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Introduction: The development of reading and complex executive functions is fundamental for achieving social, academic, and professional success. So far, there is no single neuropsychological instrument that comprehensively assesses the domains of inhibitory control, cognitive flexibility, working memory, and reading comprehension. To assess executive functions related to reading, the "Assessment of Reading and Executive Functions" (AREF) was developed. In this study, we show initial evidence of validity and reliability for four subtests - Graphophonological-Semantic Flexibility, Inhibitory Control, Flexibility, and Working Memory., Methods: A total of 93 students from 4th to 9th grade, aged 8-14, in public ( n  = 61) and private ( n  = 32) schools were evaluated. Tasks from the AREF instrument, as well as measures of reading comprehension, inhibitory control, cognitive flexibility, working memory, and intelligence, were administered. Correlations between AREF scores and the other measures were performed to assess external construct validity. Performance differences between school groups on AREF subtests were analyzed using ANOVA, t-test, and Mann-Whitney tests, and the internal consistency of the instrument's tasks was evaluated using Cronbach's alpha coefficient., Results: The scores of the AREF subtests demonstrated significant positive correlations with reading measures (ranging from 0.339 to 0.367) and executive functions (ranging from 0.209 to 0.396). Significant differences were found in the performance of some AREF tasks when comparing individuals from public and private schools, as well as between 4th and 5th graders compared to students in higher grades. The internal consistency of the tasks was low for Graphophonological-Semantic Flexibility (Cronbach's α = 0.566), moderate for Inhibitory Control and Flexibility (Cronbach's α = 0.768), and high for Working Memory (Cronbach's α = 0.881)., Discussion: The results provide initial evidence of construct validity and reliability for the AREF subtests. It is expected that this new neuropsychological test will contribute to the assessment of reading skills and executive functions, assisting in guiding clinical and educational interventions for individuals with and without neurodevelopmental disorders., Competing Interests: The AREF (ALEFE) is in negotiations for potential commercialization by the publisher AMPLA, which could, in the future, remunerate the researchers., (Copyright © 2024 de Oliveira, Vial-Martins, Pinto, Fonseca and Malloy-Diniz.)

Background: The Direct Assessment of Functional Status (DAFS) is the only instrument validated in Brazil that assesses functionality directly with the patient. However, this clinical tool takes a long time to be administered. This limits its use in hospitals and outpatient clinics that require brief assessment instruments. Additionally, we need to count with a direct assessment because the number of older adults living alone is increasing and we thus lack reliable informants., Objective: This study aimed to present the development and content validity evidence of a direct complex functionality test for older adults, the Brief Instrument for Direct Functionality Assessment (BIDFA)., Method: A total sample of 30 older adults and eight expert judges took part in the study stages. The BIDFA construction stages were: (1) literature review of functionality instruments; (2) development of seven ecological tasks to evaluate the performance of daily complex activities with the older adults; (3) content analysis by eight expert judges; (4) pilot study with 30 older adults; (5) the ecological analysis of items; (6) focus group analysis; and (7) final version of the BIDFA., Results: The BIDFA had evidence of content validity with an agreement index of 96.5%. The final version of BIDFA was left with six domains of complex functionality divided into semantic memory and time orientation; shopping skills; executive attention, math and finance skills; organization; planning and procedural memory; and problem-solving. The complex functionality score by BIDFA ranges from 0 to 100 points., Conclusion: The BIDFA was found to have good content validity by the expert judges and by the ecological analysis of the items by the older adults. The new instrument is expected to help assess the functional status of older adults, in an abbreviated context including complex functionality demands, with a wider range of total and subdomain scores., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Holz, Kochhann, da Silva, Wilson and Fonseca.)

Objective: To identify under what circumstances a university student should be allowed academic accommodation for ADHD. To frame an evidence-based policy for use in Brazil based on a worldwide experience., Methods: We reviewed the literature to acquire information on what documents are commonly required by disability services before accommodation for ADHD is made (including malingering detection). We scrutinized the eligibility criteria of the best universities worldwide. Renowned experts in the field and national stakeholders were consulted., Results: We found no international standard for the assessment of students with ADHD who request academic accommodation. Even renowned institutions worldwide differ from one another in their approaches to academic accommodation on the grounds of ADHD. We propose a national unified set of criteria for Brazilian universities, which could generalize internationally., Discussion: Rigorous assessment is paramount for aiding students with disabilities while preventing ineligible students gaining an unfair advantage. Higher education institutions nationwide and beyond may benefit from adopting a unified set of criteria for eligibility to ADHD accommodation programs., Competing Interests: Luis Augusto Rohde has received grant or research support from, served as a consultant to, and served on the speakers’ bureau of Aché, Bial, Medice, Novartis/Sandoz, Pfizer/Upjohn, and Shire/Takeda in the last three years. The ADHD and Juvenile Bipolar Disorder Outpatient Programs chaired by Dr Rohde have received unrestricted educational and research support from the following pharmaceutical companies in the last three years: Novartis/Sandoz and Shire/Takeda. Dr Rohde has received authorship royalties from Oxford Press and ArtMed. Dr. Hinshaw receives book royalties from Oxford University Press and St. Martin’s Press. The other authors report no conflicts of interest.

Planetary and human health depend on Westerners' ability to reduce meat consumption. Meat production degrades the environment while excessive meat intake is associated with cancer and cardiovascular disease, among others. Effective reasons and motivations are needed for consumers to change their diet. The fact that modern animal agriculture inflicts a great deal of pain on animals from their birth to their slaughter, animal welfare/suffering may drive consumers to curtail their meat consumption. This systematic review examined a total of 90 papers to ascertain consumers' awareness of the pain animals experience in animal agriculture, as well as consumer attitudes towards meat reduction due to animal welfare. Results show that consumers have low awareness of animal agriculture. Awareness of animal agricultural practices and animal sentience is associated with increased negative attitudes towards animal suffering. Animal suffering due to farming practices, transportation, slaughter, and animal sentience are factors that may encourage a reduction in meat consumption, and even dietary change in the short term. There is also evidence that animal suffering may be a more compelling motivation for consumers' willingness to change their diet than for health or environmental reasons. Therefore, increasing consumers' awareness of animal suffering in meat production is paramount to contributing to reduced pressure on the environment and improved human health.

