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- ItemAcesso aberto (Open Access)Ambiente familiar e desenvolvimento cognitivo infantil: uma abordagem epidemiológica(Faculdade de Saúde Pública da Universidade de São Paulo, 2005-08-01) Andrade, Susanne Anjos; Santos, Darci Neves; Bastos, Ana Cecília; Pedromônico, Márcia Regina Marcondes [UNIFESP]; Almeida-filho, Naomar De; Barreto, Mauricio L; Universidade Federal da Bahia Instituto de Saúde Coletiva; Universidade Federal da Bahia Departamento de Psicologia; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To assess the association between quality of stimulation in the family environment and child's cognitive development considering the impact of mother's schooling on the quality of stimulation. METHODS: A cross-sectional study comprising 350 children aged 17-42 months was carried out in central and peripheral areas of Salvador, Northeastern Brazil, in 1999. A socio-economic questionnaire was used, along with the Home Observation for Measurement of the Environment Scale (HOME Inventory), and the Bayley Scale for Infant Development. Bivariate and multivariate analyses were carried out through linear regression at 5% level of significance. RESULTS: There was a positive (beta=0.66) and statistically significant association between quality of stimulation in the family environment and child's cognitive development. Part of the effect was mediated by the mother's working circumstances and educational level. It was verified that a better quality of stimulation is provided for those who come early in the birth order in family, and live with only a few others under five years of age. This pattern of stimulation is better among children who live with their parents and whose mothers have better education, have a job and a partner involved in the family environment. CONCLUSIONS: Quality of stimulation in the family environment is crucial for child's cognitive development, besides the significant role of the available resources and family dynamics. The study findings show the pertinence to cognitive development of interventions which improve the quality of the environment and the child-caregiver relationship.
- ItemAcesso aberto (Open Access)Aphasia and herpes virus encephalitis: a case study(Associação Paulista de Medicina - APM, 2012-01-01) Soares-Ishigaki, Ellen Cristina Siqueira [UNIFESP]; Cera, Maysa Luchesi [UNIFESP]; Pieri, Alexandre [UNIFESP]; Ortiz, Karin Zazo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)CONTEXT: Meningoencephalitis early in life, of any etiology, is a risk factor for development of subsequent sequelae, which may be of physical, psychiatric, behavioral or cognitive origin. Anomia is a language abnormality frequently found in such cases, and other language deficits are rarely described. The aim of this study was to describe the cognitive and linguistic manifestations following a case of herpetic meningoencephalitis in a 13-year-old patient with eight years of schooling. CASE REPORT: The patient underwent a speech-language audiology assessment nine months after the neurological diagnosis. The battery of tests included the Montreal-Toulouse Language Assessment test protocol (MT Beta-86, modified), the description from the Cookie Theft task of the Boston Diagnostic Aphasia Examination (BDAE), an informal assessment of the patient's logical and mathematical reasoning, and the neuropsychological subtests from the WAIS-III scale, which assess working memory. The patient presented mixed aphasia, impairment of short-term memory and working memory, and dyscalculia. This case also presented severe cognitive and linguistic deficits. Prompt diagnosis is crucial, in order to enable timely treatment and rehabilitation of this neurological infection and minimize the cognitive deficits caused by the disease.
- ItemAcesso aberto (Open Access)Aplicação do teste M1-Alpha em sujeitos normais com baixa escolaridade: estudo piloto(Sociedade Brasileira de Fonoaudiologia, 2011-09-01) Ortiz, Karin Zazo [UNIFESP]; Costa, Flávia Pereira Da [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To determine the performance of normal subjects with low educational level on the M1-Alpha test, and to obtain parameters for potential use in the clinical evaluation of aphasic patients with low educational level. METHODS: Participants were 30 normal subjects with low educational level (one to four years of schooling), 15 male and 15 female, with ages over 18 years and below 60 years. All subjects were submitted to the M1-Alpha test, which comprehends semi-directed interview and controlled tasks. One point was given for every correct answer. Data were statistically analyzed. RESULTS: It was verified a higher number of errors, as well as greater variability of responses, in the following tasks: copying, writing to dictation, reading comprehension, and reading aloud. CONCLUSION: Low educational level influences the performance of subjects on the tasks copying, writing to dictation, reading aloud, and reading comprehension. It was possible to obtain reference data for potential clinical application of the M1-Alpha test in patients with low educational level.
- ItemSomente MetadadadosAtividade física e desempenho acadêmico: uma revisão narrativa(Universidade Federal de São Paulo (UNIFESP), 2018-10-15) Botero, Adriana Aparecida Conceição Galbiatti [UNIFESP]; Prado, Wagner Luiz do [UNIFESP]; http://lattes.cnpq.br/2118000536242631; http://lattes.cnpq.br/3949730179122722; Universidade Federal de São Paulo (UNIFESP)The Aim Of This Study Was To Identify And Discuss The Possible Mediators Of The Association Between Physical Activity And Academic Performance, Discussing The Concepts Of Determining Factors Such As Environmental / Pedagogical, Psychological And Physiological. A Narrative Review Of Scientific Articles Related To The Topic Was Carried Out. The Main Results Suggest A Positive Association Between Physical Activity And Academic Performance. Of The Main Factors That Positively Affect Academic Performance Are The Educational Policies, Intrinsic Factors Of The Student, Family Support, The Socioeconomic Level, The Social Context And The School Itself. The School Climate Of Encouragement And Support In Which Individuals Feel Safe, Supported, Engaged, Belonging To The School And Challenged Can Be Considered A Predictor Of Success For School Performance And Regular Practice Physical Activity By Schoolchildren Can Be A Potentiator Of This Environment.
