Tradução e adaptação transcultural do Game Dice Task para população brasileira

OBJECTIVE: The Game Dice Task (GDT) was developed to measure decision making under known risk. The aim of this study was to translate and adapt the GDT to a Brazilian population. METHOD: After the GDT was translated and back-translated to Brazilian Portuguese and evaluated by eight bilingual judges, 175 Brazilian adults were divided into two groups - 160 healthy volunteers and 15 traumatic brain injury (TBI) patients - and had completed the GDT. RESULTS: Differences between genders, but not age, were observed in the healthy volunteer sample. Males more frequently chose a combination of three dice while females preferred four dice. TBI patients were more impulsive than healthy volunteers; they less frequently chose a combination of three dice and made more risky decisions. CONCLUSION: Because of the rigorous process used to translate and adapt the GDT and the differences observed between patients with TBI and healthy volunteers, the Brazilian GDT was considered satisfactory for research purposes.OBJETIVO: O Game Dice Task (GDT) foi desenvolvido para avaliar a tomada de decisão de indivíduos sob situações específicas de risco conhecido. O objetivo deste estudo foi traduzir e adaptar o GDT para a população brasileira. MÉTODOS: Após ter sido traduzido e retrotraduzido para o português e ter sido avaliado por oito juízes bilíngues, 175 adultos brasileiros completaram o GDT - 160 adultos saudáveis e 15 pacientes com traumatismo cranioencefálico (TCE). RESULTADOS: Foram observadas diferenças no desempenho quanto ao gênero, mas não quanto à idade, nos adultos saudáveis. Homens escolheram mais frequentemente a combinação com três dados, enquanto as mulheres preferiram quatro dados. Pacientes com TCE foram mais impulsivos, escolheram com menor frequência a combinação de três dados e tomaram decisões mais arriscadas. CONCLUSÃO: Por causa do rigoroso processo utilizado pra traduzir e adaptar o teste GTD e do poder de discriminação entre as amostras de adultos saudáveis e com TCE, a versão brasileira desse teste foi considerada satisfatória para utilização em pesquisa.Universidade Federal de São Paulo (UNIFESP) Department of PsychobiologyUNIFESP, Department of PsychobiologySciEL

Memory In Children With Symptomatic Temporal Lobe Epilepsy.

In children with temporal lobe epilepsy (TLE), memory deficit is not so well understood as it is in adults. The aim of this study was to identify and describe memory deficits in children with symptomatic TLE, and to verify the influence of epilepsy variables on memory. We evaluated 25 children with TLE diagnosed on clinical, EEG and MRI findings. Twenty-five normal children were compared with the patients. All children underwent a neuropsychological assessment to estimate intellectual level, attention, visual perception, handedness, and memory processes (verbal and visual: short-term memory, learning, and delayed recall). The results allowed us to conclude: besides memory deficits, other neuropsychological disturbances may be found in children with TLE such as attention, even in the absence of overall cognitive deficit; the earlier onset of epilepsy, the worse verbal stimuli storage; mesial lesions correlate with impairment in memory storage stage while neocortical temporal lesions correlate with retrieval deficits.72184-

Memory in children with temporal lobe epilepsy is at least partially explained by executive dysfunction

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)An association between memory and executive dysfunction (ED) has been demonstrated in patients with mixed neurological disorders. We aimed to investigate the impact of ED in memory tasks of children with temporal lobe epilepsy (TLE). We evaluated 36 children with TLE and 28 controls with tests for memory, learning, attention, mental flexibility, and mental tracking. Data analysis was composed of comparison between patients and controls in memory and executive function; correlation between memory and executive function tests; and comparison between patients with mild and severe ED in memory tests. Children with TLE had worse performance in focused attention, immediate and delayed recall, phonological memory, mental tracking, planning, and abstraction. Planning, abstraction, and mental tracking were correlated with visual and verbal memory. Children with severe ED had worse performance in verbal and visual memory and learning tests. This study showed that ED was related to memory performance in children with TLE. (C) 2012 Elsevier Inc. All rights reserved.254577584Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Memory in children with temporal lobe epilepsy is at least partially explained by executive dysfunction

An association between memory and executive dysfunction (ED) has been demonstrated in patients with mixed neurological disorders. We aimed to investigate the impact of ED in memory tasks of children with temporal lobe epilepsy (TLE). We evaluated 36 children with TLE and 28 controls with tests for memory, learning, attention, mental flexibility, and mental tracking. Data analysis was composed of comparison between patients and controls in memory and executive function; correlation between memory and executive function tests; and comparison between patients with mild and severe ED in memory tests. Children with TLE had worse performance in focused attention, immediate and delayed recall, phonological memory, mental tracking, planning, and abstraction. Planning, abstraction, and mental tracking were correlated with visual and verbal memory. Children with severe ED had worse performance in verbal and visual memory and learning tests. This study showed that ED was related to memory performance in children with TLE. (C) 2012 Elsevier Inc. All rights reserved.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP, Foundation for the Support of Research in the State of Sao Paulo) [03/06025-3, 05/03489-4]Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES, Office for the Advancement of Higher Education)Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq, National Council for Scientific and Technological Development)This work was supported by a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, Foundation for the Support of Research in the State of São Paulo; grant nos. 03/06025-3 and 05/03489-4), as well as by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, Office for the Advancement of Higher Education), and the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq, National Council for Scientific and Technological Development). We are grateful to the staff members of the Laboratory of Clinical Neurophysiology and the Division of Psychology and Neuropsychology of the Department of Psychiatry, University of São Paulo School of Medicine, for their valuable assistance

