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Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, "Método de Integração Global"), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD's impact. MIG's theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment.

Numerical skills are part of cognitive and formal education development, and low performance in math has been associated with adverse features such as low income and unemployment. The studies of functional magnetic resonance imaging (fMRI) activation in numerical Stroop interference had been accomplished to evidence neural correlates of numerical, automatic, and controlled processes. The aim of this research was to summarize the results of the neural correlates of a number-size congruity task through meta-analysis of fMRI, behavioral evidence, and connectometry. Our study includes 15 fMRI papers (total number of subjects n=155-302, the total number of foci=81-233). Meta-analyses used an activation likelihood estimation (ALE) logarithm. For connectometry, it was used the diffusion tensor image. We found that, for the attentional control numerical Stroop effect, the activated areas were the dorsolateral prefrontal cortex, the anterior cingulate gyrus, and the intraparietal sulcus. Consistent activation over both paradigms was found in five clusters, two in the frontal and three in the parietal lobe. The matrix of connectivity showed connections between insula and inferior parietal right with 587 fibers, cingulate gyrus, and inferior parietal right with 843 fibers. Both paradigms activate parietal areas but differ in the activation of regions correlated to attentional control. The results of these meta-analyses summarized results from fMRI studies that may contribute to current theories. The results of connectometry could be interpreted regarding the fibers connection between the clusters right inferior parietal with insula and cingulate gyrus that suggests the integration of information., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Unilateral cerebral palsy (UCP) usually results in damage to the unilateral pyramidal system. However, the clinical presentation of neuromotor deficits also suggests lesions to the extrapyramidal and cerebellar systems bilaterally. In this study, we developed and tested a behavioral neuromotor examination protocol assessing impairments at three levels of motor integration for children with UCP, also considering impairments of the non-paretic upper limb as well as the influences of the laterality of the lesion. We included 30 children with UCP (10.79 ± 2.61 years) and 60 healthy children (8.27 ± 1.57 years) in the study. All children were assessed on general cognitive ability and classified according to the manual ability classification system (MACS). Our neuromotor examination protocol incorporated specific tasks for each level of motor integration: pyramidal, extrapyramidal and cerebellar. Children with UCP and controls did not differ with respect to general cognitive abilities and sex but children with UCP were significantly older. Controls performed significantly better than children with UCP on neuromotor tasks at all levels of motor integration. Additionally, performance of the non-plegine hand in children with UCP was significantly inferior to controls. With the exception of fine motor skills (pyramidal level), children with right and left UCP did not differ. Our behavioral neuromotor examination was sensitive to reveal impairments at all three levels of motor integration bilaterally in children with UCP-although more subtle for the non-paretic limb.

Math anxiety (MA) seems to result from an interaction of genetic vulnerability with negative experiences learning mathematics. Although mathematics achievement does not substantially differ between the sexes, MA levels are usually higher in girls. Molecular genetic markers of MA vulnerability have been seldom explored. This article examines the contribution of the monoamine oxidase A gene (MAOA) to MA and to sex differences in MA. Five hundred and sixty-eight third to fifth graders were genotyped for the MAOA-LPR polymorphism (a repetitive element in MAOA promoter that has been associated with MAOA enzymatic activity), and assessed on general cognitive ability, mathematics achievement, and the cognitive and affective dimensions of MA. MAOA-LPR genotypes were classified as high (MAOA-H) or low (MAOA-L) according to their predicted enzymatic activity. Mixed models controlling for effects of school, sex, general cognitive ability, and mathematics achievement were evaluated. The best fitting model included school, math achievement, sex, MAOA-LPR, and the MAOA-LPR by sex interaction. This indicated that under the MAOA-H dominant model, anxiety toward mathematics interacted with the MAOA genotype: girls with an MAOA-L genotype exhibited higher levels of MA, with a small but significant effect. The association between MAOA-L genotype and MA in girls may represent an example of developmental plasticity., (© 2022 New York Academy of Sciences.)

Background: Disorders in different levels of body representation (i.e., body schema, body structural description, and body image) are present in hemiplegic cerebral palsy (HCP). However, it remains unclear whether the body image develops from aspects of body schema and body structural description, and how this occurs in children with HCP., Objective and Methods: In a cross-sectional study, we investigated 53 children with HCP (mean age about 10 years) and 204 typically developing (TD) control children to qualitatively evaluate whether and how body schema (related sensorimotor experiences) and body structural description (related visuospatial experiences) affect the development of children's body image and whether this development is delayed through HCP. Graph analysis was used to create a lexical-semantic map of body representation from data of a semantic word fluency task., Results: Results indicated a similar qualitative pattern of influences of sensorimotor and visuospatial experiences on lexical-semantic knowledge of body parts, with a delayed developmental course in children with HCP compared to TD children., Conclusion: These findings suggest that children's body image seemed to be influenced by body schema and body structural descriptions as indicated by poorer lexical-semantic knowledge of body parts in children with HCP due to missing physical experiences of the affected body parts. This might imply that "body talk" may beneficially complement physical therapy for children with HCP to promote body image development., 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 © 2022 Cruz, Souto, Moeller, Fontes and Haase.)

Monoamine oxidase A ( MAOA ) polymorphisms have been associated with antisocial disorders. Less attention has been paid to the cognitive functioning of individuals with different MAOA alleles. No study has described the cognitive phenotype associated with the less frequent, low enzyme activity allele, MAOA_LPR*2R., Objective: We describe the cognitive correlates of boys having MAOA_LPR*2R allele, ascertained in a sample of school children with normal intelligence, not referred for behavioral disorders., Methods: Participants were eight boys, attending from the second to fifth grades in state-run schools. They were identified among 712 children with typical general cognitive ability, genotyped for MAOA_LPR polymorphism. Participants were assessed with general intelligence, mathematics and spelling achievement, and verbal and visuospatial working memory tests. Neuropsychological performance was compared to published standards, using 1 SD below the mean as a cutoff value for low performance., Results: Intelligence of boys with MAOA_LPR*2R allele varied from above average (N=2) to low average in the other children. Five out of eight boys with the MAOA_LPR*2R allele had low mathematics achievement, and three presented additional difficulties with spelling. Four out of eight children had low short-term and working memory performance., Discussion: This is the first study describing cognitive correlates and school performance in boys having the MAOA_LPR*2R allele. Having this allele, and therefore, probably low MAO-A activity, does not necessarily imply low intelligence or low school performance. However, learning difficulties, particularly in math, and low working memory performance were observed in boys having this allele. This suggests a role of MAOA in learning difficulties., Competing Interests: Disclosure: The authors report no conflicts of interest.