- ItemSomente MetadadadosAtividade, repouso e cognição de crianças escolares(Universidade Federal de São Paulo (UNIFESP), 2019-12-18) Llaguno, Nathalie Sales [UNIFESP]; Avelar, Ariane Ferreira Machado [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: Childhood is a critical period for the development of biological systems, after all it is when processes of cognitive, physical and emotional development occur. In the school phase, the cognitive process is enhanced depending on previous and current sleep-related conditions - such as have some care and the environment - and is a target phase for health interventions. Objectives: To identify individual, family and environmental characteristics of school children; describe the activity and rest profile, melatonin levels and cognitive assessment of school children; correlate individual, family and environmental characteristics, activity and rest profile, melatonin levels and cognitive assessment of school children; and develop educational material for the implementation of sleep hygiene measures. Casuistic and Method: Cross-sectional, prospective and correlation study, conducted in a private educational institution, located in the city of Diadema-SP. The sample consisted of children enrolled in Elementary School I at least 6 years old. Were evaluated the characterization of the sample, the environment and family members, analysis of the cognitive assessment and sleep aspects variables. Collection was started after approval by the study’s ethical merit. Cognitive assessment was performed by the WASI-II test and the DFH-III, and the rest and activity by the actimeter, as well the completion of a sleep diary for 15 days. Nighttime urine (from 7 pm to 7 am), was collect on the child's last day of stay with the actimeter to measure the urinary 6-sultafatoxymelatonin level. Data were stored in a spreadsheet and analyzed using SPSS Statistics 20 software. Descriptive analysis was performed by calculating the mean, standard deviation, median, minimum and maximum. To compare cognitive tests and the activity-rest, nonparametric tests were used, considering p<0.05 statistically significant values. Results: The convenience sample consisted of 18 children, 9 males and the other females, with an average age of 7.6 years, who mainly attended the 2o. the Elementary School I year. The average time at which the children went to bed was 22h58(±1h12) and woke up at 7h44(±1h10), with a mean total rest time of 483.2(±38.3) minutes and an average sleep efficiency of 90.2(±2.7)%. The WASI-II cognitive test resulted in an average total Intelligence Quotient of 102.2(±12.3), level mean of 6-sulfatoxymelatonin was 14.6(±9.0)μg/dL, with average mean of daily electronic use of 2.8(±1.9) hours. The children were grouped according the average time they went to bed: group I - before 22h58 and group II - after 22h58. No statistically significant difference was identified between the groups and there was no association between IQ and total rest time, or between total rest time and 6-sulfatoxymelatonin level. The “Sleep Hygiene for Children” booklet was elaborated and validated with experts in the second round of the Delphi technique. Conclusion: The children showed total rest time less than recommended for the age, normal IQ values, and there wasn’t significant relationship between the total rest time, IQ value and 6-sulfatoxymelatonin level. The sleep hygiene booklet was bulit and validated after the second round of the Delphi technique, constituting material that could promote the dissemination of sleep hygiene in the school environment.
- ItemAcesso aberto (Open Access)Atribuição de estados mentais no discurso de crianças do espectro autístico(Sociedade Brasileira de Fonoaudiologia, 2011-03-01) Rodrigues, Lyvia Christina Camarotto Battiston [UNIFESP]; Tamanaha, Ana Carina [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To analyze the attribution of mental states in the speech of children within the Autistic Spectrum Disorders, and verify the modification in their vocabulary and phrasal extension, after a period of speech-language therapy. METHODS: Speech samples from the initial Speech-Language Pathology evaluation and follow-up evaluations carried out after six months and one year of speech-language therapy were collected from the records of five children with autism and five with Asperger syndrome, with the aim to characterize their verbal performance and ability of attribution of mental states. Considering only spontaneous emissions, the classes of words nouns and verbs were verified and classified as terms refering to physical and mental states. The comparison between the three evaluations was performed by assessing the significance between the medians of the samples obtained (median test, with significance level at 10%). RESULTS: It was observed an increase in the number of words produced and in the number of words per sentence between the evaluation periods and after a year of speech-language therapy, for children with autism. No differences were found for the attribution of verbs regarding physical and mental states and nouns regarding mental states, for both groups. A decrease in the number of nouns regarding physical states was observed in the autism group. CONCLUSION: The attribution of mental states increased after a period of speech-language intervention, however, with no significant difference; there was an increase in the verbal behavior of children with autism.
