Memoria de trabajo, control inhibitorio y flexibilidad cognitiva en pacientes con diferentes grados de severidad en la Enfermedad de Alzheimer
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Abstract
Executive Functions (EF) are a series of processes of high cognitive hierarchy that mediate behavior for problem solving. Alzheimer`s Disease (AD) is a neurodegenerative disease that produces executive impairment in the components of Working Memory (WM), inhibitory control and cognitive flexibility. The objective of the study was to investigate the executive components affected in patients with AD according to the degree of severity, in comparison with Subjects without cognitive impairment (SWCI). 50 patients with AD and 60 SWCI were studied in a non-experimental-cross-sectional study with non-probabilistic sampling based on a series of inclusion criteria. After the application of the digit subtest (WAIS-III), Stroop test, abbreviated Wisconsin classification card test, Trail making test, part B, the results showed that the WM did not differentiate between patients with mild AD and those with SWCI, inhibitory control makes it possible to differentiate between patients with AD in a moderate and severe phase, in contrast to those in a mild state, and with regard to cognitive flexibility, there are no inconsistent differences between the different degrees of severity, with the exception of those found among those with mild and moderate AD and among the moderately severe with SWCI. In conclusion, patients with AD have greater impairment in WM, inhibitory control and cognitive flexibility, regardless of the degree of severity and age, compared to SWCI.
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Allain, P., Etcharry-Bouyx, F., & Verny, C. (2013). Executive functions in clinical and preclinical Alzheimer's disease. Revue Neurologique, 169(10), 695-708. doi: 10.1016/j.neurol.2013.07.020.
American Psychiatric Association (2013). Manual diagnóstico y estadístico de los trastornos mentales (5ª ed.). Arlington, VA: American Psychiatric Publishing.
Army Individual Test Battery. (1944). Manual of Directions and Scoring. Washington, DC: War Department, Adjutant General’s Office.
Baddeley, A. D., & Hitch, G. J. (1994). Developments in the concept of working memory. Neuropsychology, 8(4), 485–493. doi: 10.1037/0894-4105.8.4.485.
Balota, D. A., Tse, C. S., Hutchison, K. A., Spieler, D. H., Duchek, J. M., & Morris, J. C. (2010). Predicting conversion to dementia of the Alzheimer's type in a healthy control sample: the power of errors in Stroop color naming. Psychology and Aging, 25(1), 208-218. doi: 10.1037/a0017474.
Baudic, S., Barba, G. D., Thibaudet, M. C., Smagghe, A., Remy, P., & Traykov, L. (2006). Executive function deficits in early Alzheimer's disease and their relations with episodic memory. Archives of Clinical Neuropsychology, 21(1), 15-21. doi: 10.1016/j.acn.2005.07.002.
Belanger, S., Belleville, S., & Gauthier, S. (2010). Inhibition impairments in Alzheimer's disease, mild cognitive impairment and healthy aging: effect of congruency proportion in a Stroop task. Neuropsychologia, 48(2), 581-590. doi: 10.1016/j.neuropsychologia.2009.10.021.
Belleville, S., Bherer, L., Lepage, E., Chertkow, H., & Gauthier, S. (2008). Task switching capacities in persons with Alzheimer’s disease and mild cognitive impairment. Neuropsychologia, 46(8), 2225–2233. doi: 10.1016/j.neuropsychologia.2008.02.012.
Belleville, S., Chertkow, H., & Gauthier, S. (2007). Working memory and control of attention in persons with Alzheimer's disease and mild cognitive impairment. Neuropsychology, 21(4), 458-469. doi: 10.1037/0894-4105.21.4.458.
Benjamin, M. J., Cifelli, A., Garrard, P., Caine, D., & Jones, F. W. (2015). The role of working memory and verbal fluency in autobiographical memory in early Alzheimer's disease and matched controls. Neuropsychologia, 78, 115-21. doi: 10.1016/j.neuropsychologia.2015.10.006.
