Navegando por Palavras-chave "Neuropsychological Assessment"

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    Estudo da associação entre BDNF sérico e disfunção cognitiva em pacientes com lúpus eritematoso sistêmico
    (Universidade Federal de São Paulo (UNIFESP), 2020-02-07) Alessi, Helena [UNIFESP]; Barsottini, Orlando Graziani Povoas [UNIFESP]; Universidade Federal de São Paulo
    Objective: To investigate serum brain derived neurotrophic factor (BDNF) as a possible biomarker for cognitive dysfunction (CD) in a large systemic lupus erythematosus (SLE) cohort. Methods: We determined BDNF levels of 111 patients with SLE (48 with major neuropsychiatric manifestations, NPSLE, such as seizure, psychosis, myelitis, stroke, peripheral neuropathies, demyelinating syndrome, acute confusional state, aseptic meningitis, and central nervous system vasculitis) and 57 matched controls (CON). Data on cardiovascular comorbidities, medication use, autoantibodies profile, SLE disease activity (SLEDAI), and SLE damage index (SDI) were evaluated. All subjects underwent neuropsychological assessment for attention, verbal and visual memory, constructional praxis, processing speed, and executive functions. Anxiety (BAI) and depression (BDI) were assessed by questionnaires. CD was defined as 2 or more standard deviations below the normative value in three or more cognitive domains assessed. Clinical features and BDNF levels were evaluated by regression analyses. ROC curve analysis was used to determine the cut-off value. Results: CD was found in 46.8% of patients (34.9% of non-NPSLE and 62.5% of NPSLE cases). BDNF level was significantly lower in SLE patients (CON: 1,345.5 ng/ml ± 438.4, non-NPSLE: 800.4 ± 502.7, NPSLE: 779.7 ± 426.3, p<0.001), independently associated with SDI (B: -75.9, SE: 27.2, 95% CI: -129.8 – -22, p=0.006) and hypertension (B: -192.5, SE: 84.3, 95% CI: -359.7 – -25.3, p=0.024). There was no association between BDNF and CD. The cutoff value to differentiate patients and controls was 937.5 ng/ml, with a specificity of 67.9% and a sensitivity of 84.2%.Conclusion: SLE patients have lower levels of BDNF, independently of neuropsychiatric manifestations. BDNF is associated with SDI and hypertension, but not with CD, suggesting that it might be a biomarker for SLE- related damage rather than cognition.
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    Impulsividade, personalidade e funções executivas em pacientes com epilepsia mioclônica juvenil
    (Universidade Federal de São Paulo (UNIFESP), 2020-03-26) Gama, Andre Peres [UNIFESP]; Guilhoto, Laura Maria De Figueiredo Ferreira [UNIFESP]; http://lattes.cnpq.br/8910334531973071; Universidade Federal de São Paulo
    According to Janz and Christian (1957) patients with juvenile myoclonic epilepsy (JME) present unsteadiness, lack of discipline, hedonism and indifference towards their disease. The objective of this study is to evaluate if there are differences in their impulsiveness and executive function, when compared to controls, besides the relation between impulsiveness and personality traits. Inclusion criteria were: JME diagnosis; age > 18 yrs; schooling > 11 yrs. And Intelligence Quotient (IQ > 70). Impulsiveness was measured by Barratt Impulsiveness Scale (BIS-11) and personality traits by the Neo Revised Personality Inventory (NEO PI-R). Neuropsychological tests used were: Vocabulary and Block Design for estimated IQ, Controlled Oral Word Association (COWA), Digit Span, Trail Making Tests (TMT) A and B, Stroop Test (ST) and Wisconsin Card Sorting Test (WSCT). A healthy control group was used for obtaining z-scores. 50 patients (35 women) with mean age 32.5 yrs. (+9.2) were evaluated. Patients showed higher scores of Total Impulsiveness (z=0.37; p=0.005) and Motor Impulsiveness (z=0.79; p<0.001) on BIS-11. Motor Impulsiveness was also associated with a higher rate of mild psychiatric disorders (p=0.035) and worse myoclonic seizure control (p=0.007). NEO PI-R results were within the normative range, however when compared to controls differences could be observed on Neuroticism (z=-0.60; p<0.001), Openness (z=0.38; p=0.043), Agreeableness (z=-0.38; p=0.033) and Conscientiousness (z=-0.53; p=0.003), with patients’ scores tending towards dysfunctionality. Correlation between BIS-11 and Neuroticism were positive for Total (r=0.395; p=0.005), Motor (r=0.375; p=0.008) and Non-Planning Impulsiveness (r=0.339; p=0.017). Conscientiousness showed negative correlation with Total (r=-0.572; p<0.001), Motor (r=-0.389; p=0.006), Attentive (r=-0.456; p=0.001) and Non-Planning Impulsiveness (r=-0.476; p=0.001). Patient’s neuropsychological results, when compared to controls, showed worse performance on COWA (z=-0.43; p=0.009) and WCST in Total Number of Completed Categories (z=-2.08; p=0.005), Trials Taken to Complete First Category (z=1.56; p=0.013), Percentage of Total Errors (z=1.56; p<0.001), Perseveration Errors (z=0.73; p=0.002), Non-Perseveration Errors (z=1.05; p=0.003) and Conceptual Level Responses (z=-1.52; p<0.001). Correlation between BIS-11 and neuropsychological tests showed that Non-Planning Impulsiveness had influence on performance, correlating with ST I (r=0.371; p=0.008), II (r=0.368; p=0.009), III (r=0.359; p=0.010), TMT A (r=0.297; p=0.036) and B (r=0.295; p=0.038). In conclusion, patients with JME seems to present Impulsiveness, executive dysfunction and personality traits that tend to dysfunctionality, leading to lack of commitment in their treatment, consequently affecting other aspects of life. Our data showed that executive functions, personality and impulsiveness are closely linked and it is possible to infer that JME presents predominantly frontal involvement, emphasizing the importance of neuropsychological rehabilitation programs.