- ItemAcesso aberto (Open Access)Atribuição de falsas crenças no desenvolvimento de linguagem de crianças com síndrome de Down(Sociedade Brasileira de Fonoaudiologia, 2010-01-01) Silva, Tatiana Pires Da [UNIFESP]; Silva, Amanda Fernandes Da; Tamanaha, Ana Carina [UNIFESP]; Perissinoto, Jacy [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal de SergipePURPOSE: To evaluate the attribution of false belief in individuals with Down syndrome. METHODS: Eleven children of both genders with Down syndrome and ages between four and eight years composed the Down Group (DG). All subjects used verbal communication, had mild to severe mental retardation, and were attended at the same institution. In addition, 85 children within normal development with ages between four and six years were recruited at an elementary school, constituting the Control Group (CG). The Peabody Picture Vocabulary Test (PPVT) was used to compare the level of verbal comprehension of the groups, and the adaptation of the smarties test was used to assess the attribution of false belief. RESULTS: The analysis of the PPVT showed a statistically significant difference between the groups, with the DG presenting scores below the third standard deviation, and the CG, below the first standard deviation. Regarding the false belief analysis, the CG presented increasing scores in all questions as the age group increased. The same was not observed for the DG, whose subjects with best results were those that attended speech-language therapy for a longer time at the institution. No correlation was found between receptive vocabulary level and the ability of false belief. CONCLUSION: The CG showed a better performance in all questions of the false belief test, when compared to the DG. Thus, it was possible to evaluate false belief in children with Down syndrome.
- ItemSomente MetadadadosAttentional and executive functions are differentially affected by post-traumatic stress disorder and trauma(Elsevier B.V., 2014-01-01) Flaks, Mariana K. [UNIFESP]; Malta, Stella M. [UNIFESP]; Almeida, Priscila P. [UNIFESP]; Bueno, Orlando F. A. [UNIFESP]; Pupo, Mariana C. [UNIFESP]; Andreoli, Sergio B. [UNIFESP]; Mello, Marcelo F.; Lacerda, Acioly L. T. [UNIFESP]; Mari, Jair J. [UNIFESP]; Bressan, Rodrigo A. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: Among the neurocognitive impairments observed in patients with Post-traumatic Stress Disorder (PTSD), attentional and executive dysfunctions appear to correlate with negative effects on education, work, daily life activities, and social relations, as well as the re-experiencing, avoidance, and hyperarousal symptoms of PTSD. However, there is no consensus regarding which aspects of attentional and executive functions are impaired in PTSD patients.Methods: Attentional and executive functions were assessed using the digit span (WAIS-III) and spatial span (WMS-III) tests under forward and backward recall conditions, the Stroop Test, and the Wisconsin Card Sorting Test (WCST). Our sample was composed of victims of urban violence who developed PTSD (PTSD+) (n = 81), victims of urban violence who did not develop PTSD (PTSD) (n = 70), and healthy controls not exposed to trauma (HC) (n = 50).Results: the PTSD+ group had poorer performance on the spatial span forward subtest (p = 0.023; eta(2) = 0.038) and poorer execution time (p = 0.023; eta(2) = 0.042) and accuracy (p = 0.019; eta(2) = 0.044) on the Stroop Test compared to HC.Conclusions: These data suggest that there are few differences between the PTSD+ and HC groups, which are restricted to less complex measures of attentional and executive functional processes (short term capacity, selective attention, processing speed, and inhibitory control) and are related to visual stimuli. Therefore, cognitive impairments directly correlated with the manifestation of PTSD. (C) 2013 Elsevier B.V. All rights reserved.
- ItemAcesso aberto (Open Access)Avaliação da composição corporal, função cognitiva e resposta à cirurgia bariátrica em pacientes com histórico de esteatose hepática(Universidade Federal de São Paulo, 2023-11-22) Silva, Vitória Fernandes [UNIFESP]; Lee, Kil Sun [UNIFESP]; Pino, Jessica Monteiro Volejnik [UNIFESP]; http://lattes.cnpq.br/7067036778917817; http://lattes.cnpq.br/7705881286363327; http://lattes.cnpq.br/0719868888434932Introdução: O fígado é um órgão fundamental no desempenho de diversas funções vitais, incluindo o metabolismo de macronutrientes. A disfunção desse órgão pode gerar uma das hepatopatias mais alarmantes nos últimos anos, a Doença Hepática Gordurosa não Alcoólica (DHGNA). Amplo espectro histológico de lesão hepática, iniciando com esteatose hepática (EH) que está cada vez mais associada à síndrome metabólica (SM) na obesidade, para a qual, a cirurgia bariátrica é considerada um dos principais tratamentos. Objetivo: Investigar como a esteatose hepática afeta a composição corporal, o desempenho cognitivo e a resposta à cirurgia bariátrica. Métodos: Voluntárias realizaram coleta de sangue, exame de bioimpedância e uma bateria de testes cognitivos. Os parâmetros bioquímicos foram obtidos dos prontuários eletrônicos. Os metabólitos circulantes foram analisados por CG/EM usando amostras de plasma. Estratificação pelo grau de esteatose hepática (grupo 1: ausente e leve; grupo 2: moderado e grave) Resultados: Maior grau de EH apresentou maiores níveis de glicemia (p=0,012), insulina (p=0,001) e Homa-IR (p=0,001) antes da cirurgia. Foi observado um menor efeito da cirurgia sobre o ganho de massa muscular (p=0,009) e perda de gordura corporal (p=0,0013) no grupo com maior grau de EH. No teste cognitivo, observou-se melhora nos testes de atenção em ambos os grupos após a cirurgia. O perfil metabólico mostrou que os macronutrientes são as principais classes de moléculas que se alteraram entre os grupos. Discussão: De acordo com a literatura, a EH pode ser causa ou consequência da resistência insulínica. A homeostase muscular depende do equilíbrio de várias vias metabólicas, que é regulada pela insulina. Portanto, nossa observação pode ser explicada pela resistência insulínica presente antes da cirurgia, que também pode alterar o perfil dos metabólitos circulantes. Conclusão: Um maior grau de esteatose hepática parece estar associado à resistência insulínica, o que pode atenuar o efeito da cirurgia bariátrica. A investigação dessa relação é importante, pois tal relação pode colaborar para uma diminuição da qualidade de vida dos indivíduos portadores de EH.
