First symptoms and neurocognitive correlates of behavioral variant frontotemporal dementia

Q2Q1Artículo original957-970Background: Previous works highlight the neurocognitive differences between apathetic and disinhibited clinical presentations of the behavioral variant frontotemporal dementia (bvFTD).However, little is knownregarding howthe early presentation (i.e., first symptom) is associated to the neurocognitive correlates of the disease’s clinical presentation at future stages of disease. Objectives: We analyzed the neurocognitive correlates of patients with bvFTD who debuted with apathy or disinhibition as first symptom of disease. Methods: We evaluated the neuropsychological, clinical, and neuroanatomical (3T structural images) correlates in a group of healthy controls (n = 30) and two groups of bvFTD patients (presented with apathy [AbvFTD, n = 18] or disinhibition [DbvFTD, n = 16]). To differentiate groups according to first symptoms, we used multivariate analyses. Results: The first symptom in patients described the evolution of the disease. AbvFTD and DbvFTD patients showed increased brain atrophy and increased levels of disinhibition and apathy, respectively. Whole brain analyzes in AbvFTD revealed atrophy in the frontal, insular, and temporal areas. DbvFTD, in turn, presented atrophy in the prefrontal regions, temporoparietal junction, insula, and temporoparietal region. Increased atrophy in DbvFTD patients (compared to AbvFTD) was observed in frontotemporal regions. Multivariate analyses confirmed that a set of brain areas including right orbitofrontal, right dorsolateral prefrontal, and left caudate were enough to distinguish the patients’ subgroups. Conclusion: First symptom in bvFTD patients described the neurocognitive impairments after around three years of disease, playing an important role in the early detection, disease tracking, and neuroanatomical specification of bvFTD, as well as in future research on potential disease-modifying treatments

Decision making and consents given by demented patients. Are they valid? ¿Sé y puedo? Toma de decisión y consentimiento informado en los trastornos demenciantes: Dilemas diagnósticos y jurídicos en Chile

© 2017, Sociedad Medica de Santiago. All rights reserved. In Chile, more than 180 thousand people (1% of the population) have some form of dementia. The figure should increase to approximately 600,000 (3% of Chileans) by 2050. This disease poses major challenges to the society. One of them is the effective recognition of the autonomy and responsibility of the person living with this condition. This article aims to review the clinical assessment of competence, its agreement with the Chilean legal system and the challenges that the assessment of competence poses in clinical decision- making and the capacity of an individual make decisions, according to the new international obligations subscribed by Chile. It is concluded that inclusion is a pending challenge, reflected among other things, by the non-compliance with binding rules such as Article 12 of the Convention on the Rights of Persons with Disabilities, which affirms that persons with disabilities have the right to be recognized a

Decision making and consents given by demented patients. Are they valid?

In Chile, more than 180 thousand people (1% of the population) have some form of dementia. The figure should increase to approximately 600,000 (3% of Chileans) by 2050. This disease poses major challenges to the society. One of them is the effective recognition of the autonomy and responsibility of the person living with this condition. This article aims to review the clinical assessment of competence, its agreement with the Chilean legal system and the challenges that the assessment of competence poses in clinical decision- making and the capacity of an individual make decisions, according to the new international obligations subscribed by Chile. It is concluded that inclusion is a pending challenge, reflected among other things, by the non-compliance with binding rules such as Article 12 of the Convention on the Rights of Persons with Disabilities, which affirms that persons with disabilities have the right to be recognized as a person everywhere, before the lawCONICYT/ FONDECYT regular/1140423; Programa Fondap Proyecto 15150012 & Centro Basal para Centros de Excelencia, Proyecto FB 0003 de Programa Investigación Asociativa CONICYT. Programa Fondef ID16AM0006

Cortex préfrontal et contrôle de l'action (approche clinique et expérimentale)

PARIS-BIUSJ-Thèses (751052125) / SudocPARIS-BIUSJ-Physique recherche (751052113) / SudocSudocFranceF

Differences among chronic restrained eaters. The influence of motivational systems Diferencias individuales en dietantes crónicos. Influencia de los sistemas motivacionales en la alimentación

Background: Restrained eaters (RE) are individuals who restrain their food intake on a regular basis as they are frightened to gain weight. However, they tend to overeat under conditions of anxiety. It has been shown that RE possess a behavioral inhibition system that is more active in tonic terms, which would partially explain their affective vulnerability. Even so, the influence of variations in the activation levels of the emotional systems on the eating behavior of a RE is still unknown. Our hypothesis is that variations of such systems will give place to two types of RE: a successful or a non-successful one. Aim: To assess the influence of variations on the activation of motivational systems in food intake of RE. Materials and methods: As part of a factorial experimental design, 105 undergraduate university students were part of an experimental test for inducting food intake. Then they reported their levels of dietary restraint and their emotional behavioral preferences. Results

Neurocognitive models of schizophrenia: The prefrontal cortex role Modelos neurocognitivos en la esquizofrenia: Rol del córtex prefrontal

Introduction: Neurocognitive models gave place to an important improvement in our understanding of several mental disorders such as schizophrenia. In this context, Prefrontal cortex (PFC) dysfunction is an essential variable for its symptomatology account. It has been observed that abnormal level of PFC activation, as well as connectivity dysfunctions with other cerebral structures, play a central role in the delimitation of the disease. Materials and Methods: Through a theoretical, empirical, and clinical review, five neurocognitive approach of schizophrenia will be described. Conclusion: Although schizophrenia etiology is probably multiple, neural interconnectivity disorders and specially those related to PFC, explain a broad range of its symptoms. © 2006 Sociedad de Neurología, Psiquiatría y Neurocirugía

Dementia in Latin America: Epidemiological Evidence and Implications for Public Policy

Population aging is among the most important global transformations. Today, 12% of the world population is of age 60 and over and by the middle of this century this segment will represent 21.5%. The increase in population of those aged 80 and over, also referred to as the “oldest old” or the “very elderly”, will be even more pronounced, going from 1.7% of the population to 4.5% within the same period. Compared to European and North American countries, Latin America (LA) is experiencing this unprecedented demographic change at a significantly faster rate. Due to demographic and health transitions, the number of people with dementia will rise from 7.8 million in 2013 to over 27 million by 2050. Nowadays, the global prevalence of dementia in LA has reached 7.1%, with Alzheimer’s Disease (AD) being the most frequent type. This level is similar to those found in developed countries; however, the dementia rate is twice as high as that of the 65–69 years age group in developed countries. In addition, the prevalence and incidence of dementia is higher among illiterate people. Mortality rates due to dementia have risen considerably. The burden and costs of the disease are high and must be covered by patients’ families. The prevention of dementia and the development of longterm care policies and plans for people with dementia in LA, which take into account regional differences and similarities, should be urgent priorities.Comision Nacional de Investigacion Cientifica y Tecnologica, (CONICYT)/FONDECYT/11404223, CONICYT/FONDAP/15150012 Associative Research Program of CONICYT under Basal Funds Grant for Centers of Excellence, FB 000