Conclusion.Patients who had SC during childhood can exhibit inferior performance in tasks that evaluate attention, speeded information processing, executive functions, and working memory in adult life. Therefore, there is indirect evidence of the persistence of dysfunction in cerebral circuits involved with the basal ganglia. They also presented a worse self-evaluation in HRQOL that was not related to cognitive impairments.

The logical memory test of the Wechsler Memory Scale is one of the most frequently used standardized tests for assessing verbal memory and consists of two separate short stories each containing 25 idea units. Problems with practice effects arise with re-testing a patient, as these stories may be remembered from previous assessments. Therefore, alternative versions of the test stimuli should be developed to minimize learning effects when repeated testing is required for longitudinal evaluations of patients.ObjectiveTo present three alternative stories for each of the original stories frequently used in Brazil (Ana Soares and Roberto Mota) and to show their similarity in terms of content, structure and linguistic characteristics.MethodsThe alternative stories were developed according to the following criteria: overall structure or thematic content (presentation of the character, conflict, aggravation or complements and resolution); specific structure (sex of the character, location and occupation, details of what happened); formal structure (number of words, characters, verbs and nouns); and readability.ResultsThe alternative stories and scoring criteria are presented in comparison to the original WMS stories (Brazilian version).ConclusionThe alternative stories presented here correspond well thematically and structurally to the Brazilian versions of the original stories.

T he cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal-spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

RESUMO -Mesmo pacientes severamente amnésticos são capazes de aprender informações novas, apoiados em estratégias de memória implícita. No presente estudo descrevemos uma experiência de reabilitação neuropsicológica, em que um paciente amnéstico, portador de lesão cerebral por anóxia, foi submetido a treino para uso de computador, visando sua capacitação semi-profissional. O treinamento teve duração de 14 semanas, e as técnicas de ensino utilizadas foram a prática repetitiva e a aprendizagem sem erros. O paciente obteve sucesso na realização das tarefas propostas, aprendendo a operar um editor de textos e mantendo o aprendizado após a passagem do tempo. Apesar disso, lembrava-se apenas vagamente da situação de aprendizagem. O presente estudo corrobora trabalhos anteriores que observam a interação entre mecanismos de memória implícita e resíduos de memória explícita operando na aquisição de conhecimentos em pacientes amnésticos. A aprendizagem de conhecimentos específicos vem se mostrando eficiente para a reabilitação de pacientes que sofreram lesões cerebrais. PALAVRAS-CHAVE: memória implícita, reabilitação, cognição, amnésia, anóxia cerebral, aprendizagem de conhecimentos específicos. Contributions of implicit memory strategies to the rehabilitation of an amnesic patient: case reportABSTRACT -Even severe amnesic patients usually are able to learn new information using implicit memory strategies. In the present study we describe our experience in the rehabilitation of an amnesic patient who had suffered cerebral anoxia. He was taught to use a computer text editor, enabling him to sheltered work. The training program lasted 14 weeks and was based on errorless learning and drilling practice techniques. The patient succeeded in all tasks, even though he could not remember accurately the training sessions. These results meet previous studies which point out that interaction between implicit and residual explicit memory can provide a basis new learning in amnesic patients. The domain-specific knowledge acquisition is demonstrating effectiveness in neuropsychological rehabilitation of brain injured patients.

ResumoO teste Memória Lógica da Wechsler Memory Scale -Revised (WMS-R) é amplamente utilizado na prática clínica como instrumento de avaliação da memória verbal. O objetivo deste estudo foi analisar as propriedades psicométricas iniciais de versões alternativas das histórias traduzidas e livremente adaptadas da WMS-R empregadas no Brasil: três histórias equiparáveis à história Ana Soares e três à de Roberto Mota. A amostra foi constituída de 655 universitários, com idades entre 18 e 35 anos. Foi solicitada a recordação livre imediata e tardia (após 30 min) de cada história, original e alternativas. A análise de equivalência entre a recordação imediata e tardia das histórias alternativas e originais mostrou que cinco histórias foram memorizadas de forma equiparável às histórias originais se aplicadas individualmente. A recordação de três pares dessas histórias alternativas também foi equivalente à recordação do par original. Uma análise utilizando a Teoria de Resposta ao Item apontou os itens com melhor índice discriminativo. Assim, propõe-se histórias alternativas às do WMS-R que poderão ser usadas em estudos de normatização. Palavras-chave: Avaliação neuropsicológica, memória episódica, WMS-R, recordação de histórias, recordação livre. AbstractThe Logical Memory test of the Wechsler Memory Scale -Revised (WMS-R) is widely used in clinical practice as a tool for verbal memory assessment. The aim of this study was to examine the initial psychometric properties of alternative versions of the stories translated and freely adapted from WMS -R used in Brazil: three stories comparable to Ana Soares' and three to Roberto Mota's stories. The sample consisted of 655 adults aged between 18 and 35 years. Immediate and delayed free recall of each original and alternative story was requested. The analysis of equivalence between the recall of alternative and original stories showed that fi ve stories proved equivalent to the original stories, if applied individually. Recall of three pairs of these alternative stories was also equivalent to that of the original pair. An analysis using Item Response Theory (IRT) showed the items with best discriminative index. Therefore, the alternative stories proposed here can be used in normalization studies.

