Maria Alice de Mattos Pimenta Parente

Illiteracy and brain damage—1. Aphasia testing in culturally contrasted populations (control subjects)

One hundred neurologically healthy adults were tested for their pointing (choosing one of four or six line drawings as the match to an auditorily presented linguistic stimulus), naming (from line drawings), and repetition abilities. All subjects were unilingual adult right-handers. Fifty-seven subjects were totally unschooled illiterates and 43 were fluent readers. Statistically significant differences were found to exist between the scores of the illiterate and literate subpopulations across all tasks. With the focus being placed on these cultural differences, the discussion bears on: (a) the interaction between linguistic and iconographic factors in certain types of naming and pointing tasks currently used in clinical and research aphasiology, (b) some of the linguistic parameters which are apparently at stake in repetition behavior, and (c) the circumstances in which aphasiological research dealing with groups of patients cannot yield reliable data without reference to neurologically healthy controls. It is argued that, when testing brain-damaged patients of different cultural backgrounds, one runs the risk of over- or underestimating the frequency of aphasia if one does not refer to norms which explicitly take educational level into account.

Processos cognitivos na leitura de palavras em crianças: relações com compreensão e tempo de leitura

interdependent processes compose the reading. The present study analyzed the preferential usage on one of the reading routes (Dual Route Cognitive Reading Model) and the possible relations with reading comprehension and reading time in 76 children from second and third grades, in a Elementary private school. The reading of isolated words, comprehension and textual reading time were evaluated. Four groups were identified according with the skills of word reading: good readers in both routes (phonological and lexical), poor readers in both routes, preferably lexical readers and preferably phonological readers. The group of good readers in both routes was the fastest in textual reading. There werenit significant differences among the groups in reading comprehension, except in the third grade. It was concluded that both reading routes were functional in the sample, however the phonological route seems to be better developed than the lexical route, which is in expansion, suggesting a developmental process of the reading skills.

Avaliação da leitura e escrita de palavras em crianças de 2ª série: abordagem neuropsicológica cognitiva

Reading and writing are complex activities, made up of multiple processes. In Brazil there is no consensus regarding the expected performance for reading and writing for each year of schooling, besides there being a diversity of evaluation forms for these abilities. This study aims to analyze, in a neuropsychological cognitive approach, the precision in the use of routes of oral reading and writing of isolated words in 109 children attending the 2nd grade in state schools. The results showed a greater precision in the use of the phonological reading and writing route, due to the better performance in the use of pseudo-words than in the use of irregular words, high effect of regularity and extension and, the mistakes in neologisms and regularizations. However, there were signs that the lexical route is also used. It can be concluded, that children of the 2nd grade of state schools, use both routes of reading and writing of isolated words, but preferably the phonological route.

The acute effect of methylphenidate on cerebral blood flow in boys with attention-deficit/hyperactivity disorder

Methylphenidate (MPH) is the most commonly prescribed treatment for attention-deficit/hyperactivity disorder (ADHD). The therapeutic mechanisms of MPH are not, however, fully understood. We studied the effects of MPH on brain activity in male children and adolescents with ADHD, using the blood flow radiotracer technetium-99m ethyl cysteinate dimer (99mTc-ECD) and single-photon emission tomography (SPET) . The study was randomized, double blind, and placebo controlled (MPH group, n=19; placebo group, n=17), Radiotracer was administered during the performance of the Continuous Performance Test and before and after 4 days of MPH treatment. Statistical parametric mapping (SPM99) analysis showed a significant reduction in regional cerebral blood flow in the left parietal region in the MPH group compared with the placebo group (P<0.05, corrected for multiple comparisons). Our findings suggest that the posterior attentional system, which includes the parietal cortex, may have a role in the mediation of the therapeutic effects of MPH in ADHD.