Purpose: Changes in cerebral cortical regions occur in HIV-infected patients, even in those with mild neurocognitive disorders. Working memory / attention is one of the most affected cognitive domain in these patients, worsening their quality of life. Our objective was to assess whether cortical thickness differs between HIV-infected patients with and without working memory deficit., Methods: Forty-one adult HIV-infected patients with and without working memory deficit were imaged on a 1.5 T scanner. Working memory deficit was classified by composite Z scores for performance on the Digits and Letter-Number Sequencing subtests of the Wechsler Adult Intelligence Scale (third edition; WAIS-III). Cortical thickness was determined using FreeSurfer software. Differences in mean cortical thickness between groups, corrected for multiple comparisons using Monte-Carlo simulation, were examined using the query design estimate contrast tool of the FreeSurfer software., Results: Greater cortical thickness in left pars opercularis of the inferior frontal gyrus, and rostral and caudal portions of the left middle frontal gyrus (cluster 1; p = .004), and left superior frontal gyrus (cluster 2; p = .004) was observed in HIV-infected patients with working memory deficit compared with those without such deficit. Negative correlations were found between WAIS-III-based Z scores and cortical thickness in the two clusters (cluster 1: ρ = -0.59; cluster 2: ρ = -0.47)., Conclusion: HIV-infected patients with working memory deficit have regions of greater thickness in the left frontal cortices compared with those without such deficit, which may reflect increased synaptic contacts and/or an inflammatory response related to the damage caused by HIV infection., Competing Interests: The authors have declared that no competing interests exist.

Purpose: The aim of this study is to analyze and compare the performance and strategies used by control subjects and patients with unilateral brain damage on phonemic and semantic Verbal Fluency tasks., Methods: The sample consisted of 104 participants divided into four groups (26 with left hemisphere damage and aphasia- LHDa, 28 with left hemisphere damage and no aphasia- LHDna, 25 with right hemisphere damage- RHD and 25 neurologically healthy control subjects). All participants were administered the phonemic ("M" letter-based) and semantic (animals) verbal fluency tasks from the Montreal-Toulouse Language Assessment Battery (MTL-BR)., Results: Patients in the LHDa group showed the worst performance (fewer words produced, fewer clusters and switches) in both types of fluency task. RHD group showed fewer switching productions when compared with controls and LHDna had fewer words productions than controls in the first 30 seconds block., Conclusion: Our findings suggest that the LHDa group obtained lower scores in most measures of SVF and PVF when compared to the other groups.

The addition of natural fibers used as reinforcement has great appeal in the construction materials industry since natural fibers are cheaper, biodegradable, and easily available. In this work, we analyzed the feasibility of using the fibers of piassava, tucum palm, razor grass, and jute from the Amazon rainforest as reinforcement in mortars, exploiting the mechanical properties of compressive and flexural strength of samples with 1.5%, 3.0%, and 4.5% mass addition of the composite binder (50% Portland cement + 40% metakaolin + 10% fly ash). The mortars were reinforced with untreated (natural) and treated (hot water treatment, hornification, 8% NaOH solution, and hybridization) fibers, submitted to two types of curing (submerged in water, and inflated with CO 2 in a pressurized autoclave) for 28 days. Mortars without fibers were used as a reference. For the durability study, the samples were submitted to 20 drying/wetting cycles. The fibers improved the flexural strength of the mortars and prevented the abrupt rupture of the samples, in contrast to the fragile behavior of the reference samples. The autoclave cure increased the compressive strength of the piassava and tucum palm samples with 4.5% of fibers.

Objective: We aimed to evaluate whether human immunodeficiency virus (HIV)-positive patients with and without clinically significant memory deficits and healthy control participants differ on in vivo hydrogen-1 magnetic resonance spectroscopy (H-MRS) in the posterior cingulate gyri., Materials and Methods: In total, 21 HIV-positive patients with memory deficit (HIV+wMD) were compared with 15 HIV-positive patients without memory deficit (HIV+wOMD) and 22 sex-, age-, and education-matched control participants. Memory impairments were classified based on the participants' performance on the Rey Auditory Verbal Learning Test. Short echo time (30 ms), single-voxel H-MRS was performed using a 1.5-T magnetic resonance scanner., Results: The HIV+wMD and HIV+wOMD groups had higher choline/creatine ratio in the posterior cingulate gyri than the control group. There were no significant metabolite ratio differences between the HIV+wMD and HIV+wOMD groups., Conclusion: HIV-positive patients with and without memory deficits had significantly higher choline/creatine ratios than controls in the posterior cingulate gyri, which may reflect cerebral inflammation, altered cell membrane metabolism, microgliosis, and/or astrocytosis.

Verbal fluency (VF) has contributed to building cognitive maps as well as differentiating healthy populations from those with dementia., Objectives: To compare the performance of healthy controls and patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) in two semantic VF tasks (animals/clothes) and a phonemic VF task (letter P). Also, to analyze the relationship between the frequency of reading and writing habits (FRWH) and VF in individuals with low educational level., Methods: Sixty-seven older adults aged 60-80 years and with 2-8 years of schooling were divided into three groups: controls (n=25), older adults with MCI (n=24), and older adults with AD (n=18). We analyzed the type, mean size, and number of clusters, switches, intersections, and returns. A post-hoc single-factor ANOVA analysis was conducted to verify differences between groups., Results: Total words in the phonemic VF and the animal category discriminated the three groups. Regarding the animal category, AD patients performed worse than controls in the total number of words, taxonomic clusters, returns, and number of words remembered. We found a moderate correlation between FRWH and total number of words in the phonemic fluency., Conclusions: Semantic (animate) and phonemic (total words) VF differentiated controls and clinical groups from each other - the phonemic component was more related to FRWH than the semantic one. The phonemic VF seems to be more related to cognitive reserve. VF tasks, considering total words and cluster analyses, are a valuable tool to test healthy and cognitively impaired older adults who have a low educational level., Competing Interests: Disclosure: The authors report no conflicts of interest.

