and Appenzeller S (2022) Cross-cultural adaptation and initial validation of the Brazilian-Portuguese version of the pediatric automated neuropsychological assessment metrics.
Computerized batteries have been widely used to investigate cognitive impairment (CI) in patients with SLE. The aim of this study was to evaluate the cognitive performance of patients with SLE in relation to healthy controls using the Pediatric Automated Neuropsychological Assessment Metrics (Ped-ANAM) battery. In addition, we aimed to examine differences in Ped-ANAM scores according to age of disease onset, presence of disease activity, and disease damage. We included 201 consecutive adult-onset (aSLE) and childhood-onset SLE (cSLE) patients who were being followed at the hospital’s rheumatology outpatient clinic and 177 healthy controls. We applied the percentage of correct answers on the Ped-ANAM subtests and the Performance Validity Index (PVI) metric and correlated them with the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus Erythematosus Damage Index (SDI). Then, we established their relationships with neuropsychiatric systemic lupus erythematosus (NPSLE). We observed CI in a total of 38 (18.9%) SLE patients and 8 (4.5%) healthy controls (p < 0.001). CI was observed in eight (19.5%) cSLE patients and 32 (20%) aSLE patients (p = 0.8175). Individual analysis of the aSLE subtests showed a significant difference in all subtests compared to healthy controls; the greatest differences were in matching to sample (p < 0.001) and memory search ( p < 0.001). In the cSLE group, we observed a difference in the code substitution subtests (p = 0.0065) compared to the healthy controls. In the evaluation of clinical outcomes, disease activity was significantly correlated with CI in cSLE (r = 0.33; p = 0.042) and aSLE (r = 0.40; p = 0.001). We also observed an association between disease activity and neuropsychiatric manifestations (p = 0.0012) in aSLE. In conclusion, we determined that cognitive dysfunction, mainly in memory and attention, was more prevalent in patients with SLE. In both the cSLE and aSLE groups, disease activity was associated with worse cognitive function. This is the first study to use the Ped-ANAM in Brazil. Longitudinal studies are necessary to determine how the Ped-ANAM will perform over time.
BackgroundTranslation, validation, and use of a computerized battery for cognitive evaluation of patients with systemic lupus erythematosus (SLE) as part of an investigation of neuropsychiatric manifestations is useful and allows multicenter studies.MethodsThis is a quantitative transversal study with control group conducted in pediatric and adult rheumatology clinics. The computer test batteries ANAM (Automated Neuropsychological Assessment Metrics) or PedAnam (Pediatric version) was submitted to the Guidelines for the Process of Cross-Cultural Adaptation. This process has five stages: Initial translation, synthesis of the translations, back translation, harmonization, test of the prefinal version and final version. After the process, we apply the ANAM in 98 SLE patients and healthy age-matched individuals. All individuals underwent an evaluation through the battery tests taking 30 min on average to solve the problems.Results98 SLE patients, 69 female and 29 male, ages between 6 and 68 years with mean of 28.6. The control group had 84 people, 73 female and 11 male, ages between 6 and 65 years with mean of 25. For the evaluation was used the Performance Validity Index score, that provides a performance indicator, between 0 and 14, for someone with good effort, or above for someone outside the range of that expected for someone providing good effort. Patients presented an average performance of 8.05, with a minimum of 0 and a maximum of 33, while the control group had a mean of 4.4, minimum 0 and maximum of 27. As the smaller score results in a better effort, it is possible to notice meaningful differences between the groups (p<0.05).ConclusionsCognitive difficulties are often observed in SLE and practical tools like ANAM and PedAnan should be used to measure the cognitive loss that patients may have; these losses should be monitored more closely if there are other neuropsychiatric symptoms.Funding Source(s):CNPqCAPESFAPESP
Este estudo teve como principal objetivo revisitar os principais documentos legais publicados até 2013 que orientam a Educação Infantil (EI) no Brasil, analisando de que forma o movimento foi considerado e quais as orientações para o seu desenvolvimento nas práticas educativas. Visou especificamente identificar as possíveis interfaces entre o movimento e as oportunidades de trabalho do professor de Educação Física, em uma perspectiva interdisciplinar, em especial para a faixa etária até os três anos. Para tanto, analisou os principais documentos publicados pelo Ministério da Educação e divulgados no período de 1988 a 2013 para o nível de ensino. A análise dos documentos oficiais demonstrou que o movimento é reconhecido como linguagem e impulsionador do desenvolvimento integral da criança. Sendo o movimento o objeto da EF, cabe ao seu profissional estudar e influenciar as instituições educativas para que atendam as necessidades da criança pequena. O caráter interdisciplinar apresentado pelos documentos oficiais também incentiva a participação do profissional de EF.
