INECO Frontal Screening Research Articles

Neuropsychological Assessment in Schooled Adolescent Offenders and Non-Offenders

Adolescents who break the law have experienced situations that increase the likelihood of becoming involved in criminal activities such as drug use, gang involvement, adverse economic conditions, among others. All this, added to their stage of human development, which is characterized by physical, cognitive, social and emotional changes, can lead them to have deficiencies in their cognitive processes and at the same time present educational difficulties. The purpose of this study is to evaluate different cognitive processes of these adolescents in comparison to a control group with similar characteristics but who have not committed any crime and whose education has not been interrupted. For this purpose, were included (n = 62) adolescent offenders and (n = 62) adolescent non-offenders of male sex and aged 14 to 18 years was taken. Basic sociodemographic data on their education and psychoactive substance use were collected, as well as cognitive data with tests such as Ineco Frontal Screening for executive functions, Montreal Cognitive Assessment for general functions, among others. The results showed significant differences in executive functions, attentional processes, memory and language. These difficulties can be key to school performance, therefore, educational interventions adapted to these adolescents are suggested.

Impact of COVID‐19 infection on the cognition and emotion of Peruvians: analysis after 6‐12 months post‐infection

AbstractBackgroundCOVID‐19 pandemic significantly impacted different systems and organs (cardiovascular, metabolic, immune, brain, and others). More than two years after the first wave of COVID‐19 in Peru, we still do not know the consequences on cognition and emotion, and nowadays, different studies suggest the impact of COVID‐19 might trigger mild cognitive impairment, dementia, and neuropsychiatric syndromes in the future.MethodsAn ex‐post facto study was carried out with two groups, considering a neurocognitive evaluation (general cognition, verbal fluency, attention, and executive function) and emotion (depression, anxiety, and stress) and performed between 6 and 18 months after the first confirmed diagnosis of COVID‐19 in Peruvians (by PCR or antigen test). The mean age was 37.03 ± 15.57 (age range between 17 and 86 years old), and 60.5% were Female. We use the following instruments: INECO Frontal screening, Addenbrooke’s Cognitive Examination‐Revisado (ACE‐R), Verbal Fluency, TMT A/B, and DASS‐21.ResultsNo specific differences in general cognition were found. However, we found an effect in the INECO Frontal Screening (IFS) and the DASS‐21 (Anxiety scale). Patients diagnosed with COVID‐19 by PCR or antigen test have a slightly reduced frontal function (executive function).ConclusionsCOVID‐19 impacted high hierarchical frontal functions, but these effects are not well identified with general cognitive testing. Similarly, an increase in anxiety was found. More specific evaluation and sensitive techniques are needed to elucidate future COVID‐19 consequences on brain function.

Utility of the INECO Frontal Screening and the Frontal Assessment Battery in detecting executive dysfunction in early-onset cognitive impairment and dementia.

The INECO Frontal Screening (IFS) and the Frontal Assessment Battery (FAB) are executive dysfunction (ED) screening tools that can distinguish patients with neurodegenerative disorders from healthy controls and, to some extent, between dementia subtypes. This paper aims to examine the suitability of these tests in assessing early-onset cognitive impairment and dementia patients. In a memory clinic patient cohort (age mean = 57.4 years) with symptom onset at ≤65 years, we analyzed the IFS and the FAB results of four groups: early-onset dementia (EOD, n = 49), mild cognitive impairment due to neurological causes (MCI-n, n = 34), MCI due to other causes such as depression (MCI-o, n = 99) and subjective cognitive decline (SCD, n = 14). Data were gathered at baseline and at 6 and 12 months. We also studied the tests' accuracy in distinguishing EOD from SCD patients and ED patients from those with intact executive functioning. Correlations with neuropsychological measures were also studied. The EOD group had significantly (p < .05) lower IFS and FAB total scores than the MCI-o and SCD groups. Compared with the FAB, the IFS showed more statistically significant (p < .05) differences between diagnostic groups, greater accuracy (IFS AUC = .80, FAB AUC = .75, p = .036) in detecting ED and marginally stronger correlations with neuropsychological measures. We found no statistically significant differences in the EOD group scores from baseline up to 6- or 12-months follow-up. While both tests can detect EOD among memory clinic patients, the IFS may be more reliable in detecting ED than the FAB.

