Memory and attention deficit/hyperactivity disorder

O Transtorno do Déficit de Atenção/Hiperatividade (TDAH) é o transtorno psiquiátrico mais comum em crianças e adolescentes, com prevalência de 6%. O TDAH classifica-se nos subtipos desatento (TDAHD), hiperativo (TDAHH) ou combinado (TDAHC). Suas manifestações incluem problemas de cognição, comportamentais, afetivos e sociais. Distúrbios de memória e atenção são problemas cognitivos freqüentes. A memória de curta e longa duração foi avaliada em 44 sujeitos portadores do TDAH por subtipos, (TDAHD, n=17; TDAHH, n=11 ;TDHAC, n=16; idade: 12,8 anos; escolaridade: 6,1 a) e 43 indivíduos não portadores que constituíram o grupo controle (idade: 12,11 anos; escolaridade: 6,4 a). Os escores foram a média de evocações corretas em um experimento desenvolvido para este estudo. 64 figuras distribuídas em 4 apresentações com 16 figuras cada constituíram a avaliação de memória (MEMO). As apresentações para recordação imediata e tardia: memória categorizável agrupada, memória não-categorizável seriada, memória não-categorizável agrupada. Inteligência e atenção também foram analisadas. Os resultados mostraram os grupo TDAHH e TDAHC tiveram um pior desempenho na memória de longa duração categorizável e não categorizável na apresentação seriada; os três grupos com TDAH tiveram desempenho inferior ao grupo controle com figuras categorizáveis e não-categorizáveis agrupadas, com maior efeito para TDAHD e TDAHC. Os resultados indicam prejuízo de memória de longa e curta duração no TDAH independente da contribuição de estratégias de memória.Attention Deficit Hyperactivity Disorder (ADHD) is the most common psychiatric disorder among children and teenagers, with a prevalence of 6%. ADHD disorder has three subtypes: inattentive (ADHDI), hyperactive (ADHDH) and combined (ADHDC). The symptoms include cognitive, behavioral, affective, and social disturbances. Memory and attention deficits are the cognitive problems that frequently attend this disorder. Long and short-term memory were assessed in 44 children and teenagers with ADHD (ADHDD, n=17; ADADH, n=11 ;ADHDC, n=16; age: 12,8 y; 6,1 years of education) and 44 healthy participants (Control group, age: 12,11; 6,4 years of education). An experiment was developed to investigate memory (MEMO). The experiment consisted of 64 figures in 4 different presentations. Each presentation had 16 figures designed to measure immediate and delayed recall in four conditions: serial categorizable memory, grouped categorizable memory, serial non-categorizable memory, and grouped non-categorizable memory. Intelligence and attention were also assessed. The recall of ADHDD and ADHDC groups was worse in the categorizable and non-categorizable serial conditions; the performance of all three ADHD groups was worse than that of the control group with respect to the two grouped conditions, but ADHDD and ADHDC were the worst. These results suggest memory deficit for long and short-term memory on ADHD independent of memory strategies contribution

Executive functioning and reading achievement in school: a study of Brazilian children assessed by their teachers as “poor readers”

This study examined executive functioning and reading achievement in 106 6- to 8-year-old Brazilian children from a range of social backgrounds of whom approximately half lived below the poverty line. A particular focus was to explore the executive function profile of children whose classroom reading performance was judged below standard by their teachers and who were matched to controls on chronological age, sex, school type (private or public), domicile (Salvador/BA or São Paulo/SP) and socioeconomic status. Children completed a battery of 12 executive function tasks that were conceptual tapping cognitive flexibility, working memory, inhibition and selective attention. Each executive function domain was assessed by several tasks. Principal component analysis extracted four factors that were labeled “Working Memory/Cognitive Flexibility,” “Interference Suppression,” “Selective Attention,” and “Response Inhibition.” Individual differences in executive functioning components made differential contributions to early reading achievement. The Working Memory/Cognitive Flexibility factor emerged as the best predictor of reading. Group comparisons on computed factor scores showed that struggling readers displayed limitations in Working Memory/Cognitive Flexibility, but not in other executive function components, compared to more skilled readers. These results validate the account that working memory capacity provides a crucial building block for the development of early literacy skills and extends it to a population of early readers of Portuguese from Brazil. The study suggests that deficits in working memory/cognitive flexibility might represent one contributing factor to reading difficulties in early readers. This might have important implications for how educators might intervene with children at risk of academic under achievement

Benefits of combined interventions for cognitive enhancement in older adults

OBJECTIVE: To investigate the effects of different combined interventions (Stimullus, MEMO, physical activity, and psychoeducation) on the cognitive performance of older adults. METHODS: This is a quasi-experimental study with pre- and post-intervention. Thirty-four older adults underwent different combined interventions for a period of 48 weeks and were evaluated at three different points (pre-intervention; post-cognitive intervention; post-physical activity or psychoeducation intervention). Cognitive domains (verbal episodic memory, executive function, general cognitive performance) and depressive symptoms were evaluated. RESULTS: Postintervention gains in global, attentional, and mnemonic cognition were observed, as well as a reduction in depressive symptoms. The MEMO intervention + physical activity or psychoeducation resulted in greater cognitive gains, while Stimullus + psychoeducation showed benefits only in evocation and the free learning index, while Stimullus + physical activity resulted in improvement in the investigated variables. CONCLUSION: The results of these combined interventions appear promising for healthy older adults and the impact of these interventions should be discussed with individual older patients and evaluated more broadly in the context of public health.</p