Background: Discourse production is a very complex cognitive task that requires the integration of several linguistic cognitive skills. Socio-demographic factors such as schooling can impact on cognitive tasks. This study investigated the impact of age and schooling in some macrolinguistic and microlinguistic aspects in the written discourse of healthy adults., Methods: Individuals with no previous history of language, hearing, neurological, or psychiatric disorders were asked to write a story based on a figure that showed a "bank robbery." A total of 463 graphic narrative were analyzed. The schooling was stratified into the following three bands: 5 to 8 years, 9 to 11 years and 12 or more, and the age ranged from 19 to 75 years., Results: Individuals with high schooling (12 years or more) produced discourses with more information units, more coherent, and cohesive. The oldest group (60 to 75 years) needed more time to finish the written production., Conclusion: The schooling influences some micro and macrolinguistic aspects in the written discourse production. A higher educational level provided a greater number of words as well as a higher number of information units, and the discourses produced are more coherent and cohesive. The age influenced only the time of discourse production.

Background: Narrative discourse (ND) refers to one's ability to verbally reproduce a sequence of temporally and logically-linked events. Impairments in ND may occur in subjects with Amnestic Mild Cognitive Impairment (aMCI) and Alzheimer's Disease (AD), but correlates across this function, neuroimaging and cerebrospinal fluid (CSF) AD biomarkers remain understudied., Objectives: We sought to measure correlates among ND, Diffusion Tensor Imaging (DTI) indexes and AD CSF biomarkers in patients within the AD spectrum., Results: Groups differed in narrative production (NProd) and comprehension. aMCI and AD presented poorer inference abilities than controls. AD subjects were more impaired than controls and aMCI regarding WB (p<0.01). ROIs DTI assessment distinguished the three groups. Mean Diffusivity (MD) in the uncinate, bilateral parahippocampal cingulate and left inferior occipitofrontal fasciculi negatively correlated with NProd. Changes in specific tracts correlated with T-tau/Aβ1-42 ratio in CSF., Conclusions: AD and aMCI patients presented more ND impairments than controls. Those findings were associated with changes in ventral language-associated and in the inferior parahippocampal pathways. The latest were correlated with biomarkers' levels in the CSF., Methods: AD (N=14), aMCI (N=31) and Control (N=39) groups were compared for whole brain (WB) and regions of interest (ROI) DTI parameters, ND and AD CSF biomarkers.

Purpose: Search for reliability and validity evidence for the Montreal Communication Evaluation Brief Battery (MEC B) for adults with right brain damage., Methods: Three hundred twenty-four healthy adults and 26 adults with right brain damage, aged 19-75 years, with two or more years of education were evaluated with MEC B. The MEC B Battery contains nine tasks that aim to evaluate communicative abilities as discourse, prosody, lexical-semantic and pragmatic process. Two sources of reliability evidence were used: internal consistency (Cronbach's alpha) and interrater reliability. Construct validity was evaluated comparing the Montreal Communication Evaluation Battery (MEC), expanded version and MEC B tasks., Results: Internal consistence was satisfactory and the interrater reliability was considered excellent, as were correlations between MEC Battery and MEC B Battery tasks., Conclusion: The MEC B Battery showed satisfactory reliability and validity evidences. It can be used as outcome measure of intervention programs and assist speech therapists to plan rehabilitation programs.

Apollo & Rosetta is an Exergame developed for Inhibitory Control stimulation in Elementary School children. This works' goal has been to demonstrate the behavior of the difficulty curves planned for seven activities (minigames) ingame, as well as their correspondence with the variables collected during a pilot neuropsychological intervention. Seven students participated in the study and played the minigames 1528 times during the 3-month intervention. Each of the minigames had a difficulty curve computed with the goal of keeping the players in the state of Flow. The curves were designed in cycles which grow throughout levels (Normal Level) to a peak (Peak Level), followed by a rest period (Rest Level). The pilot study encompassed three different analyses: (1) Exploratory performance analysis with Spearman correlation, which indicated a positive and significant general correlation between performance and level difficulty; (2) Success exploratory analysis, which showed that as the stages progressed, the success rate increased, even if the level difficulty also increased; (3) Analysis of the factors which influenced performance, through Mixed Effects Logistic Regression and the Backward method. This analysis demonstrated that the odds ratio for overcoming challenges between Normal levels was 0.71 [0.59;0.86] times lower than Rest Level ( p -value = 0.000), whereas in Peak levels it was 0.62 [0.47;0.83] times lower than Rest level values ( p -value = 0.001). These data confirm the overall planned behavior of the difficulty curves., (Copyright © 2019 Mossmann, Cerqueira, Barbosa, Fonseca and Reategui.)

Despite the crucial role played by the executive functions (EF) to cognitive, emotional, and social development of children before and during school years, little attention has been given to construct and analyze the efficacy of programs that intend to develop them. The program of neuropsychological stimulation of cognition in students: emphasis on EF, or PENcE (an acronym from its original name in Portuguese, Programa de Estimulação Neuropsicológica da Cognição em Escolares: ênfase nas Funções Executivas ), is an early and preventive intervention program for school-aged children, and implemented at school three times a week for 5 months. The PENcE was structured in four modules, each focusing on a different executive component: organization and planning, inhibitory control, working memory, and cognitive flexibility. The objectives of this study were to verify the effectiveness of the PENcE among elementary school children and to investigate whether there are transfer effects to other executive, cognitive, and academic abilities. The sample consisted of 113 children attending 3rd or 4th grade at two public elementary schools. Eight classes participated in the study, divided into two groups: an experimental group (EG) (four classes; n = 64), which received the intervention, and a control group (CG) (four classes; n = 49), which continued their regular school activities. The EF and academic skills of both participant groups were evaluated before and after the intervention. The EG showed significantly greater improvements in inhibitory control, working memory, and abstract planning relative to the CG, with a small to medium effect size. There were transfer effects to other cognitive and academic abilities. These findings suggest the PENcE may be a useful method of improving EF and could benefit both school-aged children and education professionals.

Conversational discourse (CD) is among the most complex tasks in everyday life and relies on multiple cognitive domains (communicative and executive abilities). Alterations in discourse comprehension and production are often present in pathological aging. However, there is still a need to identify changes in healthy aging., Objective: This study aimed to compare young and older adults for the frequency of impaired communicative behaviors on a CD task. Performance was scored according to the Complementary Procedure of Conversational Discourse Analysis (CPCDA), developed based on the CD task from the Montreal Communication Evaluation Battery., Methods: A total of 95 participants (54 young-adults and 41 older adults) were evaluated. The frequency of communicative behaviors was compared between groups using MANCOVA and Chi-square tests., Results: Young adults showed fewer impairments in expression, pragmatics, cohesion, coherence, comprehension and emotional prosody. Older adults showed higher levels of verbal initiative and had fewer word finding difficulties. Communicative behaviors associated with planning and self-monitoring (e.g. repetition of information and syllabic false starts) appear to be common in the speech of healthy individuals in general., Conclusion: Studies which evaluate both discursive and cognitive skills are required to identify age-related changes. This would allow for the development of screening tools for CD assessment and preventive programs., Competing Interests: Disclosure: The authors report no conflicts of interest.