Expansive mutations in familial mental retardation 1 ( FMR1 ) gene have been associated with different phenotypes. Full mutations are associated with intellectual disability and autism spectrum disorder; premutations are associated with math learning difficulties and working memory impairments. In gray zone, neuropsychological development has not yet been described., Objectives: This study aimed to describe the frequency of FMR1 premutation and gray zone alleles in a school population sample representing a broad spectrum of variation in math achievement and detail school achievement and cognitive performance in the children identified with FMR1 premutation or gray zone alleles., Methods: We described a two-phase study. In the first phase, 2,195 school-age children were screened for math achievement. In the second phase, 378 children with normal intelligence were neuropsychologically assessed and genotyped for FMR1 . Of these, 121 children (61 girls) performed below percentile 25 in mathematics (MD group) and 257 children (146 girls) performed above percentile 25 (control group)., Results: Four pupils presented expanded alleles, one premutation and three gray zone alleles. The girl with the premutation and one boy with a gray zone allele presented impairments in working memory and arithmetic performance below percentile 6, compatible with the diagnosis of developmental dyscalculia. These children's difficulties were not associated with inaccuracy of nonsymbolic number representations or literacy impairments. Dyscalculia in these children seems to be associated mainly with working memory impairments., Conclusions: FMR1 expansions in the gray zone may contribute to dyscalculia in otherwise healthy and normally intelligent children., Competing Interests: Disclosure: The authors report no conflicts of interest.

It is still debated if the main deficit in mathematical difficulties (MD) is nonsymbolic or symbolic numerical magnitude processing., Objectives: In the present study, our main goal was to investigate nonsymbolic and symbolic numerical magnitude processing in MD and the relationship between these abilities and arithmetic., Methods: The Brazilian school-age children with MD completed a nonsymbolic and a symbolic numerical magnitude comparison task and an arithmetic task. We compared their performance with a group of children with typical achievement (TA) and investigated the association between numerical magnitude processing and arithmetic with a series of regression analyses., Results: Results indicated that children with MD had low performance in the nonsymbolic numerical magnitude comparison task. Performance in both nonsymbolic and symbolic numerical magnitude comparison tasks predicted arithmetic abilities in children with TA, but not in children with MD., Conclusions: These results indicate that children with MD have difficulties in nonsymbolic numerical magnitude processing, and do not engage basic numerical magnitude representations to solve arithmetic., Competing Interests: Disclosure: The authors report no conflicts of interest.

Brazilian students' mathematical achievement was repeatedly observed to fall below average levels of mathematical attainment in international studies such as PISA., Objective: In this article, we argue that this general low level of mathematical attainment may interfere with the diagnosis of developmental dyscalculia when a psychometric criterion is used establishing an arbitrary cut-off (e.g., performancerd to 5 th grades on basic arithmetic operations addition, subtraction, and multiplication., Results: In line with PISA results, children presented difficulties in all arithmetic operations investigated. Even after five years of formal schooling, less than half of 5 th graders performed perfectly on simple addition, subtraction, or multiplication problems., Conclusions: As such, these data substantiate the argument that the sole use of a psychometric criterion might not be sensible to diagnose dyscalculia in the context of a generally low performing population, such as Brazilian children of our sample. When the majority of children perform poorly on the task at hand, it is hard to distinguish atypical from typical numerical development. As such, other diagnostic approaches, such as Response to Intervention, might be more suitable in such a context., Competing Interests: Disclosure: The authors report no conflicts of interest.

Aim: To evaluate whether children with cerebral palsy (CP) are able to engage in a motor imagery task. Possible associations between motor imagery and functional performance, working memory, age, and intelligence were also investigated., Method: This is a case-control study that assessed 57 children (25 females, 32 males) with unilateral CP, aged 6 to 14 years (mean age: 10y 4mo; SD 2y 8mo) and 175 typically developing (control) children, aged 6 to 13 years (87 females, 88 males; mean age: 9y 4mo; SD 1y 11mo). The hand laterality judgment task was used to measure motor imagery ability. Reaction time, accuracy, and the effect of the biomechanical constraints were assessed in this task., Results: Performance in both groups followed the biomechanical constraints of the task, that is, longer reaction times to recognize stimuli rotated laterally when compared to medial stimuli. Reaction time means did not differ significantly between groups (p>0.05). Significant differences between the unilateral CP and control groups were observed for accuracy (p<0.05). Functional performance and working memory were correlates of motor imagery tasks., Interpretation: Results suggest that children with unilateral CP can engage in motor imagery; however, they commit more errors than typically developing controls. In addition, their performance in tasks of motor imagery is influenced by functional performance and working memory., (© 2020 Mac Keith Press.)

Symptoms of inattention and hyperactivity/impulsivity, arranged along a continuum, are commonly associated with neuropsychological and academic deficits, even in the general population. The aim of this study is to analyze how Attention Deficit Hyperactivity Disorder (ADHD) symptoms are associated with the performance in neuropsychological and academic abilities (phonological processing, processing speed/automatic attention, executive functions, reading, and spelling) in school-age children. The sample consisted of 216 children from 3 rd and 4 th grades (M = 8.94 years old, SD =.71) from public elementary schools of two Brazilian capitals. Pearson correlation and Multiple Linear Regression analysis were performed. Inattention symptoms were the only predictors of performance in phonological processing (phoneme suppression and rapid automatized naming of letters), processing speed/automatic attention, executive functions, such as inhibitory control and cognitive flexibility, and reading fluency. Beta values ranged from .14 to .27, and the largest value was related to an inhibitory control task. Inattention, and not hyperactivity/impulsivity symptoms, seems to affect neuropsychological functions even in non-clinical diagnosed children. Contributions and future directions are discussed.

Word-level reading is strongly associated with phonological processing. The aim of this study was to investigate the effects of cognitive and environmental variables on word reading performance. Our sample consisted of 185 fourth-grade students. Linear regression analyses were used to investigate the role of the following variables as potential predictors of word reading accuracy and fluency: phonological processing (phonological awareness, rapid automatized naming, and phonological memory); verbal fluency; working memory; socioeconomic status and an indicator of school quality (IDEB) in Brazil. Phonological awareness and rapid automatic naming were the best predictors of reading, supporting the role of phonological processing as a key contributor to the lexical aspects of reading, beyond the early years of literacy acquisition. Environmental variables were significant predictors of irregular word reading (socioeconomic status) and fluency (IDEB), corroborating multicomponent models of reading performance. The present findings demonstrate the complex interplay of factors underlying reading performance and highlight the importance of a multidimensional approach to the study of reading.