The Association between Executive Function and Performing Instrumental Daily Activities in People with Intellectual Disabilities.

Institutionalized individuals with intellectual disabilities have few opportunities to participate in instrumental activities of daily living (IADLs), which probably affects higher cognitive functions, or vice versa. The objectives of this study were to evaluate the possible difference in the ability to perform IADLs and executive functioning between individuals with and without intellectual disabilities and to determine if executive functions are associated with the performance of IADLs in people with intellectual disabilities. This was a multi-center cross-sectional study, conducted between July 2019 and May 2020. Participants with intellectual disabilities were recruited from four centers for people with intellectual disabilities. Adults without these disabilities were gathered from several community centers. The sample consisted of 90 individuals with moderate intellectual disabilities and 79 individuals with no intellectual disability. Executive functions were evaluated using the Wechsler Adult Intelligence Scale-WAIS-IV, the INECO Frontal Screening test, the Semantic Verbal Fluency Test, and the Behavioural Assessment of the Dysexecutive Syndrome-BADS-Scale. The performance of the IADLs was assessed by the Lawton and Brody Scale. The results showed that the higher the function in instrumental activities, the lower the impairment of executive functions. Executive functions accounted for 81% of the total variance in the ability to perform the IADLs. In conclusion, individuals with moderate intellectual disabilities demonstrated limitations in executing the IADLs, which were partially associated with low performance in executive functions. This information could help in the development of evidence-based intervention programs and facilitate the formulation of appropriate support strategies to enhance participation in these activities.

Synaptic loss in behavioural variant of frontotemporal dementia:an in vivo [11C]UCB‐J PET study

AbstractBackgroundPost‐mortem clinical studies and animal models described severe synaptic loss as an early feature of neurodegenerative disease, including frontotemporal dementia. Recently, PET radiotracers that bind to synaptic vesicle glycoprotein 2A have been developed and proven to enable in vivo quantification of synaptic loss in people with neurodegenerative diseases. This study used [11C]UCB‐J PET to quantify synaptic loss in people with behavioural variant frontotemporal dementia (bvFTD).MethodWe recruited 10 people with a clinical diagnosis of bvFTD and 24 age‐ and sex‐matched healthy controls. Participants underwent dynamic [11C]UCB‐J PET‐MR, and a neuropsychological assessment, including the Addenbrooke's cognitive examination (ACE‐R) as a global measure of cognitive performance, and the INECO frontal screening. Synaptic density was estimated using [11C]UCB‐J non‐displaceable binding potential (BPND) at voxel level and in whole‐brain regions of interest. General linear models were used to compare [11C]UCB‐J binding voxel‐wise between groups, and correlate synaptic density with cognitive performance in bvFTD cohort. These analyses were also performed using regional [11C]UCB‐J binding potentials, with and without partial‐volume correction. Regional correlations were performed with both frequentist and Bayesian approaches.ResultPeople with bvFTD showed severe synaptic loss compared to controls at individual level and as a group. [11C]UCB‐J binding was significantly reduced bilaterally in medial and dorsolateral frontal regions, inferior frontal gyri, anterior and posterior cingulate gyrus, insula cortex and medial temporal lobe (5.1 ≤ t ≤ 9.3, p &lt; 0.05 FWE at voxel level, Figure 1A). Results from ROI‐based analyses mirrored the voxel‐wise results, with and without partial‐volume correction. Synaptic loss in the left frontal and cingulate regions significantly correlated with cognitive impairments as assessed with ACE‐R and INECO (r &gt; 0.8, p&lt;0.001 at voxel level, p&lt;0.05 FWE at cluster level, Figure 1B). Correlations were confirmed by regional‐based analyses, with both frequentist and Bayesian approaches (Figure 1C).ConclusionDifferent analytic approaches converged showing a significant and widespread frontotemporal loss of synapses in symptomatic bvFTD, in proportion to disease severity. [11C]UCB‐J PET could therefore be a useful supporting tool for translational studies and experimental medicines strategies for new disease‐modifying treatments in this condition.

Synaptic Loss in Frontotemporal Dementia Revealed by [11 C]UCB-J Positron Emission Tomography.