Purpose: Cognitive dysfunction is common in neuropsychiatric systemic lupus erythematosus (SLE). Memory is a commonly affected cognitive domain. Clinically, however, it is difficult to detect memory deficits. The objective of this study is to evaluate whether normal controls and SLE patients with and without memory deficit differ in terms of white-matter integrity., Methods: Twenty SLE patients with memory deficit were compared to 47 SLE patients without memory deficit and 22 sex-, age-, and education-matched control individuals. Diffusion tensor imaging (DTI) was performed in a 1.5-Tesla scanner. For tract-based spatial statistics analysis, a white-matter skeleton was created. A permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD) were also projected onto the mean FA skeleton., Results: Compared to controls, SLE patients with and without memory deficit had decreased FA in: bilateral anterior thalamic radiation, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, corticospinal tract, genu, and body of the corpus callosum. SLE patients with and without memory deficit also presented increased MD and RD values compared to controls in these areas. Comparison between SLE patients with and without memory deficit did not present significant differences in DTI parameters., Conclusion: DTI can detect extensive abnormalities in the normal-appearing white matter of SLE patients with and without memory deficit, compared to controls. However, there was no difference, in terms of white-matter integrity, between the groups of SLE patients.

Verbal fluency (VF) is a widely used tool in neuropsychological assessment., Objective: We aimed to investigate the influence of age and educational level on clustering and switching in three VF modalities: phonemic (PVF), semantic (SVF) and unconstrained (UVF). We evaluated type of cluster, mean cluster size, and quantity of clusters, intersections, and returns. A total of 260 healthy subjects were assessed., Methods: Participants were divided into three age groups: young adults (18 to 39 years), middle-aged adults (40 to 59 years) and older adults (60 to 80 years) and into two groups of educational level: 1-8 years (low), 9 years or more (high). A two-way ANOVA analysis was conducted to analyze the effect of age and educational level and its interactions. A repeated measures ANOVA was performed to verify the performance during the task., Results: A main effect of age was detected on the UVF and SVF scores for total switches, taxonomic clusters, and for the total semantic clusters on the SVF. There was a greater effect of educational level on total switches (UVF, PFV and SVF), taxonomic clusters (UVF and SVF), thematic clusters and total semantic cluster (UVF), phonemic and mixed clusters (PVF), mean cluster size (UVF and SVF) and intersections (SVF). Educational level had a greater effect on all three VF tasks., Competing Interests: Disclosure: The authors report no conflicts of interest.

Acquired language impairments may accompany different conditions. Most recent studies have shown that there is an important relationship between language and cognitive functions, such as executive functions (EF). Therefore, we aimed to investigate which main EF components appear to have the greatest impact in the most prevalent acquired communication disorders in adults, and which neuropsychological tests are being used to evaluate them. In addition, we sought to characterize the relationship between the executive functions and language in these conditions. Working memory (WM) was the most frequently chosen cognitive measure, being evaluated by different span tasks. A relationship between WM and narrative and conversational discourse, writing abilities and grammatical comprehension was found. Other currently used cognitive tests included the Trail Making, Wisconsin, Stroop and Verbal Fluency tests. Language and EF have a complex relationship; hence, a complete assessment should reflect the dynamic processing of cognitive brain functions., Competing Interests: Disclosure: The authors report no conflicts of interest.

Introduction: Decision making (DM) is among the most important abilities for everyday functioning. However, the most widely used measures of DM come from behavioral paradigms, whose ecological validity and standalone use has been criticized in the literature. Though these issues could be addressed by the use of DM questionnaires as a complementary assessment method, no such instruments have been validated for use in Brazilian Portuguese. Therefore, the aim of this study was to conduct the translation and validation of the Melbourne Decision Making Questionnaire (MDMQ) for use in a Brazilian population., Methods: The adaptation of the MDMQ involved the following steps: translation, back-translation, expert review and pilot study. These steps were followed by factor analysis and internal consistency measurements, which led to the exclusion of 4 items from the scale. The 18-item version of the MDMQ was then administered to a validation sample consisting of healthy adults, as well as patients with bipolar disorder (BD) and major depressive disorder (MDD)., Results: The instrument displayed good internal consistency, with the hypervigilance subscale showing the lowest, though still acceptable, Cronbach's alpha value. Its factor structure was comparable to that of the original MDMQ according to confirmatory factor analysis. Nevertheless, the MDMQ was sensitive to both depression severity and the presence of MDD and BD, both of which are known to have an impact on DM ability., Conclusion: The version of the MDMQ produced in the present study may be an important addition to neuropsychological assessment batteries with a focus on DM and related abilities.

Purpose The objectives of this study were to determine if HIV-infected patients treated with highly active antiretroviral therapy (HAART), without dementia, suffer from longitudinal gray matter (GM) volume loss, changes in white matter (WM) integrity and deterioration in functional connectivity at rest, in an average interval of 30 months. Methods Clinically stable HIV-positive patients (on HAART, CD4 + T lymphocyte > 200 cells/μl, and viral loads <50 copies/μl) were recruited. None of them had HIV-associated dementia. Each patient underwent two scans, performed in a 1.5-T magnetic resonance imaging (MRI) scanner. FreeSurfer was used to perform cortical volumetric reconstruction and segmentation of GM structures. WM integrity was assessed using tract-based spatial statistics to post-process diffusion tensor imaging data, and FMRIB's Software Library tools were used to post-process resting-state functional magnetic resonance imaging (RS-fMRI). Results There were no significant differences in cortical thickness, deep GM volumes, or diffusivity parameters between the scans at the two time points. Five resting-state networks were identified in our patients. In the second MRI, HIV-positive patients presented increased areas of functional connectivity in visual pathways, frontoparietal and cerebellar networks, compared with the first MRI (considering p < 0.05). Conclusions RS-fMRI revealed potentially compensatory longitudinal alterations in the brains of HIV-positive patients, attempting to compensate for brain damage related to the infection.