- ItemSomente MetadadadosAvaliação da eficácia do nitroprussiato de sódio no tratamento de déficits cognitivos de indivíduos com esquizofrenia resistente ao tratamento: um estudo duplo-cego, randomizado, controlado por placebo(Universidade Federal de São Paulo (UNIFESP), 2021) Costa Junior, Edivarley Rodrigues da [UNIFESP]; Lacerda, Acioly Luiz Tavares De [UNIFESP]; Universidade Federal de São PauloSchizophrenia is a severe neuropsychiatric disease, with great impact on the patient, family and society and, despite important advances, its etiology and pathophysiology are still unknown. In the first descriptions of schizophrenia, cognitive symptoms have been considered core symptoms of the disease and have been associated with greater impairment in functioning. About one third of patients do not respond to conventional treatments with antipsychotics (dopaminergic antagonists), being considered resistant to treatment (TRS). Glutamate is the main excitatory neurotransmitter in the central nervous system and is involved in major cognitive functions such as memory and learning. One of the main evidences for the glutamatergic hypothesis comes from the psychotic syndrome induced by drugs blocking NMDA receptors, such as phencyclidine and ketamine. A proposed treatment for schizophrenia involves drugs that modulate nitric oxide, since it is a major modulator of the glutamatergic neurotransmission. Recent studies have suggested that sodium nitroprusside (SNP), a nitric oxide donor, is effective for the treatment of different symptomatic domains of schizophrenia, including positive, negative, depressive, cognitive and anxiety symptoms. Considering that, by definition, treatment-resistant schizophrenia does not respond satisfactorily to treatment with dopaminergic antagonists, in the present study we hypothesized that this subgroup would respond to an alternative mechanism of action such as modulation of the glutamatergic system through the administration of sodium nitroprusside This double-blind, randomized, placebo-controlled clinical trial aimed to examine the efficacy of repeated doses of SNP for the treatment of cognitive symptoms in schizophrenia. Twenty patients (18 to 60 years of age) with a history of non-response to ≥ 2 antipsychotics were enrolled. Patients received SNP or placebo in 4 infusions of 0.5 µg / kg / min over 4 hours. Cognitive symptoms were assessed with the Stroop Test, N-Back and verbal fluency test. SNP and placebo groups did not differ at baseline or in change from baseline over the 8 assessments. Although there were increases in blood pressure in the SNP group, it showed good tolerability and safety. Although preliminary, the present findings suggest that SNP is not effective for the treatment of cognitive symptoms in TRS, reinforcing the results of previous studies that have not shown efficacy in the treatment of chronic patients. At this point, it is conceivable to speculate that the effectiveness of the SNP may be restricted to early stages of the disease.
