ABSTRACT Background: There are no studies on adults with unilateral brain lesions regarding story reading with incidental/implicit comprehension and memory, in which memory is only assessed through delayed recall. There is a need for validation of cerebral laterality in this type of verbal recall, which includes spontaneous performance (free or uncued condition (UC)), and induced-through-question performance regarding the forgotten units (cued condition (CC)). Objectives: To explore the effects of unilateral brain lesions, of oral reading with expression (RE) and comprehension (RC) on delayed recall of a story, as either UC or CC; and to validate the ability of UC and CC to discriminate the side of brain injury. Methods: Data were obtained from 200 right-handed volunteers, among whom 42 had left-hemisphere injury (LHI), 49 had right-hemisphere injury (RHI) and 109 were demographically-matched healthy participants (HP). Patients who were unable to read, understand or speak were excluded. Results: LHI individuals presented impairment of both UC and CC, in relation to the other two groups (non-LHI) with sensitivity and specificity above 70%. LHI and RHI individuals were not significantly different in RE and RC, but they were both different from HP in all the assessments except CC, in which RHI individuals resembled HP. Despite this lack of abnormality in RHI individuals during CC, about half of this group showed impairment in UC. Additionally, whereas RE had a significant effect on UC, the moral of the story (RC) had a significant effect on both UC and CC. Conclusions: The left hemisphere was dominant for this memory task involving implicit processing.

RESUMEN Antecedentes: No existen estudios en adultos con lesiones cerebrales unilaterales sobre la lectura de una historia, con comprensión y memoria incidental/implícita, midiendo sólo el recuerdo diferido. Se necesita validar la lateralidad cerebral en este tipo de recuerdo verbal que incluye: desempeño espontáneo (condición sin claves (CS) o libre) y desempeño inducido con preguntas sobre las unidades olvidadas (condición con claves (CC)). Objetivos: Explorar el efecto de las lesiones cerebrales unilaterales, la lectura expresiva (LE) y la comprensiva (LC), sobre el recuerdo diferido de una historia, sea CS o CC. Validar CS y CC en su capacidad para discriminar el lado de la lesión cerebral. Métodos: Los datos se obtuvieron de 200 voluntarios diestros, 42 con lesiones del hemisferio izquierdo (LHI), 49 con lesiones del hemisferio derecho (LHD), y 109 participantes sanos (PS), equiparados demográficamente. Se excluyeron los pacientes que no pudieron leer, entender o hablar. Resultados: LHI resultó perjudicado respecto de los otros dos grupos (no-LHI) en CS y CC, con una sensibilidad y especificidad superior al 70%. LHI y LHD no se diferenciaron significativamente en LE ni LC, pero ambos fueron diferentes de los PS en todas las evaluaciones excepto CC, en donde LHD se asemejó a los PS. A pesar de esta ausencia de anomalía en LHD durante CC, aproximadamente la mitad de LHD mostró deterioro en CS. Además, mientras que LE tuvo un efecto significativo en CS, la moraleja de la historia (LC) tuvo un efecto significativo tanto en CS como en CC. Conclusiones: El hemisferio izquierdo fue dominante para esta tarea de memoria que involucró procesamiento implícito.

RESUMO Existem resultados contraditórios ou falta de estudos de validade relativos à função de nomeação e lateralidade cerebral. Embora a anomia seja um sintoma frequente de comprometimento da memória e o sintoma mais relevante da afasia, poucos estudos foram realizados para avaliar sua validade na detecção de pacientes com lesão no hemisfério esquerdo (LHE) conforme definição do MeSH. Objetivo: Validar um teste de nomeação por confrontação (TNC) do tipo papel-e-lápis de acordo com o lado da lesão cerebral. Selecionar um TNC abreviada válida e confiável, na qual o efeito de variáveis demográficas seja minimizado. Usar o TNC selecionado para desenvolver uma avaliação de nomeação por confrontação auxiliada por computador (CACNE). Métodos: Os dados de controle foram obtidos de 213 participantes saudáveis (PS) com idades entre 15 e 89 anos. Uma subamostra de 106 PS foi demograficamente pareada com 39 LHE e 40 pacientes com lesão no hemisfério direito (LHD). A definição de anomia e as pistas do TNC foram consideradas para a CACNE. Resultados: A confiabilidade teste-reteste e interexaminador, consistência interna e validade para a detecção de LHE foram demonstradas. Um efeito significativo da idade foi observado na PS. CACNE foi desenvolvida para detectar anomia em interação com intervenções ambientais. Conclusão: As inconsistências observadas nos estudos do TNC devem-se provavelmente à presença de anomia em quase 50% dos pacientes com LHD.

