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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2021.tde-13012022-090150
Document
Author
Full name
Maria Luisa Maia Nobre de Paiva
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2021
Supervisor
Committee
Valente, Kette Dualibi Ramos (President)
Guerreiro, Marilisa Mantovanni
Fraguas Junior, Renerio
Manreza, Maria Luiza Giraldes de
Title in Portuguese
O impacto da reabilitação cognitiva nas funções executivas e adequação social nos pacientes com epilepsia mioclônica juvenil
Keywords in Portuguese
Epilepsia
Epilepsia mioclônica juvenil
Funções executivas
Intervenção
Neuropsicologia
Reabilitação cognitiva
Treino cognitivo
Abstract in Portuguese
Introdução: A Epilepsia Mioclônica Juvenil (EMJ) é uma síndrome epiléptica generalizada idiopática, com prevalência elevada de déficits neuropsicológicos, principalmente no que se refere às funções executivas. O objetivo do presente estudo é avaliar o impacto da reabilitação cognitiva no funcionamento executivo e social dos pacientes com EMJ. Método: Vinte e sete pacientes com EMJ [idade média: 28,81 anos (DP 10,21); 63% sexo feminino; QI médio 109,14 (DP16,76)] realizaram a reabilitação cognitiva, que abordou, em de 12 sessões individuais, o treino da atenção e das funções executivas. Os pacientes realizaram uma avaliação neuropsicológica no período basal (T0) e após a intervenção (T1). Estatísticas inferenciais de Generalized Estimating Equations (GEE) foram realizadas e o nível de significância estabelecido foi de 0,05. Resultados: Em relação às funções executivas frias, houve melhora no desempenho dos componentes: atenção seletiva (TMT A [p < 0,01] e SCT 2 [p = 0,03]), do controle inibitório (SCT 3 [p = 0,02], FAS [p < 0,01] e CPT comissões [p < 0,01]), da flexibilidade mental (WCST categorias [p < 0,01]) e de todos os componentes das escalas de autorrelato (BRIEF-A). Não houve alteração nos resultados objetivos das funções executivas quentes, mas em alguns componentes dos questionários de autorrelato. Não houve mudanças nos escores do funcionamento social. Conclusão: Este estudo demonstrou que a reabilitação cognitiva esteve associada à melhora do funcionamento executivo e atencional dos pacientes com EMJ. Embora os pacientes com EMJ relataram melhora do comportamento impulsivo, este desfecho não pode ser aferido pelos instrumentos de avaliação utilizados. Não houve melhora significativa nos aspectos avaliados pelos questionários aplicados para qualidade de vida e funcionamento social a curto prazo
Title in English
The impact of cognitive rehabilitation on executive functions and social adjustment in patients with juvenile myoclonic epilepsy
Keywords in English
Cognitive rehabilitation
Cognitive training
Epilepsy
Executive functions
Intervention
Myoclonic epilepsy juvenile
Neuropsychology
Abstract in English
Introduction: Juvenile Myoclonic Epilepsy (JME) is an idiopathic generalized epileptic syndrome, with an important prevalence of neuropsychological disorders, especially with regard to executive functions. The aim of the present study was to assess the impact of cognitive rehabilitation on the executive and social functioning of JME patients. Method: Twenty-seven JME patients [mean age: 28.81 (SD 10.21); 63% female; Mean IQ 109.14 (SD16.76)] performed an intervention with a cognitive rehabilitation protocol that addressed, in 12 meetings, the training of attention and executive functions. Patients underwent a neuropsychological assessment in the baseline (T0) and after the intervention (T1). Inferential statistics of Generalized Estimating Equations (GEE) were used to verify the effect of a rehabilitation protocol before and after the intervention. The level of significance established was 0.05. Results: In regards to cold executive functions, there was an improvement in the performance of the components: selective attention (TMT A [p < .01] and SCT 2 [p = 0.03]), inhibitory control (SCT 3 [p = 0, 02], FAS [p < 0.01] and CPT commissions [p < 0.01]), mental flexibility (WCST categories [p < 0.01]) and all components of the self-report scales (BRIEF- A) There were no changes in the objective results of the hot executive functions, but in some components of the self-report questionnaires. There were no changes in social functioning scores. Conclusion: Our findings suggest that cognitive rehabilitation was associated with improved executive and attentional functioning in JME patients. Although JME patients reported improvement in impulsive behavior, this outcome cannot be measured by the assessment instruments used. There was no improvement in the results obtained by the questionnaires of social functioning in the short term
 
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Publishing Date
2022-01-20
 
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