- ItemAcesso aberto (Open Access)Avaliação da expressão de pigment epithelium-derived factor (PEDF) em ratos submetidos à hipóxia intermitente(Universidade Federal de São Paulo (UNIFESP), 2014) Julian, Guilherme Silva [UNIFESP]; Chagas, Jair Ribeiro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)A apneia obstrutiva do sono (AOS) e caracterizada principalmente por hipoxia intermitente noturna, sendo relacionada com diversas complicacoes e patologias. O modelo de hipoxia intermitente (HI) cronica em roedores e um dos modelos animais mais utilizados para estudo da AOS e, assim como a AOS, causa diversas consequencias como declinio cognitivo e prejuizos neuronais. Pigment-Epithelium Derived Factor (PEDF) e descrito como um fator sensivel a hipoxia, com as atividades neurotrofica, neuroprotetora e anti-angiogenica. O presente estudo teve como objetivo avaliar aprendizado e memoria espacial e as expressoes genica e proteica de PEDF no SNC e no ventriculo esquerdo de ratos submetidos a HI, assim como avaliar os efeitos do retorno a normoxia, apos seis semanas de hipoxia. Alem de avaliar possiveis interacoes de PEDF e enzimas angiogenicas in vitro. Ratos machos Wistar foram submetidos a protocolos de HI (21 a 5% de concentracao de O2, com ciclos de 6 minutos) por seis semanas (grupo HI), e seis semanas de HI seguidas de duas semanas de recuperacao em normoxia (grupo Rb), ambos comparados com grupo controle (CTL). Em seguida, foram realizadas analises de aprendizado e memoria por Labirinto Aquatico de Morris, estabilidade de genes de referencia em diferentes estruturas cerebrais, expressoes genica e proteica de PEDF no hipotalamo, hipocampo e cortices frontal e temporal, alem do ventriculo esquerdo cardiaco. Alem disso, o estudo da interacao de calicreinas com PEDF e com seu fragmento peptidico 388-393 foi realizado atraves da incubacao das enzimas recombinantes com PEDF e seu fragmento 388-393, a atividade foi avaliada utilizando substratos fluorogenicos com supressao interna da fluorescencia. Com excecao de 18S, todos os genes de referencia avaliados se apresentaram estaveis aos protocolos de HI, porem, a classificacao dos genes se apresentou estrutura-dependente. Embora os modelos de HI nao tenham afetado memoria e aprendizado, a expressao genica de PEDF se apresentou aumentada seletivamente no cortex temporal dos grupos HI e Rb. Por outro lado, a expressao proteica de PEDF se manteve inalterada em todas as estruturas estudadas, assim como a expressao genica em hipotalamo, hipocampo, cortex frontal e ventriculo esquerdo. A incubacao realizada in vitro demonstrou que PEDF e seu fragmento peptidico aparentemente nao apresentam nenhuma interacao com as calicreinas tissular e plasmatica. O presente estudo demonstrou que os protocolos de HI afetam a estabilidade de genes de referencia, de maneira estrutura-dependente, no cerebro. Por outro lado, o protocolo de HI nao afetou os processos de aprendizado e memoria espacial, mas afetou a expressao de PEDF no cortex temporal, seletivamente no nivel transcripcional. Alem disso, nao ha indicacoes de que o mecanismo anti-angiogenico de PEDF envolva sua interacao com as calicreinas tissular e plasmatica
- ItemSomente MetadadadosAvaliação da relação entre funções cognitivas, ansiedade e depressão em mulheres com fibromialgia(Universidade Federal de São Paulo (UNIFESP), 2014-02-26) Goulart, Rubens [UNIFESP]; Panico, Rubens Goulart [UNIFESP]; Lombardi Júnior, Imperio [UNIFESP]; http://lattes.cnpq.br/6748923176828764; http://lattes.cnpq.br/5707670458484854; Universidade Federal de São Paulo (UNIFESP)Fibromyalgia is the second most common rheumatologic disease in Brazil. Its prevalence varies between 2.5 % and 4.4 % population, affecting predominantly woman. Several studies have demonstrated the occurrence of cognitive impairments in people with fibromyalgia, particularly in those patients who also have comorbidities such as depression and anxiety. The psychological aspects of fibromyalgia still require further investigation. Information regarding cognitive impairment in fib romyalgia are inconsistent. The volunteers in this study were women diagnosed with fibromyalgia according to the ACR criteria. After, we set up a control group of the same size, with individuals from the general population, in order to enable the pairing a ccording to age, level of education and income. Patients were assessed using the Rey Complex Figure Test, RAVLT, Stroop, Trail Making Test, Digit Test (Battery WAIS - III), Hospital Anxiety and Depression Scale, Visual Analog Pain Scale and Modified Wisconsin Card Sorting Test. The characteristics of the groups show no significant differences in the matching criteria (Age P= 0,744, scholarity P=0,504, Income P=0,498). The difference in Pain as measured by AEV was 4.17 points higher (P < 0.001) for the fibromyalgia group. The results of the Hospital Anxiety and Depression scale, was respectively 4.64 and 4.19 higher for fibromyalgia group (P < 0.001); show that this group has a tendency to have more symptoms of both anxiety as depression. Regarding the attentional characteristics of the groups, there seems to be a slower tendency in sustained attention (55.65 seconds longer in the TM-B, P=0.025), extrapolating 120 seconds cutoff. We also observed a general trend of poorer performance on pictorial memory, as measured by the REY Figure. Finally, the performance of the groups on executive functions, demonstrates a trend to poorer performance on the copy of the Rey figure (4.1 points lower, P = 0.002). Fibromyalgia patients suffer from deficits in executive functio ns, particularly in planning and inhibitory control components and such deficits are reflected in loss of memory.
