Categoría: Papers con abstracts

To investigate the presence of apathy symptoms in adolescents and adults with ADHD as a behavioral manifestation of underlying motivational deficits and to determine whether apathy symptoms were associated with a specific neuropsychological profile. METHOD: A total of 38 ADHD participants (28 of the combined subtype [ADHD/C] and 10 of the inattentive subtype [ADHD/I]) and 30 healthy controls (Ctrl) were assessed on two measures of apathy administered to subjects and informants. As well, ADHD participants completed a comprehensive neuropsychological battery. RESULTS: ADHD participants presented elevated scores on measures of apathy relative to controls (ADHD/I > ADHD/C > Ctrl). Informant-based ratings of apathy correlated significantly with behavioral measures of inattention. Apathy measures correlated significantly with executive tests, working memory, verbal fluency, and general intellectual abilities, only in the inattentive sample. CONCLUSIONS: This study stresses the relevance of motivational deficits in adult ADHD as a significant clinical dimension closely linked to inattention and executive difficulties.

OBJECTIVES: Bipolar Disorders are among the ten leading causes of morbity and lithium is considered first-line treatment and the most cost-effective. Nevertheless, its use takes a back seat to other treatment options less effective, safe and more expensive; and the reasons for this remains unclear. The present study investigates clinical concepts related to its underutilization. METHOD: An anonymous questionnaire concerning different aspects of lithium clinical use (compared efficacy, adverse effects, practical aspects regarding its use, use in special populations) was administered during the XXV Congress of the Argentinean Psychiatrist Association. RESULTS: 164 questionnaires were analyzed. Less than one-third of the sample referred lithium as their most frequent treatment option, although almost 60% qualified it as effective. Almost two-thirds considered its utilization as more complex and ill-ascribed adverse effects to it. One third referred not to use it in youth and senior populations. CONCLUSIONS: contrary to current recommendations, lithium is under utilized. This is the first report on the possible causes leading to such phenomena, which can be related to ill concepts regarding its safety, clinical use and adverse effects; although not to its effectiveness.

Diagnosis of behavioral variant frontotemporal dementia (bvFTD) can be especially challenging during the early stages for several reasons, including the fact that (a) behavioral disturbances in bvFTD can mimic the symptomatic profile of psychiatric disorders; (b) neuropsychological performance may be relatively spared; and (c) changes in structural neuroimaging may go undetected. Most frequently, bvFTD is not included as part of medical or residency training outside the field of cognitive neurology. The present study aimed at examining bvFTD-related practices concerning academic and professional training, diagnosis, and treatment across Latin America. We surveyed the academic and professional aspects of clinical practice related to bvFTD of 596 physicians from different fields throughout the continent. We discuss several aspects concerning Latin American physicians’ training on dementia and bvFTD, the way in which they approach the differential diagnosis of bvFTD, and their most frequent strategies for the treatment of this condition. We conclude that information about bvFTD deserves more attention in both undergraduate and postgraduate medical education in Latin America, and that understanding clinical practices related to FTD can help design more efficient training programs for physicians in this and other world regions.

El trastorno obsesivo-compulsivo es un trastorno psiquiátrico que en un 87% de los casos se vuelve crónico. Se caracteriza por una serie de síntomas que pueden ser agrupados en obsesiones y compulsiones, que pueden llegar a ser altamente invalidantes y afectar el estilo de vida de quienes lo padecen. Es importante entender los mecanismos neurológicos del trastorno obsesivo-compulsivo para poder abordar de manera más eficaz los tratamientos. Este trabajo plantea al modelo frontoestriado como aquel que provee mayor evidencia y explica de manera más acabada los fenómenos neuropsicológicos del TOC, con las áreas cerebrales que se encuentran implicadas en él córtex cingulado anterior, los ganglios basales, y la corteza órbito-frontal. Luego, se vinculan estos resultados con aquellos hallazgos de estudios de potenciales evocados relacionados a eventos (especialmente ERN, N200 y P300) con el fin de explicar más íntegramente lascaracterísticas del trastorno. Las funciones cognitivas que se pueden vincular con loshallazgos de neuroimágenes y ERPs son relativas al procesamiento de la información,decodificación, planificación, atención voluntaria, control inhibitorio, y funcionesejecutivas en general.

