The results suggest that this Brazilian version of the BICAMS will be a valid and reliable measure once complete normative data become available.
Transcranial direct current stimulation (tDCS) applied over the dorsolateral prefrontal cortex (DLPFC) has been shown to reduce cravings in tobacco addiction; however, results have been somewhat mixed. In this study, we hypothesized that motivation to quit smoking is a critical factor of tDCS effects in smokers. Therefore, we conducted a double-blind, randomized clinical trial to evaluate the effects of both tDCS and motivation to quit on cigarette consumption and the relationship between these two factors. DLPFC tDCS was applied once a day for 5 days. Our primary outcome was the amount of cigarettes smoked per day. We collected this information at baseline (d1), at the end of the treatment period (d5), 2 days later (d7) and at the 4-week follow-up (d35). Visual Analog Scale (VAS) for motivation to quit was collected at the same time-points. 36 subjects (45 ± 11 years old; 24.2 ± 11.5 cigarettes daily smoked, 21 women) were randomized to receive either active or sham tDCS. In our multivariate analysis, as to take into account the mediation and moderation effects of motivation to quit, we found a significant main effect of tDCS, showing that tDCS was associated with a significant reduction of cigarettes smoked per day. We also showed a significant interaction effect of motivation to quit and treatment, supporting our hypothesis that tDCS effects were moderated by motivation to quit, indicating that higher levels of motivation were associated with a larger tDCS response. We found that the participants' motivation to quit alone, both at baseline and at follow-up, does not explain the decrease in the average cigarette consumption. Repetitive prefrontal tDCS coupled with high motivation significantly reduced cigarette consumption up to 4-weeks post-intervention.Clinical Trial Registration: http://ClinicalTrials.gov, NCT02146014.
Neste estudo não controlado intrassujeitos, 21 idosos com Alzheimer ou outras demências participaram de um Programa de Reabilitação Neuropsicológica, com oficinas de jardinagem e pistas coloridas. Após o programa, houve aumento nos escores dos seguintes testes: Miniexame do Estado Mental (Z=-1,98, p<0,05); Subteste Verbal de Semelhanças da Escala Wechsler [(Z=-2,09) p<0,05] e Subteste de Aprendizagem de Pares de Fácil Associação para Evocação Tardia da Escala de Memória de Wechsler [(Z=-2,07) p<0,05]. Paralelamente, observou-se redução dos escores de depressão na Escala de Depressão Geriátrica de Yesavage [(Z=-3,02) p<0,00]. Foi demonstrado ainda que essa redução estava associada à aprendizagem de pistas contextuais (reminiscências e sinalizadores) e ao tratamento com anticolinesterásicos administrados por 4 ou 12 semanas [(Z=-2,31) p<0,02]. Ressalta-se, entretanto, que o mesmo não ocorreu com participantes submetidos ao tratamento de 30 semanas [(Z=-2,21) p<0,02].
BackgroundFatigue and cognitive complaints are the most frequent persistent symptoms in patients after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to assess fatigue and neuropsychological performance and investigate changes in the thickness and volume of gray matter (GM) and microstructural abnormalities in the white matter (WM) in a group of patients with mild-to-moderate coronavirus disease 2019 (COVID-19).MethodsWe studied 56 COVID-19 patients and 37 matched controls using magnetic resonance imaging (MRI). Cognition was assessed using Montreal Cognitive Assessment and Cambridge Neuropsychological Test Automated Battery, and fatigue was assessed using Chalder Fatigue Scale (CFQ-11). T1-weighted MRI was used to assess GM thickness and volume. Fiber-specific apparent fiber density (FD), free water index, and diffusion tensor imaging data were extracted using diffusion-weighted MRI (d-MRI). d-MRI data were correlated with clinical and cognitive measures using partial correlations and general linear modeling.ResultsCOVID-19 patients had mild-to-moderate acute illness (95% non-hospitalized). The average period between real-time quantitative reverse transcription polymerase chain reaction-based diagnosis and clinical/MRI assessments was 93.3 (±26.4) days. The COVID-19 group had higher total CFQ-11 scores than the control group (p < 0.001). There were no differences in neuropsychological performance between groups. The COVID-19 group had lower FD in the association, projection, and commissural tracts, but no change in GM. The corona radiata, corticospinal tract, corpus callosum, arcuate fasciculus, cingulate, fornix, inferior fronto-occipital fasciculus, inferior longitudinal fasciculus, superior longitudinal fasciculus, and uncinate fasciculus were involved. CFQ-11 scores, performance in reaction time, and visual memory tests correlated with microstructural changes in patients with COVID-19.ConclusionsQuantitative d-MRI detected changes in the WM microstructure of patients recovering from COVID-19. This study suggests a possible brain substrate underlying the symptoms caused by SARS-CoV-2 during medium- to long-term recovery.
Objective: To evaluate the cognitive performance of institutionalized elderly in the city of Natal, state of Rio Grande do Norte, Brazil. Methods: A descriptive, longitudinal study of 85 aged individuals via an interview conducted following the application of a classification form and the Mini-Mental State Examination (MMSE), with different cutoff points according to the level of education. The study was approved by the Research Ethics Committee of the Universidad Federal do Rio Grande do Norte (164/2011). Results: The mean age of the elderly studied was 76.8 years, 48.3% were single and 62.0% women, with an average of 3.27 children and 3 years of schooling; cognitive losses were recorded over a 6-month period following the 1st assessment, declining from 18.8 to 16.9% at the 2nd assessment for the following items: orientation to space (p = 0.02), language (p = 0.02) and repetition (p = 0.01). Conclusion: The results show significant cognitive changes among elderly subjects, with 64.6% exhibiting cognitive impairment. The findings suggest systematic evaluations in elders as a mean to establish prevention measures for health losses, taking into account that the referred deficits are capable of causing damage in the everyday life of these elderly residents of institutions.
This study revealed the practical usefulness of TCS in differentiating PD from its prevalent mimics when the clinical diagnosis was initially unclear.
Screening tools in health and education provide quick indicators that anticipate diagnostic evaluation and treatment. Faced with the socio-emotional competences of children, the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE) was used in the population of children enrolled in public pre-schools in the city of Rio de Janeiro during 2011. The objective of this work was to investigate aspects of its validity and reliability. Data from 23,334 children (50.6% boys) being an average age of 5 years old (SD: 3 months) and enrolled in 625 pre-schools were analyzed. After an intensive data analysis, the Exploratory and Confirmatory Factor Analysis, the results were favorable to the multidimensional model with a social and emotional dimension: χ2 (463) = 46363.495, p <0.001; RMSEA = 0.067; CFI = 0.918; TLI = 0.913. Reliability indicators were adequate. The results confirmed validity aspects of the ASQ:SE, thereby verifying its use for children aged 5 years old.
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