to healthy controls. Remitted subjects performed better than nonremitted on inhibition and updating tasks. Whereas being a male and showing decreases in updating increase the chances of being in the nonremitted schizophrenia subjects group, increases in shifting and updating enhance the odds of being in the healthy control group. Conclusion The present findings suggest that executive function deficits are present in chronic schizophrenic patients. In addition, specific executive processes might be associated to symptom remission. Future studies examining prospectively first-episode, drug naive patients diagnosed with schizophrenia may be especially elucidative.

Commentary: Free Will and Neuroscience: From Explaining Freedom Away to New Ways of Operationalizing and Measuring It.

The long-standing debate on the nature of consciousness and the extent to which free will remains a valid concept has evolved a lot since the publication of Libets seminal work on neural antecedents of mental states and behavior (Libet et al., 1983). It is very clear now that it is just a matter of time for new sensors, experimental paradigms, and advanced techniques in data analyses provide us with such a high rate of success in forecasting motor and cognitive decisions before they appear to oneself as intentions that the whole discussion about the role of phenomenal consciousness (P-consciousness, following Blocks terminology, 1995—or simply P-states) in initiating decision-making and efferent commands will simply disappear (Block, 1995).

Tendências do neurofeedback em psicologia: revisão sistemática

Neurofeedback is a non-invasive method of operant conditioning designed to produce improvements in clinical and performance enhancement or sense of well-being in normal people by inducing neuroplastic effects in the brain. Objectives: Overview the literature indexed in PubMed and Scopus, and review the studies on attention deficit disorder and cognitive enhancement, performance and sense of well-being in normal people. Results: there are 156 complete articles published in Journals indexed in PubMed, 249 in Scopus, and an overall number of 310 papers. The application of the technique to the treatment of attention deficit disorder is well established in the literature, while the use for non-clinic conditions is still under development..

Effects of transcranial direct current stimulation on working memory and negative symptoms in schizophrenia: a phase II randomized sham-controlled trial

Background The lack of efficacy of pharmacological treatments for cognitive and negative symptoms in schizophrenia highlights the need for new interventions. We investigated the effects of tDCS on working memory and negative symptoms in patients with schizophrenia. Method Double-blinded, randomized, sham-controlled clinical trial, investigating the effects of 10 sessions of tDCS in schizophrenia subjects. Stimulation used 2 mA, for 20 min, with electrodes of 25 cm2 wrapped in cotton material soaked in saline solution. Anode was positioned over the left DLPFC and the cathode in the contralateral area. Twenty-four participants were assessed at baseline, after intervention and in a three-months follow-up. The primary outcome was the working memory score from MATRICS and the secondary outcome the negative score from PANSS. Data were analyzed using generalized estimating equations. Results We did not find group ∗ time interaction for the working memory (p = 0.720) score or any other cognitive variable (p > 0.05). We found a significant group ∗ time interaction for PANSS negative (p < 0.001, d = 0.23, CI.95 = −0.59–1.02), general (p = 0.011) and total scores (p < 0.001). Exploratory analysis of PANSS 5 factors suggests tDCS effect on PANSS negative (p = 0.012), cognitive (p = 0.016) and depression factors (p = 0.029). Conclusion The results from this trial highlight the therapeutic effects of tDCS for treatment of persistent symptoms in schizophrenia, with reduction of negative symptoms. We were not able to confirm the superiority of active tDCS over sham to improve working memory performance. Larger sample size studies are needed to confirm these findings.

Transtornos mentais comuns em educadores sociais

Objective To investigate the presence of common mental disorders (CMDs) in Social Educator of hostels and housings in the city of Sao Paulo. Methods The sample was composed by 104 Guiding Youth between 18 and 60 years (male and female), who worked at the Municipal Assistance and Social Development in Sao Paulo. We used a demographic data questionnaire in addition to the Self Report Questionnaire (SRQ-20). Results The main results demonstrated a higher prevalence of women in this function; most professionals have experienced risk situations at work; 68.3% (71 individuals) presented indices that characterize the presence of CMDs; 40.4% of women presented CMDs symptoms, whereas the CMDs rate in men was 27.9%. Conclusions In this scenario, we can conclude that the female audience is more vulnerable to the presence of CMDs in comparison to the male audience.

Doar ou não doar, eis a questão: uma análise dos fatores críticos da doação de sangue

Currently, in Brazil, 1.78% of the population area blood donors, a level lower than the ideal one that, according to WHO, should be between 3% and 5% of the population. Following this scenario, the current study has a general goal of identifying and analyzing the main critical factors of the process of blood donation in the city of Belo Horizonte, MG, under the perception of donors, potential donors and non donors. A qualitative research approach was conducted, through twenty-four semi-structured interviews. The results highlight the lack of information in the various stages of the blood donation system. During the stages of donor recruitment and awareness, communication actions convey to society incomplete information about the donation process, discouraging future actions of donation. On the other hand, a lack of appreciation of the donation experience and the construction of social values associated with the donor prevent the multiplication of social behaviors for donation. The results of this study, found from theoretical framework outlined in this study, highlight the causes or critical factors that impede changes in behavior, incremental or radical, proposed by social marketing.Currently, in Brazil, 1.78% of the population area blood donors, a level lower than the ideal one that, according to WHO, should be between 3% and 5% of the population. Following this scenario, the current study has a general goal of identifying and analyzing the main critical factors of the process of blood donation in the city of Belo Horizonte, MG, under the perception of donors, potential donors and non donors. A qualitative research approach was conducted, through twenty-four semi-structured interviews. The results highlight the lack of information in the various stages of the blood donation system. During the stages of donor recruitment and awareness, communication actions convey to society incomplete information about the donation process, discouraging future actions of donation. On the other hand, a lack of appreciation of the donation experience and the construction of social values associated with the donor prevent the multiplication of social behaviors for donation. The results of this study, found from theoretical framework outlined in this study, highlight the causes or critical factors that impede changes in behavior, incremental or radical, proposed by social marketing.