Introduction Rapid automatized naming (RAN) is the ability to name, as fast as possible, symbols such as letters, digits and figures. The present study aimed to investigate intragroup performance patterns on RAN tasks in children with attention deficit hyperactivity disorder (ADHD) symptoms alone, children with reading disability (RD) alone and controls with typical development. Methods A total of 216 Brazilian children between 8 to 11 years old were selected from public schools located in two Brazilian capitals, namely Porto Alegre and Belo Horizonte, to participate in the study. Mixed 3 (participant group: ADHD symptoms, RD or control group) × 3 (type of stimulus: letters, numbers or figures) ANOVAs were performed using response time and number of errors as dependent variables. Only intragroup comparisons are described in this paper. Results The groups with ADHD symptoms and RD showed similar performance results on naming speed. There were no differences between letters and numbers within each group, but we found slower responses in figure naming compared to the other tasks for both groups. Concerning accuracy, children with ADHD symptoms showed a similar number of errors in all three tasks. These patterns were distinct from the performance of the control group. Conclusion Results suggest a shared deficit in naming speed of alphanumeric stimuli in children with ADHD symptoms and those with RD, and impairments in naming digits correctly in children with ADHD symptoms.

Objective: The aim of this study was to investigate the psychometric properties and diagnostic accuracy of phoneme elision task (PET)., Method: We assessed cross-sectionally 470 Brazilian children (54.3% girls) aged between 7 and 11 years (mean age = 8.83, sd = 0.85), from the 2nd to 4th grades. Children were assessed in their phonemic awareness ability, as well as intelligence, general school achievement, both verbal and visuospatial working memory, single-word reading, and nonsymbolic magnitude comparison. Beyond the psychometric properties and diagnostic accuracy of PET, we also provided reference values., Results: Our data suggest that PET is composed mainly of one single construct, with high item reliability and precision (KR-20 above 0.90). In general, items have acceptable discriminability, considering item-total correlations. Overall PET is generally a good screening tool for reading and spelling difficulties (SD), as well as to identify children with learning difficulties in the early grades. However, it is not a reliable measure for screening math learning difficulties. Finally, PET shows good convergent and divergent validity., Conclusions: We provide evidence about the psychometric properties and diagnostic accuracy of a PET. Results contribute to the assessment of phonemic awareness in Brazilian children, in both clinical and research contexts. The PET can be used as a screening tool for reading and SD, which could lead to early interventions., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Although motor imagery has been pointed as a promising strategy for the rehabilitation of children with neurological disorders, information on their development throughout childhood and adolescence is still scarce. For instance, it is still unclear at what age they reach a development comparable to the motor imagery performance observed in adults. Herein we used a mental rotation task to assess motor imagery in 164 typically developing children and adolescents, which were divided into four age groups (6-7, 8-9, 10-11, and 12-13 years) and 30 adults. The effects of biomechanical constraints, accuracy, and reaction time of the mental rotation task were considered. ANOVA showed that all groups had the effect of biomechanical restrictions of the mental rotation task. We found a group effect for accuracy [ F (4, 180) = 17,560; p < 0.00; η 2 = 3.79] and reaction time [ F (4, 180) = 17.5; p < 0.001, η 2 = 0.615], with the results of children groups 6-7 and 8-9 years being significantly lower than the other groups ( p < 0.05). In all the analyses, there were no differences regarding accuracy and reaction time among the participants of the age groups 10-11 and 12-13 years and adults ( p > 0.05). Concluding, children aged 6-7 years were able to perform motor imagery, motor imagery ability improved as the participants' ages increased, and children aged 10 and over-performed similarly to adults., (Copyright © 2020 Souto, Cruz, Fontes, Batista and Haase.)

Introduction: Evidence indicates that motor deficits in hemiplegic cerebral palsy (HCP) impair both motor execution and planning. However, current rehabilitation efforts focus mainly on relieving impairments in motor execution. Motor imagery (MI) is a promising method for stimulating neural networks underlying the planning and control of movements., Objective: Evaluate the effectiveness of MI combined with physical practice in improving the function of the upper limbs in children with HCP., Method: Twenty-four participants, aged 7-14 years were divided into two groups: intervention group (IG) and control group (CG). The IG was subjected to MI training and physical practice twice a week for eight consecutive weeks, while the CG received conventional therapy. Participants were assessed with the Assisting Hand Assessment (AHA) at pre-intervention, post-intervention, and follow up., Results: The results showed improved motor functions in both groups. Analysis using the general linear model (analysis of covariance) and Bonferroni post hoc tests showed significant improvements from pre-intervention to post-intervention in the AHA for the IG. The CG showed non-significant improvement in AHA scores., Conclusions: These findings suggest that the MI training, combined with the physical practice program used in this study, was effective in improving upper limb function in children with HCP.

Introduction: Reading disability (RD) and Attention Deficit Hyperactivity Disorder (ADHD) symptoms often co-occur in school-age children., Methods: The present study evaluated the performance of 216 Brazilian children from 3 rd and 4 th grades on "cool" executive function (EF) abilities and phonological processing. The children were divided into three groups: those with ADHD symptoms only, those with RD only, and controls., Results: MANOVA analyses, controlling for age and nonverbal intelligence, showed worse performance for the RD group, compared to the ADHD symptoms group, on measures of phonological processing (phonemic awareness, phonological short-term memory, and lexical access) and "cool" EF components (orthographic verbal fluency and processing speed). The ADHD symptoms group did not differ from the control group on the majority of the "cool" EF tasks. Compared to the control group, the ADHD symptoms group and the RD group both showed significantly more errors in rapid automatized naming of figures, which evaluates the inhibition component of EF; performance on this task was similar for these groups., Conclusion: We conclude that children with RD have greater impairment in phonological processing and "cool" EF compared to those with ADHD symptoms. Furthermore, deficits in inhibitory control may be shared among children with both conditions., Competing Interests: Disclosure: The authors report no conflicts of interest.

