LETICIA LESSA MANSUR
Projetos de Pesquisa
Unidades Organizacionais
LIM/34 - Laboratório de Ciências da Reabilitação, Hospital das Clínicas, Faculdade de Medicina
12 resultados
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- Performance of a sample of patients with Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD) and healthy elderly on a lexical decision test (LDT) as a measure of pre-morbid intelligence(2015) SERRAO, Valéria Trunkl; BRUCKI, Sônia Maria Dozzi; CAMPANHOLO, Kenia Repiso; MANSUR, Letícia Lessa; NITRINI, Ricardo; MIOTTO, Eliane CorreaObjective: The objective of this study was to describe the performance of healthy elderly patients with aging-related pathologies (MCI) and patients with AD on a lexical decision test. Methods: The study included 38 healthy elderly subjects, 61 MCI and 26 AD patients from the Neurology Department of the Hospital das Clinicas, Behavioral and Cognitive Neurology Group. The neuropsychological instruments included the episodic memory test (RAVLT), subtests from the WAIS-III (Matrix Reasoning and Vocabulary) to determine estimated IQ, the Boston naming test (BNT) and Lexical Decision Test (LDT).Results:All groups differed on the MMSE, as expected according to their pathologies, memory tests, naming and estimated IQ. For the vocabulary and the LDT - measures of crystalized intelligence no differences were found. Conclusion: The LDT demonstrated that lexical decision can be used as a measure of pre-morbid IQ among the individuals assessed in a Brazilian sample.
- Nonpharmacological interventions for cognitive impairments following primary progressive aphasia: A systematic review of the literature(2013) CARTHERY-GOULART, Maria Teresa; SILVEIRA, Amanda da Costa da; MACHADO, Thais Helena; MANSUR, Leticia Lessa; PARENTE, Maria Alice de Mattos Pimenta; SENAHA, Mirna Lie Hosogi; BRUCKI, Sonia Maria Dozzi; NITRINI, RicardoABSTRACT This study provided a systematic review on nonpharmacological interventions applied to patients diagnosed with Primary Progressive Aphasia (PPA) and its variants: Semantic (SPPA), Nonfluent (NFPPA) and Logopenic (LPPA) to establish evidence-based recommendations for the clinical practice of cognitive rehabilitation for these patients. Methods: A PubMed and LILACS literature search with no time restriction was conducted with the keywords PPA (and its variants) AND rehabilitation OR training OR intervention OR therapy OR treatment OR effectiveness. To develop its evidence-based recommendations, a research committee identified questions to be addressed and determined the level of evidence for each study according to published criteria (Cicerone et al., 2000). Overall evidence for treatments was summarized and recommendations were derived. Results: Our search retrieved articles published from 1995 to 2013: 21 for SPPA, 8 for NFPPA, 3 for LPPA and 8 for PPA with no specification. Thirty-five studies were rated as Class III, consisting of studies with results obtained from one or more single-cases and that used appropriate single-subject methods with adequate quantification and analysis of results. The level of evidence of three functional interventions could not be established. One study was rated as Class II and consisted of a nonrandomized case-control investigation. Conclusion: Positive results were reported in all reviewed studies. However, in order to be recommended, some investigation regarding the intervention efficacy was required. Results of the present review allows for recommendation of some nonpharmacological interventions for cognitive deficits following PPA as Practice Options. Suggestions for further studies on PPA interventions and future research are discussed.
- Treatment of agrammatism in oral and written production in patients with Broca’s aphasia The use of implicit and explicit learning(2020) SILAGI, Marcela Lima; FERREIRA, Olavo Panseri; ALMEIDA, Isabel Junqueira de; SIMÕES, Janaina de Souza; ZAMPIERI, Sueli Aparecida; SANTANA, Beatriz Raz Franco de; MANSUR, Letícia LessaAbstract. Several approaches to the rehabilitation of agrammatism use implicit and explicit learning methods. Objective: To verify the effect of adapted Mapping Therapy and ORLA methods (explicit versus implicit learning) on the oral and written production in spontaneous language among agrammatic patients with Broca’s aphasia. Methods: Six individuals were submitted to Mapping Therapy and ORLA (Oral Reading for Language in Aphasia) treatments. Samples of oral and written production from a picture description task were compared pre and post-treatment. Results: In Mapping Therapy, the patients presented better performance after the training for the variables related to written production: number of words, nouns, verbs, closed-class words, and number of complete sentences. Regarding oral output, the patients had similar performance before and after the therapeutic process. In ORLA, the patients presented a significant difference before and after the therapeutic process in the variables related to oral production, increasing the number of words, number of verbs, and speech rate. There was no difference in pre and post-treatment performance in written production. Conclusion: Both implicit and explicit learning can be used in the treatment of agrammatism. Mapping Therapy was more effective for the treatment of agrammatism in written production, while ORLA was more effective for the agrammatism in oral production.
