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Evaluación del sistema supervisor en sujetos ancianos cony sin desinhibición

Published online by Cambridge University Press:  12 May 2020

E. Gokalsing ,
P. H. Robert ,
V. Lafont ,
I. Medecin ,
C. Baudu ,
P. Boyer ,
D. Pringuey  and
G. Darcourt
E. Gokalsing
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
P. H. Robert
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
V. Lafont
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
I. Medecin
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
C. Baudu
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
P. Boyer
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
D. Pringuey
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
G. Darcourt
Affiliation:
Centro para la Memoria, Departamento de Psiquiatria, Universidad de Nice Sophia Antipolis, Niza, Francia
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Resumen

La desinhibición y la irritabilidad, definidas como la pérdida de control del comportamiento y la emotión, son frecuentes en los ancianos. La hipótesis de trabajo para este estudio era que estos trastornos se asocian con una alteratión cognitiva de los procesos de control que se manifiesta como un comportamiento no habitual a causa de la disfunción de un componente ejecutivo general conocido como Sistema Atentivo Supervisor (SAS). Métodos. Se seleccionó un total de 28 sujetos ancianos con deterioro cognitivo leve y se los dividió en dos grupos utilizando el Inventario Neuropsiquiátrico. Catorce sujetos se asignaron al grupo desinhibido y 14 sujetos emparejados en cuanto a la edad, el sexo y el nivel educativo formaron un grupo de control sin desinhibición. La batería neuropsicológica incluía las pruebas siguientes: Mini Examen del Estado Mental, el Test de Nombres de Boston, el Test de Fichas, el Test de Trazado y la prueba de fluidez verbal. Se diseñaron específicamente dos tareas para someter a un esfuerzo al SAS: 1) Una tarea verbal específica de ordenación de oraciones en la que los sujetos tenían que utilizar razona-miento secuencial con material verbal. Cada secuencia de prueba consístia en una serie de palabras que se mostraban en orden alterado. La construcción de algunas secuencias se tenía que hacer utilizando asociaciones habituales familiares (condiciones válidas). Por contraste, otras secuencias requerían hacer caso omiso de la selección de tales asociaciones, que eran inapropiadas dentro del contexto general de la tarea (condiciones inválidas). 2) Utilizando el test de ejecución continua, se evaluaron cuatro aspectós: atención sostenida, atención selectiva, preparatión de la atención y atención supresiva. Resultados. Las únicas dife-rencias de grupo en los resultados de las pruebas neuropsicológicas fueron las siguientes: 1) La tarea de ordenación de oraciones. En comparación con el grupo de control, el grupo desinhibido mostraba deficiencia en las condiciones inválidas y la diferencia calculada entre el número de respuestas correctas en las condiciones inválidas menos el número correspondiente en las condiciones válidas era significativamente más alto, y 2) el test de ejecución continua. Los sujetos desinhibidos tenían un número significativamente más bajo de éxitos, exclusivamente en el paradigma de “atención supresiva”. Estos resultados indican que la función del sistema supervisor de los sujetos con desinhibición está deteriorada.

Keywords

comportamientocognicióndesinhibiciónancianosfrontalsupervisión
Type
Artículo original
Information
European Psychiatry (Ed. Española) , Volume 8 , Issue 1 , February 2001 , pp. 27 - 37

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