Neurología Cognitiva.artículos

Executive Functions in Latin American Older Adults: Exploring the Concept Shifting Test and Its Relationship with the APOE Gene in a Cross‐Sectional Sample from the LatAm‐FINGERS Study

2025-12-26T00:00:00Z

Executive Functions in Latin American Older Adults: Exploring the Concept Shifting Test and Its Relationship with the APOE Gene in a Cross‐Sectional Sample from the LatAm‐FINGERS Study Melillo Cardoso, Davi; Vasconcelos Friedlander, Clarisse; Sanches Yassuda, Monica; Cruz de Souza, Leonardo; Crivelli, Lucía; Kimie Suemoto, Claudia; Martin, Maria Eugenia; Calandri, Ismael Luis; Acosta‐Baena, Natalia; Surace, Ezequiel Ignacio; Damian, Andrés; Da Graça Morais Martin, Maria; Vigil‐Martinez, Ana; Henrique Cançado, Gustavo; Salinas‐Contreras, Rosa Maria; Custodio, Belen; Cusicanqui, María Isabel; Delgado, Carolina; Sevlever, Gustavo Emilio; Allegri, Ricardo Francisco Background Latin America (LA) faces high vulnerability to dementia risk factors. Early detection of cognitive decline, particularly in executive functions (EF), is crucial. The Trail Making Test (TMT) has limitations, while the Concept Shifting Test (CST) offers potential advantages but lacks LA adaptation. This study examines CST's correlation with other EF tests and its relationship with APOE‐ε4 in older adults. Methods Cross‐sectional analysis of LatAm‐FINGERS baseline data, including TMT, CST, Stroop Test, and fluency tasks. APOE genotyping used PCR‐RFLP analysis. Jamovi software (v2.3) analyzed correlations (p < 0.05). Results Sample: 1,143 individuals from 11 LA countries. Mean age = 67.4 years (±4.7), education = 13.2 years (±3.5), 73.9% women, 57.3% mixed‐race. 21.4% carried APOE‐ε4 allele. Mean CST shifting score: 16.0 (±19.3). Significant correlations with age (𝜌=0.085; p = 0.009) and education (𝜌 = ‐0.201; p <0.001). No sex differences (p = 0.172). CST shifting score showed moderate correlation with TMT‐flexibility (𝜌=0.372; p <0.001), weak correlations with Stroop (𝜌=‐0.175; p <0.001), semantic (𝜌=‐0.133; p <0.001) and phonemic fluency (𝜌=‐0.184; p <0.001). No significant differences in CST shifting (p = 0.951) or TMT‐flexibility (p = 0.767) between APOE‐ε4 groups. Conclusions Weak correlations between CST shifting, Stroop‐flexibility, and fluency tasks suggest they assess different EF aspects. The moderate CST‐TMT correlation may indicate refined cognitive flexibility measurement in CST. While useful for EF assessment in LA, CST doesn't replace TMT. Diverse tools are crucial for early dementia detection. The lack of association between APOE‐ε4 and cognitive scores emphasizes the importance of assessment regardless of genetic risk.

Cognitive and neuroimaging trajectories in the behavioral variant of Alzheimer's disease

2025-12-26T00:00:00Z

Cognitive and neuroimaging trajectories in the behavioral variant of Alzheimer's disease Calandri, Ismael Luis; Phillips, Jeffrey S.; Tideman, Pontus; Singleton, Ellen Hanna; La Joie, Renaud; van der Flier, Wiesje M.; Jonkman, Laura E.; Hansson, Oskar; Rabinovici, Gil D.; Pijnenburg, Yolande A. L.; Ossenkoppele, Rik; Mastenbroek, Sophie E. Background The behavioral variant of Alzheimer's disease (bvAD) is a rare atypical presentationcharacterized by early and prominent behavioral changes, clinically akin to the behavioral variant of fronto‐temporal dementia (bvFTD). The natural history of bvAD is poorly understood. This study investigates the progression of bvAD in a multinational cohort, comparing bvAD with matched bvFTD and typical AD (tAD) groups. Method We analyzed 81 bvAD participants from four centers and matched them by age, sex, and education to bvFTD (n = 80), tAD (n = 81), and controls (n = 78). Participants completed longitudinal clinical assessments and underwent repeated structural MRI. We combined neurocognitive variables into domain‐specific composites. Furthermore, we extracted cortical thickness and volumetric MRI data using FreeSurfer andcomputed atemporal AD‐signature and a frontal region‐of‐interest. Linear mixed models were used to evaluate cognitive and neuroimaging trajectories. The model coefficients are presented as standardized (β), and the effect is assessed through estimated marginal means (EMM). Result Demographic features are shown in Table 1. Subjects with bvAD exhibited significant decline in executive function (β=‐0.62, 95%CI[‐1.02, ‐0.22], p = 0.03, EMM=‐0.19), memory (β=‐1.62, 95%CI[‐1.90, ‐1.33], p < 0.001, EMM=‐0.49), language (β=‐0.95, 95%CI[‐1.31, ‐0.59], p < 0.01, EMM=‐0.18), and visuospatial function (β=‐0.80, 95%CI[‐1.31, ‐0.28], p < 0.05) compared to controls. Compared to bvFTD, individuals with bvAD showed relatively greater memory (p = 0.005) and language (p = 0.04) preservation over time, while no significant differences were observed in visuospatial function (p = 0.65) or executive function (p = 0.4). In contrast, bvAD did not differ significantly from tAD in memory (p = 0.1), language (p = 0.6), visuospatial function (p = 0.99), or executive function. Individuals with bvAD exhibited significant decline in the AD‐signature (β=‐0.91, 95%CI[‐1.34, ‐0.48], EMM=‐0.49) and frontal ((β=‐0.66, 95%CI[‐1.16, ‐0.15], EMM=‐0.29) regions‐of‐interest compared to controls. Compared to tAD, no significant differences were found in both regions of interest (p = 0.61, p = 0.91). Compared to bvFTD, individuals with bvAD showed significantly greater atrophy in the AD‐signature regions (p = 0.02) and significantly less atrophy in frontal lobe (p = 0.03). Conclusion The progression of bvAD differs both cognitivelyand anatomically from bvFTD, while showing a progression pattern that is very similar to tAD. These results underscore the importance of investigating AD pathology in the context of cognitive‐behavioral decline.