Synaptic loss is an early feature of neurodegenerative disease models, and is severe in post mortem clinical studies, including frontotemporal dementia. Positron emission tomography (PET) with radiotracers that bind to synaptic vesicle glycoprotein 2A enables quantification of synaptic density in vivo. This study used [11 C]UCB-J PET in participants with behavioral variant frontotemporal dementia (bvFTD), testing the hypothesis that synaptic loss is severe and related to clinical severity. Eleven participants with clinically probable bvFTD and 25 age- and sex-matched healthy controls were included. Participants underwent dynamic [11 C]UCB-J PET, structural magnetic resonance imaging, and a neuropsychological battery, including the revised Addenbrooke Cognitive Examination, and INECO frontal screening. General linear models compared [11 C]UCB-J binding potential maps and gray matter volume between groups, and assessed associations between synaptic density and clinical severity in patients. Analyses were also performed using partial volume corrected [11 C]UCB-J binding potential from regions of interest (ROIs). Patients with bvFTD showed severe synaptic loss compared to controls. [11 C]UCB-J binding was reduced bilaterally in medial and dorsolateral frontal regions, inferior frontal gyri, anterior and posterior cingulate gyrus, insular cortex, and medial temporal lobe. Synaptic loss in the frontal and cingulate regions correlated significantly with cognitive impairments. Synaptic loss was more severe than atrophy. Results from ROI-based analyses mirrored the voxelwise results. In accordance with preclinical models, and human postmortem evidence, there is widespread frontotemporal loss of synapses in symptomatic bvFTD, in proportion to severity. [11 C]UCB-J PET could support translational studies and experimental medicine strategies for new disease-modifying treatments for neurodegeneration. ANN NEUROL 2023;93:142-154.

A Proposal of Cognitive Intervention in Patients with Alzheimer's Disease through an Assembling Game: A Pilot Study.

(1) Background: Alzheimer’s disease is an irreversible brain disease, and current treatments are aimed at fighting cognitive decline. We have explored the feasibility of a game-based intervention for people with moderate Alzheimer’s disease; (2) Methods: Six participants, five women and one man, were recruited from a day center to participate in a five-week study, which included a re- and post-evaluation with the Montreal Cognitive Assessment (MoCA) and INECO Frontal Screening (IFS) tests. Three participants were assigned to the control group and three others to the experimental one. Both groups performed a play activity consisting of assembling a pie toy. Participants in the experimental group were asked to make a pie matching a sample after a time interval. Control group participants were asked to freely assemble a pie without the matching component; (3) Results: Patients were shown to be motivated during such an activity during the nine sessions. The experimental group showed a significant increase in IFS scores when comparing the post- and pre-intervention assessments. No significant differences were observed in MoCA scores; (4) The intervention created a social and emotional climate suitable to maintaining participants’ satisfaction and motivation, as well as to developing executive function while promoting positive emotions.

Neuropsychiatric Symptoms in Behavioral Variant Frontotemporal Dementia and Alzheimer's Disease: A 12-Month Follow-Up Study.

Introduction: Neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) are highly prevalent and may complicate clinical managements.Objective: To test whether the Neuropsychiatry Inventory (NPI) could detect change in neuropsychiatric symptoms and caregiver's distress in patients diagnosed with behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD) from baseline to a 12-month follow-up and to investigate possible predictors of change in NPI scores.Methods: The sample consisted of 31 patients diagnosed with bvFTD and 28 patients with AD and their caregivers. The Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), the INECO Frontal Screening (IFS), the Frontal Assessment Battery (FAB), the Executive Interview (EXIT-25) and the NPI were applied. Descriptive statistics, Mann-Whitney U test, Wilcoxon test, Chi square (χ2) test and Linear Regression Analysis were used.Results: NPI total and caregiver distress scores were statistically higher among bvFTD patients at both assessment points. MMSE, ACE-R scores significantly declined and NPI Total and Distress scores significantly increased in both groups. In the bvFTD group, age was the only independent predictor variable for the NPI total score at follow up. In the AD group, ACE-R and EXIT-25, conjunctively, were associated with the NPI total score at follow up.Conclusions: In 12 months, cognition declined and neuropsychiatric symptoms increased in bvFTD and AD groups. In the AD group only, cognitive impairment was a significant predictor of change in neuropsychiatric symptoms.

Social Cognition and Behavioral Assessments Improve the Diagnosis of Behavioral Variant of Frontotemporal Dementia in Older Peruvians With Low Educational Levels.