Normas de asociación semántica para 20 categorías en adultos y ancianos

O desenvolvimento de normas para categorias semânticas é necessário para a compreensão do modo como os indivíduos organizam o conhecimento na memória e para a construção de instrumentos de avaliação cognitiva. O objetivo do presente estudo é fornecer normas associativas de 20 categorias semânticas para adultos e idosos brasileiros. Participaram do estudo 236 pessoas, entre 40 e 88 anos, das cinco regiões brasileiras. Os participantes responderam a um questionário de dados sociodemográficos e a um questionário de itens para categorias semânticas, e foram solicitados a produzir os cinco primeiros exemplares de cada categoria apresentada. Os resultados foram agrupados e são apresentadas as normas das categorias (exemplares, tamanho da categoria, respostas corretas, em branco e erros), bem como as respostas de cada categoria que foram comuns a todas as regiões brasileiras.The development of semantic category norms is necessary to assist in the understanding of how individuals organize knowledge in memory, and to the creation of cognitive assessment instruments. The aim of this study is to provide associative norms of 20 semantic categories for Brazilian adults and elderly. The study included 236 participants from 40 to 88 years of age from the five Brazilian regions. They answered a socio-demographic questionnaire and a semantic category questionnaire, in which they were asked to produce the first five items of each category. Results are presented in category norms (items, category set size, correct responses, no responses and errors), as well as the responses that were common to all Brazilian regions belonging to each category.Es necesario el desarrollo de normas para categorías semánticas para poder comprender cómo las personas organizan el conocimiento en la memoria y para la construcción de instrumentos de evaluación cognitiva. El objetivo de este estudio es proporcionar normas asociativas de 20 categorías semánticas para muestras de brasileños adultos y ancianos. Participaron 236 personas entre 40 y 88 años, de cinco regiones de Brasil. Los participantes completaron un cuestionario de datos sociodemográfico y un cuestionario de ítems para categorías semánticas y se les solicitó la producción de los cinco primeros ejemplares de cada categoría presentada. Los resultados fueron agrupados y son presentadas las normas de las categorías (ejemplares, tamaño de categoría, respuestas correctas, en blanco y errores), así como las respuestas de cada categoría, comunes a todas las regiones de Brasil

Normas de asociación semántica para 20 categorías en adultos y ancianos

O desenvolvimento de normas para categorias semânticas é necessário para a compreensão do modo como os indivíduos organizam o conhecimento na memória e para a construção de instrumentos de avaliação cognitiva. O objetivo do presente estudo é fornecer normas associativas de 20 categorias semânticas para adultos e idosos brasileiros. Participaram do estudo 236 pessoas, entre 40 e 88 anos, das cinco regiões brasileiras. Os participantes responderam a um questionário de dados sociodemográficos e a um questionário de itens para categorias semânticas, e foram solicitados a produzir os cinco primeiros exemplares de cada categoria apresentada. Os resultados foram agrupados e são apresentadas as normas das categorias (exemplares, tamanho da categoria, respostas corretas, em branco e erros), bem como as respostas de cada categoria que foram comuns a todas as regiões brasileiras.The development of semantic category norms is necessary to assist in the understanding of how individuals organize knowledge in memory, and to the creation of cognitive assessment instruments. The aim of this study is to provide associative norms of 20 semantic categories for Brazilian adults and elderly. The study included 236 participants from 40 to 88 years of age from the five Brazilian regions. They answered a socio-demographic questionnaire and a semantic category questionnaire, in which they were asked to produce the first five items of each category. Results are presented in category norms (items, category set size, correct responses, no responses and errors), as well as the responses that were common to all Brazilian regions belonging to each category.Es necesario el desarrollo de normas para categorías semánticas para poder comprender cómo las personas organizan el conocimiento en la memoria y para la construcción de instrumentos de evaluación cognitiva. El objetivo de este estudio es proporcionar normas asociativas de 20 categorías semánticas para muestras de brasileños adultos y ancianos. Participaron 236 personas entre 40 y 88 años, de cinco regiones de Brasil. Los participantes completaron un cuestionario de datos sociodemográfico y un cuestionario de ítems para categorías semánticas y se les solicitó la producción de los cinco primeros ejemplares de cada categoría presentada. Los resultados fueron agrupados y son presentadas las normas de las categorías (ejemplares, tamaño de categoría, respuestas correctas, en blanco y errores), así como las respuestas de cada categoría, comunes a todas las regiones de Brasil

Environmental Co-Exposure to Lead and Manganese and Intellectual Deficit in School-Aged Children

