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Besides the classical symptoms of Parkinson's disease (PD) such as rest tremor, rigidity, bradykinesia and postural instability and its high prevalence in Brazilian clinical settings 1 impaired non-motor functions such as cognitive disorders are also common events 2 . At the disease onset, 24% of patients present cognitive decay, especially memory disorders and disturbances of some executive functions such as impaired selective attention, thinking flexibility, and planning difficulty 3 . In dementia, the patient with PD also reveals deterioration of declarative memory (but with relative preserved recognition), visuoconstructive skills, and nominating ability 4 . These disturbances depend on mostly frontal-striatum connections 5 and involve other areas of the brain such as the parietal regions and subcortical structures 6 .With respect to the non-motor symptoms of moderate and mild PD, we proposed the following hypotheses in the present study: A) patients in the initial stages of PD, and without clinical dementia, may present early impairment of several cognitive functions, such as visuoconstructive and visuospatial skills; and B) The clock drawing test (CDT), a simple and easily applicable tool, helps in identifying these early alterations.This study aimed to identify early cognitive im- EARLY IMPAIRMENT OF COGNITIVE FUNCTIONS IN PARKINSON'S DISEASE

Introdução: Evidências apontam que a ingestão exacerbada de frutose pode desencadear distúrbios característicos da síndrome metabólica. Objetivos: Analisar os efeitos da ingestão de dieta rica em frutose sobre aspectos metabólicos de ratos da linhagem Wistar. Adicionalmente, verificar a capacidade aeróbia através da identificação da máxima fase estável de lactato (MFEL). Métodos: Dezesseis ratos foram separados em dois grupos de oito animais: a) controle, alimentados com dieta balanceada, e b) frutose, alimentados com dieta rica em frutose. Foram analisadas a tolerância à glicose (área sob a curva de glicose durante teste de tolerância à glicose), sensibilidade à insulina (taxa de remoção da glicose sérica após sobrecarga exógena de insulina), perfil lipídico sérico e concentração de lactato sanguíneo [lac]s durante exercício na intensidade da MFEL. Resultados: Teste t não pareado (p < 0,05) revelou diferença para a tolerância à glicose e triglicérides, porém não houve diferença na sensibilidade à insulina e na [lac]s. Anova one way com post hoc de Newman-Keuls (p < 0,05) revelou diferença para a cinética da glicose durante o teste de tolerância, mas não para a cinética do lactato durante exercício na MSSL. Conclusão: As alterações fisiológicas provocadas pela dieta rica em frutose e inerentes à síndrome metabólica não prejudicam a capacidade aeróbia de ratos.Palavras-chave: máxima fase estável de lactato, síndrome metabólica, exercício. ABSTRACTIntroduction: Evidence points that exacerbated ingestion of fructose may trigger disturbs characteristic of the metabolic syndrome. Objectives: To analyze the effects of a fructose rich diet on metabolic aspects of Wistar lineage rats. Additionally, to verify the aerobic capacity, through the identification of the maximal lactate steady state (MSSL). Procedures: Sixteen rats were separated in two groups of eight animals: a) Control, fed a balanced diet, and b) fructose, fed a fructose-rich diet. The glucose tolerance, (area under serum glucose during a glucose tolerance test), insulin sensibility (glucose disappearance rate after exogenous insulin administration), serum lipid profile and blood lactate concentration [lac]b during exercise at MSSL intensity, have been analyzed. Results: Non-paired t test (p<0.05) revealed difference between groups in the area under the curve of glucose and serum triglycerides, no difference in insulin sensibility or in [lac]b was detected, though. One-way ANOVA with Newman Keuls post hoc revealed difference in the glucose kinetics during tolerance test, but not in the lactate kinetics during the MSSL. Conclusion: The physiological alterations promoted by fructose-rich diet and intrinsic to the metabolic syndrome do not harm the aerobic capacity of rats.