ABSTRACT There are contradictory results or lack of validity studies concerning the naming function and brain laterality. Although anomia is a frequent symptom of memory impairment, and the most relevant symptom of aphasia, few studies have been conducted to evaluate its validity for detecting patients with left-hemisphere damage (LD), as per the MeSH definition. Objective: To validate a paper-and-pencil confrontation naming test (CNT) according to side of brain injury; to select a valid and reliable abbreviated CNT wherein the effect of demographic variables is minimized; and to use the selected CNT to develop a computer-aided confrontation-naming evaluation (CACNE). Methods: Control data were obtained from 213 healthy participants (HP) aged 15 to 89 years. A subsample of 106 HP was demographically matched to 39 patients with LD and 40 patients with right-hemisphere damage (RD). Anomia definition and CNT cues were considered for the CACNE. Results: Test-retest and inter-rater reliability, internal consistency, and validity for detecting LD were demonstrated. A significant age effect was observed in HP. The CACNE was developed to detect anomia in interaction with environmental interventions. Conclusion: The inconsistencies observed in the CNT studies were probably due to the presence of anomia in almost 50% of the RD patients.

ABSTRACT Purpose To explore the relationship between the two components of spontaneous speech in the Brief Aphasia Evaluation (BAE) and the rest of the scale represented by its three main factors: The Expression, Comprehension, and Complementary factors. Methods BAE has proven validity and reliability. The evaluation of spontaneous speech in this scale comprises two components: Performance Rank (score: 0-3) and Type of Disorder (Fluency [F], Content [C], or Mixed [FC]) when rank < 3. Sixty-seven patients with left brain damage and 30 demographically matched healthy participants (HP) were studied. It was analyzed the correlation between Performance Rank and the three BAE factors and, recoding 3 as 0 and < 3 as 1, the sensitivity/specificity of this component for each factor. The effect of Type of Disorder on the three factors was analyzed. Results 1) Performance Rank: Correlations of 0.84 (Expression), 0.81 (Comprehension), and 0.76 (Complementary) were observed, with a sensitivity and specificity ≥ 78% for any factor; 2) Type of Disorder: The performance significantly decreased from FC to C and from C to F in Expression (FC < C < F), from FC to C and from FC to F also in Comprehension and Complementary, from patients with any type of disorder to HP. Conclusion Performance Rank was a relevant indicator of aphasia by its consistency with valid and comprehensive dimensions of acute language impairments. A degree difference between F and C was observed, being F a milder disorder; i.e., fluency problems were less severe than retrieval or anomia ones.

RESUMEN Objetivo Explorar la relación entre los dos componentes del habla espontánea en la Evaluación Breve de la Afasia (EBA) y el resto de la escala, representada por sus tres factores principales: Expresión, Comprensión y Complementario. Método EBA ha demostrado validez y confiabilidad. La evaluación del habla espontánea consta de dos componentes: Grado de Desempeño (puntuación: 0-3) y Tipo de Trastorno (Fluidez (F), Contenido (C), o Mixto (FC)) cuando grado<3. Se estudiaron 67 pacientes con lesión cerebral izquierda y 30 participantes sanos (PS), emparejados demográficamente. Se analizó la correlación entre Grado de Desempeño y los tres factores de EBA y, recodificando 3 como 0 y <3 como 1, la sensibilidad/especificidad del componente para cada factor. Se analizó el efecto de Tipo de Trastorno sobre los tres factores. Resultados 1) Grado de Desempeño: Se observaron correlaciones de 0,84 (Expresión), 0,81 (Comprensión), y 0,76 (Complementario), con una sensibilidad y especificidad ≥ 78% para cualquier factor; 2) Tipo de Trastorno: El desempeño disminuyó significativamente desde FC a C y desde C a F en Expresión (FC<C<F); desde FC a C y desde FC a F también en Comprensión y Complementario; desde los pacientes con cualquier tipo de trastorno a PS. Conclusión Grado de Desempeño fue un indicador relevante de la afasia por su consistencia con dimensiones válidas y comprensivas de trastornos agudos del lenguaje. Se observó una diferencia de grado entre F y C, siendo F un trastorno más leve, vale decir, los problemas de fluidez fueron menos severos que los de evocación o anomia.

ABSTRACT Purpose To study the relationship between the caregiver’s perception about the patient’s impairment in spontaneous speech, according to an item of four questions administered by semi-structured interview, and the patient’s performance in the Brief Aphasia Evaluation (BAE). Methods 102 right-handed patients with focal brain lesions of different types and location were examined. BAE is a valid and reliable instrument to assess aphasia. The caregiver’s perception was correlated with the item of spontaneous speech, the total score and the three main factors of the BAE: Expression, Comprehension and Complementary factors. The precision (sensitivity/ specificity) about the caregiver's perception of the patient's spontaneous speech was analyzed with reference to the presence or absence of disorder, according to the professional, on the BAE item of spontaneous speech. Results The studied correlation was satisfactory, being greater (higher than 80%) for the following indicators: the item of spontaneous speech, the Expression factor and the total score of the scale; the correlation was a little smaller (higher than 70%) for the Comprehension and Complementary factors. Comparing two cut-off points that evaluated the precision of the caregiver's perception, satisfactory results were observed in terms of sensitivity and specificity (>70%) with likelihood ratios higher than three. By using the median as the cut-off point, more satisfactory diagnostic discriminations were obtained. Conclusion Interviewing the caregiver specifically on the patient's spontaneous speech, in an abbreviated form, provides relevant information for the aphasia diagnosis.