The Mini-Mental Examination for Children (MMC) is a widely used tool for assessing global cognitive deficits, however,is still unknown whether MMC is sensitive for investigating cognitive profiles associated with learning difficulties (LD)., Objective: Here we investigate the feasibility of using the MMC for screening school-aged children with learning difficulties in spelling and math., Methods: The MMC and other neurophysiological tests were administered to a sample of 168 children, aged 7 to 12 years. The sample was subdivided into a Control group and LD group (Math Difficulties, Spelling Difficulties, Math and Spelling Difficulties). Diagnostic accuracy was assessed with ROC analysis. Convergent and divergent validity was assessed using correlation analysis., Results: Performance on the MMC was associated with nonverbal intelligence, age and school achievement. The LD group had significantly lower performance on the MMC than the Control group. Performance on the MMC discriminated LD children with a global accuracy of around 0.80. Associations between the MMC and the other neuropsychological variables were higher for finger gnosis (r=0.40) and generally higher for early elementary school grades. The MMC proved satisfactory for identifying LD children with good accuracy. Nonverbal intelligence, and perceptual/motor abilities play an important role in MMC performance., Conclusion: The MMC could be a useful instrument for screening children with LD., Competing Interests: Disclosure: The authors report no conflicts of interest.

Math anxiety (MA) is a phobic reaction to math activities, potentially impairing math achievement. Higher frequency of MA in females is explainable by the interaction between genetic and environmental factors. The molecular-genetic basis of MA has not been investigated. The COMT Val158Met polymorphism, which affects dopamine levels in the prefrontal cortex, has been associated with anxiety manifestations. The valine allele is associated with lower, and the methionine allele with higher, dopamine availability. In the present study, the effects of sex and COMT Val158Met genotypes on MA were investigated: 389 school children aged 7-12 years were assessed for intelligence, numerical estimation, arithmetic achievement and MA and genotyped for COMT Val158Met polymorphism. The Math Anxiety Questionnaire (MAQ) was used to assess the cognitive and affective components of MA. All genotype groups of boys and girls were comparable regarding genotype frequency, age, school grade, numerical estimation, and arithmetic abilities. We compared the results of all possible genetic models: codominance (Val/Val vs. Val/Met vs. Met/Met), heterosis (Val/Met vs. Val/Val plus Met/Met), valine dominance (Val/Val plus Val/Met vs. Met/Met), and methionine dominance (Met/Met plus Val/Met vs. Val/Val). Models were compared using AIC and AIC weights. No significant differences between girls and boys and no effects of the COMT Val158Met polymorphism on numerical estimation and arithmetic achievement were observed. Sex by genotype effects were significant for intelligence and MA. Intelligence scores were higher in Met/Met girls than in girls with at least one valine allele (valine dominance model). The best fitting model for MA was heterosis. In Anxiety Toward Mathematics, heterozygous individuals presented MA levels close to the grand average regardless of sex. Homozygous boys were significantly less and homozygous girls significantly more math anxious. Heterosis has been seldom explored, but in recent years has emerged as the best genetic model for some phenotypes associated with the COMT Val158Met polymorphism. This is the first study to investigate the genetic-molecular basis of MA.

Although progress has been made, the cognitive, biological and, particularly, the genetic underpinnings of math learning difficulties (MD) remain largely unknown. This difficulty stems from the heterogeneity of MD and from the large contribution of environmental factors to its etiology. Understanding endophenotypes, e.g., the role of the Approximate Number System (ANS), may help understanding the nature of MD. MD associated with ANS impairments has been described in some genetic conditions, e.g., 22q11.2 deletion syndrome (22q11.2DS or Velocardiofacial syndrome, VCFS). Recently, a girl with MD was identified in a school population screening. She has a new syndrome resulting from a microdeletion in 22q11.2 (LCR22-4 to LCR22-5), a region adjacent to but not overlapping with region 22q11.2 (LCR22-2 to LCR22-4), typically deleted in VCFS. Here, we describe her cognitive-neuropsychological and numerical-cognitive profiles. The girl was assessed twice, at 8 and 11 years. Her numerical-cognitive performance at both times was compared to demographically similar girls with normal intelligence in a single-case, quasi-experimental study. Neuropsychological assessment was normal, except for relatively minor impairments in executive functions. She presented severe and persistent difficulties in the simplest single-digit calculations. Difficulties in commutative operations improved from the first to the second assessment. Difficulties in subtraction persisted and were severe. No difficulties were observed in Arabic number writing. Difficulties in single-digit calculation co-occurred with basic numerical processing impairments in symbolic and non-symbolic (single-digit comparison, dot sets size comparison and estimation) tasks. Her difficulties suggest ANS impairment. No difficulties were detected in visuospatial/visuoconstructional and in phonological processing tasks. The main contributions of the present study are: (a) this is the first characterization of the neuropsychological phenotype in 22q11.2DS (LCR22-4 to LCR22.5) with normal intelligence; (b) mild forms of specific genetic conditions contribute to persistent MD in otherwise typical persons; (c) heterogeneity of neurogenetic underpinnings of MD is suggested by poor performance in non-symbolic numerical processing, dissociated from visuospatial/visuoconstructional and phonological impairments; (d) similar to what happens in 22q11.2DS (LCR22-2 to LCR22-4), ANS impairments may also characterize 22q11.2DS (LCR22-4 to LCR22-5).

Mental calculation is thought to be tightly related to visuospatial abilities. One of the strongest evidence for this link is the widely replicated operational momentum (OM) effect: the tendency to overestimate the result of additions and to underestimate the result of subtractions. Although the OM effect has been found in both infants and adults, no study has directly investigated its developmental trajectory until now. However, to fully understand the cognitive mechanisms lying at the core of the OM effect it is important to investigate its developmental dynamics. In the present study, we investigated the development of the OM effect in a group of 162 children from 8 to 12 years old. Participants had to select among five response alternatives the correct result of approximate addition and subtraction problems. Response alternatives were simultaneously presented on the screen at different locations. While no effect was observed for the youngest age group, children aged 9 and older showed a clear OM effect. Interestingly, the OM effect monotonically increased with age. The increase of the OM effect was accompanied by an increase in overall accuracy. That is, while younger children made more and non-systematic errors, older children made less but systematic errors. This monotonous increase of the OM effect with age is not predicted by the compression account (i.e., linear calculation performed on a compressed code). The attentional shift account, however, provides a possible explanation of these results based on the functional relationship between visuospatial attention and mental calculation and on the influence of formal schooling. We propose that the acquisition of arithmetical skills could reinforce the systematic reliance on the spatial mental number line and attentional mechanisms that control the displacement along this metric. Our results provide a step in the understanding of the mechanisms underlying approximate calculation and an important empirical constraint for current accounts on the origin of the OM effect.

