Journal of The International Neuropsychological Society, Mar 4, 2021
The ability to recognize others' emotions is a central aspect of socioemotional functioning. Emot... more The ability to recognize others' emotions is a central aspect of socioemotional functioning. Emotion recognition impairments are well documented in Alzheimer's disease and other dementias, but it is less understood whether they are also present in mild cognitive impairment (MCI). Results on facial emotion recognition are mixed, and crucially, it remains unclear whether the potential impairments are specific to faces or extend across sensory modalities, Method: In the current study, 32 MCI patients and 33 cognitively intact controls completed a comprehensive neuropsychological assessment and two forced-choice emotion recognition tasks, including visual and auditory stimuli. The emotion recognition tasks required participants to categorize emotions in facial expressions and in nonverbal vocalizations (e.g., laughter, crying) expressing neutrality, anger, disgust, fear, happiness, pleasure, surprise, or sadness. Results: MCI patients performed worse than controls for both facial expressions and vocalizations. The effect was large, similar across tasks and individual emotions, and it was not explained by sensory losses or affective symptomatology. Emotion recognition impairments were more pronounced among patients with lower global cognitive performance, but they did not correlate with the ability to perform activities of daily living. Conclusions: These findings indicate that MCI is associated with emotion recognition difficulties and that such difficulties extend beyond vision, plausibly reflecting a failure at supramodal levels of emotional processing. This highlights the importance of considering emotion recognition abilities as part of standard neuropsychological testing in MCI, and as a target of interventions aimed at improving social cognition in these patients.
Executive functions are affected differently in healthy aging, Mild Cognitive Impairment (MCI) an... more 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 cutoffs 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 cutoffs 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.
RESUMO: As Funções Executivas assumem um papel de supervisão e de auto-regulação da atividade cog... more RESUMO: As Funções Executivas assumem um papel de supervisão e de auto-regulação da atividade cognitiva, respostas emocionais e comportamento do indivíduo. Défices executivos são centrais em inúmeras perturbações adquiridas e desenvolvimentais, como acontece no caso específico das Perturbações do Espectro do Autismo. Com o objetivo de contribuir para a caraterização e diagnóstico diferencial de quadros clínicos associados a défices executivos, investigação recente tem investido no estudo de perfis executivos em populações clínicas.No presente estudo procedeu-se à caracterização do funcionamento executivo numa população infantil com Síndrome de Asperger (N = 15; M = 9.6 anos) e num grupo sem perturbações de desenvolvimento emparelhado nas variáveis sexo, idade e inteligência não-verbal. Os domínios executivos avaliados foram o planeamento, iniciativa, memória de trabalho, flexibilidade cognitiva, auto-monitorização, uso de feedback e regulação emocional. Os resultados sugerem um comprometimento executivo global no grupo clínico, sendo o desempenho significativamente inferior ao do grupo normativo em todas as provas. A capacidade de planeamento (resultado na prova Key Search da bateria BADS-C) funcionou como a melhor preditora do grupo de pertença (clínico vs. não-clínico), sugerindo uma supremacia de défice executivo neste sub-domínio na Síndrome de Asperger. Adicionalmente, o inventário parental DEX-C (bateria BADS-C) revelouse um bom preditor do grupo de pertença, colocando em destaque a relevância da utilização de instrumentos de avaliação comportamental na caracterização de perfis executivos. Os resultados obtidos serão apresentados e discutidos no contexto de modelos teóricos e dados empíricos recentes, dando particular relevo às implicações a nível educativo na Síndrome de Asperger. Palavras-chave: Funções Executivas, Síndrome de Asperger, Avaliação Neuropsicológica infantil. Introdução As Funções Executivas (FE) referem-se a um constructo multidimencional que diz respeito a uma variedade de processos cognitivos superiores, independentes, que incluem o planeamento, a iniciativa, a construção de hipóteses, a flexibilidade cognitiva, a resolução de problemas, a tomada de decisão, o julgamento e a utilização de feedback, sendo estas operações essenciais para um comportamento eficaz e contextualmente adaptado (Spreen & Strauss, 1998). De um ponto de vista neuropsicológico, as FE têm sido associadas à atividade do córtice pré-frontal (CPF), embora se reconheça o envolvimento de outras estruturas corticais e subcorticais como os gânglios basais, o brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Repositório do ISPA
