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M C Etchepareborda

Publications and source records attributed to M C Etchepareborda.

15 recordsLinked to original sources
PubMed2004

[The neuropaediatric and pathogenic clinical bases of autistic spectrum disorder].

INTRODUCTION: The dimension of the autistic spectrum embraces a considerable degree of clinical complexity which is, in turn, an expression of the numerous systems involved in the functioning of the central nervous system. Every day different biological factors are revealed which put in doubt other factors that, in a more objective way, appear to be involved in a particular aetiology. DEVELOPMENT AND CONCLUSIONS: It is clear that exactly what causes autistic spectrum disorder is still unknown and it may be useful to analyse cases with a known aetiology and correlate them with other similar cases, as it is likely to be this association between findings and studies in the future that will probably enable us to better define the bases and the underlying causes of the complex and manifold origin of the autistic spectrum. This will enable a more efficient therapeutic approach to be developed, which, when all is said and done, is what is primarily sought in the management of children with autistic spectrum disorder.

Autistic Disorder↗
PubMed2004

[Cognitive flexibility, an additional symptom of attention deficit hyperactivity disorder. Is it a therapeutically predictive element?].

INTRODUCTION: Cognitive flexibility is a capability acquired during infancy that can be evaluated from the age of 8 onwards. This executive function can affect patients with dorsolateral frontal lesions. Involvement of this function in some children with attention deficit hyperactivity disorder (ADHD) would point to an additional disorder. AIMS: The objective of this study was to report on the involvement of cognitive flexibility in patients with ADHD from the age of 8 years onwards, to establish a correlation with the progressive phenomenon in its development, and to relate the findings from the study of cognitive flexibility with those of the attentional function. PATIENTS AND METHODS: A group of 50 children diagnosed as suffering from ADHD (8 21 years old) and 50 normal children were evaluated. The same subjects were submitted to a study of their attentional functions, their inhibitory control mechanisms as well as their cognitive flexibility. RESULTS: At least 38% of the patients studied showed involvement of cognitive flexibility. No statistically significant relation was observed when data were linked to the age variable, which could point to the absence of the maturation factor, unlike the results observed in the case of sustained attention. Patients with poor cognitive flexibility also present disorders involving attentional discrimination, the control of impulses and interference control. CONCLUSIONS: The group with cognitive rigidity as a symptom added to the attentional disorder could correspond to a complex subtype that does not respond so successfully to stimulants. Consequently, cognitive flexibility studies could reflect an indicator for selecting the type of pharmacological treatment to be employed.

Adolescent↗
PubMed2004

[Experimental bases for evaluating attention in attention deficit hyperactivity disorder].

INTRODUCTION: The experimental evaluation of the time variable in attention enables us to distinguish between what can be considered as its normal and its pathological behaviour. It has proved to be useful in evaluating the population suffering from attention disorders (attention deficit hyperactivity disorder, frontal lesions, etc.) as a means of defining the extent to which the patient is affected by the disorder and also in designing a training programme for later use. DEVELOPMENT: The most notable attentional paradigms are attentional blink (AB), repetition blindness, change detection, psychological refractory period, task switching, and negative and positive priming. Patients with ADHD showed a poor capacity for identification of target stimuli (T1) in attentional blink tests; they also displayed a significantly higher attentional blink than that observed in the control group, especially for time intervals between 300 and 600 ms after the first target letter (T1). CONCLUSIONS: Attention is a complex, dynamic concept derived from the interaction of different neuroanatomical systems. There are several different theories to explain disorders affecting the attentional skills. One of the explanations comes into being as a result of linking sustained attentional disorder with impulsiveness and hyperactive behaviour. Another is related to selective attention disorders. This distinction allows us to discern the involvement of two systems that will give rise to different clinical symptoms and hence the presence of attentional subtypes. Thus, for example, it is possible to find a first group with disorders affecting attention, impulsiveness and disinhibition, and a second group with slow reactions and in a state of confusion and/or inattention as regards the events taking place around them (but they do not have impulsiveness or disinhibition).

Attention↗
PubMed2004

[The neurofunctional foundation of cognitive rigidity in attention deficit hyperactivity disorder: some preliminary findings].