Background: White matter hyperintensities (WMH) are commonly associated with vascular dementia and poor executive functioning. Notwithstanding, recent findings have associated WMH with Alzheimer's disease as well as other cognitive functions, but there is no consensus., Objective: This study aimed to verify the relationship between WMH and cognitive performance in Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD) patients. The study also sought to identify cognitive and demographic/cultural factors that might explain variability of WMH., Methods: The sample was composed of 40 participants (18 MCI and 22 AD patients) aged ≥ 65 years. Spearman's correlation was performed among cognitive performance (memory, language, visuospatial ability, and executive function) and WMH evaluated by the Fazekas and ARWMC scales. Two stepwise linear regressions were carried out, one with cognitive and the other with demographic/cultural variables as predictors., Results: Only naming showed significant correlation with ARWMC. Fazekas score exhibited significant correlation with all cognitive domains evaluated. Fazekas score was better predicted by episodic visual memory and age., Conclusion: This study found that the most relevant cognitive profile in MCI and AD patients with WMH was related to episodic memory. And, without taking clinical aspects into consideration, age was the best predictor of WMH., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objectives: To describe normative data for the Hayling Test and the Trail Making Test (TMT) in a sample of Brazilian adults, and to investigate the effects of age and education on test performance., Method: A total of 313 (TMT) and 364 (Hayling) individuals with age ranges of 19-39, 40-59, and 60-75 years, and with at least 5 years of formal education, participated in this study. The tests were administered as part of a large battery of a normative project. Individuals were evaluated individually in silent, ventilated rooms at a university clinic. Instrument protocols were scored by trained research assistants and double-checked to ensure data reliability., Results: There were major effects of age on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Errors B/15, B/45), and major effects of education on the TMT (Time B, Errors B, B-A) and on the Hayling Test (Time A, Errors B/15, B/45). Interaction effects were found in Time B and B-A for the Hayling Test and in Time A for the TMT., Conclusions: Age and education were critical for performance on both verbal and non-verbal executive functions.

Objective: The goal of this study was to describe the construction process and content validity evidence of an early and preventive intervention program for stimulating executive functions (EF) in Elementary School children within the school environment., Methods: The process has followed the recommended steps for creating neuropsychological instruments: internal phase of program organization, with literature search and analyses of available materials in the classroom; program construction; analysis by expert judges; data integration and program finalization. To determine the level of agreement among the judges, a Content Validity Index (CVI) was calculated., Results: Content validity was evidenced by the agreement among the experts with regards to the program, both in general and for each activity. All steps taken were deemed necessary because they contributed to the identification of positive aspects and possible flaws in the process., Conclusion: The steps also helped to adapt stimuli and improve program tasks and activities. Methodological procedures implemented in this study can be adopted by other researchers to create or adapt neuropsychological stimulation and rehabilitation programs. Furthermore, the methodological approach allows the reader to understand, in detail, the technical and scientific rigor adopted in devising this program., Competing Interests: Disclosure: The authors report no conflicts of interest.

Introduction: The importance of executive functions (EF) in childhood development, and their role as indicators of health, well-being, professional and academic success have been demonstrated by several studies in the literature. FE are cognitive processes that aim to control and manage behavior to achieve specific goal and included skills planning, inhibition, cognitive flexibility, (executive) attention and the central executive component of working memory (WM). In the context of education, the EF are crucial for continued learning and efficient academic performance due to their involvement in several components of the educational process., Objective: The aim of this article was to describe the development and content validity of the CENA Program for Educational Training on the Neuropsychology of Learning, with an emphasis on executive functions and attention., Methods: The study involved seven specialists (four responsible for evaluating the program, and three involved in brainstorming), and was carried out in three stages:Background research: neuropsychology and education;Program development - author brainstorming andEvaluation by expert judges The goals, language and methods., Results: CENA Program were considered adequate, attesting to its content validity as a school-based neuropsychological intervention., Conclusion: Teacher training in school neuropsychology may be an important area for future investment and contribute to academic achievement and student development in the Brazilian education system., Competing Interests: Disclosure: The authors report no conflicts of interest.

Objective: To verify whether differences exist between groups of Brazilian adults aged 40-59 and 60-75 in respective performance on the Bells Test, given the dearth of literature investigating the relationship between focused visual attention and the age factor., Methods: Eighty-four neurologically healthy adults (half aged 40-59 and half 60-75) with high educational level (40-59 years group: M=17.75 years' education; SD=4.00; 60-75 years group: M=15.85 years education; SD=3.19) were assessed using the Bells Test. Data on accuracy and processing speed were compared between groups by ANCOVA, controlled for the covariates education and frequency of reading and writing habits., Results: There were no significant differences between the age groups., Conclusion: It is suggested that aging influences sustained and focused attention and speed processing after 75 years of age on visual cancellation paradigms, when executive and attentional changes tend to be more marked. Further studies should investigate healthy older and oldest-old adults, as well as groups with low and intermediate educational backgrounds. In addition, Brazilian clinical populations should also be characterized, particularly those with neurological disorders that might have visual hemineglect., Competing Interests: Disclosure: The authors report no conflicts of interest.

Introduction:: The Hayling Test assesses the components of initiation, inhibition, cognitive flexibility and verbal speed by means of a sentence completion task. This study presents the process of developing the Brazilian version of the Child Hayling Test (CHT) and reports evidence of its content validity., Methods:: 139 people took part in the study. The adaptation was performed by seven translators and 12 specialist judges. An initial sample of 92 healthy children was recruited to test a selection of sentences adapted from previous adult and pediatric versions of the instrument, and a sample of 28 healthy children was recruited for pilot testing of the final version. The instrument was developed in seven stages: 1) translation, 2) back-translation, 3) comparison of translated versions, 4) preparation of new stimuli, 5) data collection with healthy children to analyze comprehension of the stimuli and analyses by the authors against the psycholinguistic criteria adopted, 6) analyses conducted by judges who are specialists in neuropsychology or linguistics, and 7) the pilot study., Results:: Twenty-four of the 72 sentences constructed were selected on the basis of 70-100% agreement between judges evaluating what they assessed and level of comprehensibility. The pilot study revealed better performance by older children, providing evidence of the instrument's sensitivity to developmental factors., Conclusions:: Future studies employing this version of CHT with clinical pediatric populations who have frontal lesions and dysfunctions and in related areas are needed to test functional and differential diagnoses of preserved or impaired executive functions.