- Heterogeneity in semantic priming effect with a lexical decision task in patients after left hemisphere stroke(2016) HOLDERBAUM, Candice Steffen; MANSUR, Letícia Lessa; SALLES, Jerusa Fumagalli deABSTRACT Investigations on the semantic priming effect (SPE) in patients after left hemisphere (LH) lesions have shown disparities that may be explained by the variability in performance found among patients. The aim of the present study was to verify the existence of subgroups of patients after LH stroke by searching for dissociations between performance on the lexical decision task based on the semantic priming paradigm and performance on direct memory, semantic association and language tasks. All 17 patients with LH lesions after stroke (ten non-fluent aphasics and seven non aphasics) were analyzed individually. Results indicated the presence of three groups of patients according to SPE: one exhibiting SPE at both stimulus onset asynchronies (SOAs), one with SPE only at long SOA, and another, larger group with no SPE.
- Quanti-qualitative components of the semantic verbal fluency test in cognitively healthy controls, mild cognitive impairment, and dementia subtypes(2019) WAJMAN, Jose Roberto; CECCHINI, Mario Amore; BERTOLUCCI, Paulo Henrique Ferreira; MANSUR, Leticia LessaThis study is aimed to evaluating the underlying cognitive strategies used during Semantic Verbal Fluency (SVF) performance and comparing the differences between cognitively healthy controls (CHC), amnestic and amnestic-multiple domain mild cognitive impairment (a-MCI and a-md-MCI), Alzheimer?s disease (AD), Lewy body dementia (LBD), and behavioral variant frontotemporal dementia (bvFTD). The cross-sectional study comprised 236 participants involving 78 CHC individuals, 33 a-MCI and 48 a-md-MCI, 39 AD, 22 LBD, and 16 bvFTD patients. Scores differed significantly when comparing CHC with dementia groups, showing medium to large variances. The best components in distinguishing between CHC and the dementia groups were the SVF-Total score and SVF-Cluster Size variables. CHC showed different performance in the SVF-Cluster Size variable compared with a-md-MCI, AD, and bvFTD; whereas, in the SVF-Mean Cluster Size, CHC differed from MCI?s, AD, and LBD. The switching component displayed smaller capacity to differentiate between the clinical groups. The effect size was large comparing AD with bvFTD (1.267) and medium comparing AD with LBD (0.689) using the SVF-Cluster Size variable, but small using the other variables for the comparisons between dementia groups. Quanti-qualitative examination of the SVF may provide a valuable clue in distinguishing CHC from MCI and different dementia subtypes.
- Analysis of prototypical narratives produced by aphasic individuals and cognitively healthy subjects(2015) SILVEIRA, Gabriela; MANSUR, Letícia LessaAphasia can globally or selectively affect comprehension and production of verbal and written language. Discourse analysis can aid language assessment and diagnosis.Objective:[1] To explore narratives that produce a number of valid indicators for diagnosing aphasia in speakers of Brazilian Portuguese. [2] To analyze the macrostructural aspects of the discourse of normal individuals. [3] To analyze the macrostructural aspects of the discourse of aphasic individuals.Methods:The macrostructural aspects of three narratives produced by aphasic individuals and cognitively healthy subjects were analyzed.Results:A total of 30 volunteers were examined comprising 10 aphasic individuals (AG) and 20 healthy controls (CG). The CG included 5 males. The CG had a mean age of 38.9 years (SD=15.61) and mean schooling of 13 years (SD=2.67) whereas the AG had a mean age of 51.7 years (SD=17.3) and mean schooling of 9.1 years (SD=3.69). Participants were asked to narrate three fairy tales as a basis for analyzing the macrostructure of discourse. Comparison of the three narratives revealed no statistically significant difference in number of propositions produced by the groups. A significant negative correlation was found between age and number of propositions produced. Also, statistically significant differences were observed in the number of propositions produced by the individuals in the CG and the AG for the three tales.Conclusion:It was concluded that the three tales are applicable for discourse assessment, containing a similar number of propositions and differentiating aphasic individuals and cognitively healthy subjects based on analysis of the macrostructure of discourse.
