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Background: Professional soccer athletes are exposed to repetitive head impacts and are at risk of developing chronic traumatic encephalopathy., Objective: To evaluate regional brain glucose metabolism (rBGM) and gray matter (GM) volume in retired soccer players (RSPs)., Methods: Male RSPs and age and sex-matched controls prospectively enrolled between 2017 and 2019 underwent neurological and neuropsychological evaluations, brain MRI and [18F]FDG-PET in a 3.0-Tesla PET/MRI scanner. Visual analysis was performed by a blinded neuroradiologist and a blinded nuclear physician. Regional brain glucose metabolism and GM volume were assessed using SPM8 software. Groups were compared using appropriate statistical tests available at SPM8 and R., Results: Nineteen RSPs (median [IQR]: 62 [50-64.5] years old) and 20 controls (60 [48-73] years old) were included. Retired soccer players performed worse on mini-mental state examination, digit span, clock drawing, phonemic and semantic verbal fluency tests, and had reduced rBGM in the left temporal pole (pFDR = 0.008) and the anterior left middle temporal gyrus (pFDR = 0.043). Semantic verbal fluency correlated with rBGM in the right hippocampus, left temporal pole, and posterior left middle temporal gyrus (p ≤ 0.042). Gray matter volume reduction was observed in similar anatomic regions but was less extensive and did not survive correction for multiple comparisons (pFDR ≥ 0.085). Individual [18F]FDG-PET visual analysis revealed seven RSPs with overt hypometabolism in the medial and lateral temporal lobes, frontal lobes, and temporoparietal regions. Retired soccer players had a higher prevalence of septum pellucidum abnormalities on MRI., Conclusion: Retired soccer players had reduced rBGM and GM volume in the temporal lobes and septum pellucidum abnormalities, findings possibly related to repetitive head impacts., Competing Interests: Dr. JF has received compensation for consultancies to Novartis, AC Immune, Biogen, and Esteve. The other authors have no conflict of interest to declare., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/).)

Background: Brain concussion (BC) is seen as a public health priority due to its high incidence and morbidity rate, among thousands of people around the world. There are needs for fast identification, accurate diagnosis and correct management in order to reduce the short and long-term problems relating to BC. Proper knowledge of BC in the population and among clinicians is a critical factor in achieving this., Objectives: To evaluate the level of self-reported BC knowledge and gaps/misconceptions, and to identify variables correlated with this level., Methods: A cross-sectional descriptive survey was performed. A Brain Concussion Knowledge Questionnaire (BCKQ) that had been created to capture data was widely distributed. Total scores, domain partial scores and percentages of correct and incorrect answers were calculated to ascertain the level of knowledge relating to BC., Results: The sample was formed by 1,247 Brazilian adults (age: 41.7±11.8 years). Partial scores of the BCKQ revealed the existence of poor knowledge and misconceptions in all domains of the questionnaire, especially regarding questions about recovery from and management of BC. Moderate correlations between BCKQ scores and professions (p=0.312; P=0.00) or previous brain concussion knowledge (p=0.489; P=0.00) were observed. In a multiple linear regression model, age, profession and sports practice were predictors of BC knowledge., Conclusion: This first study to analyze the level of BC knowledge in a sample of Brazilian adults suggests that poor knowledge and misconceptions are present. Thus, meaningful and useful information was provided by this study for developing health education programs about BC for the population in order to improve fast diagnosis and correct BC management.

Unlabelled: Topographical disorientation (TD) has not been as extensively studied as other frequent manifestations of Alzheimer's disease (AD)., Objective: To verify the occurrence of TD and to identify the neuropsychological dysfunctions associated with TD in AD., Method: Thirty patients with probable AD, their caregivers and 30 subjects without dementia (controls) were interviewed with a questionnaire and evaluated with tests related to topographical orientation., Results: AD patients, even those with mild dementia, differ from controls in the questionnaire on topographical orientation and in most neuropsychological tests except for tests of spatial working memory, point localization, three dimension and nonsense figure copy. When the performances in the neuropsychological tests of patients with mild or moderate dementia were compared, only landmark recognition and route description were more impaired in moderate dementia., Conclusion: TD occurs even in mild dementia of AD, a finding apparently not explained by the impairments of more elementary spatial functions.

The Corsi block-tapping test was developed as a non-verbal task to measure spatial memory. In this test, cubes are tapped by the examiner in novel sequences of increasing length after which participants are required to reproduce each sequence immediately., Objectives: To evaluate spatial working memory in Alzheimer's disease (AD) patients., Methods: 30 elderly control subjects (21 women, 9 men) and 30 patients with probable Alzheimer's disease (15 women and 15 men), with 8 or more years of schooling, were evaluated with the Mini-Mental State Examination (MMSE), digit span and Corsi block-tapping test. Proportions were compared using Chi-Square, and continuous variables with the Mann-Whitney tests., Results: AD patients were older than controls (p=0.014), but there were no differences regarding gender or educational level between these groups. The performance on the Corsi block-tapping test differed between AD and control individuals (p=0.010), and between patients with moderate dementia and controls (p=0.032), but not between control individuals and patients with mild dementia (p=0.090)., Conclusions: In the present study, AD patients with moderate dementia showed impairment in spatial working memory while those with mild dementia did not. This finding may be due to the relatively small sample size, but it is also possible that spatial memory may be normal in the initial (limbic) phase of AD.

The importance of investigating the etiology for dementia lies in the possibility of treating potentially reversible dementias. The aims of this retrospective study are to determine the prevalence of potentially reversible dementias among 454 outpatients seen at the Cognitive and Behavioral Neurology Unit, Hospital das Clínicas, São Paulo University School of Medicine-Brazil, between the years of 1991 and 2001, and observe their evolution in follow-up. Among the initial 454 patients, 275 fulfilled the DSM-IV criteria for dementia. Alzheimer's disease was the most frequent diagnosis (164 cases; 59.6%). Twenty-two cases (8.0%) of potentially reversible dementia were observed, the most frequent diagnoses being neurosyphilis (nine cases) and hydrocephalus (six cases). Full recovery was observed in two patients and partial recovery in 10 patients. Two cases were not treated and eight cases were lost on follow-up. The prevalence found in the present study falls within the range reported in previous studies (0-30%).