- ItemAcesso aberto (Open Access)Avaliação da restrição de participação e de processos cognitivos em idosos antes e após intervenção fonoaudiológica(Sociedade Brasileira de Fonoaudiologia, 2011-03-01) Magalhães, Ruth [UNIFESP]; Iorio, Maria Cecilia Martinelli [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the restriction of participation in activities of daily living and cognitive processes in older adults, according to gender and age, before and after rehabilitation. METHODS: The study included 50 individuals, 23 females and 27 males. The elderly were divided into two groups: Group 1 to 24 individuals aged between 60 and 74 years (11 females and 13 males), Group 2 - 26 elderly aged above 75 years (12 of female and 14 male). The elderly were evaluated before one year after the adaptation of hearing aids through the HHIE test and MMSE. Bimonthly follow-ups were conducted a total of seven meetings, to ensure the effective use of the prosthesis. As for the statistical analysis were performed descriptive and statistical analysis. RESULTS: There was a reduction of the restriction of participation in social and emotional scales HHIE post-intervention in both groups, individuals of both genders. The MMSE test results were better in the post-intervention, regardless of gender and age of the participant. CONCLUSION: There is little perception of the restrictions on participation in activities of daily living after rehabilitation. Moreover, the elderly of different ages and both genders decreased cognitive constraints refer after hearing aid fitting
- ItemAcesso aberto (Open Access)Avaliação das alterações cognitivas, saúde mental e qualidade de vida em pacientes adultos com distúrbio respiratório obstrutivo do sono de grau leve(Universidade Federal de São Paulo (UNIFESP), 2020-10-22) Klichouvicz, Priscila Calixto [UNIFESP]; Poyares, Dalva Lucia Rollemberg [UNIFESP]; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4706950A2; http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K8187521Z3; Universidade Federal de São Paulo (UNIFESP)Introduction: Sleep Disordered Breathing (SDB) can lead to cognitive impairments, mood and can reduce patient´s quality of life. There are different cognitive domains, such as intelligence, memory, attention, language, executive functions, among others. Estimate that cognitive impairment is caused by serious disorders, however, the magnitude of these impairments is not very likely, especially in the mild forms, including Upper Airway Resistance Syndrome (UARS) and Mild Obstructive Sleep Apnea (OSA). Objective: This study aimed to evaluate the cognitive functions, mental health and quality of life in patients with mild SDB. Methods: 52 participants with either genders and with body mass index (BMI) < 35 Kg/m2 were included; between the ages of 25 to 50 years, according to clinical polysomnographic diagnosis of UARS (AHI score < 5 events/hours and RDI score ≥ 5 events/hour with excessive daytime sleepiness (EDS) complaints and Epworth Sleepiness Scale scores (ESS) > 10 and/or the Modified Fatigue Impact Scale scores ≥ 38); Mild OSA (5 events/hour ≤ AHI < 15 events/hour with complains) and control group without diagnosis of Sleep Breathing Disorders and no complains. Participants were allocated into 2 groups: Group 1 – Control group (n = 19) and Group 2 – UARS + mild OSA or mild SDB (n = 33). The evaluations consisted of full-night polysomnography exam (PSG); Epworth Sleepiness Scale (ESS); Pittsburgh Sleep Quality Index (PSQI); Modified Fatigue Impact Scale (MFIS-BR); Functional Outcomes of Sleep Questionnaire (FOSQ); application of cognitive instruments to assess memory, attention, executive functions; application of Beck Depression Inventory; Beck Anxiety Inventory; Lipp`s Stress Symptoms Inventory for Adults (ISSL) and finally anthropometric measurements were also collected. Results: Regarding the sleep structure, it was found that the mild SDB group showed higher proportion of the sleep stage N2 and lower proportion of sleep stage N3 when compared to the control group (p= 0,006, p=0,008, respectively). For the cognitive assessment it was observed that patients with mild Sleep Disordered Breathing had a lower performance in the immediate episodic memory domain (p=0,02) with no significant differences in the other cognitive functions evaluated. The mild SDB group showed an increase in the depressive symptoms and in the fatigue score when compared to control group (p = 0,05, p = 0,007, respectively). Conclusions: Mild SDB may be associated with symptoms of depression, fatigue and changes in sleep structure with reduced slow- wave sleep. Cognitive alteration was observed in the domain of verbal episodic memory, however, in the absence of other changes it may not have relevant clinical significance. Interestingly and contrary to our hypothesis, the UARS group showed more cognitive changes, consistently and significantly when compared to mild OSA group, however UARS and mild OSA group did not differ in relation to symptoms of depression, anxiety, stress, fatigue, impact of sleepiness on quality of life, excessive sleepiness and some sleep parameters.