- Performance of the Visual Analogue Scale of Happiness and of the Cornell Scale for Depression in Dementia in the Tremembé Epidemiological Study, Brazil(2014) CÉSAR, Karolina G.; BRUCKI, Sonia M.D.; TAKADA, Leonel T.; NASCIMENTO, Luiz Fernando C.; GOMES, Camila M.S.; ALMEIDA, Milena C.S.; OLIVEIRA, Maira O.; PORTO, Fábio H.G.; SENAHA, Mirna L.H.; BAHIA, Valéria S.; SILVA, Thaís Bento L.; IANOF, Jéssica N.; SPÍNDOLA, Lívia; SCHMIDT, Magali T.; JORGE, Mário S.; VALE, Patrícia H.F.; CECCHINI, Mário A.; CASSIMIRO, Luciana; SOARES, Roger T.; GONÇALVES, Márcia R.; SMID, Jerusa; PORTO, Claudia S.; CARTHERY-GOULART, Maria Teresa; YASSUDA, Mônica S.; MANSUR, Letícia L.; NITRINI, RicardoDepression is a major growing public health problem. Many population studies have found a significant relationship between depression and the presence of cognitive disorders. OBJECTIVE: To establish the correlation between the Visual Analogue Scale of Happiness and the Cornell Scale for Depression in Dementia in the population aged 60 years or over in the city of Tremembé, state of São Paulo, Brazil. METHODS: An epidemiological survey involving home visits was carried out in the city of Tremembé. The sample was randomly selected by drawing 20% of the population aged 60 years or older from each of the city's census sectors. In this single-phase study, the assessment included clinical history, physical and neurological examination, cognitive evaluation, and application of both the Cornell Scale and the Analogue Scale of Happiness for psychiatric symptoms. The presence of depressive symptoms was defined as scores greater than or equal to 8 points on the Cornell Scale. RESULTS: A total of 623 subjects were evaluated and of these 251 (40.3%) had clinically significant depressive symptoms on the Cornell Scale, with a significant association with female gender (p<0.001) and with lower education (p=0.012). One hundred and thirty-six participants (21.8%) chose the unhappiness faces, with a significant association with age (p<0.001), female gender (p=0.020) and low socioeconomic status (p=0.012). Although there was a statistically significant association on the correlation test, the correlation was not high (rho=0.47). CONCLUSION: The prevalence of depressive symptoms was high in this sample and the Visual Analogue Scale of Happiness and Cornell Scale for Depression in Dementia should not be used as similar alternatives for evaluating the presence of depressive symptoms, at least in populations with low educational level.
- Semantic memory: Nouns and action verbs in cognitively unimpaired individuals and frontotemporal lobar degeneration(2013) MANSUR, Leticia Lessa; CARTHERY-GOULART, Maria Teresa; BAHIA, Valéria Santoro; BAK, Thomas H.; NITRINI, RicardoABSTRACT Among the instruments to evaluate semantic memory, the Pyramids and Palm Trees (PPT) and the Kissing and Dancing (KDT) tests are widely used but none have a performance referential for cognitively normal and impaired Brazilian populations. Objective: [A] To study these two tests in a sample of young healthy Brazilian individuals living in São Paulo; [B] To apply the results to the evaluation of two cases diagnosed with frontotemporal lobar degeneration. Methods: We evaluated 50 normal participants (41 females and 9 males) aged between 20-63 years, with schooling level of 14-20 years. In addition, two individuals diagnosed with frontotemporal lobar degeneration were examined, one with behavioral-variant frontotemporal dementia and the other with semantic dementia. Results: On the two tests, no effects of age, gender and schooling on the performance of normal individuals were observed. According to the performance of the sample of controls, scores below 46 points on the PPT and below 47 on the KDT are suggestive of deficits in semantic memory. The analyses of both cases indicated double dissociation in establishing associations between nouns and action verbs. Although the two patients had low scores on both tests, the patient with behavioral-variant frontotemporal dementia performed better on the PPT compared to the KDT, while the patient with semantic dementia showed the reverse, performing better on the KDT. Conclusion: The PPT and KDT are suitable tests for use in the Brazilian population, with minimal need for adjustments. They are applicable tools both for cognitive assessment and research in semantic memory. In the present study, we obtained representative values of performance for cognitively unimpaired individuals and demonstrated the utility of these instruments for cognitive assessment of patients with FTLD.
