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Doctoral Thesis
DOI
Document
Author
Full name
Camila de Vasconcelos Geraldi Tomaselli
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2019
Supervisor
Committee
Sakamoto, Américo Ceiki (President)
Fernandes, Regina Maria Franca
Foss, Maria Paula
Rosset, Sara Regina Escorsi
Teixeira, Ivanda de Souza Silva Tudesco
Title in Portuguese
Reabilitação neuropsicológica em pacientes com epilepsia do lobo temporal mesial dominante
Keywords in Portuguese
Epilepsia do lobo temporal
Estimulação cognitiva
Memória
Reabilitação neuropsicológica
Abstract in Portuguese
A epilepsia do lobo temporal mesial (ELTM) é uma síndrome epiléptica de alta prevalência e de difícil controle medicamentoso. Cerca de 80% das cirurgias realizadas em centros de epilepsia são para tratamento desta síndrome. Do ponto de vista neuropsicológico, os pacientes portadores da ELTM podem apresentar prejuízos no processamento de memória declarativa, sejam elas de caráter verbal e/ou não-verbal, além de outras esferas da cognição. Normalmente, associam-se às queixas de memória, dificuldade de adaptação psicossocial e, consequentemente, piora na qualidade de vida. A reabilitação neuropsicológica tem demonstrado efeitos positivos como forma de tratamento para pacientes com lesões cerebrais de etiologias diversas. O presente estudo investigou os efeitos da reabilitação neuropsicológica no desempenho cognitivo, nas queixas de memória e sintomas de humor de 26 pacientes com ELTM clínica ou cirurgicamente tratados comparados a 14 indivíduos sem queixas neurológicas. De maneira geral, a reabilitação mostrou-se viável para pacientes com epilepsia independente do momento do tratamento: houve melhora na memória episódica auditivo-verbal, na aprendizagem, na fluência nominal, na intensidade das queixas de memória e nos sintomas depressivos. Mudanças semelhantes também foram observadas no grupo sem queixas neurológicas. Adicionalmente pode-se observar que a melhor resposta cognitiva após intervenção ocorreu no grupo com epilepsia cirurgicamente tratado, com melhora na maioria das variáveis cognitivas.
Title in English
Neuropsychological rehabilitation in dominant temporal lobe epilepsy patients
Keywords in English
Cognitive training
Memory
Neuropsychological rehabilitation
Temporal lobe epilepsy
Abstract in English
Temporal lobe epilepsy (TLE) is a high prevalence and drug resistant epileptic syndrome. Around 80% of surgeries performed at epilepsy centers aim this syndrome treatment. From the neuropsychological point of view, the patients with the TLE show declarative memory impairment, neither verbal and / or nonverbal processing and other cognitive failures. Usually, they are associated with memory complaints, difficulty in psychosocial adaptation and, consequently, worsening in quality of life. Neuropsychological rehabilitation has demonstrated positive effects as one of the treatments for patients with diverse brain injuries. The present study investigated the effects of neuropsychological rehabilitation on cognitive performance, memory complaints and mood symptoms of 26 TLE patients clinically or surgically treated compared to 14 individuals without neurological symptoms. Overall, rehabilitation proved to be feasible for patients with epilepsy regardless treatment timing: there was improvement in verbal episodic memory, learning, verbal fluency, memory complaints and depressive symptoms. Similar changes were also found in the group without neurological conditions. Additionally, the best cognitive response after intervention occurred in the group surgically treated, with improvement in most of the cognitive variables.
 
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Publishing Date
2019-08-09
 
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