Background: The behavioral variant of frontotemporal dementia (bvFTD), characterized by early behavioral abnormalities and late memory impairment, is a neurodegenerative disorder with a detrimental impact on patients and their caregivers. bvFTD is often difficult to distinguish from other neurodegenerative diseases, such as Alzheimer's disease (AD), using brief cognitive tests. Combining brief socio-cognitive and behavioral evaluations with standard cognitive testing could better discriminate bvFTD from AD patients. We sought to evaluate the diagnostic accuracy of brief socio-cognitive tests that may differentiate bvFTD and AD patients with low educational levels.Methods: A prospective study was performed on 51 individuals over the age of 50 with low educational levels, with bvFTD or AD diagnosed using published criteria, and who were receiving neurological care at a multidisciplinary neurology clinic in Lima, Peru, between July 2017 and December 2020. All patients had a comprehensive neurological evaluation, including a full neurocognitive battery and brief tests of cognition (Addenbrooke's Cognitive Examination version III, ACE-III), social cognition (Mini-social Cognition and Emotional Assessment, Mini-SEA), and behavioral assessments (Frontal Behavioral Inventory, FBI; Interpersonal Reactivity Index—Emphatic Concern, IRI-EC; IRI—Perspective Taking, IRI-PT; and Self-Monitoring Scale—revised version, r-SMS). Receiver operating characteristic (ROC) analysis to calculate the area under the curve (AUC) was performed to compare the brief screening tests individually and combined to the gold standard of bvFTD and AD diagnoses.Results: The AD group was significantly older than the bvFTD group (p < 0.001). An analysis of the discriminatory ability of the ACE-III to distinguish between patients with AD and bvFTD (AUC = 0.85) and the INECO Frontal Screening (IFS; AUC = 0.78) shows that the former has greater discriminatory ability. Social and behavioral cognition tasks were able to appropriately discriminate bvFTD from AD. The Mini-SEA had high sensitivity and high moderate specificity (83%) for discriminating bvFTD from AD, which increased when combined with the brief screening tests ACE-III and IFS. The FBI was ideal with high sensitivity (83%), as well as the IRI-EC and IRI-PT that also were adequate for distinguishing bvFTD from AD.Conclusions: Our study supports the integration of socio-behavioral measures to the standard global cognitive and social cognition measures utilized for screening for bvFTD in a population with low levels of education.

Sensitivity and specificity of the INECO frontal screening (IFS) in the detection of patients with traumatic brain injury presenting executive deficits

Executive dysfunction (EF) is a common feature of adult traumatic brain injury (TBI), especially in moderate to severe cases. Assessing EF usually requires the administration of an extensive neuropsychological battery, which is time consuming and expensive. The INECO frontal screening (IFS) is a brief, easy-to-administer screening test which has previously shown to be useful in the detection of executive deficits in different psychiatric and neurological populations. The aim of the present study was to assess the usefulness of the IFS in the detection of executive dysfunction in TBI patients. Twenty-eight TBI patients and thirty-two healthy controls were assessed with a battery that included classical executive tests and the IFS. Our results indicated that with a cutoff score of 26.25 points, the IFS showed good sensitivity and specificity in the detection of executive impairments in TBI patients. It also showed good positive and negative predicted values. Our results suggest that the IFS can be considered a useful tool for identifying executive dysfunction in patients with TBI.

Neuroanatomy of complex social emotion dysregulation in adolescent offenders.

Social emotions require the correct integration of emotional, cognitive, and social processes and are critical for complex social interactions. Adolescent criminal offenders (AOs) show abnormalities in the experience of basic emotions. However, most research has focused solely on basic emotions, neglecting complex social emotions that could be critical for social reintegration. The purpose of this study was to investigate the behavioral and neural correlates of social emotions (envy and Schadenfreude) in AOs. We explored the experience of complex social emotions, as well as their anatomical correlates, in AOs (n = 19) and a nonoffenders control group (NOs, n = 20). Additionally, we assessed the relationship between social emotions, executive functions (EFs), and fluid intelligence (FI). Structural brain imaging was obtained in all participants. The results showed that AOs had significantly lower envy and Schadenfreude ratings and exhibited lower performance in EFs compared with NOs. The measurement of EFs relied on the INECO frontal screening (IFS). Experiencing fewer social emotions was associated with diminished EFs but not with FI. Moreover, in AOs, reduced levels of envy and Schadenfreude were linked with reduced gray matter volumes in regions subserving mentalizing abilities (inferior parietal lobe and precuneus) and socioemotional processing (inferior and middle temporal regions), as well as key hubs of the executive frontoparietal network (inferior parietal lobule, orbital and rectus gyri). Additional analysis on the AOs revealed no associations between the type of crime and our variables of interest (EFs, FI and social emotions). Our findings are the first to provide evidence on abnormalities in the experience of social emotions in AOs that are associated with neurocognitive markers of social cognition and EFs. Understanding social emotions and their abnormalities (under-experience) as complex intertwined processes may have important future translational implications, including risk prediction for social adaptation/reintegration, sociocognitive targeted interventions, and skill training for social emotions in vulnerable populations.

