Categoría: Papers con abstracts

INTRODUCTION: The processing of the emotion of disgust is attributed to the insular cortex (IC), which is also responsible for social emotions and higher-cognitive functions. We distinguish the role of the IC from its connections in regard to these functions through the assessment of emotions and social cognition in a double case report. These subjects were very rare cases that included a focal IC lesion and a subcortical focal stroke affecting the connections of the IC with frontotemporal areas. MATERIALS & METHODS: Both patients and a sample of 10 matched controls underwent neuropsychological and affective screening questionnaires, a battery of multimodal basic emotion recognition tests, an emotional inference disambiguation task using social contextual clues, an empathy task and a theory of mind task. RESULTS: The insular lesion (IL) patient showed no impairments in emotion recognition and social emotions and presented with a pattern of delayed reaction times (RTs) in a subset of both groups of tasks. The subcortical lesion (SL) patient was impaired in multimodal aversive emotion recognition, including disgust, and exhibited delayed RTs and a heterogeneous pattern of impairments in subtasks of empathy and in the contextual inference of emotions. CONCLUSIONS: Our results suggest that IC related networks, and not the IC itself, are related to negative emotional processing and social emotions. We discuss these results with respect to theoretical approaches of insular involvement in emotional and social processing and propose that IC connectivity with frontotemporal and subcortical regions might be relevant for contextual emotional processing and social cognition.

We compared the utility of two executive-function brief screening tools, the Institute of Cognitive Neurology (INECO) Frontal Screening (IFS) and the Frontal Assessment Battery (FAB), in their ability to detect executive dysfunction in a group of behavioral variant frontotemporal dementia (bv-FTD, n = 25) and Alzheimer’s disease (AD, n = 25) patients in the early stages of their disease and in comparison to a group of age-, gender-, and education-matched controls (n = 26). Relative to the FAB, the IFS showed (a) better capability to differentiate between types of dementia; (b) higher sensitivity and specificity for the detection of executive dysfunction; (c) stronger correlations with standard executive tasks. We conclude that while both tools are brief and specific for the detection of early executive dysfunction in dementia, the IFS is more sensitive and specific in differentiating bvFTD from AD, and its use in everyday clinical practice can contribute to the differential diagnosis between types of dementia.

La escala de impulsividad de Barratt es un instrumento diseñado para evaluar el constructo impulsividad en tres dimensiones: atencional, motora y no planeada. La escala ha sido aplicada en pacientes con diferentes diagnósticos, en los cuales la sintomatología de impulsividad es característica. En Argentina no existen estudios que evalúen las propiedades psicométricas del instrumento en población clínica. El objetivo del trabajo fue evaluar las propiedades psicométricas de la escala en una muestra de la Ciudad de Buenos Aires. Se seleccionaron 150 sujetos adultos: 67 no presentaban diagnóstico psiquiátrico relevante, 56 cumplían criterios de trastorno bipolar y 27 presentaban diagnóstico de trastorno por déficit de atención. Se evaluaron la consistencia interna, la validez de constructo, la validez discriminativa y la estructura factorial. El alfa de Cronbach fue de 0,84 para la escala total. Asimismo, el instrumento ha demostrado indicadores aceptables de validez de constructo y validez discriminativa. Se encontraron diferencias al comparar la estructura factorial original con los resultados del presente estudio. Los resultados apoyan la utilidad de la escala en el contexto psiquiátrico, científico y clínico para evaluar el constructo de impulsividad. El puntaje total de la escala ha obtenido los indicadores más robustos de confiabilidad y validez.

A commentary on ERP investigation of study-test back- ground mismatch during face recognition in schizophrenia by Guillaume et al. (2012). Schizophr. Res. 134, 101–109.

La interocepción como censado del estado homeostático y visceral, ha sido recientemente postulada como requisito para la conciencia de estados emocionales corporales (Craig, 2009). Vías parasimpáticas y espinotalámicas que codifican esta información corporal tienen relevo en la corteza insular. Simultáneamente, han sido descriptas otras funciones insulares implicadas en procesos conscientes, como la intencionalidad, la toma de decisiones, la conciencia sensorio-motora, la percepción temporal, reconocer la imagen visual de uno mismo o percibir confiables a otros individuos (Craig, 2009; Ibanez, Gleichgerrcht, & Manes, 2010). Esta evidencia, sumada a resultados de estudios de lesión y neuroimágenes funcionales, sugiere que la corteza insular anterior (IA) sería la encargada de integrar señales multimodales cognitivas, emocionales y sociales para dirigir las conductas motivacionales que entrañan la supervivencia del individuo. En esta revisión analizamos el cúmulo de evidencia que involucran a la interocepción y al procesamiento insular integrativo en el surgimiento de estados emocionales conscientes, a través de estudios de lesiones y de técnicas de conectividad funcional en resonancia magnética funcional (RMF).