Purpose: To verify age and education effects on communication performance of healthy adults in the Montreal Communication Evaluation Battery, Portuguese version (MAC-PT)., Methods: The sample comprised 90 healthy adults from Portugal, European Portuguese speakers, divided into nine groups according to educational level (4-9, 10-13, and > 13 years of formal schooling) and age (19-40, 41-64, and 65-80 years). The influence of age and education was assessed by comparing mean scores between groups, using a two-way analysis of variance followed by Bonferroni post hoc tests (p ≤ 0.05)., Results: The results showed that participants' performance was influenced by age in pragmatic-inferential, discursive, and prosodic tasks. Education had the greatest influence on the performance in all processes evaluated by the MAC-PT., Conclusion: Age and education seem to influence the communicative performance and should be considered in the assessment of neurological patients.

Purpose: This study investigated the influence of suggestive signs of depression (SSD) in right-hemisphere brain-damaged (RHD) patients following a stroke on their cognitive performance measured by a brief neuropsychological assessment battery., Methods: Forty-two adults with RHD after a single episode of stroke and 84 matched controls participated in this study. They were assessed by means of the Geriatric Depression Scale and by Brief Neuropsychological Assessment Battery NEUPSILIN., Results: Almost half of the patients showed SSD. The RHD group with SSD (RHD+) showed poorer performance in at least one task among all evaluated cognitive domains (concentrated attention, visual perception, working memory, episodic verbal memory and semantic memory, auditory and written language, constructional praxia and verbal fluency)., Conclusion: The association of depression and RHD seems to enhance the occurrence and the severity of cognitive déficits. A brief neuropsychological assessment can be useful to identify cognitive impairment caused by this neuropsychiatric disorder.

Context and Objective: There is growing concern about understanding how sociodemographic variables may interfere with cognitive functioning, especially with regard to language. This study aimed to investigate the relationship between performance in the Brazilian version of the Montreal-Toulouse language assessment battery (MTL-BR) and education, age and frequency of reading and writing habits (FRWH)., Design and Setting: Cross-sectional study conducted in university and work environments in Rio Grande do Sul, Brazil., Method: The MTL-BR was administered to a group of 233 healthy adults, aged 19 to 75 years (mean = 45.04, standard deviation, SD = 15.47), with at least five years of formal education (mean = 11.47, SD = 4.77)., Results: A stepwise multiple linear regression model showed that, for most tasks, the number of years of education, age and FRWH were better predictors of performance when analyzed together rather than separately. In separate analysis, education was the best predictor of performance in language tasks, especially those involving reading and writing abilities., Conclusion: The results suggested that the number of years of education, age and FRWH seem to influence performance in the MTL-BR, especially education. These data are important for making diagnoses of greater precision among patients suffering from brain injuries, with the aim of avoiding false positives.

Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI). Deficits in narrative discourse occur early in dementia caused by Alzheimer's disease (AD), and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and micro-linguistic aspects, 77 individuals (patients with AD and a-MCI and a control group) were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups' performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD.

Executive functions are involved in a series of human neurological and psychiatric disorders. For this reason, appropriate assessment tools with age and education adjusted norms for symptom diagnosis are necessary., Objective: To present normative data for adults (19-75 year-olds; with five years of education or more) on the Modified Wisconsin Card Sorting Test (MWCST), Stroop color and word test and Digit Span test. Age and education effects were investigated., Methods: Three samples were formed after inclusion criteria and data analysis: MWCST (n=124); Digit Span (n=123), and Stroop test (n=158). Groups were divided into young (19-39), middle-aged (40-59) and older (60-75) participants with five to eight years of education and nine years of education or more. Two-way ANOVA and ANCOVA analyses were used., Results: Education effects were found in most variables of the three tasks. An age effect was only found on color naming and color-word naming speed from the Stroop test. No interactions were detected., Conclusion: In countries with heterogeneous educational backgrounds, the use of stratified norms by education to assess at least some components of executive functions is essential for an ethical and accurate cognitive diagnosis., Competing Interests: Disclosure: The authors report no conflicts of interest.

Over recent years, neuropsychological research has been increasingly concerned with the need to develop more ecologically valid instruments for the assessment of executive functions. The Hotel Task is one of the most widely used ecological measures of executive functioning, and provides an assessment of planning, organization, self-monitoring and cognitive flexibility., Objective: The goal of this study was to adapt the Hotel Task for use in the Brazilian population., Methods: The sample comprised 27 participants (three translators, six expert judges, seven healthy adults, ten patients with traumatic brain injuries and one hotel manager). The adaptation process consisted of five steps, which were repeated until a satisfactory version of the task was produced. The steps were as follows:(1) Translation;(2) Development of new stimuli and brainstorming among the authors;(3) Analysis by expert judges;(4) Pilot studies;(5) Assessment by an expert in business administration and hotel management., Results: The adapted version proved adequate and valid for the assessment of executive functions. However, further research must be conducted to obtain evidence of the reliability, as well as the construct and criterion validity, sensitivity and specificity, of the Hotel Task., Conclusion: Many neurological and/or psychiatric populations may benefit from the adapted task, since it may make significant contributions to the assessment of dysexecutive syndromes and their impact on patient functioning., Competing Interests: Disclosure: The authors report no conflicts of interest.

The objective of this paper was to describe the evolution of language assessments in patients with acquired neurological diseases over a period of around 45 years from 1970, when interdisciplinarity in Neuropsychology first began in Brazil, to the present day. The first twenty years of data was based on memories of Speech Pathology University Professors who were in charge of teaching aphasia. We then show the contributions of Linguistics, Cognitive Psychology, as well as Psycholinguistic and Psychometric criteria, to language evaluation. Finally, the current panorama of adaptations and creations of validated and standardized instruments is given, based on a search of the databases Pubmed, Scopus and Lilacs. Our closing remarks highlight the diversity in evaluation approaches and the recent tendency of language evaluations linked to new technologies such as brain imaging and computational analysis., Competing Interests: Disclosure: The authors report no conflicts of interest.