Math learning disability (MLD) is a heterogeneous condition characterized by severe and persistent difficulties in learning math, including difficulties in learning multiplication facts., Objective: In this article, we compared the responses of two MLD children to multiplication facts training., Methods: One of the children was a 9 year-old girl (HV) who presented mild math difficulties associated with lower accuracy of the Approximate Number System (ANS). The other was an 11 year-old boy (GA) who presented severe math difficulties related to impaired phonological processing due to developmental dyslexia. Both children underwent an intervention for multiplication, comprising conceptual instructions and retrieval practice of the times table., Results: HV's accuracy and response speed improved consistently on both training tasks, while GA's accuracy improved on the Simple Calculation Task only. Error analyses indicated that, after training, HV produced fewer errors of the type "close miss", and GA produced less omission but more operand errors., Conclusion: We argue that these differences between their responses to the training tasks were caused by differences in the mechanisms underlying their math difficulties. These results support the notion that individual specificities regarding math disabilities should be taken into account during preparation of training interventions., Competing Interests: Disclosure: The authors report no conflicts of interest.

Clinical observations indicate that many children with hemiplegic cerebral palsy refrain from using or disregard the affected upper limb. The aim of the present study is to investigate deficits in different body representations (body schema, body structural description, and body image) in children with hemiplegic cerebral palsy (HCP) compared to typically-developing (TD) children. Three groups of children participated in this study: 42 TD children (aged 5.17-10.91 years), 23 children with right HCP (aged 5.83-10.92 years), and 22 children with left HCP (aged 5.67-10.90 years). The results demonstrate generalized deficits in all three body representations in children with HCP, and do not offer evidence for an effect of hemiplegia laterality.

Cognitive impairment is frequent in cerebral palsy (CP) and there is a lack of multiprofessional screening instruments., Objective: The aim of this study was to investigate the utility of the Mini-Mental State Examination for Children (MMC), an adapted version of the Mini-Mental State Examination, in screening for cognitive impairments in children with CP., Methods: We assessed 397 Brazilian children, 310 with typical development and 87 with CP (hemiplegic and quadriplegic forms), aged 5-16 years. Association between the MMC and general intelligence was assessed by the Colored Progressive Matrices instrument., Results: Psychometric indexes for the MMC were adequate. ROC analyses revealed effective diagnostic accuracy in all ages assessed. Cut-off values are reported. Major difficulties on the MMC were observed in children with CP, particularly individuals with the quadriplegic form. Moreover, the MMC showed moderate correlation with the intelligence test, and was reliable in discriminating, among clinical cases, those with poorer cognitive abilities., Conclusion: The MMC could be useful as a multiprofessional screening instrument for cognitive impairment in children with hemiplegic CP. Results of the MMC in quadriplegic CP children should be interpreted with caution. Diagnosis should be confirmed by further psychological testing., Competing Interests: Disclosure: The authors report no conflicts of interest.

In many countries, a radical political divide brings several socially relevant decisions to a standstill. Could cognitive, affective and social (CAS) neuroscience help better understand these questions? The present article reviews the moral-psychological and neuroevolutionary basis of the political partisanship divide. A non-systematic literature review and a conceptual analysis were conducted. Three main points are identified and discussed: 1) Political partisan behavior rests upon deep moral emotions. It is automatically processed and impervious to contradiction. The moral motifs characterizing political partisanship are epigenetically set across different cultures;2) partisanship is linked to personality traits, whose neural foundations are associated with moral feelings and judgement;3) Self-deception is a major characteristic of political partisanship that probably evolved as an evolutionary adaptive strategy to deal with the intragroup-extragroup dynamics of human evolution. CAS neuroscience evidence may not resolve the political divide, but can contribute to a better understanding of its biological foundations., Competing Interests: Disclosure: The authors report no conflicts of interest.

Introduction: Congenital amusia is a developmental disorder associated with deficits in pitch height discrimination or in integrating pitch sequences into melodies. This quasi-experimental pilot study investigated whether there is an association between pitch and numerical processing deficits in congenital amusia. Since pitch height discrimination is considered a form of magnitude processing, we investigated whether individuals with amusia present an impairment in numerical magnitude processing, which would reflect damage to a generalized magnitude system. Alternatively, we investigated whether the numerical processing deficit would reflect a disconnection between nonsymbolic and symbolic number representations., Method: This study was conducted with 11 adult individuals with congenital amusia and a control comparison group of 6 typically developing individuals. Participants performed nonsymbolic and symbolic magnitude comparisons and number line tasks. Results were available from previous testing using the Montreal Battery of Evaluation of Amusia (MBEA) and a pitch change detection task (PCD)., Results: Compared to the controls, individuals with amusia exhibited no significant differences in their performance on both the number line and the nonsymbolic magnitude tasks. Nevertheless, they showed significantly worse performance on the symbolic magnitude task. Moreover, individuals with congenital amusia, who presented worse performance in the Meter subtest, also presented less precise nonsymbolic numerical representation., Conclusions: The relationship between meter and nonsymbolic numerical discrimination could indicate a general ratio processing deficit. The finding of preserved nonsymbolic numerical magnitude discrimination and mental number line representations, with impaired symbolic number processing, in individuals with congenital amusia indicates that (a) pitch height and numerical magnitude processing may not share common neural representations, and (b) in addition to pitch processing, individuals with amusia may present a deficit in accessing nonsymbolic numerical representations from symbolic representations. The symbolic access deficit could reflect a widespread impairment in the establishment of cortico-cortical connections between association areas.

Reading and spelling performance have a significant correlation with number transcoding, which is the ability to establish a relationship between the verbal and Arabic representations of numbers, when a conversion of numerical symbols from one notation to the other is necessary. The aim of the present study is to reveal shared and non-shared mechanisms involved in reading and writing of words and Arabic numerals in Brazilian school-aged children. One hundred and seventy-two children from second to fourth grades were evaluated. All of them had normal intelligence. We conducted a series of hierarchical regression models using scores on word spelling and reading single words and Arabic numerals, as dependent variables. As predictor variables we investigated intelligence, the phonological and visuospatial components of working memory (WM) and phonemic awareness. All of the writing and reading tasks (single word spelling and reading as well as number reading and number writing) were significantly correlated to each other. In the regression models, phonological WM was specifically associated to word reading. Phonemic awareness was the only cognitive variable that systematically predicted all of the school skills investigated, both numerical and word tasks. This suggests that phonemic awareness is a modular cognitive ability shared by several school tasks and might be an important factor associated to the comorbidity between dyslexia and dyscalculia.

