Evolution of language assessment in patients with acquired neurological disorders in Brazil

Diagnóstico da demência frontotemporal: recomendações do Departamento Científico de Neurologia Cognitiva e do Envelhecimento da Academia Brasileira de Neurologia

RESUMO A “demência frontotemporal” (DFT) é uma síndrome clínica, cujo denominador comum é o acometimento focal dos lobos frontais e/ou temporais. A DFT tem três fenótipos clínicos distintos: a variante comportamental e dois subtipos linguísticos, a saber, a afasia progressiva primária não-fluente/agramática (APP-NF/A) e a afasia progressiva primária semântica (APP-S). A DFT é a segunda causa mais comum de demência em indivíduos com idade inferior a 65 anos, após a doença de Alzheimer. O presente artigo apresenta recomendações para diagnóstico da DFT no cenário brasileiro, considerando os três níveis de complexidade do sistema de saúde: atenção primária à saúde e níveis secundários. São propostos protocolos de investigação diagnóstica abrangendo testagem cognitiva, avaliação comportamental, avaliação fonoaudiológica, exames laboratoriais e de neuroimagem.

Diagnosis of frontotemporal dementia: recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology

ABSTRACT “Frontotemporal dementia” (FTD) is a clinical syndrome characterized by the focal involvement of the frontal and/or temporal lobes. FTD has three clinical phenotypes: the behavioral variant and two linguistic subtypes, namely, non-fluent/agrammatic primary progressive aphasia (PPA-NF/A) and semantic PPA (PPA-S). FTD is the second most common cause of dementia in individuals under the age of 65 years. This article presents recommendations for the diagnosis of FTD in the Brazilian scenario, considering the three levels of complexity of the health system: primary health care, secondary and tertiary levels. Diagnostic guidelines are proposed, including cognitive testing, behavioral and language assessments, laboratory tests, and neuroimaging.

Study Protocol on Hormonal Mediation of Exercise on Cognition, Stress and Immunity (PRO-HMECSI): Effects of Different Exercise Programmes in Institutionalized Elders

Physical activity (PA) in elders has been shown to have positive effects on a plethora of chronic diseases and to improve immunity, mental health, and cognition. Chronic stress has also been shown to have immuno-suppressive effects and to accelerate immunosenescence. Exercise could be a significant factor in ameliorating the deleterious effects of chronic stress, but variables such as the type, intensity, and frequency of exercise that should be performed in order to effectively reduce the stress burden need to be defined clearly. PRO-HMECSI will allow us to investigate which hormonal and immunological parameters are able to mediate the effects of exercise on mucosal immunity, psychological/biological stress, and cognitive functioning in older people. Phase I consists of an observational cross-sectional study that compares elders groups (n = 223, >65 years) by functional fitness levels aiming to identify biomarkers involved in maintaining immune and mental health. Neuroendocrine and immune biomarkers of stress, psychological well-being related to mental health, neurocognitive function, functional fitness, and daily PA will be evaluated. Phase II consists of a 28-week intervention in elders with mild cognitive impairment (MCI) profile (n = 149, >65 years, divided in three groups of exercise and one control group), aiming to investigate whether the positive effect of three different types of chair-based exercise programs on physical and psychological health is mediated by an optimal endocrine environment. Primary outcomes are measures of cognitive function and global health. Secondary outcomes include the evaluation the other dimensions such as immune function, psychological health, and depression. Few studies addressed the effects of different types of exercise interventions in older population samples with MCI. We will also be able to determine which type of exercise is more effective in the immune and hormonal function of this population.