Diagnostic accuracy of brief cognitive screening tools to diagnose vascular cognitive impairment in Peru.

To evaluate the diagnostic accuracy of three brief cognitive screening (BCS) tools, Peruvian version of Addenbrooke's Cognitive Examination (ACE-Pe), of INECO Frontal Screening (IFS-Pe) and of the Mini-Mental State Examination (MMSE-Pe), for the diagnosis of vascular cognitive impairment (VCI) and its non-dementia stages (VCI-ND) and vascular dementia (VD) in patients with cerebral stroke in Lima-Peru. A cohort analysis to evaluate the diagnostic accuracy of three BCS for VCI. Two hundred and four patients were evaluated: 61% Non-VCI, 30% VCI-ND and 9% VD. To discriminate patients with VCI from controls, the area under the curve (AUC) of ACE-Pe, IFS-Pe and MMs-Pe were 0.99 (95% confidence interval [CI] 0.98-0.99), 0.99 (95%CI 0.98-0.99) and 0.87 (95%CI 0.82-0.92), respectively. Of the three BCS, the IFS-Pe presented a larger AUC to discriminate VCI-ND from VD (AUC=0.98 [95%CI 0.95-1]) compared to ACE-Pe (AUC=0.84 [95%CI 0.74-0.95]) and MMSE-Pe (0.92 [95%CI 0.86-0.99]). The IFS-Pe presented a higher sensitivity (S), specificity (Sp), and positive (+LR) and negative likelihood ratios (-LR) (S=96.72%, Sp=89.47%, +LR=9.1 and -LR=0.03) than ACE-Pe (S=96.72%, Sp=63.16%, +LR=2.62 and -LR=0.05) and MMSE-Pe (S=90.16%, Sp=78.95%, +LR=4.28 and -LR=0.12). In the multiple regression analysis, the IFS-Pe was not affected by age, sex or years of schooling. The IFS-Pe has the best diagnostic accuracy for detecting VCI and discriminating between pre-dementia (VCI-ND) and dementia (VD) stages.

Evaluation of sensitivity and specificity of the INECO Frontal Screening and the Frontal Assessment Battery in mild cognitive impairment.

ABSTRACT.The Frontal Assessment Battery (FAB) and the INECO Frontal Screening (IFS) are two instruments frequently used to explore cognitive deficits in different diseases. However, studies reporting their use in patients with mild cognitive impairment (MCI) are limited.Objective:To compare the sensitivity and specificity of FAB and IFS in mild cognitive impairment (multiple-domain amnestic MCI subtype — md-aMCI).Methods:IFS and FAB were administered to 30 md-aMCI patients and 59 healthy participants. Sensitivity and specificity were investigated using the Receiver Operating Characteristic (ROC) analysis.Results:The area under the ROC curve (AUC) of IFS for MCI patients was .82 (sensitivity=0.96; specificity=0.76), whereas the AUC of FAB was 0.74 (sensitivity=0.73; specificity=0.70).Conclusions:In comparison to FAB, IFS showed higher sensitivity and specificity for the detection of executive dysfunctions in md-aMCI subtype. The use of IFS in everyday clinical practice would allow detecting the frontal dysfunctions in MCI patients with greater precision, enabling the early intervention and impeding the transition to more severe cognitive alterations.

The INECO Frontal Screening for the Evaluation of Executive Dysfunction in Cerebral Small Vessel Disease: Evidence from Quantitative MRI in a CADASIL Cohort from Colombia - Corrigendum.

