Brazilian Institute of Neuropsychology and Behaviour

Recent advances in applied geophysics have greatly enhanced our ability to accurately image and understand the Earth’s physical characteristics and geological processes [...]

Working memory plays a pivotal role in cognitive functioning, serving as a dynamic interface for processing and integrating information across various domains. It is crucial for executing complex tasks such as reading comprehension, mathematical problem-solving, and logical reasoning. This study investigates the relationship between working memory and motor skills, inhibitory control, and language abilities in elementary school students, highlighting the role of specific assessment instruments in this analysis. The research involved 1107 students, aged 7 to 10 years, from public schools in Joinville, Brazil. Working memory was evaluated using the Neuropsychopedagogical Screening Scale for Working Memory (NSSWM), which comprises 23 items that assess the temporary storage and processing of information needed for tasks such as language comprehension, arithmetic, and problem-solving. Motor skills were assessed using the Neuropsychopedagogical Screening for Children's Motor Development, a 7-item scale focusing on motor coordination, fine motor control, and organizational skills during school activities. Inhibitory control was measured with the Child Inhibitory Control Screening Scale (CICS), which includes 18 scenarios that evaluate inhibitory responses, planning, and impulsivity. Phonological skills were assessed using the Screening Scale for Phonological Skills (SSPS), which measures the ability to recognize formal language characteristics through 17 items. Lastly, reading and writing skills were evaluated using the Children's Reading and Writing Screening Scale (CRWSS), a 16-item scale designed to identify potential difficulties in acquiring these skills in a school setting. The results revealed significant correlations between working memory and other cognitive domains, with motor skills exhibiting the strongest association (r=0.916, p=0.012). Additionally, inhibitory control (r=0.732, p=0.028) and phonological awareness (r=0.815, p=0.034) showed strong correlations with working memory, indicating that students with better-developed skills in these areas tend to perform better in working memory tasks, which, in turn, positively impacts their academic performance. The study underscores the importance of early neuropsychopedagogical interventions that address both cognitive and motor development. By employing specific, targeted assessment instruments, educators and mental health professionals can better identify students at risk of academic difficulties and implement effective strategies to enhance their cognitive and behavioral development, ultimately fostering a more supportive and inclusive learning environment.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0525/a.php" alt="Hit counter" /></p>

The Parkinson's Disease-Cognitive Rating Scale (PD-CRS) is a widely used tool for detecting mild cognitive impairment (MCI) in Parkinson's Disease (PD) patients, however, the neuroanatomical underpinnings of this test's outcomes require clarification. This study aims to: (a) investigate cortical volume (CVol) and cortical thickness (CTh) disparities between PD patients exhibiting mild cognitive impairment (PD-MCI) and those with preserved cognitive abilities (PD-IC); and (b) identify the structural correlates in magnetic resonance imaging (MRI) of overall PD-CRS performance, including its subtest scores, within a non-demented PD cohort. This study involved 51 PD patients with Hoehn & Yahr stages I-II, categorized into two groups: PD-IC (n = 36) and PD-MCI (n = 15). Cognitive screening evaluations utilized the PD-CRS and the Montreal Cognitive Assessment (MoCA). PD-MCI classification adhered to the Movement Disorder Society Task Force criteria, incorporating extensive neuropsychological assessments. The interrelation between brain morphology and cognitive performance was determined using FreeSurfer. Vertex-wise analysis of the entire brain demonstrated a notable reduction in CVol within a 2,934 mm2 cluster, encompassing parietal and temporal regions, in the PD-MCI group relative to the PD-IC group. Lower PD-CRS total scores correlated with decreased CVol in the middle frontal, superior temporal, inferior parietal, and cingulate cortices. The PD-CRS subtests for Sustained Attention and Clock Drawing were associated with cortical thinning in distinct regions: the Clock Drawing subtest correlated with changes in the parietal lobe, insula, and superior temporal cortex morphology; while the PD-CRS frontal-subcortical scores presented positive correlations with CTh in the transverse temporal, medial orbitofrontal, superior temporal, precuneus, fusiform, and supramarginal regions. Additionally, PD-CRS subtests for Semantic and Alternating verbal fluency were linked to CTh changes in orbitofrontal, temporal, fusiform, insula, and precentral regions. PD-CRS performance mirrors neuroanatomical changes across extensive fronto-temporo-parietal areas, covering both lateral and medial cortical surfaces, in PD patients without dementia. The observed changes in CVol and CTh associated with this cognitive screening tool suggest their potential as surrogate markers for cognitive decline in PD. These findings warrant further exploration and validation in multicenter studies involving independent patient cohorts.

