Despite the implication of fronto-striatal circuits in attention-deficit/hyperactivity disorder (ADHD), there is a lack of information on the role of these regions, especially the thalamus, in the heterogeneity of ADHD. We assessed the (1)H-magnetic resonance spectroscopy profile in ventromedial prefrontal cortex (VMPFC)-thalamic-striatal regions bilaterally in three groups of subjects (age range 18-24 years old): ADHD inattentive type (ADHD-I; n = 9), ADHD combined type (ADHD-C; n = 10) and non-ADHD controls (n = 12). The peaks of N-acetylaspartate, Choline (Cho), myo-inositol (mI), creatine (Cr) and glutamate-glutamine-GABA (Glx) to Cr were calculated. Subjects with ADHD-C showed lower mI/Cr ratio in the right VMPFC than controls, higher Cho/Cr ratio in the left thalamus-pulvinar than the ADHD-I group and higher Glx/Cr ratio in left putamen than individuals with ADHD-I and controls. This metabolic profile suggests a disruption of fronto-striato-thalamic structures in the ADHD-C as a result of lower neuronal energetic metabolism.

A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: positive effect on the social functioning of schizophrenic patients Estudo controlado randomizado de 12 semanas do programa cognitivo-comportamental IPT (Terapia Psicológica Integrada) com efeito positivo sobre o funcionamento social em pacientes com esquizofrenia Abstract Objectives: The present study was designed to evaluate the effect of twelve weekly sessions of the cognitive-behavioral program originally known as the Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten, designated the Integrated Psychological Therapy (IPT) program in English, on cognition, social adjustment and quality of life in schizophrenic outpatients, comparing it to the effect of treating such patients as usual. Method: Fifty-six adult outpatients (from 18 to 65 years of age) with ICD-10-based diagnoses of schizophrenia were randomly assigned to two different groups: active intervention (IPT group); and treatment as usual (control group). Outcome measures were quality of life (as determined using the WHOQOL-Bref), cognition (MiniMental State Examination and Word Recall Test), global functioning (DSM-IV Global Assessment of Functioning Scale), social functioning (Social and Occupational Functioning Assessment Scale) and social adjustment (Social Adjustment Scale). Results: The findings suggest that, in comparison with treatment as usual (control group), the twelve-session IPT program had a positive effect on several outcome measures: cognition in the domains of spatiotemporal orientation (p = 0.051) and memory (p = 0.031); overall social adjustment (p = 0.037), leisure/social life (p = 0.051) and family relations (p = 0.008); overall functioning (p = 0.000); social-occupational functioning (p = 0.000); and quality of life in the psychological domain (p = 0.021). Conclusion: The twelvesession cognitive-behavioral IPT intervention demonstrated superiority over treatment as usual in its effects on cognition, social adjustment and quality of life. Studies involving larger samples, longer follow-up periods and additional outcome measures are needed in order to assess the specific effects on dimensions of social functioning, cognitive functioning and quality of life in patients with schizophrenia.Descriptors: Quality of life; Social adjustment; Cognition; Schizophrenia; Social support Resumo Objetivos: O presente estudo foi designado para avaliar o efeito de 12 sessões semanais do programa cognitivo-comportamental IPT (Integrated Psychological Therapy -Integriertes psychologisches Therapieprogramm für schizophrene Patienten -Terapia Psicológica Integrada), comparado ao tratamento usual sobre o funcionamento cognitivo, ajustamento social e qualidade de vida em pacientes ambulatoriais com esquizofrenia. Método: Cinqüenta e seis pacientes ambulatoriais adultos (idade entre 18 e 65 anos) com diagnóstico de esquizofrenia pela CID-10, foram aleatoriamente designados para dois grupos: intervenção ativa (IPT) e tratamen...