déficit de memória verbal e visual, desorientação temporal, abulia e bradipsiquismo. Método: Estruturação de horários fixos na rotina diária; exposição a um calendário 3 vezes ao dia; caminhadas diárias; monitorização do familiar na execução de tarefas de auto cuidado, fornecendo auxílio mediante comandos verbais curtos e pistas específicas. Resultados: Foram observados aumento da iniciativa, maior autonomia nas AVDs, diminuição do período de latência para qualquer resposta, melhora da atenção, orientação temporal e bradipsiquismo. Conclusões: Estratégias de controle do comportamento trazem ganhos e limitações para pacientes e familiares. Embora obriguem a adaptação a uma rotina pouco flexível, promovem o aprendizado através da automatização de procedimentos que se valem de mecanismos de memória implícita preservados. Estes recursos podem elevar o grau de autonomia do paciente em casa. PALAVRAS-CHAVE: reabilitação, cognição, neuropsicologia, anóxia cerebral, psicologia comportamental. Procedures to improve daily activities performance in individuals with cerebral anoxia: case report ABSTRACT -Objective:To present a rehabilitation case study; procedures to improve the performance on daily activities were used by the caregiver. Patient: Cerebral anoxia due to cardiac arrest. He presented memory deficits for both visual and verbal material, temporal disorientation, abulia, psychomotor slowing and bradypsychism. Methods: daily activities were developed in fixed hours; calendar was presented 3 times a day ; daily walks were performed; self-care activities were performed by the patient with short verbal commands and cues from the caregiver. Results: We observed improvement on initiative and autonomy for daily activities, attention, temporal orientation and bradypsychism. There was also reduction on response time. Conclusions: Behavioral control strategies result on improvement for patients and their family although limit their routine. Behavioral control strategy promotes learning through the preserved implicit memory mechanism and results on enhancement at patient's autonomy at home.

The neurobehavioral impairments associated with aneurysms of the anterior communicating artery (ACoA) are severe amnesia, executive problems and personality changes. Although most patients achieve a favorable neurological outcome, those cognitive deficits usually prevent return to previous activities and levels of social integration.ObjectivesTo report the outcomes of a neuropsychological and behavioral intervention in a 55 year-old man with very severe memory and executive dysfunctions following ACoA aneurysm rupture.MethodsNeuropsychological intervention focused in functional adjustment in everyday life was used, including individual sessions with the patient, discussion sessions with caregivers and also work with patient at home, aiming generalization of the rehabilitation strategies. Neuropsychological and functional assessments were conducted pre and post intervention.ResultsImportant improvements were seeing in behavior and daily living performance after treatment.ConclusionsA neuropsychological rehabilitation approach focused on goals based on the family and caregivers necessities is an efficient manner in which to carry out cognitive rehabilitation in severe cases. The importance of a supportive family should be stressed.

As lesões cerebrais podem apresentar-se como déficits neurológicos bem evidentes, tais como dificuldades motoras; porém outros déficits menos diagnosticados e valorizados podem estar associdados, como alterações comportamentais e cognitivas. Essas alterações também necessitam de medicação efetiva, tanto para a melhora funcional quanto para possibilitar um convívio social mais adequado. Neste trabalho, revisamos os principais déficits não cognitivos e as principais linhas de tratamento medicamentoso ora em uso.