RESUMOA avaliação da coordenação motora de pessoas com deficiência intelectual (DI) é foco de diversas pesquisas na área da Educação Física. Neste sentido, o objetivo do presente estudo é constatar protocolos de avaliação da coordenação motora para pessoas com DI, além de apresentar os protocolos de avaliação da coordenação motora encontrados, com maior enfoque no Teste do Movimento ABC (M-ABC Test), pois o mesmo foi desenvolvido especificamente para avaliar pessoas com a referida deficiência. Foram utilizadas as bases de dados Scirus, Sciverse, Scielo, Embase, Pubmed, Lilacs e Google Scholar. Constatou-se que a literatura traz vários testes que elucidam a avaliação da coordenação motora em pessoas com DI, porém, ainda há a necessidade de maior aplicação. Concluiu-se que a avaliação motora é uma forma de fornecer subsídios para que os professores de Educação Física possam orientar suas práticas conforme as necessidades envolvidas na população em foco, além de fornecer dados consistentes para estudos científicos.Palavras-Chave: Avaliação. Educação física. Protocolos. Coordenação motora. Deficiência intelectual.
BACKGROUNDNeuropsychiatric manifestations are frequently seen in patients with childhood-onset systemic lupus erythematosus (cSLE). These symptoms are difficult to diagnose and classify. In this sense, the magnetic resonance imaging (MRI) associated with cognitive dysfunction screening batteries, such as the pediatric neuropsychological assessment metrics (PedAnam), compose an investigation protocol. The objective was to explore and test approaches to calculate the cognitive performance score (CSP) of the PedAnam battery based on principal component analysis (PCA) and to correlate the results with the brain volume numbers obtained by MRI. METHODSPatients responded to PedAnam and performed MRI (Siemens 3T scanner) on the same day. Basic characteristics about the disease were collected. Sagittal MR images were T1-weighted and segmented using Freesurfer software. The PedAnam results were analyzed using PCA as the cognitive performance score. The variance-covariance matrix of the normalized precision scores of the PedAnam subtests was decomposed into a series of eigenvectors with corresponding eigenvalues. The first eigenvector was used to preserve most of the total variance of the matrix. Furthermore, the score automatically generated by PedAnam is notable. The data from the PCA and effort process were correlated with volumetric results of brain volume and hippocampus. RESULTSWe included 54 cSLE patients (mean age 12 SD = 3.6 [86.19%] women); age at disease onset ranged from 5 to 17 years (mean 12.85, SD = 3.44); disease duration ranged from 6-30 years (mean 14, SD = 5.82); The predominant race was white, with 41 people (75.93%), followed by Afrodescendant (24.08%). We analyzed each accuracy separately in terms of measures of centrality and dispersion. After calculating the PCA, we obtained the median between 1.13 and 3.96, which shows that for our cohort, we cannot use the cut-off point of the scientific literature (0.25). While effort, a standard metric automatically provided by the software, presented an average of 7 (0-19), the score is interpreted as ranging from 0-33; the lower, the better the performance, and results greater than 15 may present cognitive deficits. From the proposed cut-off point, 6 patients had cognitive deficits. As for the association with MRI, we observed that the white brain substance volume correlated with CPS (r = 0.41, p = 0.023). While the effort did not show any statistically significant association. CONCLUSIONWe observed that the PCA analyzed in our cohort presented higher indices of variance distribution. Additionally, we observed that this simplified cognitive performance score was associated with white matter volume.
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