Fleni coglioma: battery for the detection of cognitive compromise in patients with low grade Glioma

Los nuevos procedimientos quirúrgicos han beneficiado a los pacientes con Gliomas de Bajo Grado (GBG), quienes tienen una mayor esperanza de vida. Por este motivo existe un creciente interés en proteger la cognición y mejorar su calidad de vida. Los objetivos del estudio fueron: (1) Construir y administrar una batería neuropsicológica que permita examinar el perfil cognitivo prequirúrgico en pacientes con GBG y determinar los efectos posquirúrgicos. (2) Diseñar una intervención intraquirúrgica para pacientes con lesiones en el hemisferio izquierdo a fin de minimizar posibles déficits posteriores. Se evaluaron 19 pacientes con una batería prequirúrgica que evalúa los distintos dominios cognitivos: memoria, lenguaje, atención, funciones ejecutivas, habilidades visuoespaciales, cognición social, praxias y gnosias. Asimismo, los pacientes completaron cuestionarios neuropsiquiátricos con el fin de valorar funcionalidad, estado anímico y calidad de vida. Los pacientes presentaron déficit en múltiples dominios cognitivos en la evaluación prequirúrgica, al comparar su rendimiento con valores normativos ajustados por edad, sexo y educación. Los resultados del presente estudio demuestran la importancia de la administración de la batería neuropsicológica específicamente diseñada para pacientes con GBG y la evaluación de los dominios cognitivos para lograr la detección y el seguimiento de posibles trastornos cognitivos.New surgical procedures have benefited patients with Low-Grade Gliomas (LGG), who have a longer life expectancy. For this reason there is a growing interest in protecting cognition and improving their quality of life. The objectives of the study were: (1) To construct and administer a neuropsychological battery to examine the pre-surgical cognitive profile in patients with LGG and to determine the post-surgical effects. (2) To design an intra-surgical intervention for patients with lesions in the left hemisphere in order to minimize possible later deficits. 19 patients were evaluated with a pre-surgical battery that assesses different cognitive domains: memory, language, attention, executive functions, visuospatial skills, social cognition, praxias and gnosias. Patients also completed neuropsychiatric questionnaires to assess functionality, mood and quality of life. Patients presented deficits in multiple cognitive domains in the pre-surgical evaluation, when comparing their performance with normative values adjusted for age, sex and education. The results of the present study demonstrate the importance of the administration of the neuropsychological battery specifically designed for LGG patients and the assessment of cognitive domains to achieve detection and follow-up of possible cognitive disorders

Effectiveness of cognitive rehabilitation on mild cognitive impairment using teleneuropsychology

ABSTRACT The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives: To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods: A sample of 60 patients with mild cognitive impairment according to Petersen’s criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on each outcome of interest over time (pre/post-intervention). Results: A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions: Our study suggests that CTR is an effective intervention

Working group recommendations for the practice of teleneuropsychology in Latin America

Objective: Teleneuropsychology (teleNP) could potentially expand access to services for patients who are confined, have limited personal access to healthcare, or live in remote areas. The emergence of the COVID-19 pandemic has significantly increased the use of teleNP for cognitive assessments. The main objective of these recommendations is to identify which procedures can be potentially best adapted to the practice of teleNP in Latin America, and thereby facilitate professional decision-making in the region. Method: Steps taken to develop these recommendations included (1) formation of an international working group with representatives from 12 Latin American countries; (2) assessment of rationale, scope, and objectives; (3) formulation of clinical questions; (4) evidence search and selection; (5) evaluation of existing evidence and summary; and (6) formulation of recommendations. Levels of evidence were graded following the Oxford Centre for Evidence-Based Medicine system. Databases examined included PubMed, WHO-IRIS, WHO and PAHO-IRIS, Índice Bibliográfico Español en Ciencias de la Salud (IBCS), and LILACS. Results: Working group members reviewed 18,400 titles and 422 abstracts and identified 19 articles meeting the criteria for level of evidence, categorization, and elaboration of recommendations. The vast majority of the literature included teleNP tests in the English language. The working group proposed a series of recommendations that can be potentially best adapted to the practice of teleNP in Latin America. Conclusions: There is currently sufficient evidence to support the use of videoconferencing technology for remote neuropsy chological assessments. These recommendations will likely contribute to the advancement of teleNP research and practice in the region