Lexical-semantic impairments are common consequences of acquired neurological damage. However, little is known about the benefits of existing treatment methods for this type of language impairment., Objective: To evaluate current research into lexical-semantic interventions for adults with dementia, TBI or stroke., Methods: The PubMed, PsycInfo and SCOPUS databases were searched for studies related to rehabilitation, neurological conditions, communicative and lexical-semantic skills published between 2004 and 2014., Results: Twenty-eight of the 453 abstracts found were selected for the review based on the PRISMA method. Most of the studies described treatments for anomia. Semantic tasks were the most commonly used, followed by phonological and gestural strategies. Interventions were individual and involved formal tasks, although the number, frequency and duration of sessions varied between studies., Conclusion: Although lexical-semantic interventions lead to improvements in language abilities, they are still poorly described in the literature, and must be further investigated in terms of their efficacy, effectiveness and long-term effects., Competing Interests: Disclosure: The authors report no conflicts of interest.

Although the frontal lobes have traditionally been considered the neural substrates of executive functioning (EF), recent studies have suggested that other structures, such as the cerebellum, may be associated with these abilities. The role of the cerebellum has only been sparsely investigated in connection with decision making (DM), an important component of EF, and the few results obtained on this front have been inconclusive. The current study sought to investigate the role of the cerebellum in DM by comparing the performance of patients with cerebellar strokes, frontal-damaged patients, and a healthy control group on the Iowa Gambling Task (IGT). A total of nine cerebellar-damaged adults participated in the study, as well as nine individuals with frontal strokes and 18 control individuals. Patients were administered a version of the IGT adapted to the population of Southern Brazil. There was a marginal difference in mean IGT net scores between the two clinical groups, although both displayed impaired performance as compared to the control group. Overall, the DM ability of patients with cerebellar damage proved to be more preserved than that of individuals with frontal lobe strokes, but less preserved than that of the control group. These data suggested that, while the frontal lobes may be the most important brain structures for DM, the cerebellum might also play an active role in this cognitive function. Future studies assessing participants with lesions in different cerebellar regions and hemispheres will prove invaluable for the understanding of the neural structures involved in DM, and make significant contributions to the globalist-localizationist debate in DM neuroscience.

Objective: To assess the predictive role of education and frequency of reading and writing habits (FRWH) on the cognitive flexibility, inhibition and planning abilities of healthy elderly individuals., Methods: Fifty-seven healthy adults aged between 60 and 75 years with 2 to 23 years of formal education were assessed as to the frequency with which they read and wrote different types of text, as well as their number of years of formal education. Executive functions were evaluated using the Hayling Test and the Modified Wisconsin Card Sorting Test (MWCST)., Results: Weak to moderate positive correlations were found between education, FRWH and the number of categories completed in the MWCST, while negative correlations were identified between these variables and the number of perseverative and non-perseverative errors on the task. Only the FRWH was significantly correlated with the number of failures to maintain set. Speed and accuracy on the Hayling Test were only correlated with participant education. Both education and FRWH significantly predicted performance on the MWCST, and the combination of these two variables had a greater predictive impact on performance on this task than either of the two variables alone. Variability in scores on the Hayling Test was best accounted for by participant education., Conclusion: In this sample of elderly subjects, cognitive flexibility was sufficiently preserved to allow for adequate performance on verbal tasks, but may have benefitted from the additional stimulation provided by regular reading and writing habits and by formal education in the performance of more complex non-verbal tasks., Competing Interests: Disclosure: The authors report no conflicts of interest.

Language impairments in patients with acquired brain injury can have a negative impact on social life as well as on other cognitive domains. Discourse impairments are among the most commonly reported communication deficits among patients with acquired brain damage. Despite advances in the development of diagnostic tools for detecting such impairments, few studies have investigated interventions to rehabilitate patients presenting with these conditions., Objective: The aim of this study was to present a systematic review of the methods used in the rehabilitation of discourse following acquired brain injury., Methods: The PubMed database was searched for articles using the following keywords: "rehabilitation", "neurological injury", "communication" and "discursive abilities"., Results: A total of 162 abstracts were found, but only seven of these met criteria for inclusion in the review. Four studies involved samples of individuals with aphasia whereas three studies recruited samples of individuals with traumatic brain injury., Conclusion: All but one article found that patient performance improved following participation in a discourse rehabilitation program.

This study describes the adaptation of a revised Brazilian version of the Patient Competency Rating Scale (PCRS-R-BR), which focuses on executive, mnemonic, and attention functions. Evidence of content-based and external validity is also reported. The cross-cultural adaptation was conducted in five phases: 1) translations and back translations; 2) item analysis by authors; 3) classification by experts; 4) revisions and reformulations by authors; 5) pilot study with a sample of patients with mild and moderate/severe traumatic brain injury (TBI). Data were analyzed descriptively, and the PCRS-R-BR scores of groups with mild vs. moderate/severe TBI were compared using the Mann-Whitney test. Patients and their relatives were divided into groups and compared using repeated-measures analysis. The results of the PCRS-R-BR questionnaire for relatives and discrepancy scores of patients with moderate/severe TBI revealed significantly more impairment than that found in the group of patients with mild TBI. There were significant differences between item and total scores of both groups of patients and relatives. Results indicated a high level of item content agreement between experts. This study found initial evidence of PCRS-R-BR content-based and external validity when the questionnaire was applied to patients with mild and moderate/severe TBI and their relatives.

Purpose: The purpose of this study was to analyze the recognition of figures from the modified MT Beta-86 test for subsequent refinement and adaptation of this language assessment instrument., Methods: This study was organized into two parts. The first part of the study involved 61 subjects with educational level higher than nine years. Naming of 266 visual stimuli was elicited and concordance among participants on figure naming was also determined. Concordance of responses was assessed using Cochrane's test at a 5% level of significance. Some visual stimuli were subsequently re-designed and images were replaced. The second part of this study involved the re-testing of the new images among 110 individuals ranging in age from 18 to 75 years of both genders, stratified into four educational bands (A: 1-4 years; B: 5-8 years; C: 9-11 years; and D: more than 12 years). Stimuli with concordance level of 70% or higher were considered adequate., Results: In part A of the study, from the index of agreement of naming, the figures considered suitable for inclusion in the adapted version were selected. In part B, all the figures had a response concordance level over 70%., Conclusion: Figures in the Modified MT Beta-86 test suitable for retention in the new version of the instrument were identified. Analysis of low sample recognition was used to identify boards for replacement, and those for retention, in the new version of the test.