Cognitive rehabilitation has been validated by scientific research as the most effective interven... more Cognitive rehabilitation has been validated by scientific research as the most effective intervention in patients with cognitive and functional deficits following Acquired Brain Injury. We present a case study of a male patient, A.F., 62 years old, dexterous, 4 years of education, with subdural and extradural hematoma frontoparietotemporal as a result of a traumatic brain injury (TBI) after being run over. A.F. performed a neuropsychological assessment 7 months after the TBI. Several difficulties were identified on executive functioning, specifically in verbal fluency, cognitive flexibility, behavioral inhibition, and sustained and selective attention. The patient began a 16-week cognitive rehabilitation program with a psychologist. The sessions with the psychologist (1 hour) were complemented with exercises to do at home. The exercises were paper-and-pencil based and adapted to the cognitive profile and the patient's personal interests. After the end of the intervention program a neuropsychological assessment was performed and improvements have been identified in memory (short and long-term), verbal fluency, selective attention, and abstract reasoning. However, limitations in the cognitive flexibility remained. A.F. family reported improvements in the mnemonic and initiative abilities, but the maintenance of risky behaviors. The positive evolution in different cognitive domains (formal assessment) and the functional improvements (indicated by the family) suggest benefits in implementing customized cognitive rehabilitation programs according to the pattern of brain injury, cognitive profile, and interests of each patient.
A perceptual and acoustic characterization was provided on the expression of liking and disliking... more A perceptual and acoustic characterization was provided on the expression of liking and disliking in the European Portuguese language. Thirty participants identified vocal patterns and judged the intensity of expressed affect in one-word items recorded by six untrained speakers. Listeners consistently associated vocal profiles with the two emotional patterns of liking and disliking. However, liking intonation was easier to recognize than disliking intonation. The feature most commonly associated with liking intonation was a wider and higher F0 pattern and a rising-falling contour. For disliking, the results revealed a flatter melodic pattern with a fall into the stressed syllable yielding a low plateau. In sum, both prosodic patterns showed different and consistent correlates.
Participants: • 18 children (12 boys) with high-functioning autism (HFA; 5-15 years, M = 8.06, SD... more Participants: • 18 children (12 boys) with high-functioning autism (HFA; 5-15 years, M = 8.06, SD = 2.31) who met the DSM-5 criteria for Autism [2]. The additional methods used in the diagnostic procedure were the Autism Diagnostic Interview-Revised (ADI-R; [3]) and the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2; [4]). Also, all HFA participants were required to have an IQ ≤ 70. • 18 typically developing peers (TD) matched on age (M = 8.06, SD = 2.31), nonverbal intelligence (assessed with the Raven's Coloured Progressive Matrices), and gender. • All participants were native speakers of European Portuguese, born and raised in monolingual homes in the North of Portugal, with no visual or hearing problems. Material & Procedure: • The utterances were collected with the European Portuguese Version of the Profiling Elements of Prosodic Systems-Communication [5]. In particular, we used the four expressive tasks of the functional level: (1) Turn-end Expression: to assess the ability to produce questioning versus declarative intonation (N= 16 utterances).
Prosodic systems (e.g., prosodic structure, intonation, and rhythm) play a key role in spoken lan... more Prosodic systems (e.g., prosodic structure, intonation, and rhythm) play a key role in spoken language. These systems mediate the phonetic substance of speech within a wide range of linguistic and communicative functions (Ladd, 2008; Peppé, 1998).! ! The way a utterance is spoken can change the meaning...!