Math learning disability (MLD) or developmental dyscalculia is a highly prevalent and persistent difficulty in learning arithmetic that may be explained by different cognitive mechanisms. The accuracy of the number sense has been implicated by some evidence as a core deficit in MLD. However, research on this topic has been mainly conducted in demographically selected samples, using arbitrary cut-off scores to characterize MLD. The clinical relevance of the association between number sense and MLD remains to be investigated. In this study, we aimed at assessing the stability of a number sense accuracy measure (w) across five experimental sessions, in two clinically defined cases of MLD. Stable measures of number sense accuracy estimate are required to clinically characterize subtypes of MLD and to make theoretical inferences regarding the underlying cognitive mechanisms. G. A. was a 10-year-old boy with MLD in the context of dyslexia and phonological processing impairment and his performance remained steadily in the typical scores range. The performance of H. V., a 9-year-old girl with MLD associated with number sense inaccuracy, remained consistently impaired across measurements, with a nonsignificant tendency to worsen. Qualitatively, H. V.'s performance was also characterized by greater variability across sessions. Concomitant clinical observations suggested that H. V.'s difficulties could be aggravated by developing symptoms of mathematics anxiety. Results in these two cases are in line with the hypotheses that at least two reliable patterns of cognitive impairment may underlie math learning difficulties in MLD, one related to number sense inaccuracy and the other to phonological processing impairment. Additionally, it indicates the need for more translational research in order to examine the usefulness and validity of theoretical advances in numerical cognition to the clinical neuropsychological practice with MLD., (© 2015 The Institute of Psychology, Chinese Academy of Sciences and Wiley Publishing Asia Pty Ltd.)

Number transcoding (e.g., writing 29 when hearing "twenty-nine") is one of the most basic numerical abilities required in daily life and is paramount for mathematics achievement. The aim of this study is to investigate psychometric properties of an Arabic number-writing task and its capacity to identify children with mathematics difficulties. We assessed 786 children (55% girls) from first to fourth grades, who were classified as children with mathematics difficulties (n = 103) or controls (n = 683). Although error rates were low, the task presented adequate internal consistency (0.91). Analyses revealed effective diagnostic accuracy in first and second school grades (specificity equals to 0.67 and 0.76 respectively, and sensitivity equals to 0.70 and 0.88 respectively). Moreover, items tapping the understanding of place-value syntax were the most sensitive to mathematics achievement. Overall, we propose that number transcoding is a useful tool for the assessment of mathematics abilities in early elementary school., (© The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The approximate number system (ANS) has been consistently found to be associated with math achievement. However, little is known about the interactions between the different instantiations of the ANS and in how many ways they are related to exact calculation. In a cross-sectional design, we investigated the relationship between three measures of ANS acuity (non-symbolic comparison, non-symbolic estimation and non-symbolic addition), their cross-sectional trajectories and specific contributions to exact calculation. Children with mathematical difficulties (MD) and typically achieving (TA) controls attending the first six years of formal schooling participated in the study. The MD group exhibited impairments in multiple instantiations of the ANS compared to their TA peers. The ANS acuity measured by all three tasks positively correlated with age in TA children, while no correlation was found between non-symbolic comparison and age in the MD group. The measures of ANS acuity significantly correlated with each other, reflecting at least in part a common numerosity code. Crucially, we found that non-symbolic estimation partially and non-symbolic addition fully mediated the effects of non-symbolic comparison in exact calculation.

Approximately 6% of school-aged children have math difficulties (MD). A neurogenetic etiology has been suggested due to the presence of MD in some genetic syndromes such as 22q11.2DS. However, the contribution of 22q11.2DS to the MD phenotype has not yet been investigated. This is the first population-based study measuring the frequency of 22q11.2DS among school children with MD. Children (1,564) were identified in the schools through a screening test for language and math. Of these children, 152 (82 with MD and 70 controls) were selected for intelligence, general neuropsychological, and math cognitive assessments and for 22q11.2 microdeletion screening using MLPA. One child in the MD group had a 22q11.2 deletion spanning the LCR22-4 to LCR22-5 interval. This child was an 11-year-old girl with subtle anomalies, normal intelligence, MD attributable to number sense deficit, and difficulties in social interactions. Only 19 patients have been reported with this deletion. Upon reviewing these reports, we were able to characterize a new syndrome, 22q11.2 DS (LCR22-4 to LCR22-5), characterized by prematurity; pre- and postnatal growth restriction; apparent hypotelorism, short/upslanting palpebral fissures; hypoplastic nasal alae; pointed chin and nose; posteriorly rotated ears; congenital heart defects; skeletal abnormalities; developmental delay, particularly compromising the speech; learning disability (including MD, in one child); intellectual disability; and behavioral problems. These results suggest that 22q11.2 DS (LCR22-4 to LCR22-5) may be one of the genetic causes of MD., (© 2014 Wiley Periodicals, Inc.)

Mathematics learning difficulties are a highly comorbid and heterogeneous set of disorders linked to several dissociable mechanisms and endophenotypes. Two of these endophenotypes consist of primary deficits in number sense and verbal numerical representations. However, currently acknowledged endophenotypes are underspecified regarding the role of automatic vs. controlled information processing, and their description should be complemented. Two children with specific deficits in number sense and verbal numerical representations and normal or above-normal intelligence and preserved visuospatial cognition illustrate this point. Child H.V. exhibited deficits in number sense and fact retrieval. Child G.A. presented severe deficits in orally presented problems and transcoding tasks. A partial confirmation of the two endophenotypes that relate to the number sense and verbal processing was obtained, but a much more clear differentiation between the deficits presented by H.V. and G.A. can be reached by looking at differential impairments in modes of processing. H.V. is notably competent in the use of controlled processing but has problems with more automatic processes, such as nonsymbolic magnitude processing, speeded counting and fact retrieval. In contrast, G.A. can retrieve facts and process nonsymbolic magnitudes but exhibits severe impairment in recruiting executive functions and the concentration that is necessary to accomplish transcoding tasks and word problem solving. These results indicate that typical endophenotypes might be insufficient to describe accurately the deficits that are observed in children with mathematics learning abilities. However, by incorporating domain-specificity and modes of processing into the assessment of the endophenotypes, individual deficit profiles can be much more accurately described. This process calls for further specification of the endophenotypes in mathematics learning difficulties.