Studies have demonstrated that, for urban children, dust represents the main exposure to sources of metals like lead (Pb) and manganese (Mn). We aimed to investigate the exposure to these metals and their association with intellectual deficit in children living in an industrial region. This cross-sectional study recruited volunteers from four elementary schools in the town of Sim&#245;es Filho, Brazil. We evaluated 225 school-aged children (7&#8315;12 years) for blood lead (PbB) and manganese hair (MnH) and toenails (MnTn) by graphite furnace atomic absorption spectrometry. Child and maternal IQs were estimated using the Wechsler Abbreviated Scale for Intelligence (WASI). Median and range PbB were 1.2 (0.3&#8315;15.6) &#956;g/dL. MnH and MnTn medians (ranges) were 0.74 (0.16&#8315;8.79) &#956;g/g and 0.85 (0.15&#8315;13.30) &#956;g/g, respectively. After adjusting for maternal IQ, age and Mn exposure, child IQ drops by 8.6 points for a 10-fold increase in PbB levels. Moreover, an effect modification of Mn co-exposure was observed. In children with low MnTn, association between Pb and child IQ was not significant (&#946; = &#8722;6.780, p = 0.172). However, in those with high MnTn, the association was increased by 27.9% (&#946; = &#8722;8.70, p = 0.036). Low Pb exposure is associated with intellectual deficit in children, especially in those with high MnTn

Comparative study of esketamine and racemic ketamine in treatment-resistant depression: Protocol for a non-inferiority clinical trial

Carvalho, Lucas Pedreira de. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Laboratório de Pesquisa Clínica. Salvador, BA, Brasil. a Postgraduate Program in Medicine and Health, b Psychiatry Service, University Hospital, Universidade Federal da Bahia, Salvador, c LiNC—Laboratório Interdisciplinar de Neurociências Clínicas, d Depatment of Anesthesiology, e PRODAF—Programa de Transtornos Afetivos, Universidade Federal de São Paulo, São Paulo, f Postgraduate Program in Psychology, Institute of Psychology, g Immunology Service, Universidade Federal da Bahial, h Clinical Research Laboratory (LAPEC), Gonçalo Moniz Institute, Fiocruz-Bahia, Salvador, Brazil, i McGill Group for Suicide Studies, Douglas Mental Health University Institute & Department of Psychiatry, McGill University, Montreal, Canada, j Center for Research and Clinical Trials Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, Brazil.Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2018-12-21T16:28:46Z No. of bitstreams: 1 Melo FSC Comparative_study_of_esketamine_and_racemic.64.pdf: 212500 bytes, checksum: 350198044d38100f8cc9dd703451de7c (MD5)Approved for entry into archive by Ana Maria Fiscina Sampaio ([email protected]) on 2018-12-21T16:45:26Z (GMT) No. of bitstreams: 1 Melo FSC Comparative_study_of_esketamine_and_racemic.64.pdf: 212500 bytes, checksum: 350198044d38100f8cc9dd703451de7c (MD5)Made available in DSpace on 2018-12-21T16:45:26Z (GMT). No. of bitstreams: 1 Melo FSC Comparative_study_of_esketamine_and_racemic.64.pdf: 212500 bytes, checksum: 350198044d38100f8cc9dd703451de7c (MD5) Previous issue date: 2018Allergan and Lundbeck and research fees from Janssen Pharmaceutical during the last 12 months. ALTL has received consulting fees from Janssen Pharmaceutical, Daiichi Sankyo Brasil, Cristalia Produtos Químicos e Farmacêuticos, Libbs Farmacêutica and SanofiAventis and has received research fees from Eli Lilly, H. Lundbeck A/S, Servier Laboratories, Hoffman-La Roche and Forum Pharmaceuticals during the last 12 months.Múltipla - ver em NotasThe use of ketamine as an option in the treatment of depressive disorder is growing rapidly, supported by numerous clinical trials attesting its efficacy and safety. Esketamine, the S (+) enantiomer of ketamine, is the most widely used form in the anesthetic environment in some countries, and new studies have shown that it may also be effective in depression and with better tolerability. However, no study so far has directly compared esketamine with racemic ketamine. Here we propose a protocol of a clinical trial to evaluate esketamine as a noninferior medicationMethods/design: This study protocol is for a randomized, controlled, double-blind noninferiority clinical trial. Subjects will be 18 years or older, with major depression characterized as treatment-resistant. Participants will receive a single infusion of either esketamine (0.25mg/kg) or ketamine (0.5 mg/kg) over 40 minutes. The primary outcome will be the difference in remission rates between the 2 treatment arms at 24 and 72hours after drug infusion. Secondary outcomes will include other timepoints, measurements of cognition, dissociation, and blood biomarkers. Discussion: A head-to-head study is the best way to evaluate whether the esketamine is in fact comparable to the racemic ketamine in terms of both efficacy and safety, and, if positive, it would be an initial step to increase the access to that type of treatment worldwide. Ethics and dissemination: The study was approved by the local Institutional Review Board (University Hospital Professor Edgard Santos—Federal University of Bahia—Number: 46657415.0.0000.0049). Subjects will only participate after voluntarily agreeing and signing the Informed Consent Form. The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration: This trial has been registered in the Japan Primary Registries Network (JPRN): UMIN000032355, which is affiliated with the World Health Organization. when compared to ketamine in the treatment of patients with treatment-resistant depression