Journal of The International Neuropsychological Society, Mar 4, 2021
The ability to recognize others' emotions is a central aspect of socioemotional functioning. Emot... more The ability to recognize others' emotions is a central aspect of socioemotional functioning. Emotion recognition impairments are well documented in Alzheimer's disease and other dementias, but it is less understood whether they are also present in mild cognitive impairment (MCI). Results on facial emotion recognition are mixed, and crucially, it remains unclear whether the potential impairments are specific to faces or extend across sensory modalities, Method: In the current study, 32 MCI patients and 33 cognitively intact controls completed a comprehensive neuropsychological assessment and two forced-choice emotion recognition tasks, including visual and auditory stimuli. The emotion recognition tasks required participants to categorize emotions in facial expressions and in nonverbal vocalizations (e.g., laughter, crying) expressing neutrality, anger, disgust, fear, happiness, pleasure, surprise, or sadness. Results: MCI patients performed worse than controls for both facial expressions and vocalizations. The effect was large, similar across tasks and individual emotions, and it was not explained by sensory losses or affective symptomatology. Emotion recognition impairments were more pronounced among patients with lower global cognitive performance, but they did not correlate with the ability to perform activities of daily living. Conclusions: These findings indicate that MCI is associated with emotion recognition difficulties and that such difficulties extend beyond vision, plausibly reflecting a failure at supramodal levels of emotional processing. This highlights the importance of considering emotion recognition abilities as part of standard neuropsychological testing in MCI, and as a target of interventions aimed at improving social cognition in these patients.
Executive functions are affected differently in healthy aging, Mild Cognitive Impairment (MCI) an... more 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 cutoffs 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 cutoffs 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.
RESUMO: As Funções Executivas assumem um papel de supervisão e de auto-regulação da atividade cog... more RESUMO: As Funções Executivas assumem um papel de supervisão e de auto-regulação da atividade cognitiva, respostas emocionais e comportamento do indivíduo. Défices executivos são centrais em inúmeras perturbações adquiridas e desenvolvimentais, como acontece no caso específico das Perturbações do Espectro do Autismo. Com o objetivo de contribuir para a caraterização e diagnóstico diferencial de quadros clínicos associados a défices executivos, investigação recente tem investido no estudo de perfis executivos em populações clínicas.No presente estudo procedeu-se à caracterização do funcionamento executivo numa população infantil com Síndrome de Asperger (N = 15; M = 9.6 anos) e num grupo sem perturbações de desenvolvimento emparelhado nas variáveis sexo, idade e inteligência não-verbal. Os domínios executivos avaliados foram o planeamento, iniciativa, memória de trabalho, flexibilidade cognitiva, auto-monitorização, uso de feedback e regulação emocional. Os resultados sugerem um comprometimento executivo global no grupo clínico, sendo o desempenho significativamente inferior ao do grupo normativo em todas as provas. A capacidade de planeamento (resultado na prova Key Search da bateria BADS-C) funcionou como a melhor preditora do grupo de pertença (clínico vs. não-clínico), sugerindo uma supremacia de défice executivo neste sub-domínio na Síndrome de Asperger. Adicionalmente, o inventário parental DEX-C (bateria BADS-C) revelouse um bom preditor do grupo de pertença, colocando em destaque a relevância da utilização de instrumentos de avaliação comportamental na caracterização de perfis executivos. Os resultados obtidos serão apresentados e discutidos no contexto de modelos teóricos e dados empíricos recentes, dando particular relevo às implicações a nível educativo na Síndrome de Asperger. Palavras-chave: Funções Executivas, Síndrome de Asperger, Avaliação Neuropsicológica infantil. Introdução As Funções Executivas (FE) referem-se a um constructo multidimencional que diz respeito a uma variedade de processos cognitivos superiores, independentes, que incluem o planeamento, a iniciativa, a construção de hipóteses, a flexibilidade cognitiva, a resolução de problemas, a tomada de decisão, o julgamento e a utilização de feedback, sendo estas operações essenciais para um comportamento eficaz e contextualmente adaptado (Spreen & Strauss, 1998). De um ponto de vista neuropsicológico, as FE têm sido associadas à atividade do córtice pré-frontal (CPF), embora se reconheça o envolvimento de outras estruturas corticais e subcorticais como os gânglios basais, o brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Repositório do ISPA