INTRODUCTION: It has been proposed that there is an impairment in cognitive flexibility in children with attention deficit hyperactivity disorder (ADHD). The Wisconsin card sorting test (WCST) is the most widely used neuropsychological test for assessing this process. Previous studies have reported the presence of a subgroup of children with ADHD which has a low cognitive flexibility. In addition this subgroup showed a high resistance to the treatment with stimulant medication. OBJECTIVES: The aim of this study was to examine whether there were different patterns of brain magnetic activity in different subgroups of ADHD, during the performance of a cognitive flexibility task, such as WCST. PATIENTS AND METHODS: We recruited a sample of 18 children, divided into three groups according to DSM IV R diagnostic criteria. Here we present preliminary data based on a subsample of nine children. Brain magnetic activity was registered while the children performed the WCST by means of Magnetoencephalography (MEG). This is a non invasive neuroimaging technique with a high spatio temporal resolution. RESULTS: Preliminary results showed that ADHD mixed group had a higher rate of perseverative responses. In addition, a different pattern of brain magnetic activity was noted in this group, showing less activation in anterior cingulate cortex and dorsolateral prefrontal cortex in the left hemisphere during the first 400 ms. CONCLUSIONS: MEG seems to be an useful tool to describe the brain network that subserves cognitive flexibility in different groups of children. It could have important repercussions in the classification of ADHD, both neuropsychologically and pharmacologically.

Attention Deficit Disorder with Hyperactivity↗
PubMed2004

[Psychopedagogical management of attention deficit hyperactivity disorder with the model of executive function training].

Different therapeutic models have been presented with which to treat the condition of attention deficit hyperactivity disorder (ADHD) and the scientific literature speaks of the benefits linked to multimodal approaches. The National Institute of Mental Health report grants combined treatments an essential role. Throughout the literature authors agree that the executive functions are intrinsically related to the functions of the frontal lobe. We consider executive function training (EFT) to be another resource available within the different approaches used to treat ADHD and which is oriented towards developing and reinforcing the neuropsychological functions so as to give rise to new cognitive resources. Working memory is responsible for storage for a minimum amount of time while the information needed to resolve higher cognitive processes is manipulated. Some authors consider executive dysfunction to be a distinguishing element of ADHD. This type of dysfunction would make it more difficult for the higher cognitive processes to be carried out and is therefore a disorder that conditions the problems observed in the formal academic learning processes. The EFT programme consists of specific work modules and is aimed at favouring the appearance, development and operation of the affected functions.

Attention↗
PubMed2003

[Intervention in dyslexic disorders: phonological awareness training].

Taking into account the systems for the treatment of brain information when drawing up a work plan allows us to recreate processing routines that go from multisensory perception to motor, oral and cognitive production, which is the step prior to executive levels of thought, bottom-up and top-down processing systems. In recent years, the use of phonological methods to prevent or resolve reading disorders has become the fundamental mainstay in the treatment of dyslexia. The work is mainly based on phonological proficiency, which enables the patient to detect phonemes (input), to think about them (performance) and to use them to build words (output). Daily work with rhymes, the capacity to listen, the identification of phrases and words, and handling syllables and phonemes allows us to perform a preventive intervention that enhances the capacity to identify letters, phonological analysis and the reading of single words. We present the different therapeutic models that are most frequently employed. Fast For Word (FFW) training helps make progress in phonematic awareness and other linguistic skills, such as phonological awareness, semantics, syntax, grammar, working memory and event sequencing. With Deco-Fon, a programme for training phonological decoding, work is carried out on the auditory discrimination of pure tones, letters and consonant clusters, auditory processing speed, auditory and phonematic memory, and graphophonological processing, which is fundamental for speech, language and reading writing disorders. Hamlet is a programme based on categorisation activities for working on phonological conceptualisation. It attempts to encourage the analysis of the segments of words, syllables or phonemes, and the classification of a certain segment as belonging or not to a particular phonological or orthographical category. Therapeutic approaches in the early phases of reading are oriented towards two poles based on the basic mechanisms underlying the process of learning to read, the grapheme phoneme transformation process and global word recognition. The interventionalist strategies used at school are focused on the use of cognitive strategy techniques. The purpose of these techniques is to teach pupils practical strategies or resources aimed at overcoming specific deficiencies.

Child↗
PubMed2003

[Multisensory stimulation].

INTRODUCTION: Diagnosis in early care (EC) involves a global study that covers the child's development, their personal history, family and surroundings. The specific aims of an intervention programme in EC could be summed up in four areas: the prevention of deficits or difficulties, the detection of problems linked with a socio-family deficiency or shortages, the stimulation of development, and help and assistance for families. Multisensory stimulation (MSS) of small children is essential for their future existence. The presentation of stimuli must follow a strict schedule; indeed, this observation is so important that if the critical moment for incorporating a stimulus is missed, providing the stimulus at another time will not have the same effect. METHOD: Intellectual development during early childhood was taken into account when defining the fundamental aims of a therapeutic intervention programme in EC. To develop suitable therapy according to these concepts, an EMS (Snoezelen) room with certain special characteristics is required. This room must allow the stimuli offered in each moment and under each sensory modality to be controlled. CONCLUSION: Applying intervention programmes in a proper, specific and timely manner will enable us to accompany each child, as far as is possible in each case, in the development of his or her abilities and capabilities.

