Maila Rossato Holz

Executive functions profiles in traumatic brain injury adults: implications for rehabilitation studies

Abstract Primary objective: This study aimed to identify and characterize profiles of executive functions (EF) following traumatic brain injury (TBI). Research design: The sample was comprised of 84 adult outpatients with mild and moderate/severe TBI who were assessed by means of a battery of EF tasks. A Hierarchical Cluster analysis was performed with tasks Z-scores. Clusters were compared by means of ANOVA and Chi-square analyses. Main outcomes and results: Three clusters were characterized by deficits in: (1) inhibition, flexibility and focused attention; (2) inhibition, flexibility, working memory and focused attention; and (3) no expressive executive deficits. Clusters did not differ in clinical or demographical variables. Conclusions: The first cluster replicated findings of previous studies on TBI EF profiles. IT is suggested that TBI rehabilitation studies of EF must select participants by their EF profile rather than for clinical or demographical variables.

Reading and writing habits as a predictor of verbal fluency in elders.

Introduction: Semantic and phonemic verbal fluency tasks are the most used verbal fluency versions to evaluate dementia patients, while unconstrained and action fluencies have been poorly investigated in aging. This study aimed to evaluate if the factors diagnosis, age, and reading and writing habits can predict the performance of four types of verbal fluency in healthy elderly (HE), mild cognitive impairment (MCI), and Alzheimer’s disease (AD) participants. Method: Eighty participants were included in this study (21 mild AD, 32 MCI, and 27 HE). The participants performed a reading and writing habits questionnaire, neuropsychological evaluation, and semantic, phonemic, unconstrained, and action verbal fluency tasks. Diagnosis, age, and reading and writing habits were entered as predictors in a stepwise linear regression model for each of the four verbal fluency tasks. Results: The stepwise procedure eliminated age for all models as being nonsignificant. Unconstrained and semantic verbal fluency were better predicted by the diagnosis followed by reading and writing habits. On the other hand, phonemic and action verbal fluency were better predicted by reading and writing habits followed by diagnosis. Conclusion: Reading and writing habits contributed to the prediction of all verbal fluency tasks, highlighting their role in cognitive function. The sensitivity of these verbal fluency tasks to sociocultural and clinical factors should be considered in the neuropsychological assessment.

Cognitive performance in patients with Mild Cognitive Impairment and Alzheimer's disease with white matter hyperintensities: An exploratory analysis

ABSTRACT. Background: White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimers disease as well as other cognitive functions, but there is no consensus. Objective: This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimers disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH. Methods: The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearmans correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors. Results: Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age. Conclusion: This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH.

DEFICITS IN UNCONSTRAINED, PHONEMIC AND SEMANTIC VERBAL FLUENCY IN HEALTHY ELDERS, MILD COGNITIVE IMPAIRMENT AND MILD ALZHEIMER’S DISEASE PATIENTS

Pradeep J. Nathan, Rosemary A. Abbott, Yen Ying Lim, Samantha Galluzzi, Moira Marizzoni, Cristina Bagnoli, Claudio Babiloni, David Bartres-Faz, Regis Bordet, Mira Didic, Lucia Farotti, Gianluigi Forloni, Jorge Jovicich, Camillo Marra, Jose Luis Molinuevo, Flavio Nobili, Jeremie Pariente, Lucilla Parnetti, Pierre Payoux, Jean-Philippe Ranjeva, Paolo Rossini, Peter Schonknecht, Tilman Hensch, Andrea Soricelli, Magda Tsolaki, Pieter Jelle Visser, Jens Wiltfang, Olivier Blin, Giovanni B. Frisoni, Inventiv Health & University of Cambridge, Cambridge, United Kingdom; 2 Cambridge Cognition, Cambridge, United Kingdom; The Florey Institute, The University of Melbourne, Parkville, Australia; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; 5 Department of Physiology and Pharmacology, University of Rome, Rome, Italy; Universitat de Barcelona and IDIBAPS, Barcelona, Spain; Department of Pharmacology, University of Lille Nord de France, Lille, France; 8 Service de Neurologie et Neuropsychologie, Marseille, France; 9 University of Perugia, Perugia, Italy; 10 IRCCS, Istituto di Ricerche Farmacologiche Mario Negri,, Milan, Italy; University of Trento, Trento, Italy; Catholic University, Rome, Italy; Alzheimer’s Disease Unit and Other Cognitive Disorders Unit, Hospital Clinic de Barcelona, Barcelona, Italy; 14 University of Genoa, Italy, Genoa, Italy; 15 Department of Neurology, CMRR and Inserm U825, Toulouse, France; Universit e de Toulouse, Toulouse, France; CIC-UPCET, CHU La Timone, AP-HM, UMR CNRS-Universite de la Mediterranee, Marseille, France; Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany; Fondazione SDN per la Ricerca e l’Alta Formazione in Diagnostica Nucleare, Naples, Italy; 20 Aristotle University of Thessaloniki, Thessaloniki, Greece; 21 Department of Neurology, Alzheimer Centre, VU Medical Centre, Amsterdam, Netherlands; University of Duisburg-Essen, Essen, Germany; Mediterranean Institute of Cognitive Neurosciences, Marseille, France; 24 University Hospitals, Geneva, Switzerland. Contact e-mail: Pradeep.Nathan@ inventivhealth.com

FREQUENCY OF NEUROLOPSYCHOLOGICAL DEFICITS AFTER TRAUMATIC BRAIN INJURY

Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.

FRECUENCIA DE DÉFICITS NEUROPSICOLÓGICOS POSTERIORES A LESIÓN CEREBRAL TRAUMÁTICA

Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.

Frequência de déficits neuropsicológicos após traumatismo cranioencefálico

Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.

Frecuencia de déficits neuropsicológicos post lesión cerebral traumática

Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.Traumatic brain injury (TBI) can lead to significant changes in daily life, as well as in social, labor, communicative, and cognitive domains (attention, memory and executive functions). This study aimed to characterize the occurrence of post-TBI neuropsychological deficits as well as to determine whether there is an impact related to the level of severity of the trauma on the patients performance. Ninety-six adults participated in the study, who were divided in two groups to assess the traumas level of severity: mild TBI (n=39) and severe TBI (n=57). This severity was classified by the Glasgow Coma Scale, by the duration of consciousness loss, or by post-traumatic amnesia. There were no differences between the groups regarding variables of age and years of schooling. A Chi- square test was used to do a comparison between the two groups in terms of occurrence of neuropsychological deficits. Verbal, visuospatial, mnemonic, linguistic and executive tests composed a flexible neuropsychological battery. Patients with mild TBI had better scores compared to those with severe TBI (number of errors and in completed categories of the Modified Wisconsin Card Sorting Test (MWCST); errors in Part B of The Hayling Test; and proactive and retroactive interference in the Rey Auditory Verbal Learning Test (RAVLT). The severity of the trauma seems to differentiate individuals performance on episodic memory of new information and in the control of interference between memories; the same is applied to flexibility and inhibition functions. These results suggest the need for more investments in public health policy actions, prioritizing neurocognitive remedial intervention and prevention methods for such condition with high incidence of sequelae.