Cognitive rehabilitation has been validated by scientific research as the most effective interven... more Cognitive rehabilitation has been validated by scientific research as the most effective intervention in patients with cognitive and functional deficits following Acquired Brain Injury. We present a case study of a male patient, A.F., 62 years old, dexterous, 4 years of education, with subdural and extradural hematoma frontoparietotemporal as a result of a traumatic brain injury (TBI) after being run over. A.F. performed a neuropsychological assessment 7 months after the TBI. Several difficulties were identified on executive functioning, specifically in verbal fluency, cognitive flexibility, behavioral inhibition, and sustained and selective attention. The patient began a 16-week cognitive rehabilitation program with a psychologist. The sessions with the psychologist (1 hour) were complemented with exercises to do at home. The exercises were paper-and-pencil based and adapted to the cognitive profile and the patient's personal interests. After the end of the intervention program a neuropsychological assessment was performed and improvements have been identified in memory (short and long-term), verbal fluency, selective attention, and abstract reasoning. However, limitations in the cognitive flexibility remained. A.F. family reported improvements in the mnemonic and initiative abilities, but the maintenance of risky behaviors. The positive evolution in different cognitive domains (formal assessment) and the functional improvements (indicated by the family) suggest benefits in implementing customized cognitive rehabilitation programs according to the pattern of brain injury, cognitive profile, and interests of each patient.
A perceptual and acoustic characterization was provided on the expression of liking and disliking... more A perceptual and acoustic characterization was provided on the expression of liking and disliking in the European Portuguese language. Thirty participants identified vocal patterns and judged the intensity of expressed affect in one-word items recorded by six untrained speakers. Listeners consistently associated vocal profiles with the two emotional patterns of liking and disliking. However, liking intonation was easier to recognize than disliking intonation. The feature most commonly associated with liking intonation was a wider and higher F0 pattern and a rising-falling contour. For disliking, the results revealed a flatter melodic pattern with a fall into the stressed syllable yielding a low plateau. In sum, both prosodic patterns showed different and consistent correlates.
Participants: • 18 children (12 boys) with high-functioning autism (HFA; 5-15 years, M = 8.06, SD... more Participants: • 18 children (12 boys) with high-functioning autism (HFA; 5-15 years, M = 8.06, SD = 2.31) who met the DSM-5 criteria for Autism [2]. The additional methods used in the diagnostic procedure were the Autism Diagnostic Interview-Revised (ADI-R; [3]) and the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2; [4]). Also, all HFA participants were required to have an IQ ≤ 70. • 18 typically developing peers (TD) matched on age (M = 8.06, SD = 2.31), nonverbal intelligence (assessed with the Raven's Coloured Progressive Matrices), and gender. • All participants were native speakers of European Portuguese, born and raised in monolingual homes in the North of Portugal, with no visual or hearing problems. Material & Procedure: • The utterances were collected with the European Portuguese Version of the Profiling Elements of Prosodic Systems-Communication [5]. In particular, we used the four expressive tasks of the functional level: (1) Turn-end Expression: to assess the ability to produce questioning versus declarative intonation (N= 16 utterances).
Prosodic systems (e.g., prosodic structure, intonation, and rhythm) play a key role in spoken lan... more Prosodic systems (e.g., prosodic structure, intonation, and rhythm) play a key role in spoken language. These systems mediate the phonetic substance of speech within a wide range of linguistic and communicative functions (Ladd, 2008; Peppé, 1998).! ! The way a utterance is spoken can change the meaning...!
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