Child↗
PubMed2002

[The early detection of dyslexia and approach to treatment].

INTRODUCTION: The first sign of problems of dyslexia appears in phonographic decoding when the child tries to associate graphic signs with phonological sequences so as to pronounce words. During this process the child tries to recognise words visually and associate them with the names of objects. DEVELOPMENT: Spatial agnosia is a very common symptom in children with dyslexia and may be detected at preschool age. This spatial disorientation is closely linked with the notion of body, time and sometimes rhythm. Difficulty in identifying colours is an early symptom of dyslexia. Drawing up a plan of work, taking into account the systems for processing cerebral information, allows us to recreate habits of multisensorial perceptive processing; motor, oral and cognitive production, after executive levels of thought, button up and top down systems for processing. Fast For Word (FFW) training helps to achieve advances in phonemic consciousness whilst other linguistic abilities such as phonological, semantic, syntactic and grammatical consciousness, working memory and sequencing of events are integrated. Hamlet is a programme for working in phonological concepts based on classification activities. It aims to favour the analysis of segments of words, syllables or phonemes and the classification of a particular segment as belonging to a particular phonological or orthographical category or not.

Agnosia↗
PubMed2002

[Models of drug treatment in the attention deficit disorder with hyperactivity].

INTRODUCTION: In recent years various drug protocols have been used for the treatment of nuclear symptoms and comorbid states of the attention deficit disorder with hyperactivity. DEVELOPMENT: Dopaminergic model: the butyrophenones (haloperidol, pipamperone) and the phenothiazines (chloropromazine, thioridazine) are the classical drugs used to block the dopaminergic receptors and thus modify the level of their effect on attention. Another appropriate example of this model is tiapride. Noradrenergic model: noradrenaline plays a part in the phasic control and selective type of attention so that modifying this will also lead to changes in the functioning of attention. An example is athomexitine, which is a selective noradrenaline uptake inhibitor. Its use in patients with attention deficit disorder with hyperactivity has shown significant improvement in neuropsychological studies. Another example of the same model is that of the alpha adrenergic antagonists cloridine and guanfacine. The serotoninergic model: the drugs which modify the level of serotonin are mainly the group known as selective serotonin uptake inhibitors'. They are used to treat disorders of mood and anxiety and may make people more impulsive. They are usually used in patients with comorbid disorders and attention deficit disorder with hyperactivity. Pipamperone is a 5-HT2 receptor antagonist. Another example is busipirone (Buspar), a 5-HT1 receptor agonist. Gabergic model: gamma aminobutyric acid is an inhibitory aminoacid with a specific, but limited, distribution in the CNS. It has an inhibitory effect on the post synaptic membrane. It plays a part in the regulation of the subcortical attention circuit.

Anti-Anxiety Agents↗
PubMed1999

[Child neuropsychology in the next millennium].

INTRODUCTION: The progress made in recent decades in neuropsychology has meant a major advance in the recognition of sub-types of various disorders of nervous development. DEVELOPMENT: Recognition of symptomatology by means of a fragmental study of the components of all the different systems for obtaining information brings to light new therapeutic options. The different neuropsychological tests are used to study not only the final development of a particular ability but also how this has been achieved. Study of the type of mistakes made by each child permits recognition of the neuro-cognitive profile used. Cognitive rehabilitation of different processes presenting in infancy and adolescence offers the possibility of acquiring an alternative system of learning to minimize or substitute for deficiency. This is possible in cases affecting secondary or tertiary processing areas. CONCLUSIONS: The recognition of alternative routines, used to overcome specific disorders of nervous system development, makes one reflect on the way in which information is acquired, processed and produced by the brain and the possibility of generating auxiliary strategies for processing, even in healthy brains, so that perhaps options will be available in the case of future lesions (aphasia, Alzheimer's disease, etc.).

Child↗
PubMed1999

[Neurocognitive and pharmacological approach to specific learning disorders].

INTRODUCTION: Specific learning disorders are distinguished from general development disorders since, in general, only a certain number of processing mechanisms are involved whilst the remainder are unaffected. DEVELOPMENT: The classification proposed by the DSM-IV takes a step towards clinical understanding and use of a common nomenclature. However, neuropsychological assessment is essential to understanding clinical subtypes. The neuro-cognitive approach, when taking into account the processing systems affected or involved, should include the strategies and principles of a cognitive-behavioural approach, accompanied by computerized cognitive training. Pharmacological treatment uses drugs with different modes of action depending on the specific neuropsychological characteristics of each type of disorder of nerve development. We discuss the clinical use of various drugs in view of investigations, present and past: methylphenidate for the dys-attentional subtype of ADHD; piracetam in developmental dyslexia of dysideatic type; citocolina in the infantile dysphasias of sensory input predominance, thiapride in dysfluencial and combined subtype of ADHD; pipamperona in behaviour disorders and the hyperactive-impulsive subtype of ADHD, with or without associated and selegilina in the dysattention subtype of ADHD and the dysgraphias of the subtype with predominance of calligraphy and spatial disorders.