Although verbal and numerical abilities have a well-established interaction, the impact of phonological processing on numeric abilities remains elusive. The aim of this study is to investigate the role of phonemic awareness in number processing and to explore its association with other functions such as working memory and magnitude processing. One hundred seventy-two children in 2nd grade to 4th grade were evaluated in terms of their intelligence, number transcoding, phonemic awareness, verbal and visuospatial working memory and number sense (non-symbolic magnitude comparison) performance. All of the children had normal intelligence. Among these measurements of magnitude processing, working memory and phonemic awareness, only the last was retained in regression and path models predicting transcoding ability. Phonemic awareness mediated the influence of verbal working memory on number transcoding. The evidence suggests that phonemic awareness significantly affects number transcoding. Such an association is robust and should be considered in cognitive models of both dyslexia and dyscalculia.

Background: Cognitive disorders in infants and children who are vertically infected with human immunodeficiency virus (HIV) have been recognized since the inception of the epidemic., Objective: The present study investigated neuropsychological performance in a cohort of vertically infected Brazilian children and adolescents who underwent antiretroviral therapy. The neuropsychological tasks were designed to evaluate executive function and processing speed., Methods: Children and adolescents were recruited at a major research and treatment reference center for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV) in Minas Gerais, Brazil. Forty-one individuals aged 5 to 17 years were enrolled. Twelve were mildly symptomatic (HIV-infected group, Centers for Disease Control and Prevention [CDC] class A or B), and 29 had advanced clinical disease (AIDS group, CDC class C)., Results: The results showed that HIV-infected children and adolescents exhibited lower performance on neuropsychological tasks than sociodemographically comparable, typically developing controls. Motor and cognitive processing speed and executive function appeared to be the most discriminative domains., Conclusion: HIV-infected individuals with more-advanced disease stages exhibited lower performance levels and had greater performance heterogeneity on neuropsychological tasks. Thus, the observed neuropsychological impairments, although more pronounced in participants with more advanced stages of the disease, did not correlate with the variable used (CDC stage)., Competing Interests: Disclosure: The authors report no conflicts of interest.

Transcoding between numerical systems is one of the most basic abilities acquired by children during their early school years. One important topic that requires further exploration is how mathematics proficiency can affect number transcoding. The aim of the current study was to investigate transcoding abilities (i.e., reading Arabic numerals and writing dictation) in Brazilian children with and without mathematics difficulties, focusing on different school grades. We observed that children with learning difficulties in mathematics demonstrated lower achievement in number transcoding in both early and middle elementary school. In early elementary school, difficulties were observed in both the basic numerical lexicon and the management of numerical syntax. In middle elementary school, difficulties appeared mainly in the transcoding of more complex numbers. An error analysis revealed that the children with mathematics difficulties struggled mainly with the acquisition of transcoding rules. Although we confirmed the previous evidence on the impact of working memory capacity on number transcoding, we found that it did not fully account for the observed group differences. The results are discussed in the context of a maturational lag in number transcoding ability in children with mathematics difficulties., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Catechol-O-methyltransferase (COMT) is an enzyme that is particularly important for the metabolism of dopamine. Functional polymorphisms of COMT have been implicated in working memory and numerical cognition. This is an exploratory study that aims at investigating associations between COMT polymorphisms, working memory, and numerical cognition. Elementary school children from 2th to 6th grades were divided into two groups according to their COMT val158met polymorphism [homozygous for valine allele (n = 61) vs. heterozygous plus methionine homozygous children or met+ group (n = 94)]. Both groups were matched for age and intelligence. Working memory was assessed through digit span and Corsi blocks. Symbolic numerical processing was assessed through transcoding and single-digit word problem tasks. Non-symbolic magnitude comparison and estimation tasks were used to assess number sense. Between-group differences were found in symbolic and non-symbolic numerical tasks, but not in working memory tasks. Children in the met+ group showed better performance in all numerical tasks while val homozygous children presented slower development of non-symbolic magnitude representations. These results suggest COMT-related dopaminergic modulation may be related not only to working memory, as found in previous studies, but also to the development of magnitude processing and magnitude representations.

The Montreal Battery of Evaluation of Amusia (MBEA) is a battery of tests that assesses six music processing components: scale, contour, interval, rhythm, metric, and music memory. The present study sought to verify the psychometric characteristics of the MBEA in a sample of 150 adolescents aged 14-18 years in the city of Belo Horizonte, Minas Gerais, Brazil, and to develop specific norms for this population. We used statistical procedures that explored the dimensional structure of the MBEA and its items, evaluating their adequacy from empirical data, verifying their reliability, and providing evidence of validity. The results for the difficult levels for each test indicated a trend toward higher scores, corroborating previous studies. From the analysis of the criterion groups, almost all of the items were considered discriminatory. The global score of the MBEA was shown to be valid and reliable ( r K-R20 =0.896) for assessing the musical ability of normal teenagers. Based on the analysis of the items, we proposed a short version of the MBEA. Further studies with larger samples and amusic individuals are necessary to provide evidence of the validity of the MBEA in the Brazilian milieu. The present study brings to the Brazilian context a tool for diagnosing deficits in musical skills and will serve as a basis for comparisons with single case studies and studies of populations with specific neuropsychological syndromes., Competing Interests: Disclosure: The authors report no conflicts of interest.

Purpose: To identify relevant items and most frequents categories related to functioning and disability recorded by professionals involved in rehabilitation of children with cerebral palsy (CP) and to assess the filling of the records., Methods: A retrospective cross-sectional study based on the written documents provided by an interdisciplinary rehabilitation team. Participated in the study 40 patients with CP, aged 10 months to 17 years. Two raters extracted information from the patients' medical documents as recorded by physicians, physiotherapists, occupational therapists, speech therapists, social workers, psychologists and dieticians using the ICF-CY. Patients' records were scored (+functioning, -disability and *environmental factors) using 27 ICF-CY items to assess the filling of the records., Results: Eighty-one items in the medical records [body structure(15), bodily functions(32), activity(24) and environmental factors(10)] were identified as related to the evaluation of the different professions involved with neuro-rehabilitation. Physiotherapy and occupational therapy provided the most comprehensive assessments performed. Fourteen categories had a minimum frequency of 40% during the registration process., Conclusions: The content of the information involves categories related to the structures and body functions, activities and environmental factors. The information follows a heterogeneous pattern in content and number of categories. The most frequent items can comprise a set of codes for triage of CP. It is necessary to establish an interdisciplinary consensus based on ICF-CY for systematize the information's record.