Clinical Validation of the SECONDs Tool for Evaluating Disorders of Consciousness in Argentina

2025-10-07T00:00:00Z

Clinical Validation of the SECONDs Tool for Evaluating Disorders of Consciousness in Argentina Russo, María Julieta; Sampayo, María de la Paz; Arias, Paula; García, Vanina; Gambero, Yanina; Maiarú, Mariano; Deschle, Florencia; Pavón, Hernán Background: The Coma Recovery Scale-Revised (CRS-R) is the gold standard for diagnosing chronic disorders of consciousness (DoC); however, its clinical utility is limited by lengthy administration and the need for specialized training. The Simplified Evaluation of Disorders of Consciousness (SECONDs) provides a faster and more user-friendly alternative. Objective: This study aims to evaluate the validity and reliability of the Argentine adaptation of the SECONDs scale in adults with chronic DoC due to acquired brain injury. Methods: Twenty-nine patients were evaluated over two consecutive days by three blinded raters. On day one, rater A administered the SECONDs (A1) and rater B administered the CRS-R (B) to assess concurrent validity. On day two, rater A repeated the SECONDs (A2), and rater C performed an additional SECONDs assessment (C), permitting evaluation of intra-rater (A1 vs. A2) and inter-rater (A vs. C) reliability. Results: The SECONDs demonstrated excellent intra-rater (ICC = 0.98) and inter-rater (ICC = 0.86) reliability. Concurrent validity with the CRS-R was strong (r = 0.73, p < 0.001). Diagnostic agreement was high between A1 and B (κ = 0.75) and between both A1-A2 and A1-C (κ = 0.82). The median administration time was significantly shorter for the SECONDs (10 vs. 15 min; p < 0.001). Conclusion: The Argentine SECONDs is a valid, reliable, and efficient tool for the clinical assessment of DoC patients in rehabilitation settings.

Associations of lifestyle factors with amyloid pathology in persons without dementia

2025-11-13T00:00:00Z

Associations of lifestyle factors with amyloid pathology in persons without dementia Oomens, Julie E.; Vos, Stephanie Jb; Maserejian, Nancy N.; Boada, Mercè; Didic, Mira; Engelborghs, Sebastiaan; Fladby, Tormod; van der Flier, Wiesje M.; Frisoni, Giovanni B.; Fröhlich, Lutz; Gill, Kiran Dip; Grimmer, Timo; Hort, Jakub; Allegri, Ricardo Francisco; Alzheimer's Disease Neuroimaging Initiative (ADNI); A4 Study group; Dominantly Inherited Alzheimer Network (DIAN); European Prevention of Alzheimer's Dementia (EPAD) consortium, Fundació ACE Healthy Brain Initiative (FACEHBI); Japan Alzheimer's Disease Neuroimaging Initiative (J-ADNI), Korean Brain Aging Study for the Early Diagnosis and Prediction of Alzheimer's Disease (KBASE); Presymptomatic Evaluation of Experimental or Novel Treatments for Alzheimer's Disease (PREVENT-AD) research group BackgroundThe association between lifestyle factors and Alzheimer's disease (AD) pathophysiology remains incompletely understood.ObjectiveThe aim of this study was to assess the association of alcohol consumption, smoking behavior, sleep quality and physical, cognitive, and social activity with cerebral amyloid pathology.MethodsFor this cross-sectional study, we selected participants from the Amyloid Biomarker Study data pooling initiative. We used generalized estimating equations to assess associations of dichotomized lifestyle measures with amyloid pathology.ResultsWe included 9171 participants with normal cognition (NC) and 2555 participants with mild cognitive impairment (MCI) from the Amyloid Biomarker Study. Of participants with NC, 58% were women, 34% were APOE ε4 carrier, and 27% had amyloid pathology. Of participants with MCI, 48% were women, 47% were APOE ε4 carrier, and 57% had amyloid pathology. In NC, cognitively active participants were less likely to have amyloid pathology (OR = 0.77, 95%CI 0.66-0.89, p < 0.001). In MCI, participants who had ever smoked or had sleep problems were less likely to have amyloid pathology (OR = 0.85, 95%CI 0.73-0.99, p = 0.029; OR = 0.62, 95%CI 0.45-0.86, p = 0.004).ConclusionsIn NC, cognitive activity was associated with a lower frequency of amyloid pathology. In MCI, favorable lifestyle behaviors were not associated with a lower frequency of amyloid pathology. The results of the current study contribute to the broader evidence base on lifestyle and AD by further characterizing the role of lifestyle behaviors in AD pathology across different clinical stages.