Background:Diagnosis of Sjogren’s disease relies on a combination of clinical and laboratory findings. Minor Salivary Gland biopsy (MSGB) abnormalities hold significant relevance within the diagnostic framework. However, previous research has noted limited concordance with MSGB assessments, attributed to variations in histological criteria and underestimation of characteristics such as focus score (FS) and germinal centers.Objectives:This study aimed to assess the interobserver and intraobserver reliability of MSGB analysis, using the recommendations published by the EULAR group in 2017.Methods:The intra and interobserver reproducibility of MSGB of 196 adult patients, aged ≥18, with suspicion of Sjogren’s disease was analyzed by two pathologists. Examiner A (ExA) reviewed the slides twice, with a two-month gap, using a standardized blind procedure. Examiner B (ExB) assessed 115 slides randomly. ExA’s first-round assessments were compared with the routine examiners (ExR) and ExB (interobserver analysis), and with the second-round assessments (intraobserver analysis). All pathologists, including ExR, underwent prior training for MSGB analysis following the EULAR 2017 recommendations.Agreement of the pathologists on qualitative variables was analyzed using the Kappa coefficient. For quantitative FS agreement, the Intraclass Correlation Coefficient (ICC) was calculated.Results:Overall, interobserver and intraobserver analyses showed good agreement (k ≥ 0.6) for area, dichotomized FS (presence or absence of FS ≥ 1), and histological diagnosis of focal lymphocytic sialadenitis. Conversely, assessment of structural damage indicated only modest to fair agreement (k ≤ 0.4) for interobserver reliability. A comparable pattern, although with higher values, was seen in the intraobserver analysis. Table 1 depicts the results for each parameter.The ICC for FS was 0.71 (95% CI 0.63-0.77) when comparing the ExR and ExA evaluations, 0.86 (95% CI 0.77-0.91) when comparing the ExA and ExB evaluations, and 0.93 (95% CI 0.91-0.95) for the intraobserver evaluation (ExA-ExA).Table 1.Inter and intraobserver reliability of MSGBInterobserver ExR/ExA (n=196)Interobserver ExA/ExB (n=115)Intraobserver ExA/ExA (n=196)p-valueKappa(95% CI)p-valueKappa(95% CI)p-valueKappa(95% CI)Area<0.0010.66 (0.45-0.87)<0.0010.78 (0.57-0.99)<0.0010.82 (0.67-0.96)dFS<0.0010.73 (0.63-0.84)<0.0010.84 (0.74-0.95)<0.0010.87 (0.79-0.94)Acinar depletion<0.0010.30 (0.17-0.43)0.0010.18 (0.03-0.34)<0.0010.38 (0.25-0.52)Acinar dilatation0.0020.21 (0.08-0.35)0.250.02 (0.00-0.17)<0.0010.32 (0.18-0.45)Duct dilatation<0.0010.25 (0.08-0.42)0.250.04 (0.00-0.17)<0.0010.50 (0.33-0.66)Fibrosis<0.0010.22 (0.10-0.34)0.010.11 (0.00-0.25)<0.0010.53 (0.40-0.66)Adiposis<0.0010.40 (0.27-0.53)0.140.05 (0.00-0.19)<0.0010.60 (0.46-0.73)GC–like structures<0.0010.42 (0.18-0.65)<0.0010.31 (0.00-0.64)<0.0010.56 (0.40-0.73)LESA--<0.0010.60 (0.42-0.78)<0.0010.70 (0.59-0.82)Final Report ConclusionWLN<0.0010.56 (0.43-0.69)0.180.03 (0.00-0.27)<0.0010.83 (0.74-0.91)NSCS<0.0010.43 (0.30-0.56)0.030.17 (0.00-0.34)<0.0010.74 (0.65-0.84)FLS<0.0010.73 (0.63-0.84)<0.0010.76 (0.63-0.89)<0.0010.89 (0.81-0.96)MSGB: Minor Salivary Gland biopsy; ExA: Examiner A; ExB: Examiner B; ExR: routine examiners; dFS: dichotomized focus score; GC: germinal centers; LESA: lymphoepithelial lesions; WLN: within limits of normal; NSCS: non-specific chronic sialadenitis; FLS: focal lymphocytic sialadenitisConclusion:In this single-center cross-sectional study, inter and intraobserver reliability exhibited favorable levels for histological diagnosis of focal lymphocytic sialadenitis, while reliability for estimating structural damage was comparatively lower. This discrepancy may be the result of less preparation of pathologists for assessing damage, compared to the assessment of inflammatory alterations. Imperatively improving the reliability of MSBG requires the establishment of robust standardization of histopathological assessment and comprehensive training of pathologists.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

Introduction/Background: Surgery plays a crucial role in the surgical management of posterior fossa tumors in children, but maximizing the resection while preserving function remains challenging. Along with other tools available to the surgeon, intraoperative neuromonitoring aims at improving safety during these complex interventions. This case report highlights the role of real-time intraoperative neuromonitoring during surgery and its impact on the surgeon's decision-making process. Case report: We present the case of a 10-year-old boy with a fourth ventricle medulloblastoma, who underwent microneurosurgical resection under intraoperative neuromonitoring. The use of neurophysiological monitoring yielded relevant information during the tumor dissection of the floor of the fourth ventricle, the most crucial step of surgery, thus helping the surgeon to change tactics to minimize long-term neurological deficits. Conclusion: In combination with meticulous microneurosurgery techniques, modern anesthetic regimens, and ultrasonic aspiration, intraoperative neuromonitoring adds up to the surgeon's armamentarium for increasing safety and improving outcomes following surgery for pediatric patients bearing posterior fossa tumors.

"Visceral leishmaniasis and potential role of vitamin D." Acta Clinica Belgica, ahead-of-print(ahead-of-print), pp. 1–2KEYWORDS: Leishmaniasisoutcomevitamin D Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationFundingThe author(s) reported that there is no funding associated with the work featured in this article.