Employment is an indicator of socioeconomic status. Unemployment is a worldwide social challenge, especially in emerging countries, accounting for a proportion of the overall higher mortality rates found in these nations. We assessed the relationship between employment status and in-hospital mortality among acute ischemic stroke patients participating in the Argentinean National Stroke Registry (ReNACer), a prospective, country-wide, hospital-based stroke registry aimed at improving quality of stroke care in Argentina. We compared demographic and socioeconomic characteristics, risk factors, acute treatment, and stroke severity between employed and unemployed patients with acute ischemic stroke participating in ReNACer. We developed a multiple logistic regression model to identify predictors of in-hospital mortality. Among the 726 patients with acute ischemic stroke included in the study, 39.5% were unemployed. In-hospital mortality was higher in the patients who were unemployed at the time of the stroke compared with those who were employed (12.0% vs 5.0%; P = .003). On multivariate analysis, being unemployed (odds ratio [OR], 3.58; 95% confidence interval [CI], 1.36-7.37; P = .005), stroke severity (OR, 3.54; 95% CI 1.11-10.40; P = .018), and infarct size >15 mm (OR, 2.80; 95% CI, 1.18-6.60; P = .019) were associated with in-hospital mortality after adjusting for relevant covariates. Social factors may influence poor outcomes after stroke. In the present study, unemployment was associated with a higher risk of adjusted in-hospital mortality. Strategies targeting individuals at high risk of cardiovascular diseases and poorer outcomes should be implemented to reduce stroke impact.

Human communication in a natural context implies the dynamic coordination of contextual clues, paralinguistic information and literal as well as figurative language use. In the present study we constructed a paradigm with four types of video clips: literal and metaphorical expressions accompanied by congruent and incongruent gesture actions. Participants were instructed to classify the gesture accompanying the expression as congruent or incongruent by pressing two different keys while electrophysiological activity was being recorded. We compared behavioral measures and event related potential (ERP) differences triggered by the gesture stroke onset. Accuracy data showed that incongruent metaphorical expressions were more difficult to classify. Reaction times were modulated by incongruent gestures, by metaphorical expressions and by a gesture-expression interaction. No behavioral differences were found between the literal and metaphorical expressions when the gesture was congruent. N400-like and LPC-like (late positive complex) components from metaphorical expressions produced greater negativity. The N400-like modulation of metaphorical expressions showed a greater difference between congruent and incongruent categories over the left anterior region, compared with the literal expressions. More importantly, the literal congruent as well as the metaphorical congruent categories did not show any difference. Accuracy, reaction times and ERPs provide convergent support for a greater contextual sensitivity of the metaphorical expressions.

Increase in use of atypical antipsychotics has been paralleled by an increase in the incidence of intentional and nonintentional overdose. Pediatric cases are uncommon, but may be severe. We describe a case of a child presenting with severe extrapiramidal symptoms, initially interpreted as seizures, caused by a nonintentional intoxication with risperidone, and review management options and the literature.

Neuroleptics having dopamine receptor-blocking properties are frequently responsible for the development of movement disorders. This has been known for many years as these adverse events were identified soon after the introduction of these drugs for the treatment of psychiatric disorders. Parkinsonism, acute dystonic reactions, akathisia, and tardive dyskinesias are the different clinical presentations of these disorders. Tardive dyskinesia is the most problematic among them as it may persist even after discontinuation of the offending drug, and become an irreversible phenomenon. The term «tardive dyskinesia » encompasses a variety of clinical phenomena including stereotypic behaviors, dystonia, myoclonus, and tics. Stereotypies and orobuccolingual dyskinesias are the most frequently observed tardive disorders, particularly in the elderly population exposed to neuroleptics, while dystonic phenomena are more prevalent in younger individuals. The development of these disorders is dependent on the potency of the drug, duration of exposure, and a number of predisposing factors, including age, gender, and presence of organic brain disease. The pathophysiology is rather complex and involves changes in the dopamine synapse both at the pre- and postsynaptic level, as well as plastic changes involving transcription factors and activation of different molecular cascades downstream of the dopamine receptor. The introduction of more novel pharmacological agents, like the so-called atypical neuroleptics, has significantly reduced the incidence of these disorders; however, the prescribing physician has to be aware that a lower risk is not synonymous with absence of risk.

Beyond extrastriate body area (EBA) and fusiform body area (FBA): Context integration in the meaning of actions. Autores Amoruso L, Couto JB, Ibanez A. Año 2011 Journal  Amoruso L, Couto JB, Ibanez A. Volumen (5): 124 Abstract   Otra información    

Language, memory and the temporal lobes. Autores Manes F, Gleichgerrcht E. Año 2011 Journal  Manes F, Gleichgerrcht E. Volumen 24(4): 263-264 Abstract   Otra información