- ItemAcesso aberto (Open Access)Avaliação de funções executivas no transtorno de compulsão alimentar : revisão sistemática da literatura e metanálise(Universidade Federal de São Paulo (UNIFESP), 2017-09-26) Cury, Maria Elisa Gisbert [UNIFESP]; Claudino, Angelica de Medeiros [UNIFESP]; Berberian, Arthur de Almeida [UNIFESP]; http://lattes.cnpq.br/6416386670668146; http://lattes.cnpq.br/4532343545365473; http://lattes.cnpq.br/8719369837672482; Universidade Federal de São Paulo (UNIFESP)Déficits de funções executivas (FE) são características observadas em indivíduos com transtorno da compulsão alimentar (TCA). A investigação de tais déficits contribui para uma melhor compreensão sobre a etiologia, curso e prognóstico do TCA, assim como para a adequação de terapêuticas. No entanto, ainda é limitada a literatura existente em termos de resultados consolidados, que possam contribuir para uma melhor compreensão da influência das FE no comportamento alimentar compulsivo. Objetivos: avaliar o estado de arte das investigações sobre funções executivas em pacientes com TCA através de coleta abrangente, análise crítica e síntese das evidências científicas disponíveis. Métodos: revisão sistemática da literatura buscando-se artigos que examinaram funções executivas em pessoas com diagnóstico de TCA (publicados até 25 de agosto de 2015). As buscas foram realizadas nas bases de dados eletrônicas Pubmed, Psycinfo, Scopus realizando-se o cruzamento dos seguintes descritores: binge eating disorder or binge eating and executive function or executive control or cognitive control or set-shifting or decisionmaking or working memory or inhibitory control or problem solving or attention. A revisão seguiu as recomendações propostas pelo documento Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Os critérios de inclusão foram revisões sistemáticas sobre o tema e estudos que: 1) envolveram adultos de ambos os sexos, com diagnóstico de TCA; 2) compararam pessoas com TCA a pessoas sem o transtorno (estudos experimentais do tipo caso-controle ou ensaios clínicos), e 3) que utilizaram como desfecho, qualquer medida classificada no domínio de funções executivas e, 4) publicados nas línguas inglesa, portuguesa ou espanhola. Metanálises agregando os achados de estudos elegíveis que avaliaram a mesma função cognitiva foram realizadas. Resultados: Dos 2.258 estudos identificados pelas buscas, 18 preencheram os critérios de inclusão. Destes, três eram revisões sistemáticas e 15 eram estudos caso-controle, sendo que oito deles tiveram resultados incluídos nas metanálises realizadas. Os achados das metanálises sugerem pior desempenho de pessoas com TCA em relação a controles sem TCA obesos e de peso normal na tomada de decisão (SMD = -0,63; IC 95%: - 0,95; -0,32) e na flexibilidade cognitiva – duas metanálises: 1. Trial Making Test (MD = 11,88; IC 95%: 2,92; 20,84), e 2.Winsconsin Card Sorting Test e Penn Conditional Exclusion Task Test (SMD = 0,36; IC 95%: 0,10; 0,61) – e na comparação apenas com obesos xi sem TCA no domínio solução de problemas (SMD = -0,65; IC 95% IC: -0,98;-0,32). A análise qualitativa dos resultados relativos aos domínios controle inibitório, memória de trabalho planejamento e monitoramento revelou achados mistos para déficits executivos no grupo com TCA versus pessoas sem TCA. Conclusão: Embora limitado pelo número pequeno de estudos realizados, os resultados de metanálises sugerem prejuízos em algumas esferas cognitivas de pessoas com TCA, porém os achados referentes a estudos isolados não permitem conclusões definitivas, justificando o seguimento de pesquisas neste campo, com vistas ao aprofundamento do conhecimento científico na área e potencial aplicação clínica.
- ItemAcesso aberto (Open Access)Avaliação do estado nutricional de folato, vitamina B12 e estado cognitivo em idosos acompanhados pelo estudo de coorte da Vila Clementino, EPIDOSO(Universidade Federal de São Paulo, 2020-01-27) Liu, Ângela Sun Li Wu; Tomita, Luciana Yuki [UNIFESP]; http://lattes.cnpq.br/4118529511504082; http://lattes.cnpq.br/2711961574831830Objetivo: Investigar o estado nutricional de folato (fo) e vitamina B12 (B12) e a sua relação com o estado cognitivo entre idosos residentes no município de São Paulo. Métodos: Estudo transversal, com dados da linha de base do ensaio clínico em idosos de maio/2018 a junho/2019. Foram incluídos idosos sem demência ou demência questionável e sem depressão. Concentrações séricas de B12, fo total, sérico e eritrocitário foram determinadas. Calculou-se as medidas de tendência central e dispersão e empregou-se testes x2 ou exato de Fisher, teste t de Student ou Mann- Whitney com nível de significância de 5%. Os fatores associados à concentração sanguínea de fo sérico, eritrocitário, total e B12 foram identificados pelo modelo de regressão linear múltipla. Análise de regressão logística para avaliar fatores associados ao Comprometimento Cognitivo Leve (CCL). Resultados: Avaliou-se 169 idosos, 78% mulheres, idade média (DP) de 75,6 (7,3) anos e renda per capita mediana (P25, P75) de R$2750,00 (1500; 4300). Prevalências de deficiência de fo sérico, eritrocitário e B12 sérica foram, respectivamente, 13%, 27% e 5%. Mais da metade reportou consumo inadequado de fo e cerca de 20% de B12. Fatores associados ao fo eritrocitário foram: Índice de Massa Corporal (IMC), continuar trabalhando, uso de medicamento, deficiência de B12, consumo de colesterol, carboidrato, zinco, cálcio e magnésio (R2 ajustado=13,8%). Fatores associados ao fo total foram: IMC, continuar trabalhando, uso de medicamento, deficiência de B12, dieta rica em colesterol, carboidrato e zinco (R2 ajustado=9,8%). Com relação à B12 foram: uso de prótese, IMC, sedentarismo, fo eritrocitário, CCL e não receber aposentadoria, consumo de álcool, vitamina D e selênio (R2 ajustado=15,4%). Fatores associados positivamente ao CCL foram: idade e menor nível de escolaridade e, negativamente, ser mulher e maior consumo de tiamina. Conclusão: A deficiência de fo sérico, eritrocitário e B12 sérica foi baixa. Mais de 50% reportou consumo inadequado de fo e 20% de B12. Foi encontrada uma associação negativa entre B12 e CCL.
