Dementia e Neuropsychologia最新文献

Neurodegenerative diseases pose significant challenges due to their impact on brain structure, function, and cognition. As life expectancy rises, the prevalence of these disorders is rapidly increasing, resulting in substantial personal, familial, and societal burdens. Efforts have been made to optimize the diagnostic and therapeutic processes, primarily focusing on clinical, cognitive, and imaging characterization. However, the emergence of non-invasive brain stimulation techniques, specifically transcranial magnetic stimulation (TMS), offers unique functional insights and diagnostic potential. TMS allows direct evaluation of brain function, providing valuable information inaccessible through other methods. This review aims to summarize the current and potential diagnostic utility of TMS in investigating neurodegenerative diseases, highlighting its relevance to the field of cognitive neuroscience. The findings presented herein contribute to the growing body of research focused on improving our understanding and management of these debilitating conditions, particularly in regions with limited resources and a pressing need for innovative approaches.

Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep.

Objective: This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances.

Methods: This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022.

Results: A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems.

Conclusion: Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.

The advancement of neuroimaging technology offers a pivotal reference for the early detection of mild cognitive impairment (MCI), a significant area of focus in contemporary cognitive function research. Structural MRI scans present visual and quantitative manifestations of alterations in brain tissue, whereas functional MRI scans depict the metabolic and functional state of brain tissues from diverse perspectives. As various magnetic resonance techniques possess both strengths and constraints, this review examines the methodologies and outcomes of multimodal magnetic resonance technology in MCI diagnosis, laying the groundwork for subsequent diagnostic and therapeutic interventions for MCI.

Cognitive deficits are highly prevalent following a stroke, with memory, attention, and psychomotor speed being among the most affected functions. Prior research indicates that cognitive rehabilitation for stroke patients yields substantial improvements in cognitive performance and concurrently exerts a positive influence on reducing depressive symptoms.

Objective: The goal of this study was to provide a description and assessment of the influence of cognitive rehabilitation on the attentional performance and depressive symptoms of individuals diagnosed with stroke.

Methods: Participants underwent a neuropsychological assessment both prior to and following a 15-week remote cognitive rehabilitation intervention. This intervention involved the implementation of various cognitive tasks aimed at rehabilitating attentional skills.

Results: The outcomes of the individualized descriptive assessment revealed a no table inclination towards enhanced attentional performance. The comparative results indicated that the cognitive rehabilitation intervention for stroke patients proved effective in facilitating a substantial reduction in depressive symptoms and enhancing participants' alternating attention. While it is acknowledged that certain individuals may still exhibit deficiencies in various facets of attentional performance, cognitive rehabilitation contributed to the clinical amelioration of these individuals.

Conclusion: Clinical improvement holds profound significance in the day-to-day existence of these individuals, bolstering their autonomy and fortifying their sense of self-efficacy, as attested by their personal perceptions and self-reports.

Due to the progressive need for care, older adults with dementia are at risk of becoming institutionalized. Caregivers of these patients are tasked with the challenge of controlling behavioral and psychological symptoms without sufficient knowledge and are therefore at greater risk of developing physical and mental health problems. In this context, psychoeducational interventions can help greatly toward improving caregiver well-being.

Objective: to investigate the prevalence of behavioral and psychological symptoms of dementia (BPSD) in aged residents of long-term care facilities (LTCFs), to determine the prevalence of burden and common mental disorders in caregivers, and to assess the effects of a psychoeducational intervention.

Methods: an intervention study was performed at LTCFs for aged people. The following instruments were used: Self-Reporting Questionnaire and Zarit Burden Interview for caregivers; and the MMSE, Katz Index, Clinical Dementia Rating scale and Neuropsychiatry Inventory-Questionnaire for older adults.

Results: Of the 72 aged residents assessed, 52 (72.2%) were female and mean age was 82.3 (±8.14) years. The most prevalent neuropsychiatric symptoms were euphoria and elation (74%), followed by agitation and aggression (74%). Of the 54 caregivers, 49 (90.7%) were women and mean age was 33.9 (±10.8) years. Overall, 33.3% screened positive for common mental disorder and 36.1% for burden/overload. A statistically significant association was found between burden and working in philanthropic institutions (p=0.003) and also between burden and presence of common mental disorder or otherwise (p=0.001). After the psychoeducational intervention, 42.8% reported reduced burden.

Conclusion: The residents presented neuropsychiatric symptoms. Caregivers showed burden and common mental disorders, especially in philanthropic institutions. It was observed a reduction in burden of caregivers with psychoeducational intervention, showing the importance of this strategy.