RESUMEN Objetivo Estudiar la relación entre la percepción del cuidador sobre el deterioro en el habla espontánea del paciente, según un ítem de cuatro preguntas administradas mediante entrevista semiestructurada, y el desempeño del paciente en la Evaluación Breve de la Afasia (EBA). Método Se examinaron 102 pacientes diestros, con lesiones cerebrales focales de diferente tipo y localización. EBA es un instrumento válido y confiable para la medida de la afasia. Se correlacionó la percepción del cuidador con el ítem de habla espontánea, la puntuación total y los tres principales factores de EBA: el factor de Expresión, el de Comprensión y el Complementario. Se analizó la precisión (sensibilidad-especificidad) de la percepción del cuidador sobre el habla espontánea del paciente, respecto de la presencia o ausencia de trastorno, según el profesional, en el ítem de habla espontánea de EBA. Resultados La correlación estudiada fue satisfactoria, siendo mayor (superior al 80%) para los siguientes indicadores: el ítem de habla espontánea, el factor de Expresión y la puntuación total de la escala; la correlación fue un poco menor (superior al 70%) para el factor de Comprensión y el Complementario. Comparando dos puntos de corte que evaluaron la precisión en la percepción del cuidador, se observaron resultados satisfactorios en términos de sensibilidad y especificidad (>70%), con cocientes de probabilidad superiores a 3. Usando la mediana como punto de corte, se obtuvieron discriminaciones diagnósticas más satisfactorias. Conclusión Entrevistar al cuidador específicamente sobre el habla espontánea del paciente, en forma abreviada, proporciona información relevante para el diagnóstico de la afasia.

Los modelos animales de aproximación-evitación son útiles para el estudio inicial de drogas con efecto sobre la ansiedad pero los componentes de la ansiedad valorados por estos modelos continúan pobremente definidos. Los modelos complejos de evaluación permiten inferencias más completas que aquellos que evalúan sólo una conducta. Estudios previos demuestran que el antidepresivo tricíclico desipramina ejerce un selectivo efecto anticonflicto sobre ratas adultas sometidas a un programa de privación proteica en edad perinatal, en parámetros de conducta espontánea (laberinto en cruz elevado) e ingesta condicionada (Geller-Seifter). Dichas ratas hiponutridas muestran alteraciones en la neurotransmisión noradrenérgica que se asemejan a la activación generalizada del sistema noradrenérgico que presentan los pacientes que sufren ataques de pánico. Se evaluó la actividad anticonflicto de la desipramina en una prueba de conflicto etológico: el test de bebida en campo abierto, sin descartar a priori ninguna conducta, bajo un enfoque multivariado. Este enfoque no ha sido considerado en estudios previos de campo abierto y drogas antipánico. Sobre cuatro variables seleccionadas por análisis factorial, la administración de desipramina a una dosis de 10mg/kg por sólo 7 días produjo una significativa interacción dieta × droga, consistente con estudios previos. La interacción fue independiente de los efectos de ambos tratamientos sobre el peso o la ingesta y se expresó, en las ratas hiponutridas, como un decremento en todas las conductas excepto en el tiempo de bebida con respecto a las ratas controles que mostraron, en general, un decremento en todas las conductas excepto en la frecuencia de acicalamiento.

Approach-avoidance animal models are useful as initial screens for drugs affecting anxiety, but the components of anxiety assessed by these models remain poorly defined. Complex models of evaluation allow more complete inferences than those which are obtained when only one behavior is evaluated. Previous studies demonstrate that the tricyclic-antidepressant desipramine exerts a selective anticonflict effect on adult rats submitted to a protein deprivation schedule at perinatal age, in parameters of spontaneous behavior (elevated plus-maze) and conditioned intake (Geller Seifter). These deprived rats show alterations in noradrenergic neurotransmission that resembled the generalized activation of noradrenergic system displayed by patients suffering from panic attacks. The desipramine anticonflict activity was evaluated by a test of ethological conflict: the Open Field Drink Test, without discarding any behavior a priori under a multivaried approach. This approach has not been considered in previous studies with the open field and antipanic drugs. Considering the four variables selected by factorial analysis, desipramine (10 mg/kg/day) administered IP during just 7 days produced a significant diet x drug interaction which was consistent with previous studies. That interaction was independent of the effects of both treatments on weight or intake and was expressed, on deprived rats, as a decrease in all the behaviors, except for the time of drinking, with respect to the control rats, which displayed, in general, a decrease in all the behaviors except for the frequency of grooming.