Objectives: To integrate instruments to operationalize an ICF-based approach for cerebral palsy (CP); to assess differences in activity and participation among children with hemiplegia, diplegia and quadriplegia CP; to verify the facilitators or barriers to functioning; and to investigate the explanatory factors (cognitive and motor) for the type of school attended by children with CP (regular or special)., Methods: Sixty children with CP were assessed using the Mini-Mental State Examination and an ICF-based instrument and their parents were interviewed. Data were analysed by Chi-Squared, Anova's and Kruskal-Wallis tests and multivariate logistic regression., Results: Significant differences between CP sub-groups were found for chewing, urinary function, cognitive function and activities and participation. Twelve environmental factors were identified as barriers. Multivariate regression identified cognitive function as a significant explanatory variable for the type of school attended, whereas motor function was not significant., Conclusions: The ICF-based approach allows a comprehensive assessment, relevant for planning interventions.

Finger counting has been associated to arithmetic learning in children. We examined children with (n = 14) and without (n = 84) mathematics learning difficulties with ages between 8 and 11 years. Deficits in finger gnosia were found in association to mathematical difficulties. Finger gnosia was particularly relevant for the performance in word problems requiring active manipulation of small magnitudes in the range between 1 and 10. Moreover, the deficits in finger gnosia could not be attributed to a shortage in working memory capacity but rather to a specific inability to use fingers to transiently represent magnitudes, tagging to be counted objects, and reducing the cognitive load necessary to solve arithmetic problems. Since finger gnosia was more related to symbolic than to non-symbolic magnitude processing, finger-related representation of magnitude seems to be an important link for learning the mapping of analog onto discrete symbolic magnitudes.

Adrenoleukodystrophy is a neurodegenerative X-linked recessive disorder. It is characterized by abnormal function of peroxisomes, which leads to an accumulation of very long-chain fatty acids in plasma and tissues, especially in the cortex of adrenal glands and white matter of the central nervous system, causing demyelinating disease and adrenocortical insufficiency (Addison's disease). It is caused by a mutation in the ABCD1 gene (ATP-binding cassette, subfamily D, member 1), which encodes the protein adrenoleukodystrophy that is involved in the transport of fatty acids into the peroxisome for degradation. Variable expression has been recognized in families of patients who have this disease. A Brazilian family from Minas Gerais State, Brazil, was studied. The proband is an adult living in Minas Gerais State, Brazil; he had adrenomyeloneuropathy, adrenocortical insufficiency and a stable cerebral form. DNA was extracted from a blood sample and was sequenced to identify the mutation. The patient's exons were cloned for confirmation. A new mutation was found in exon 5 of the ABCD1 gene (c.1430delA), as well as a single-nucleotide polymorphism in exon 6. The mutation causes a frame shift, resulting in a truncated protein with almost total absence of the ATP binding domain.

Objective: To assess knowledge related to the ICF before and after an ICF training and to identify items to compose a monocentric rehabilitation ICF code set for cerebral palsy (CP)., Methods: (a), Design: A cross-sectional study with a descriptive-explorative design. (b), Participants: Professionals from the fields of physiotherapy, nutrition, dentistry, occupational therapy, psychology, social work, speech therapy and medicine. (c), Instrument: A questionnaire to assess ICF's knowledge (total score = 17)., Results: A high effect size of the ICF training was found (Cohen's d = 4.10). Ninety-one and 43 ICF categories were selected for a comprehensive evaluation and triage, respectively, for CP., Conclusion: ICF categories were identified to compose a comprehensive evaluation and for triage through an ICF code sets for CP. Studies are needed to validate the instrument on the knowledge of the ICF and to test the impact of ICF's training for clinical rehabilitation of CP.

Health-related quality of life (HRQOL) is an important marker for health-related impacts on individuals with chronic diseases. This HRQOL study compares multiple sclerosis (MS) patients to a socio-demographically-matched healthy control group. HRQOL was assessed by means of a modular instrument (DEFU/DEFIS), which allows comparisons between diseased and healthy individuals. Main goal of the study was to obtain pertinent data to build a more reliable theoretical framework concerning HRQOL in MS. Another aim was to test the hypothesis of the so-called happiness paradox, according to which disabled individuals could maintain reasonable levels of HRQOL. Results show that MS individuals present lower levels of HRQOL in comparison to healthy controls, arguing against the happiness paradox hypothesis. Preservation of HRQOL levels against certain levels of disability may be restricted to a group of patients.

The constant conflict between decisions leading to immediate pleasurable consequences versus behaviors aiming at long-term social advantages is reviewed here in the framework of the evolutionary systems regulating behavior. The inescapable temporal perspective in decision-making in everyday life is highlighted and integrated with the role of the executive functions in the modulation of subcortical systems. In particular, the representations of the 'non-existent' future in the prefrontal cortical regions and how these representations can bridge theory and practice in everyday life are addressed. Relevant discussions regarding the battle between emotions and reasons in the determination of more complex decisions in the realm of neuroeconomics and in moral issues have been reserved for a second essay.

Unlabelled: Mismatch Negativity is a functional index of the supratemporal auditory cortex., Aim: The aim of the present study on Mismatch Negativity (MMN) in multiple sclerosis (MS) patients was to evaluate if the MMN can be correlated with cognitive deficits assessed by the Paced Auditory Addition Task--PASAT., Method: a clinical study in forty females and 20 males separated in two groups: control individuals and those with a definite diagnosis of MS underwent a duration and frequency MMN. The MMN latencies and negative amplitudes obtained from the MS group were compared to the ones from the control group. The scores from the Paced Auditory Addition Task were correlated either with the presence or the absence of MMN., Results: MMN was found in 60% of the individuals with multiple sclerosis within the auditory stimulation protocol with varied durations, and in 45 % within the auditory stimulation protocol with frequency variations. There were no statistically significant differences in latencies and amplitudes when compared to controls. We found a statistically significant correlation for the lack of MMN wave together with cognitive disorder asserted by the PASAT., Conclusions: The MMN correlated to the cognitive deficit assessed by the PASAT.