Introdução.A epilepsia de ausência na infância é um distúrbio neurológico que causa importantes dificuldades biopsicossociais e um atraso no desenvolvimento da aprendizagem. Objetivo. Descrever a importância do diagnóstico precoce e verificar fatores que impactam na aprendizagem em crianças com epilepsia de ausência. Método. Revisão de literatura pertinente acerca da epilepsia de ausência na infância, seu impacto na aprendizagem e respectivas repercussões. Conclusão. Ainda que a epilepsia de ausência possa ser uma condição comum encontrada em crianças, geralmente o seu diagnóstico não costuma ser fácil, o que pode levar a dificuldades no desempenho da aprendizagem. Diante disso, torna-se fundamental que os pais e profissionais envolvidos com a criança tenham pleno conhecimento sobre sua condição, sobre seus aspectos biopsicossociais e que estejam atentos aos sinais de alarme da epilepsia de ausência.

Objective: To assess the metabolic alterations of the thalamus in subjects with schizophrenia compared to healthysubjects and to investigate whether specific schizophrenic symptoms are associated with metabolic alterationsmeasured by 1H MRS. Methods: This is a case-control study including patients with schizophrenia diagnosed usingthe Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, DMS-IV and the Operational CriteriaChecklist for Psychotic Illness (OPCRIT). Proton magnetic resonance spectroscopy (1H MRS) was used to assessmetabolite concentrations (N-acetylaspartate, choline, creatinine, myoionositol and lactacte) in the left and rightthalamus of 13 patients with schizophrenia and 13 healthy controls. Results: In this study, concentrations ofspecific metabolites in the thalamus, determined by 1H MRS, were similar for individuals with schizophrenia andcontrols. It was observed that cases with family history of schizophrenia and disorganized speech demonstrated areduction in the ratio of the metabolites NAA /Cho in the thalamic nuclei on the right side. However, those withorganized delusions, hallucinations and non-affective auditory hallucinations had an increase of metabolites on theright side compared to the left thalamus. Decreased thalamic metabolic activity in patients with positive symptomswas observed in contrast with those who had well-organized delusions and auditory non-affective hallucinations,core symptoms of schizophrenia. Conclusion: A lateralized thalamic involvement was verified, suggesting thatorganic and genetic factors compromise the right thalamus and that the disorganization associated with delusionsand hallucinations compromises the left thalamic nuclei. Further studies to investigate the correlation betweensymptoms and thalamic dysfunction are warranted. (Rev Neuropsiquiatr 2011;74:183-190)

Rev Neurocienc 2013;21(4):628-632 revisão 628 RESUMO Introdução. A epilepsia de ausência na infância é um distúrbio neurológico que causa importantes dificuldades biopsicossociais e um atraso no desenvolvimento da aprendizagem. Objetivo. Descrever a importância do diagnóstico precoce e verificar fatores que impactam na aprendizagem em crianças com epilepsia de ausência. Método. Revisão de literatura pertinente acerca da epilepsia de ausência na infância, seu impacto na aprendizagem e respectivas repercussões. Conclusão. Ainda que a epilepsia de ausência possa ser uma condição comum encontrada em crianças, geralmente o seu diagnóstico não costuma ser fácil, o que pode levar a dificuldades no desempenho da aprendizagem. Diante disso, torna-se fundamental que os pais e profissionais envolvidos com a criança tenham pleno conhecimento sobre sua condição, sobre seus aspectos biopsicossociais e que estejam atentos aos sinais de alarme da epilepsia de ausência. ABSTRACTIntroduction. The childhood absence epilepsy is a neurological disorder that causes a significant biopsychosocial difficulties and a delay in development of learning. Objective. To describe the importance of early diagnosis and identify factors that impact on learning in children with absence epilepsy. Method. Review of literature about childhood absence epilepsy, its impact and effects on learning. Conclusions. Although absence epilepsy can be a common condition found in children, usually the diagnosis is not easy, which can lead to difficulties in learning performance. Therefore, it is essential that parents and professionals involved with the child should be fully aware of its condition on biopsychosocial aspects and to be alert to warning signs of absence epilepsy.