The INECO Frontal Screening for the Evaluation of Executive Dysfunction in Cerebral Small Vessel Disease: Evidence from Quantitative MRI in a CADASIL Cohort from Colombia – Corrigendum - Volume 26 Issue 10

The INECO Frontal Screening for the Evaluation of Executive Dysfunction in Cerebral Small Vessel Disease: Evidence from Quantitative MRI in a CADASIL Cohort from Colombia.

Executive dysfunction is a predominant cognitive symptom in cerebral small vessel disease (SVD). The Institute of Cognitive Neurology Frontal Screening (IFS) is a well-validated screening tool allowing the rapid assessment of multiple components of executive function in Spanish-speaking individuals. In this study, we examined performance on the IFS in subjects with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), an inherited condition leading to the early onset of SVD. We further explored associations between performance on the IFS and magnetic resonance imaging (MRI) markers of SVD. We recruited 24 asymptomatic CADASIL subjects and 23 noncarriers from Colombia. All subjects underwent a research MRI and a neuropsychological evaluation, including the IFS. Structural MRI markers of SVD were quantified in each subject, together with an SVD Sum Score representing the overall burden of cerebrovascular alterations. General linear model, correlation, and receiver operating characteristic curve analyses were used to explore group differences on the IFS and relationships with MRI markers of SVD. CADASIL subjects had a significantly reduced performance on the IFS Total Score. Performance on the IFS correlated with all quantified markers of SVD, except for brain atrophy and perivascular spaces enlargement. Finally, while the IFS Total Score was not able to accurately discriminate between carriers and noncarriers, it showed adequate sensitivity and specificity in detecting the presence of multiple MRI markers of SVD. These results suggest that the IFS may be a useful screening tool to assess executive function and disease severity in the context of SVD.

Validation of the RUDAS for the Identification of Dementia in Illiterate and Low-Educated Older Adults in Lima, Peru.

Objectives: To evaluate the performance of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) in discriminating between controls and patients with mild cognitive impairment (MCI) and dementia in an illiterate population with low-levels of education.Methods: We compared the cognitive performance of 187 elderly subjects who were illiterate (controls n = 60; MCI n = 64; dementia n = 63). Neuropsychological measures included the RUDAS-PE, Mini-Mental State Examination (MMSE), INECO Frontal Screening (IFS), and Pfeffer Functional Activities Questionnaire (PFAQ). The results were compared to a neuropsychological evaluation (gold standard), including use of Clinical Dementia Rating (CDR) scores.Results: We found a Cronbach's alpha was 0.65; Spearman's correlation coefficient was 0.79 (p < 0.01). The area under the receiver operating characteristics curve for the RUDAS to discriminate dementia from MCI was 98.0% with an optimal cut-off <19 (sensitivity 95%, specificity 97%); whereas, to differentiate MCI and controls was 98.0% with an optimal cut-off <23 (sensitivity 89%, specificity 93%).Conclusions: Based on its excellent psychometric properties, we find the RUDAS-PE suitable to aid in the opportune detection of dementia in a geriatric illiterate population with low-levels of education.

Sistemas de activación y de inhibición de conducta y su relación con el funcionamiento ejecutivo en excombatientes irregulares del conflicto armado colombiano

Objetivo: Explorar la relación entre los sistemas de activación de conducta (SAC) / sistema de inhibición de conducta (SIC) y funciones ejecutivas (FE) en excombatientes del conflicto armado colombiano. Metodología: Estudio observacional, exploratorio, con muestra no aleatoria de 39 excombatientes del programa de la Alta Consejería de la Presidencia para la Reintegración, residentes en Antioquia-Colombia, edad 35±7.6 años, 87.2% hombres, y escolaridad 10±2.8 grados; comparados con un grupo control de 14 no combatientes (edad 33±6.1 años, 71.4% hombres y escolaridad 10±2.7 grados). Se les administró un cuestionario de SAC/SIC, usando la sensibilidad a la recompensa (SR) y la sensibilidad al castigo (SC). Para la FE se aplicó la prueba Ineco Frontal Screening (IFS). Resultados: Hubo alteraciones específicas de la FE: en la ejecución de instrucciones conflictivas (IC), memoria de trabajo verbal (MTV) y control inhibitorio verbal (CIV). Se evidenciaron correlaciones directas, con coeficientes de moderados a altos entre el SAC (SR) y la capacidad de abstracción CA, el control motor inhibitorio (CMI), la MTV, la memoria de trabajo espacial (MTE) y el funcionamiento ejecutivo global (IFSTOT). Conclusiones: Los excombatientes presentaron un rendimiento inferior en la memoria de trabajo verbal y el control inhibitorio verbal, lo que impacta las capacidades de anticipación, establecimiento de metas, diseño de planes, iniciación de conductas voluntarias y el control inhibitorio. Lo anterior puede generar la toma de decisiones equivocadas.

