Disfunções cognitivas em pacientes com hipotireoidismo subclínico

Abstract

OBJETIVO: Avaliar a presença de disfunções cognitivas em pacientes com hipotireoidismo subclínico (HS). SUJEITOS E MÉTODOS: Estudo seccional comparando os achados neuropsicológicos de 89 pacientes com HS e 178 indivíduos eutireoidianos. Para avaliação neuropsicológica, foram utilizados: Teste de Performance Contínua (CPT-II), Iowa Gambling Task, Teste de Stroop, Teste de Wisconsin (WCST), Teste da Figura Complexa de Rey-Osterreich, Teste de Fluência Verbal (categorias semântica e fonológica) e Teste de Aprendizagem Auditivo Verbal de Rey. RESULTADOS: Os pacientes mostraram pior desempenho na flexibilidade cognitiva (WCST) e na capacidade de manter atenção sustentada (erros por omissão no CPT-II). CONCLUSÕES: Esses déficits podem causar prejuízos na vida diária do paciente, constituindo possíveis indicações de tratamento.

The Iowa Gambling Task (IGT) in Brazil: a systematic review

“…Incorporating a larger neuropsychological test battery into the study of IGT performance in Brazil is also desirable in future studies. Sixteen studies [7][8][9][10][11][13][14][15][19][20][21]30,32,34,35,40 incorporated the CPT-II and found significant associations between the two tasks. This suggests common cognitive constructs involving impulsivity in attentional and motor dimensions in both the IGT and the CPT-II.…”

“…Another neuropsychological instrument frequently associated with the IGT was the WCST, in 12 studies. 8,12,[15][16][17]26,30,32,33,36,37,39 Even though correlations between the two instruments appear to be weak (e.g., perseverative WCST errors vs. performance on the first block of the IGT), investigators 39 have suggested that this relationship remains inconclusive. While the IGT is considered a classical instrument in the evaluation of high emotional influence and the WCST has a higher preponderance of low emotional influence, 26,52 additional work using more tasks of high and low emotional as well as executive influence are needed to confirm this tentative association in the IGT literature.…”

“…Health-related issues were analyzed in 11 publications (31%) 21,23,26,30,[32][33][34][35]37,38,40 and covered a variety of neurological issues. Three studies 23,37,38 focused on stroke and its impact on decision-making, with one study addressing treatment implications.…”

“…Likewise, in a study investigating temporal lobe epilepsy, the authors did not report IGT testing results. 33 Despite being an isolated report, a recent publication on cognitive impairment due to subclinical hypothyroidism 32 had the largest sample (n = 267) of all Brazilian IGT studies. The study reported differences in cognitive flexibility measured by the WCST and in sustained attention measured by the CPT-II (omission errors), but IGT scores (net score and blocks) showed no statistically significant differences between those with and without subclinical hypothyroidism.…”