Funções neuropsicológicas em crianças com dificuldades de leitura e escrita

In the studies about the relationship between reading and writing difficulties and neuropsychological associated factors there are controversies around the hypotheses of a possible deviation or developmental delay. To analyze this polemic the present study compared the neuropsychological task performances of second grade children with reading and writing difficulties (n=14) with two groups: one contrasting reading and writing competence, but not age (n=15), and the other contrasting age, but not reading and writing competence (1st grade; n=9). The results showed that the scores of the second grade group with reading and writing difficulties were statistically lower to second grade children competent in reading and writing in phonological awareness, oral language and phonological memory, not differing significantly from the first grade group. Such findings favor the developmental delay hypothesis of these neuropsychological functions in children with reading and writing difficulties.

Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: A systematic review of the literature

This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. METHODS A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. RESULTS Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. CONCLUSION Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.

The acute effect of methylphenidate in Brazilian male children and adolescents with ADHD: A randomized clinical trial

Objective: To evaluate the acute efficacy of methylphenidate (MPH) in Brazilian male children and adolescents with ADHD. Method: In a 4-day, double-blind, placebo-controlled, randomized, fix dose escalating, parallel-group trial, 36 ADHD children and adolescents were allocated to two groups: MPH (n = 19) and placebo (n = 17). Participants were evaluated pre- and posttreatment using the 10-item Conners Abbreviated Rating Scale (ABRS), the Children’s Global Assessment Scale (CGAS), and a simplified version of the Continuous Performance Test (CPT). Results: The MPH group had a significantly greater decrease in ABRS scores and a significantly higher increase in CGAS scores than the placebo group (p < 0.01). The MPH group showed also a significantly higher proportion of patients with a robust improvement (decrement of at least 50% in the ABRS score after the intervention) than the placebo group (p < 0.01). The MPH effect size for the ABRS was 1.05 (95% CI = 0.73-1.37). Conclusion: Our results extend the efficacy of MPH on the ADHD core symptoms extensively demonstrated in clinical trials with samples from some developed countries to a sample from a developing country where a diverse culture may modulate the clinical presentation of the disorder.

Literacy as a determining factor for brain organization: from Lecours’ contribution to the present day

This review aimed to discuss the influence of literacy and formal education on human brain organization, based on evidence drawn from three sources: (1) results and limitations of a project coordinated by André Roch Lecours on the influence of illiteracy on brain organization and of studies on aphasia in illiterate populations; (2) data on the impact of schooling on the neuropsychological assessment of healthy and brain-damaged individuals, and (3) studies on the effect of schooling on dementia. These findings suggest that schooling and literacy processes influence cerebral organization of healthy individuals, as well as of brain-lesion individuals and those with dementia. Concerning illiteracy, the systematic pioneering studies developed by Lecours and the continuity of his investigations were essential to alert the scientific and clinical communities to take into account the role of educational experience on cognitive processing and its brain substrates.

Transtorno de estresse pós-traumático e funções cognitivas

Post Traumatic Stress Disorder (PTSD) is a prevalent disorder which is associated with neurobiological and cognitive impairments. This paper is a theoretical review of the uses of neuropsychological assessment in PTSD. Conceptual aspects of this disorder are reviewed, as well as the neurobiological alterations related to cognitive impairments. Finally, it is argued that the assessment of memory, attention, and executive function impairments is as relevant to the clinical intervention as it is to the refinement of the psychological theories of PTSD.

Ativação de modelos mentais no recontar de histórias por idosos

Text comprehension is a complex activity that requires resources from short term memory (STM) and from episodic memory (EM). Strategies directed to goals and intentions avoid an overload of the STM and activates the EM. To study the influence of aging on those mechanisms, we analyzed the recall of a story by two different groups of adults: 17 subjects, 30 to 50 years old, and 14 with more than 60 years of age. The younger group remembered more propositions than the elders, but both groups recalled better the macro than the microstructure. No differences regarding number of inference, interference, and reconstruction were found. Nevertheless, residual analysis showed that younger adults organized their recall telling the actions of the original story, whereas the older adults chose a subjective organization of the main facts, suggesting that due to a reduction of the working memory, the elderly elaborated strategies to have access to information of the EM, showing their mental representations in their recall.