Patients with neurodegenerative diseases are required to use cognitive resources while maintaining postural control. The aim of this study was to investigate the effects of a frontal cognitive task on postural control in patients with Alzheimer, Parkinson and controls. Thirty-eight participants were instructed to stand upright on a force platform in two experimental conditions: single and dual task. Participants with Parkinson's disease presented an increase in the coefficient of variation greater than 100% in the dual task as compared to the single task for center of pressure (COP) area and COP path. In addition, patients with Parkinson's and Alzheimer's disease had a higher number of errors during the execution of the cognitive task when compared to the group of elderly without neurodegenerative diseases. The motor cortex, which is engaged in postural control, does not seem to compete with frontal brain regions in the performance of the cognitive task. However, patients with Parkinson's and Alzheimer's disease presented worsened performance in cognitive task.Resumo-"Tarefa dupla e controle da postura na doença de Alzheimer e na doença de Parkinson". Pacientes com doenças neurodegenerativas utilizam recursos cognitivos para manutenção do controle postural. O objetivo deste estudo foi investigar os efeitos de uma tarefa cognitiva frontal no controle postural em pacientes com Alzheimer, com Parkinson e idosos sem doenças neurodegenerativas. Trinta e oito participantes foram instruídos a ficar em pé sobre uma plataforma de força em duas condições experimentais: tarefa simples e tarefa dupla com uma tarefa cognitiva frontal. Foi observado aumento no coeficiente de variação superior a 100% na área e na trajetória do centro de pressão (COP) em condição de tarefa dupla em pacientes com Parkinson. Foi observada também, diferença significativa na comparação entre grupos, mostrando que pacientes com Parkinson e Alzheimer tiveram maior número de erros durante a execução da tarefa cognitiva, quando comparado ao grupo de idosos sem doenças neurodegenerativas. O córtex motor envolvido na manutenção do controle postural parece não competir com regiões frontais cerebrais no desempenho desse tipo de tarefa cognitiva, no entanto, os pacientes com doença de Parkinson e doença de Alzheimer apresentaram pior desempenho durante a execução de uma tarefa cognitiva frontal.Palavras-chave: controle da postura, tarefa dupla, doença de Alzheimer, doença de Parkinson Resumen-"Doble tarea y el control postural en la enfermedad de Alzheimer y la enfermedad de Parkinson". Pacientes con enfermedades neurodegenerativas utilizan de recursos cognitivos para el mantenimiento del control postural. El objetivo de este estudio fue investigar los efectos de una tarea cognitiva frontal en el control postural de pacientes con enfermedad de Alzheimer, enfermedad de Parkinson y ancianos sin enfermedades neurodegenerativas. Treinta y ocho participantes fueron instruidos para mantenerse en pie sobre una plataforma de fuerza en dos condiciones experimentales:...

BackgroundInadequate oxygenation may cause lesions and brain atrophy during aging. Studies show a positive association between pulmonary function and the cognitive performance of individuals from middle age on.ObjectiveTo investigate the effect of aerobic physical exercises and respiratory training on the blood oxygenation, pulmonary functions, and cognition of the elderly.DesignThis was a randomized and controlled trial with three parallel groups. A total of 195 community-dwelling elderly were assessed for eligibility; only n=102 were included and allocated into the three groups, but after 6 months, n=68 were analyzed in the final sample. Participants were randomized into a social interaction group (the control group), an aerobic exercise group (the “walking” group), or a respiratory training group (the “breathing” group). The main outcome measures were the Wechsler Adult Intelligence Scale, Wechsler Memory Scale, Wisconsin Card Sorting Test, respiratory muscular strength, cirtometry (thoracic–abdominal circumference); oxygen saturation in arterial blood (SpO2), and hemogram.ResultsNo differences were observed for any of the blood parameters. Aerobic exercise and respiratory training were effective in improving the pulmonary parameters. Better cognitive performance was observed for the breathing group as regards abstraction and mental flexibility. The walking group remained stable in the cognitive performance of most of the tests, except attention. The control group presented worst performance in mental manipulation of information, abstraction, mental flexibility, and attention.ConclusionOur results showed that both the walking and breathing groups presented improvement of pulmonary function. However, only the breathing group showed improved cognitive function (abstraction, mental flexibility). The improvement in cognitive functions cannot be explained by blood parameters, such as SpO2, erythrocytes, hemoglobin, and hematocrit.