Underlying the neuropsychological manifestations of Alzheimer's disease (AD), hypothalamic-pituitary-adrenal (HPA) axis dysregulation and subsequent hypercortisolemia have been proposed as major mechanisms driving AD progression from mild cognitive impairment (MCI) to the onset of dementia. Nonetheless, changes in cerebrospinal fluid (CSF) levels of HPA axis hormones remain controversial despite their potential in AD diagnosis and prognosis testing.

Objective: This study aimed to review the evidence of the variation in CSF levels of CRH, ACTH, and cortisol in subjects with mild cognitive impairment (MCI) and AD compared with subjects without cognitive disorders.

Methods: A systematic review was conducted in MEDLINE, EMBASE, and Web of Science databases on July 5, 2022.

Results: Seventeen observational studies were included. The results from the compiled investigations showed that individuals with AD exhibit a significant elevation of CSF cortisol levels which appear to correlate with the presence of the ApoE-ε4 allele, being higher in those homozygous for this allele. The variation of CSF CRH and ACTH levels in AD, on the other hand, is still inconclusive. Moreover, most studies found no significant difference in CSF cortisol levels in individuals with MCI compared to healthy subjects and patients with AD.

Conclusion: The findings gathered in this review disclose a significant elevation of CSF cortisol levels in AD. Future investigations are warranted to elucidate the potential use of CSF cortisol as a biomarker in AD-associated dementia.

Primary progressive aphasia is a clinical syndrome caused by neurodegeneration of areas and neural networks involved in language, usually in the left hemisphere. The term "crossed aphasia" denotes an acquired language dysfunction caused by a lesion in the ipsilateral hemisphere to the dominant hand.

Objective: To describe a case of crossed aphasia in a 60-year-old left-handed patient with a non-fluent variant of primary progressive aphasia diagnosis (age of onset=52), evidenced by a left asymmetry on brain SPECT scan.

Methods: Clinical and family history, the Edinburgh Handedness Inventory, Measurement of Functional Activities in Older Adults in the Community, the "Mini-Mental State Examination", the Trail Making Test, the Tower of London, and the Neuropsychological assessment for dementia, and neuroimaging studies were carried out.

Results: Neuropsychological assessment showed severe cognitive impairment, especially regarding language. The magnetic resonance imaging showed important signs of cortico-subcortical atrophy, with predominance in the frontal and temporal lobes. The single-photon emission computed tomography scan showed moderate to severe hypoperfusion in the left cerebral hemisphere, including the hippocampus.

Conclusion: We described a clinical case of crossed aphasia in a left-handed woman with a non-fluent variant of primary progressive aphasia with asymmetry on brain SPECT, mainly on the left, followed up for seven years.

Social cognition is an umbrella term used to address the set of neurocognitive processes involved in effective social interaction, such as Theory of Mind and empathy, and is important for understanding of others' intentions and actions and decision making. Narratives can serve as tools for learning social norms and understanding other people, as they involve mental simulations of social interactions. This review aimed to gather the results of current studies on the effects of reading and watching fiction movies on the development of social cognition. We included 16 publications, all of which were empirical studies. The results showed that, depending on individual factors, as well as on the specifics of the intervention, both reading and watching movies seem to influence the processes of development of social cognition, especially if associated with concomitant or subsequent activities, such as discussions. More research is needed to understand the specific details of this relationship.

Primary Progressive Aphasia (PPA) is a progressive language disorder associated with frontotemporal impairment and mainly affects the left hemisphere of the brain. In general, this condition compromises abilities related to comprehension and expression of language. The diagnosis of PPA depends on in-depth knowledge regarding functions of language, neurology, and neuropsychology. Speech and language therapists (SLTs) have a pivotal role in the diagnosis and rehabilitation of PPA. The absence of these professionals involved in the diagnosis and rehabilitation may reflect on the quality of care of people with PPA.

Objective: To identify the sociodemographic, educational, and professional practice characteristics of SLTs who work with people with PPA in Brazil.

Methods: An online questionnaire was disseminated to reach SLTs across Brazil. The questionnaire collected information regarding sociodemographics, training and education, practice (time, setting, service provision), and sources of referral.

Results: The study included 71 participants (95.8% women). Specialization was the most frequent educational level followed by master's degree, and participants where mainly from the Southeast and South regions of Brazil. Neurologists were the professionals who most referred patients with PPA to SLTs. Finally, SLTs worked primarily in homecare settings and provided mainly individual therapy services.

Conclusion: SLTs who work with PPA in Brazil can be characterized mainly as professionals with postgraduate degrees, relatively young, and from the South and Southeast regions of Brazil.

Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population.

Objective: To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person's performance on RUDAS and on the items that constitute it.

Methods: A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items.

Results: Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147).

Conclusion: This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.