María Victoria Perea Bartolomé

Blind Randomized Controlled Study of the Efficacy of Cognitive Training in Parkinson's Disease

The aim of this study was to analyze the efficacy of a cognitive training program on cognitive performance and quality of life in nondemented Parkinsons disease patients. Participants who met UK Brain Bank diagnosis criteria for Parkinsons disease, with I–III Hoehn & Yahr, aged 50–80, and nondemented (Mini‐Mental State Examination ≥ 23) were recruited. Patients cognitive performance and functional and quality‐of‐life measures were assessed with standardized neuropsychological tests and scales at baseline and after 4 weeks. Subjects were randomly and blindly allocated by age and premorbid intelligence (Vocabulary, Wechsler Adult Intelligence Scale‐III) into 2 groups: an experimental group and a control group. The experimental group received 4 weeks of 3 weekly 45‐minute sessions using multimedia software and paper‐and‐pencil cognitive exercises, and the control group received speech therapy. A total of 28 patients were analyzed. Compared with the control group participants (n = 12), the experimental group participants (n = 16) demonstrated improved performance in tests of attention, information processing speed, memory, visuospatial and visuoconstructive abilities, semantic verbal fluency, and executive functions. There were no observable benefits in self‐reported quality of life or cognitive difficulties in activities of daily living. We concluded that intensive cognitive training may be a useful tool in the management of cognitive functions in Parkinsons disease.

Executive functioning in obese individuals waiting for clinical treatment.

BACKGROUND Executive functions have an important role in human behavioural regulation and can be a determinant of eating behaviour. Our aim was to study the different components of executive functions in obese individuals waiting for clinical treatment, comparing them with normoweight subjects with similar socio-demographic characteristics. METHOD A total of 114 adults (76 obese and 38 normoweight) completed a neuropsychological battery that included tasks of conceptualization and abstraction, motor programming, response maintenance, inhibition and resistance, problem solving, cognitive flexibility, and verbal fluency. RESULTS There was a statistically significant difference between groups for all the dimensions of the executive functions evaluated, with the obese group showing poorer performance compared to normoweight. CONCLUSIONS Obese individuals demonstrated poorer executive functions than normoweight individuals.

The effect of cognitive impairment on self-generation in Hispanics with TBI.

The objective of this study was to determine the moderating effect of cognitive impairment (CI) on the usefulness of the generation effect to improve learning and memory in Hispanics with traumatic brain injury (TBI). Sixty-one Hispanic individuals with TBI (29 without CI, 22 with mild to moderate CI, and 10 with severe CI) and 44 healthy controls (HC) were required to remember the last word in each of 32 sentences. Target words were presented in a self-generated and provided condition. Recall and recognition were examined immediately, after 30 minutes, and at one week. Individuals remembered and recalled significantly more words in the generated condition than the provided condition, regardless of group or time. The self-generation technique equally benefitted all participants regardless of TBI status or degree of CI. Future cognitive rehabilitation programs designed to improve short-term recall and recognition in Hispanic individuals with TBI should include the self-generation technique. Further research into the longer-term effects of the generation effects is warranted.

Recognition of thematic and taxonomic conceptual relations in patients with aphasia

Background: There is mounting evidence that there exist conceptual non-verbal deficits in patients with aphasia. In the current paper, taxonomic and thematic conceptual relations are the focus of interest. There is a debate surrounding this topic regarding whether they are part of the same semantic system or there are independent systems dedicated to each kind of relations. Aims: Our aim was to study and look for possible dissociations in a group of fluent and non-fluent aphasic patients on their ability to recognise conceptual relations (taxonomic and thematic). Methods & Procedures: Previous studies have usually proposed forced-choice tasks, which give the patients closed response options and do not allow the researcher to assess the criteria for the choice the participants have made. In the following study we assigned different types of conceptual tasks (forced choice and free choice) to a group of 25 stroke patients (7 fluent and 18 non-fluent aphasic patients), as well as 30 healthy control participants. We assessed the hit rates and the response criteria followed by the patients. Outcomes & Results: The results showed that although all aphasic patients experienced difficulties in establishing both types of conceptual relations in verbal tasks, dissociations were observed particularly in non-verbal tasks showing poor performance in thematic relations. This was especially noticeable in non-fluent aphasic patients. Meanwhile, fluent aphasic patients showed more difficulty in establishing taxonomic relations in the pictorial free-choice task and a tendency to use thematic criteria. Conclusion: These results support the claim that there exist separate systems for both kinds of conceptual relations. Implications for the assessment of semantic deficits in aphasic patients were discussed.