Child↗
PubMed1999

[Epilepsy and learning: a neuropsychological approach].

INTRODUCTION: The quality of life of an epileptic patient largely depends on the interplay of the control of the convulsive crises and the degree to which higher mental functions are affected. Some types of epilepsy lead to mental retardation during development and with others the basic cerebral mechanisms for processing data are damaged and this may lead to transient or permanent cogniscitive deterioration. DEVELOPMENT: There are certain important clinical factors such as the site of the discharge regarding the lobe, hemisphere, type of cerebral area involved and the age of the patient. We describe the clinical features of each type of epilepsy with respect to focal or generalized involvement. The subclinical effects of continuous discharges affects processing in the areas involved and therefore intellectual function, thus leading to a secondary learning disorder. The neuropsychological tests used in investigation of higher cerebral functions in epilepsy include, in general, tests to assess speed of processing, attention, memory, reasoning and visuospacial ability and frontal executive functions. CONCLUSIONS: These tests should be sufficiently sensitive so as to detect minimal changes in the state of the illness, the time elapsed and the medication given. Anticonvulsant drugs may themselves cause changes in mental functions. There may often be mixed neurocognitive behaviour depending on the drug used. There may also be transient cognitive deterioration.

Anticonvulsants↗
PubMed1999

[Neuropsychological subtypes of the inattention and hyperactivity syndrome].

INTRODUCTION: One of the commonest neurological development disorders is the syndrome of inattention with hyperactivity, ADHD. The complex neurobiological network which intervenes in paying attention permits us to maintain a basal state of alertness, to focalize and maintain attention for long periods, select the stimulus-signal required and analyze its components, and also to simultaneously carry out processes of input-output and performance (tutorial, controlling). DEVELOPMENT: Damage to the various systems participating in 'paying attention' leads to a syndrome of inattention, with or without hyperactivity. The distinction into clinical sub-types (combined, mainly lacking attention or mainly hyperactive and impulsive) gives a primary differentiation of the syndrome. However, from the neuropsychological point of view, some degree of heterogeneity within the groups which defines academic behaviour and conduct may also be recognized. This type of study permits a more specific neuro-cognitive and pharmacological approach. Some clinical characteristics of the syndrome of inattention improve with different drugs, such as the state of alterness (methylphenidate), impulsivity (pipamperone) and selective attention (tiapride). However, this treatment is symptomatic and in most cases is useful to accompany the ultimate biological development of the neocortical control mechanisms. CONCLUSIONS: A neuro-cognitive approach which permits acquisition of habits of control, functional strategies, sequential planning of activities and per- and post-functional surveillance is fundamental. The EFE programme for training executive functions is directed towards working with the damaged processing mechanisms in each neuropsychological subtype.

Attention Deficit Disorder with Hyperactivity↗
PubMedDate not supplied

[Treatment of children with a paroxysmal electroencephalogram without seizures].

INTRODUCTION: The paroxysmal and focal alterations in the electroencephalogram (EEG) of subjects who have never experienced epileptic seizures may be associated with neurodevelopmental disorders in infancy. AIMS: To determine the true behaviour of the bioelectrical manifestation we have developed a therapeutic protocol with anticonvulsive drugs to enable us to evaluate the degree of clinical improvement along with that of the bioelectrical resolution. PATIENTS AND METHODS: Four groups of patients were selected with 10 patients in each group, allocated according to their clinical diagnosis. The study groups were made up of patients suffering from language and speech disorders (LSD), specific learning difficulties (SLD), attention deficit hyperactivity disorder (ADHD), and a fourth group with mixed neuropsychological symptoms (MNS). RESULTS: A linear relation was found between the behaviour of the clinical progress and the electroencephalographic progress in the groups with LSD and ADHD, and to a lesser extent with the MNS and SLD groups. Clinical progress was considered to be successful in three of the 10 children studied in group A (LSD), in one of the 10 in group B (SLD), in two of the ten belonging to group C (ADHD), and in three of the 10 subjects in group D (MNS). CONCLUSIONS: The pharmacological treatment of neurodevelopmental disorders, with an abnormal EEG pattern and no seizures, was found to behave favourably in 80% of the cases for the four groups under study. The presence of an EEG-4 pattern, slow focal activity, was indicative of a regular clinical prognosis.

Adolescent↗