- ItemAcesso aberto (Open Access)Avaliações cognitivas e da atenção sustentada na apneia obstrutiva do sono de grau leve(Universidade Federal de São Paulo (UNIFESP), 2016-07-31) Carneiro, Aline de Almeida Millani Gomes [UNIFESP]; Bittencourt, Lia Rita Azeredo [UNIFESP]; http://lattes.cnpq.br/6882391059348792; http://lattes.cnpq.br/5142030646736155; Universidade Federal de São Paulo (UNIFESP)Introduction: Evidence of related cognitive repercussions in Obstructive Sleep Apnea (OSA) has been well investigated in the literature. However, most of the present studies assess patients with moderate/severe OSA. Objective: Evaluate the effect of mild OSA on the cognitive consequences. Methods: The sample consisted of volunteers of both genders; aged between 18 to 65 years old and body mass index ? 35Kg/m2. We have selected 2 groups; one mild OSA group with Apnea-Hypopnea Index (AHI) from 5 to 15 independently of presenting symptoms/signals, and a control group with AHI < 5; Respiratory Disturb Index (RDI) < 5, Arousal Index (AI) < 15 and Epworth Sleepiness Scale (ESS) < 10. Evaluation between groups was performed by physical exam, full-night polysomnography, battery of cognitive tests, Performance Vigilance Test (PVT). Statistical analysis was performed by descriptive analysis (mean ± standard deviation) and for between groups analysis, univariate General Linear Model (GLM) test and GLM repeated measures, considering significant if p ? 0.05. Results: The sample consisted of 106 individuals, 35 in the control group and 71 in mild OSA group. There were no significant differences in cognitive assessments conducted between mild AOS group and the control group. Conclusion: Patients with mild OSA do not have cognitive impairment compared to control subjects.
- ItemSomente MetadadadosBehavioural changes observed in demyelination model shares similarities with white matter abnormalities in humans(Elsevier B.V., 2015-07-01) Oliveira, Nathalia Serra de [UNIFESP]; Boilesen, Sabine Nunes [UNIFESP]; Carvalho, Carolina Prado de França [UNIFESP]; Le Sueur-Maluf, Luciana [UNIFESP]; Zollner, Ricardo de Lima; Spadari, Regina Celia [UNIFESP]; Medalha, Carla Christina [UNIFESP]; Castro, Glaucia Monteiro de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Campinas (UNICAMP)Multiple sclerosis (MS) is a chronic, inflammatory, demyelinating disease of the central nervous system (CNS). Further to the symptoms resulting from demyelination, new studies point to the involvement of neuroinflammation and white matter abnormalities in psychiatric disorders and neurodegenerative diseases. Cuprizone, a model of MS, produces consistent demyelination and elicits behavioural, morphological and inflammatory changes in animals that share some similarities with those observed in humans. in this study, we used the cuprizone model in Lewis rats to evaluate clinical signs triggered by the demyelination process which could be comparable with the symptoms seen in white matter abnormalities in human beings. To induce the demyelination process, 0.6% cuprizone was added to the Lewis rats' diet for 4 weeks. We proceeded with behavioural, morphological and immunological analyses. Animals fed with cuprizone exhibited behavioural changes: higher scores in the neurotoxicity test, reduced exploratory and locomotion behaviour, and also an increase of permanency in the closed arm of the elevated plus maze test, were observed. in these analyses, the animals showed motor coordination impairment and anxiety-like behaviour. Demyelination also triggered changes in discrimination of objects identified by an increase in the time spent close to a familiar object. These behavioural alterations were associated with a significant increase in the levels of TNF-alpha and corticosterone, consistent with the activation of microglia and astrocytes. Taken together, the results of this work show the cuprizone/Lewis rat model demyelination as an attractive paradigm for studying the correlation between white matter abnormalities and behaviour. (C) 2015 Elsevier B.V. All rights reserved.
- ItemSomente MetadadadosCapacidade de abstração e o teste de provérbios(Universidade Federal de São Paulo (UNIFESP), 1997) Siviero, Marilena Occhini [UNIFESP]; Bertolucci, Paulo Henrique Ferreira [UNIFESP]
- ItemAcesso aberto (Open Access)Catechol-O-methyltransferase (COMT) polymorphisms modulate working memory in individuals with schizophrenia and healthy controls(Assoc Brasileira Psiquiatria, 2017) Matsuzaka, Camila T. [UNIFESP]; Christofolini, Denise; Ota, Vanessa K. [UNIFESP]; Gadelha, Ary [UNIFESP]; Berberian, Arthur A. [UNIFESP]; Noto, Cristiano [UNIFESP]; Mazzotti, Diego R. [UNIFESP]; Spindola, Leticia M. [UNIFESP]; Moretti, Patricia N. [UNIFESP]; Smith, Marilia A. C. [UNIFESP]; Melaragno, Maria I. [UNIFESP]; Belangero, Sintia I. [UNIFESP]; Bressan, Rodrigo A. [UNIFESP]Objective: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role. Methods: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs. Results: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype* group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients. Conclusion: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.