Bondi, M. W., Serody, A. B., Chan, A. S., Eberson-Shumate, S. C., Delis, D. C., Hansen, L. A., & Salmon, D. P. (2002). Cognitive and neuropathologic correlates of Stroop Color-Word Test performance in Alzheimer's disease. Neuropsychology,16(3), 335-343. doi: 10.1037//0894-4105.16.3.335.
Burgess, P. W., Alderman, N., Evans, J., Emslie, H., & Wilson, B. A. (1998). The ecological validity of tests of executive function. Journal International of Neuropsychological Society, 4(6), 447-458. doi: 10.1017/s1355617798466037.
Cañas, M. (2016). Disfunción ejecutiva en pacientes con Demencia tipo Alzheimer. Relación con los trastornos neuroconductuales y las capacidades funcionales. (Tesis doctoral). Recuperada de: https://www.gredos.usal.es/bitstream/handle/10366/132905/DPBPMCC_Ca%c3%b1asLucendoM_Disfunci%c3%b3nejecutiva.pdf?sequence=1&isAllowed=y
Cañas, M., Perea, M. V., & Ladera, V. (2020). Inhibitory Control and the Resistance to Interference With dementia of the Alzheimer Type Patients of Different Degree of Severity. Test: Engineering & Management, 83, 25853– 25863.
Chen, T. F., Chen, Y. F., Cheng, T. W., Hua, M. S., Liu, H. M., & Chiu, M. J. (2009). Executive dysfunction and periventricular diffusion tensor changes in amnesic mild cognitive impairment and early Alzheimer's disease. Human Brain Mapping, 30(11), 3826-3836. doi: 10.1002/hbm.20810.
Collete, F., Van der Linden, M., & Salmon, E. (1999). Executive disfunction in Alzheimer´s disease. Cortex, 35(1), 57-72. doi: 10.1016/s0010-9452(08)70785-8.
Crawford, T. J., & Higham, S. (2016). Distinguishing between impairments of working memory and Inhibitory control in cases of early dementia. Neuropsychologia, 81, 61–67. doi: 10.1016/j.neuropsychologia.2015.12.007.
Dickerson, B. C., Wolk, D. A., & Initiative Alzheimer's Disease Neuroimaging (2011). Dysexecutive versus amnesic phenotypes of very mild Alzheimer's disease are associated with distinct clinical, genetic and cortical thinning characteristics. Journal of Neurology, Neurosurgery and Psychiatry, 82(1), 45-51. doi: 10.1136/jnnp.2009.199505.
Dubois, B., Slachevsky, A., Litvan, I., & Pillon, B. (2000). The FAB: a Frontal Assessment Battery at bedside. Neurology, 55(11), 1621-1626. doi: 10.1212/wnl.55.11.1621.
El Haj, M., Antoine, P., & Kapogiannis, D. (2015). Flexibility decline contributes to similarity of past and future thinking in Alzheimer's disease. Hippocampus, 25(11),1447-55. doi: 10.1002/hipo.22465.
Fernández-Calvo, B., Ramos, F., & Menezes de Lucena, V. (2013). Frontal variant of Alzheimer's disease and typical Alzheimer's disease: A comparative study. Anales de Psicología, 29(1), 293-300. doi: 10.6018/analesps.29.1.138231.
Gleichgerrcht, E., Chade, A., Torralva, T., Roca, M., & Manes, F. (2011). Comparing the Neuropsychiatric Profile of Patients with Alzheimer Disease Who Present Spared versus Impaired Executive Functioning. Current Gerontology and Geriatrics Research, 2011, 514059. doi: 10.1155/2011/514059.
Godefroy, O., Martinaud, O., Verny, M., Mosca, C., Lenoir, H., Bretault, E., & Roussel, M. (2014). The dysexecutive syndrome of Alzheimer's disease: the GREFEX study. Journal of Alzheimers Disease, 42(4), 1203-1208. doi: 10.3233/jad-140585.
Golden, C. J. (1994). STROOP. Test de Colores y Palabras. Manual. Madrid: TEA Ediciones.