Hyperfamiliarity for unknown faces after non-paraneoplastic limbic encephalitis: a case report

A 39-year-old, right-handed Caucasian woman was admitted to the hospital, after suffering two generalized tonic–clonic seizures. The patient had experienced a nonspecific prodromal illness with myalgias, malaise, and low fever 2 days previously. Over the following days, she developed mild confusion, agitation, and memory problems. She also presented several witnessed episodes of oral automatisms, with open eyes and unresponsiveness, which lasted 2–3 min. This background information was reported by the husband, because at the initial evaluation, the patient showed severe anterograde amnesia and retrograde amnesia for recent events. During admission, she asked the staff and other patients if she had met them before, and this was recorded in the clinical history as ‘‘misidentification syndrome.’’ She had no previous neurological or psychiatric history. Extensive laboratory workup was normal. Autoantibody tests and multiple microbial studies were negative. Cerebrospinal fluid (CSF) analysis revealed a mild lymphocytic pleocytosis (30 cells/lL) and elevated protein (69 mg/dL). Serum and CSF testing were negative for known onconeural antibodies (anti-Yo, Hu, Ri, Tr, CV2, Ma2, and amphiphysin), intraneural antigens (glutamic acid decarboxylase antibodies), serum antibodies directed against surface-expressed neural proteins [ion channels (NMDA, GABAB, and AMPA receptors) and ion channel-associated molecules (LGI1, CASPR2, Contactin-2)]. The electroencephalogram (EEG) showed non-specific diffuse theta slowing. Pan-body CT and mammogram showed no evidence of malignancy. Finally, the magnetic resonance imaging (MRI-contrast enhancement at 1.5 T) was normal.

F14 The F.A.S. versus P.M.R phonological verbal fluency in manifest and pre-manifest patients with huntington’s disease of burgos (Spain)

Background Verbal fluency tasks have been identified as important indicators of executive functioning impairment in patients with Huntington’s disease (HD). The F.A.S. test has been widely used to assess phonological fluency in Anglo-Saxon people, because these three letters are the most frequent in English language. In the contrast, normative data have been developed for the letters P, M and R since they are more frequent in the Spanish population. Aims To compare the performance in phonological verbal fluency (F.A.S vs P.M.R) in a sample of HD participants and their correlation with the global cognitive status. Method Pilot, cross sectional study. The F.A.S. and P.M.R fluency tests were administered to a sample of patients with HD (2 pre-manifests, 4 manifests). Scores in terms of correct words for each letter, perseverations and intrusions were collected. The global cognitive status was assessed by the Mini-mental State Examination (maximum score 35). Data were analysed using non parametric tests. Results The F.A.S and P.M.R fluency testes were comparable (total score p = 0.24, intrusions score p = 0.31, perseveration score p = 0.08). However, there was a higher correlation of P.M.R with MMSE (rs = 0.81, p = 0.05) compared to F.A.S. (rs = 0.60, p = 0.20). Conclusions F.A.S and P.M.R provided an equivalent measure of phonological verbal fluency in our sample. However, P.M.R seems to be a better predictor of global cognitive status. Based on these preliminary results, the phonological verbal fluency should be analysed based on the patient’s mother tongue. Further studies including a higher sample size and group differences (manifest vs. pre-manifest) are needed to confirm these preliminary results.

F10 Analysis of performance in two different versions of stroop test in manifest and pre-manifest patients with huntington’s disease of burgos (Spain)

Background There is a growing interest in the cognitive impairment shown by patients with Huntington’s disease (HD). Alteration in visuospatial functions and saccadic eye movements had been demonstrated. Therefore, these factors should be taken into account when designing tasks to assess other cognitive domains. Stroop Colour and Word Test provide three scores based on the number of items completed on each stimulus sheet: colour naming (CN), word reading (WR) and interference (I). In Spanish population we have normative data for vertical form (items listed in columns). Aims To compare the performance of the horizontal reading (items listed in rows) and the vertical reading (in columns) of the Stroop Test, and their correlation with the global cognitive status and eye movement disturbances in a sample of HD participants. Method Pilot, cross-sectional study. The Stroop tests were administered to 2 pre-manifest HD and 4 manifest HD patients. The global cognitive status was assessed by the Mini-mental State Examination (maximum score 35). Eye movements were assessed by the UHDRS motor scale. Data were analysed using non parametric tests. Results The total scores of WR, CN and I of the Stroop tests were similar when they were administered horizontally or vertically (p = 0.91; p = 0.17, p = 0.68, respectively). However, the vertical WR showed higher correlation with the MMSE (rs = 0.84) and inverse correlation with abnormal eye movements (rs = −0.94), compared to the horizontal WR (rs = 0.75, rs = −0.89, respectively). Conclusions Vertical and horizontal forms of Stroop Test yield equivalent results in our sample. However, the vertical reading shows higher correlation with the cognitive status and with eye movement disturbances compared to the horizontal reading. Further studies including higher sample size and group differences (manifest vs. pre-manifest) are needed to confirm these preliminary results.