Few studies involving the cognition of middle-aged adults are available in the international literature, particularly investigating the process of cognitive aging, executive components and attention., Objectives: The aim of this study was to investigate whether there are differences in performance on neuropsychological tasks of executive functions and sustained attention between two age groups., Methods: The sample consisted of 87 adults aged from 19 to 59 years old, divided into two groups according to the age variable (younger adults and middle-aged adults). All participants were Brazilian and had no sensory, psychiatric or neurological disorders; subjects also had no history of alcohol abuse, and no self-reported use of illicit drugs or antipsychotics. The neuropsychological instruments administered were the Hayling Test, Trail Making Test, Bells Test and verbal fluency tasks., Results: Groups showed no significant differences in relation to sociodemographic variables, educational level or frequency of reading and writing habits. The younger adult group performed better than the middle-aged group on tasks that involved mainly processing speed, cognitive flexibility and lexical search., Conclusions: These findings serve as a valuable reference for cognitive processing in middle-aged adults, since a large number of comparative studies focus only on the younger and later phases of adulthood. Additional studies are needed to investigate possible interaction between different factors such as age and education., Competing Interests: Disclosure: The authors report no conflits of interest.

Objective: To describe the frequency of pragmatic and executive deficits in right brain damaged (RBD) and in traumatic brain injury (TBI) patients, and to verify possible dissociations between pragmatic and executive functions in these two groups., Methods: The sample comprised 7 cases of TBI and 7 cases of RBD. All participants were assessed by means of tasks from the Montreal Communication Evaluation Battery and executive functions tests including the Trail Making Test, Hayling Test, Wisconsin Card Sorting Test, semantic and phonemic verbal fluency tasks, and working memory tasks from the Brazilian Brief Neuropsychological Assessment Battery NEUPSILIN. Z-score was calculated and a descriptive analysis of frequency of deficits (Z< -1.5) was carried out., Results: RBD patients presented with deficits predominantly on conversational and narrative discursive tasks, while TBI patients showed a wider spread pattern of pragmatic deficits. Regarding EF, RBD deficits included predominantly working memory and verbal initiation impairment. On the other hand, TBI individuals again exhibited a general profile of executive dysfunction, affecting mainly working memory, initiation, inhibition, planning and switching. Pragmatic and executive deficits were generally associated upon comparisons of RBD patients and TBI cases, except for two simple dissociations: two post-TBI cases showed executive deficits in the absence of pragmatic deficits., Discussion: Pragmatic and executive deficits can be very frequent following TBI or vascular RBD. There seems to be an association between these abilities, indicating that although they can co-occur, a cause-consequence relationship cannot be the only hypothesis., Competing Interests: Disclosure: The authors report no conflits of interest.

This systematic review aimed to identify the designs, procedures, and results of empirical studies that performed neuropsychological interventions on WM in adults., Methods: A PubMed and LILACS literature search was conducted using the keywords working memory AND ( training OR rehabilitation OR intervention ) AND adult ., Results: Of the seven studies found, three were randomized controlled trials, two were case reports, one was a clinical trial, and one was an evaluation study. With regard to the type of programs and samples, three studies employed global programs with healthy elderly adults and four employed specific programs for samples with neurologically-impaired adults., Conclusions: The effectiveness of the WM intervention programs was more evident in studies that employed specific methods of rehabilitation for samples with neurological disorders than in those based on global programs with healthy adults. There is a need for more empirical studies to verify the effectiveness of WM intervention programs in order to provide adequate guidance for clinical neuropsychologists and future research., Competing Interests: Disclosure: The authors report no conflicts of interest.

Neuropsychological studies on the processing of some specific cognitive functions throughout aging are essential for the understanding of human cognitive development from ages 19 to 89., Objectives: This study aimed to verify the occurrence of differences in the processing of episodic memory, concentrated attention and speed of attentional processing among four age groups of adults., Methods: A total of 136 neurologically healthy adults, aged 19-89, with 9 or more years of schooling, took part in the study. Participants were divided according to four age groups: young, middle-aged, elderly and oldest old adults. Subtests of the Brief Neuropsychological Evaluation Instrument (NEUPSILIN) were applied for the cognitive assessment. Mean score of corrected answers and of response times were compared between groups by means of a one-way ANOVA test with post-hoc Scheffe procedures and ANCOVA including the co-variables of years of schooling and socio-economical scores., Results: In general, differences in performance were observed from 60 years old on. Only the episodic memory task of delayed recall reflected differences from the age of around 40 onwards and processing speed from around the age of 70 onwards. Thus, differences were found between the age groups regarding their cognitive performance, particularly between young adults and elderly adults, and young adults and oldest old adults., Conclusions: Our research indicates that the middle-aged group should be better analyzed and that comparative cross-sectional studies including only extreme groups such as young and elderly adults are not sufficient., Competing Interests: Disclosure: The authors report no conflicts of interest.

This review aimed to discuss the influence of literacy and formal education on human brain organization, based on evidence drawn from three sources: (1) results and limitations of a project coordinated by André Roch Lecours on the influence of illiteracy on brain organization and of studies on aphasia in illiterate populations;(2) data on the impact of schooling on the neuropsychological assessment of healthy and brain-damaged individuals, and(3) studies on the effect of schooling on dementia. These findings suggest that schooling and literacy processes influence cerebral organization of healthy individuals, as well as of brain-lesion individuals and those with dementia. Concerning illiteracy, the systematic pioneering studies developed by Lecours and the continuity of his investigations were essential to alert the scientific and clinical communities to take into account the role of educational experience on cognitive processing and its brain substrates.

Right-brain-damaged individuals may present discursive, pragmatic, lexical-semantic and/or prosodic disorders., Objective: To verify the effect of right hemisphere damage on communication processing evaluated by the Brazilian version of the Protocole Montréal d'Évaluation de la Communication (Montreal Communication Evaluation Battery) - Bateria Montreal de Avaliação da Comunicação, Bateria MAC, in Portuguese., Methods: A clinical group of 29 right-brain-damaged participants and a control group of 58 non-brain-damaged adults formed the sample. A questionnaire on sociocultural and health aspects, together with the Brazilian MAC Battery was administered., Results: Significant differences between the clinical and control groups were observed in the following MAC Battery tasks: conversational discourse, unconstrained, semantic and orthographic verbal fluency, linguistic prosody repetition, emotional prosody comprehension, repetition and production. Moreover, the clinical group was less homogeneous than the control group., Conclusions: A right-brain-damage effect was identified directly, on three communication processes: discursive, lexical-semantic and prosodic processes, and indirectly, on pragmatic process.