Grant, D. A., & Berg, E. A. (1948). A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. Journal of Experimental Psychology, 38(4), 404-411. doi: 10.1037/h0059831.
Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M., & Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal International of Neuropsychology Society,14(2), 266-278. doi: 10.1017/s1355617708080302.
Guarino, A., Favieri, F., Boncompagni, I., Agostini, F., Cantone, M., & Casagrande, M. (2018). Executive Functions in Alzheimer Disease: A Systematic Review. Frontiers in Aging Neuroscience, 10, 437. doi: 10.3389/fnagi.2018.00437.
Hassenstab, J., Monsell, S. E., Mock, C., Roe, C. M., Cairns, N. J., Morris, J. C., …. Kukull, W. (2015). Neuropsychological Markers of Cognitive Decline in Persons With Alzheimer Disease Neuropathology. Journal of Neuropathology and Experimental Neurology, 74(11), 1086-1092. doi: 10.1097/NEN.0000000000000254.
Hutchison, K. A., Balota, D. A., & Duchek, J. M. (2010). The Utility of Stroop Task Switching as a Marker for Early Stage Alzheimer’s Disease. Psychology and Aging, 25(3), 545–559. doi: 10.1037/a0018498.
IBM Corp. (2013). IBM SPSS Statistics for Windows, 22.0. Armonk, NY: IBM Corp.
Johnson, J. K., Head, E., Kim, R., Starr, A., & Cotman, C. W. (1999). Clinical and pathological evidence for a frontal variant of Alzheimer disease. Archives of Neurology, 56(10), 1233-1239. doi: 10.1001/archneur.56.10.1233
Joubert, S., Gour, N., Guedj, E., Didic, M., Guériot, C., Koric, L., … Ceccaldi, M. (2016). Early-onset and late-onset Alzheimer's disease are associated with distinct patterns of memory impairment. Cortex, 74, 217-32. doi: 10.1016/j.cortex.2015.10.014
Kongs, S. K., Thompson, L. L., Iverson, G. L., & Heaton, R. K. (2000). WCST-64: Wisconsin Card Sorting Test-64 Card version. Professional manual. Odessa, FL: Psychological Assessment Resources.
Kortte, K. B., Horner, M. D., & Windham, W. K. (2002). The trail making test, part B: cognitive flexibility or ability to maintain set?. Applied Neuropsychology, 9(2), 106-109. doi: 10.1207/S15324826AN0902_5
Larrabee, G. J., & Kane, R. L. (1986). Reversed digit repetition involves visual and verbal processes. International Journal of Neuroscience, 30(1-2), 11-15. doi: 10.3109/00207458608985649.
Leh, S. E., Petrides, M., & Strafella, A. P. (2010). The neural circuitry of executive functions in healthy subjects and Parkinson's disease. Neuropsychopharmacology, 35(1), 70-85. doi: 10.1038/npp.2009.88.
Leuba, G., Vernay, A., Zimmermann, V., Saini, K., Kraftsik, R. & Savioz, A. (2009). Differential damage in the frontal cortex with aging, sporadic and familial Alzheimer's disease. Brain Research Bulletin, 80(4-5), 196-202. doi: 10.1016/j.brainresbull.2009.06.009.
Lezak, M. D. (2004). Executive Functions and Motor Performance. En M. D. Lezak, D. B. Howieson & D. W. Loring (Eds.), Neuropsychological Assessment (pp. 611–646). New York: Oxford University Press.
Lobo, A., Saz, P., Marcos, G., & ZARADEMP (2002). Examen Cognoscitivo Mini-Mental. Madrid: TEA.
López-Pousa, S., Llinás, J., Amiel, J., Vidal, C., & Vilalta, J. (1990). CAMDEX: una nueva entrevista psicogeriátrica. Actas Luso-españolas Neurologia, Psiquiatria y ciencias afines, 18(5), 290-295.