Atrial fibrillation (AF) is the major cause of cardioembolic stroke. It often remains occult when asymptomatic and paroxysmal. We hypothesized that the detection of AF after acute ischemic stroke (AIS) or transient ischemic attack (TIA) could be improved by using continuous cardiac monitoring (CCM) immediately after admission. We sought to determine the detection rate of AF by immediate in-hospital CCM after cryptogenic and noncryptogenic AIS or TIA in patients without a previous diagnosis of AF. We retrospectively studied a cohort of 155 patients with cryptogenic and noncryptogenic AIS or TIA without known AF. We compared the detection rates of newly diagnosed AF (NDAF) in patients admitted to areas with CCM and those never admitted to these areas. We developed a multiple logistic regression model for identifying predictors of NDAF. We characterized NDAF episodes and analyzed how the availability of CCM data changed secondary prevention strategies. We detected NDAF in 21 patients (13.5%). Diagnostic rates of NDAF in patients who underwent CCM and those who did not undergo CCM were 18.2% and 2.2%, respectively (P = .005). The median time from admission to recognition of NDAF was 2.0 days. Most NDAFs were paroxysmal (95.2%) and lasted less than 1 hour (85.7%). Diabetes mellitus and infarct size were predictors of NDAF. Detection of NDAF prompted the initiation of anticoagulation therapy in 8.2% of the patients admitted to areas with CCM availability. Our findings suggest that immediate and prolonged CCM significantly improves the detection of NDAF after cryptogenic and noncryptogenic AIS or TIA, and that diabetes mellitus and infarct size are significantly associated with NDAF.

Several case reports have linked solvent exposure to Parkinson disease (PD), but few studies have assessed associations with specific agents using an analytic epidemiologic design. We tested the hypothesis that exposure to specific solvents is associated with PD risk using a discordant twin pair design. METHODS: Ninety-nine twin pairs discordant for PD ascertained from the National Academy of Sciences/National Research Council World War II Veteran Twins Cohort were interviewed regarding lifetime occupations and hobbies using detailed job task-specific questionnaires. Exposures to 6 specific solvents selected a priori were estimated by expert raters unaware of case status. RESULTS: Ever exposure to trichloroethylene (TCE) was associated with significantly increased risk of PD (odds ratio [OR], 6.1; 95% confidence interval [CI] 1.2-33; p = 0.034), and exposure to perchloroethylene (PERC) and carbon tetrachloride (CCl(4) ) tended toward significance (respectively: OR, 10.5; 95% CI, 0.97-113; p = 0.053; OR, 2.3; 95% CI, 0.9-6.1; p = 0.088). Results were similar for estimates of exposure duration and cumulative lifetime exposure. INTERPRETATION: Exposure to specific solvents may increase risk of PD. TCE is the most common organic contaminant in groundwater, and PERC and CCl(4) are also ubiquitous in the environment. Our findings require replication in other populations with well-characterized exposures, but the potential public health implications are substantial.

Several lines of experimental evidence support an association between facial processing and social cognition, but no direct link between cortical markers of facial processing and complex cognitive processes has been reported until now. In the current study, we tested the hypothesis that cortical electrophysiological markers for the processing of facial emotion are associated with individual differences in executive and social cognition skills. We tested for correlations between the amplitude of event-related potentials (N170) in a dual valence task and participants’ scores on three neuropsychological assessments (general neuropsychology, executive functioning, and social cognition). N170 was modulated by the stimulus type (face versus word) and the valence of faces (positive versus negative). The neural source of N170 was estimated to be the fusiform gyrus. Robust correlations were found between neuropsychological markers and measures of facial processing. Social cognition skills (as measured by three tests: the Reading the Mind in the Eyes test, the Faux Pas test, and the Iowa Gambling Task) correlated with cortical measures of emotional discrimination. Executive functioning ability also correlated with the cortical discrimination of complex emotional stimuli. Our findings suggest that the cortical processing of facial emotional expression is associated with social cognition skills.

The goal of this study is to assess the role of membership and valence effects on errors performed in a racial implicit association test indexed by event-related potentials (ERPs). Non-indigenous participants performed an implicit association test (IAT) paradigm emphasizing the feedback of error due to misclassification of ingroup (non-indigenous) and outgroup (indigenous) faces as well as positive and negative words. As expected, participants responded to the compatible task with higher accuracy than to incompatible tasks. This is the first report demonstrating that IAT errors produce electrophysiological ERP modulation. Our results suggest that medial frontal negativity is modulated not only by IAT error of membership and valence classifications but also by IAT compatible and incompatible tasks. These results provide a basis for the future use of the misclassification error in the IAT recorded simultaneously with ERPs in other classic social psychology contexts.

The lifespan of people with severe mental illness (SMI) is shorter compared to the general population. This excess mortality is mainly due to physical illness. We report prevalence rates of different physical illnesses as well as important individual lifestyle choices, side effects of psychotropic treatment and disparities in health care access, utilization and provision that contribute to these poor physical health outcomes. We searched MEDLINE (1966 – August 2010) combining the MeSH terms of schizophrenia, bipolar disorder and major depressive disorder with the different MeSH terms of general physical disease categories to select pertinent reviews and additional relevant studies through cross-referencing to identify prevalence figures and factors contributing to the excess morbidity and mortality rates. Nutritional and metabolic diseases, cardiovascular diseases, viral diseases, respiratory tract diseases, musculoskeletal diseases, sexual dysfunction, pregnancy complications, stomatognathic diseases, and possibly obesity-related cancers are, compared to the general population, more prevalent among people with SMI. It seems that lifestyle as well as treatment specific factors account for much of the increased risk for most of these physical diseases. Moreover, there is sufficient evidence that people with SMI are less likely to receive standard levels of care for most of these diseases. Lifestyle factors, relatively easy to measure, are barely considered for screening; baseline testing of numerous important physical parameters is insufficiently performed. Besides modifiable lifestyle factors and side effects of psychotropic medications, access to and quality of health care remains to be improved for individuals with SMI.