Effects of transcranial direct current stimulation on action-verb processing in patients with Parkinson's disease

The aim of this study is to investigate the effects of transcranial direct current stimulation (tDCS) combined with cognitive training (CT) on action-verb processing in patients with Parkinson’s disease (PD). A pilot, randomized double-blind controlled, clinical trial was conducted with 30 patients with PD assigned to two groups: (I) active anodal tDCS over M1 and IFG plus CT (experimental group), or (II) sham tDCS plus CT (control group). All PD participants who met UK Parkinson Disease Society Brain Bank criteria were evaluated using part III of the Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr’s stages I or II. The patients were undergoing antiparkinsonian therapy and were evaluated during the “on” phase of their medication, and were evaluated with the Addenbrooke Cognitive Examination- revised and the INECO Frontal Screening. The primary outcome (action-verb processing) was assessed by time-picture word paradigm. Motor impairment, bradykinesia and balance, were analyzed as secondary outcomes. We found that active vs. sham tDCS led to an increase in the rate of correct responses in the time-picture word paradigm. This improvement were more notable in verbs with high manipulability versus verbs with low manipulability. Our results showed that active stimulation of left IFG and M1 resulted in improvements in action-verb processing. Thus, our findings encourage further investigation exploring tDCS as an adjuvant therapy for cognitive treatment in PD.

Distinguishing mild cognitive impairment from healthy aging and Alzheimer's Disease: The contribution of the INECO Frontal Screening (IFS).

Executive functions are affected differently in healthy aging, Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD), and evaluating them is important for differential diagnosis. The INECO Frontal Screening (IFS) is a brief neuropsychological screening tool, developed to assess executive dysfunction in neurodegenerative disorders. Goals: We aimed to examine whether and how MCI patients can be differentiated from cognitively healthy controls (HC) and mild to moderate AD patients based on IFS performance. We also explored how IFS scores are associated with age, years of education, and depressive/anxious symptoms (as assessed by the Hospital Anxiety and Depression Scale). Method: IFS total scores were compared between 26 HC, 32 MCI and 21 mild to moderate AD patients. The three groups were matched for age and education. The Area Under the Curve (AUC) was analyzed and optimal cut-offs were determined. Results: Healthy participants had higher IFS scores than both clinical groups, and MCI patients had higher scores than AD patients. IFS showed high diagnostic accuracy for the detection of MCI (AUC = .89, p < .001) and AD (AUC = .99, p < .001), and for the differentiation between the clinical groups (AUC = .76, p < .001). We provide optimal cut-offs for the identification of MCI and AD and for their differentiation. We also found that, in general, higher education predicted higher IFS scores (no associations with age and depressive/anxious symptoms were observed). Altogether, these findings indicate that evaluating executive functions with the IFS can be valuable for the identification of MCI, a high-risk group for dementia, and for differentiating this condition from healthy aging and AD.

Validation of the RUDAS in Patients With a Middle-Level Education in Lima, Peru.

To assess the psychometric properties of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) to discriminate controls from patients with mild cognitive impairment (MCI) and early dementia (ED) in a population with a mid-level education. A total of 133 patients from a memory clinic were administered the RUDAS-PE, INECO Frontal Screening, Addenbrooke's Cognitive Examination, and Mini-Mental State Examination. Results were compared against a neuropsychological evaluation (gold standard). Validity measures, internal consistency, and concurrent validity were calculated. Cronbach's α was 0.68; Pearson's ratio was 0.79 (P < .01). The area under the receiver-operating characteristics curve of the RUDAS to discriminate between ED and MCI was 89.0% (optimal cutoff at <21), whereas between MCI and controls, it was 99.0% (optimal cutoff at <24). The RUDAS-PE has acceptable psychometric properties performing well in its ability to discriminate controls from patients with MCI and ED.