Mandell, A. M., & Green, R. C. (2011). Alzheimer’ s Disease. En A. E. Budson, & N. W. Kowall (Eds.), The Handbook of Alzheimer’s Disease and Other Dementias (pp. 1-90). Oxford: Blackwell. doi: 10.1002/9781444344110.
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R., Jr., Kawas, C. H., … Phelps, C. H. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dementia, 7(3), 263-269. doi: 10.1016/j.jalz.2011.03.005.
Miyake, A., & Friedman, N. P. (2012). The Nature and Organization of Individual Differences in Executive Functions: Four General Conclusions. Current Directions in Psychological Science, 21(1), 8-14. doi: 10.1177/0963721411429458.
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex "Frontal Lobe" tasks: a latent variable analysis. Cognitive Psychology, 41(1), 49-100. doi: 10.1006/cogp.1999.0734.
Moraine, P. (2014). Las funciones ejecutivas del estudiante: mejorar la atención, la memoria, la organización y otras funciones para facilitar el aprendizaje. Madrid: Narcea.
Navarro Merino, E., Conde Sendin, M., & Villanueva Osorio, J. (2015). Enfermedad de Alzheimer. Medicine, 11(72), 4306-4315. doi: 10.1016/j.med.2015.01.002.
Rami, L., Molinuevo, J. L., Sanchez-Valle, R., Bosch, B., & Villar, A. (2007). Screening for amnestic mild cognitive impairment and early Alzheimer's disease with M@T (Memory Alteration Test) in the primary care population. International Journal of Geriatric Psychiatry, 22(4), 294-304. doi: 10.1002/gps.1672.
Reisberg, B., Ferris, S. H., de Leon, M. J., & Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of Psychiatry, 139(9), 1136-1139. doi: 10.1176/ajp.139.9.1136.
Stern, R. A., Andersen, S. L., & Gavett, B. E. (2011). Executive Functioning. En A. E. Budson, & N. W. Kowall (Eds.), The Handbook of Alzheimer’s Disease and Other Dementias (pp. 1-47). Oxford: Blackwell Publishing.
Talbot, K., Young, R. A., Jolly-Tornetta, C., Lee, V. M., Trojanowski, J. Q., & Wolf, B. A. (2000). A frontal variant of Alzheimer's disease exhibits decreased calcium-independent phospholipase A2 activity in the prefrontal cortex. Neurochemistry International, 37(1), 17-31. doi: 10.1016/s0197-0186(00)00006-1.
Tirapu, J., García, A., Ríos, M., & Ardila, A. (2011). Neuropsicología de la corteza prefrontal y las funciones ejecutivas. Barcelona: Viguera Ediciones.
Van der Flier, W. M., Pijnenburg, Y. A., Fox, N. C., & Scheltens, P. (2011). Early-onset versus late-onset Alzheimer's disease: the case of the missing APOE ε4 allele. Lancet Neurology, 10(3), 280–288. doi: 10.1016/S1474-4422(10)70306-9.
Vasconcelos, L. G., Jackowski, A. P., Oliveira, M. O., Ribeiro Flor, Y. M., Souza, A. A., Bueno, O. F., & Brucki, S. M. (2014). The thickness of posterior cortical areas is related to executive dysfunction in Alzheimer's disease. Clinics, 69(1), 28-37. doi: 10.6061/clinics/2014(01)05.
Wechsler, D. (1999). WAIS-III. Escala de inteligencia de Wechsler para adultos-III. Manual Técnico. Madrid: TEA.
Woodward, M. C., Rowe, C. C., Jones, G., Villemagne, V. L., & Varos, T. A. (2015). Differentiating the frontal presentation of Alzheimer's disease with FDG-PET. Journal of Alzheimers Disease, 44(1), 233-242. doi: 10.3233/JAD-141110.
Zhou, B., Zhao, Q., Teramukai, S., Ding, D., Guo, Q., Fukushima, M., & Hong, Z. (2010). Executive function predicts survival in Alzheimer disease: a study in Shanghai. Journal of Alzheimers Disease, 22(2), 673-682. doi: 10.3233/JAD-2010-100318.