Distinct Domains Of Impulsivity Are Impaired In Juvenile Myoclonic Epilepsy But Not In Temporal Lobe Epilepsy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Objective: The Barratt Impulsiveness Scale (BIS-11) is the most widely used questionnaire to study impulsivity in persons with psychiatric disorders, but it has rarely been applied to persons with epilepsy. The present study aimed to evaluate the usefulness of BIS-11 as a tool to explore impulsivity in two distinct epilepsy syndromes. Method: The BIS-11 was applied to 20 patients with juvenile myoclonic epilepsy (JME) (32.5 +/- 8.95 years old), 20 patients with temporal lobe epilepsy (TLE) (37.7 +/- 13.25 years old), and 26 healthy controls (31.86 +/- 11.25 years old). The scores in motor, attentional, and lack of planning impulsivity were compared between groups. Results: Patients with JME showed higher scores than patients with TLE and controls in all domains: motor (JME vs TLE: 28.60 vs 13.25 (mean score), p < 0.001 and JME vs controls: 28.60 vs 14.12, p < 0.001), attentional (JME vs TLE: 21.55 vs 13.45, p < 0.001 and JME vs controls: 21.55 vs 14.88, p < 0.001) and nonplanning (JME vs TLE: 28.05 vs 13.10, p < 0.001 and JME vs controls: 28.05 vs 16.15, p < 0.001). Conclusion: Higher BIS-11 scores in all domains of impulsivity [i.e., motor, attentional, and lack of planning] corroborated previous findings described in patients with JME. On the other hand, BIS-11 could not demonstrate problem solving and inhibitory control deficits related to impulsive behavior, which were described in patients with TLE. Other behavioral measures may be more sensitive to some aspects of impulsivity in TLE. Our results reinforce the concept that distinct epileptic syndromes require different neuropsychological approaches, especially considering a complex construct such as impulsivity. (C) 2015 Elsevier Inc. All rights reserved.454448Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)FAPESP [12/09025-3, 13/11361-4]CNPq [307262/2011-1

Delineating behavioral and cognitive phenotypes in juvenile myoclonic epilepsy: are we missing the forest for the trees?

Patients with juvenile myoclonic epilepsy (JME) have executive dysfunction and impulsive traits. There are lines of evidence that JME is a heterogeneous epilepsy syndrome considering outcome. In this study, we aimed to analyze this heterogeneity beyond seizure control. The objective was to identify whether the pattern of cognitive dysfunction and impulse control is also heterogeneous, in an attempt to establish possible differences in patients with easy-and hard-to-control epilepsies. Essentially, 57 patients with JME were compared with 44 controls. Patients and controls were assessed with a neuropsychological battery for executive, attention, and memory functions. The expression of impulsive traits was evaluated with the Temperament and Character Inventory - novelty seeking domain. Then, patients were categorized according to seizure control as having easy-and hard-to-control JME. Patients with hard-to-control JME showed worse performance in 12 out of 25 neuropsychological tests than those with easy-to-control JME. Patients with hard-to-control JME also demonstrated significantly higher scores in novelty seeking -subfactor impulsiveness (p=0.002). Our study demonstrated the existence of distinct or more severe cognitive and psychiatric profiles in a subset of patients with JME. Patients with treatment-refractory seizures seem to present a broader impairment related to both cognitive deficits and impulsive traits. These findings suggest that patients with JME are not equally compromised by executive and memory deficits or dysfunction, neither by their impulsive traits. Thus, there is a need for a better characterization of patients with JME to include diverse phenotypes since our results suggest a possible existence of distinct groups of patients with JME549599CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP307262/2011-105/56464-9; 07/52110-

Distinct domains of impulsivity are impaired in juvenile myoclonic epilepsy but not in temporal lobe epilepsy

The Barratt Impulsiveness Scale (BIS-11) is the most widely used questionnaire to study impulsivity in persons with psychiatric disorders, but it has rarely been applied to persons with epilepsy. The present study aimed to evaluate the usefulness of BIS-11 as a tool to explore impulsivity in two distinct epilepsy syndromes. The BIS-11 was applied to 20 patients with juvenile myoclonic epilepsy (JME) (32.5±8.95years old), 20 patients with temporal lobe epilepsy (TLE) (37.7±13.25years old), and 26 healthy controls (31.86±11.25years old). The scores in motor, attentional, and lack of planning impulsivity were compared between groups. Patients with JME showed higher scores than patients with TLE and controls in all domains: motor (JME vs TLE: 28.60 vs 13.25 (mean score), p<0.001 and JME vs controls: 28.60 vs 14.12, p<0.001), attentional (JME vs TLE: 21.55 vs 13.45, p<0.001 and JME vs controls: 21.55 vs 14.88, p<0.001) and nonplanning (JME vs TLE: 28.05 vs 13.10, p<0.001 and JME vs controls: 28.05 vs 16.15, p<0.001). Higher BIS-11 scores in all domains of impulsivity [i.e., motor, attentional, and lack of planning] corroborated previous findings described in patients with JME. On the other hand, BIS-11 could not demonstrate problem solving and inhibitory control deficits related to impulsive behavior, which were described in patients with TLE. Other behavioral measures may be more sensitive to some aspects of impulsivity in TLE. Our results reinforce the concept that distinct epileptic syndromes require different neuropsychological approaches, especially considering a complex construct such as impulsivity.The Barratt Impulsiveness Scale (BIS-11) is the most widely used questionnaire to study impulsivity in persons with psychiatric disorders, but it has rarely been applied to persons with epilepsy. The present study aimed to evaluate the usefulness of BIS-1454448FAPESP - FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULOCAPES - COORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIORCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO12/09025-3; 13/11361-4SEM INFORMAÇÃO307262/2011-