- Primary progressive aphasia: Classification of variants in 100 consecutive Brazilian cases(2013) SENAHA, Mirna Lie Hosogi; CARAMELLI, Paulo; BRUCKI, Sonia M.D.; SMID, Jerusa; TAKADA, Leonel T.; PORTO, Claudia S.; CÉSAR, Karolina G.; MATIOLI, Maria Niures P.; SOARES, Roger T.; MANSUR, Letícia L.; NITRINI, RicardoABSTRACT Primary progressive aphasia (PPA) is a neurodegenerative clinical syndrome characterized primarily by progressive language impairment. Recently, consensus diagnostic criteria were published for the diagnosis and classification of variants of PPA. The currently recognized variants are nonfluent/agrammatic (PPA-G), logopenic (PPA-L) and semantic (PPA-S). Objective: To analyze the demographic data and the clinical classification of 100 PPA cases. Methods: Data from 100 PPA patients who were consecutively evaluated between 1999 and 2012 were analyzed. The patients underwent neurological, cognitive and language evaluation. The cases were classified according to the proposed variants, using predominantly the guidelines proposed in the consensus diagnostic criteria from 2011. Results: The sample consisted of 57 women and 43 men, aged at onset 67.2±8.1 years (range of between 53 and 83 years). Thirty-five patients presented PPA-S, 29 PPA-G and 16 PPA-L. It was not possible to classify 20% of the cases into any one of the proposed variants. Conclusion: It was possible to classify 80% of the sample into one of the three PPA variants proposed. Perhaps the consensus classification requires some adjustments to accommodate cases that do not fit into any of the variants and to avoid overlap where cases fit more than one variant. Nonetheless, the established current guidelines are a useful tool to address the classification and diagnosis of PPA and are also of great value in standardizing terminologies to improve consistency across studies from different research centers.
- Communication map of elderly people: Sociodemographic and cognitive-linguistic aspects(2013) SILAGI, Marcela Lima; PERES, Aline Rufo; SCHOCHAT, Eliane; MANSUR, Leticia LessaABSTRACT Language and communication difficulties may occur in the elderly population. This is the case of the tip-of-the-tongue phenomenon and receptive and auditory comprehension difficulties. Few studies have focused on examining the effects of social exposure on maintaining communication in the aging process. Objectives: [1] To describe the communication map of healthy elderly subjects; [2] To search for associations between frequency and time dedicated to communication and cognitive and sociodemographic factors. Methods: Healthy elderly subjects were submitted to cognitive screening, the Token Test - Revised, and the Verbal Fluency test, and answered the ASHA-FACS and the Circles of Communication Partners questionnaires. Results: 55 subjects, 67% female, with ages over 60 years and varied schooling were included in the sample. Interlocutors in the circle of close friends and acquaintances predominated in the communication map, although the time devoted to communication with these partners was lower than in other circles. Overall, the elderly reported no deficits in language comprehension, with some reports of the tip-of-the-tongue phenomenon. Poor performances on the Token Test - Revised and in phonemic verbal fluency along with reports of communication functionality indicated that these subjects compensate for their problems. Conclusion: Older subjects with lower schooling tended to predominantly communicate within the family circle. Within other circles, the number of hours devoted to communication and dialogue partners was not associated with age or schooling. The time devoted to the circle of communication with friends may indicate cognitive difficulties.