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The only recommended pharmacological treatments for specific dementias are donepezil, galantamine, rivastigmine, and memantine (recommended drugs, RD). However, other drugs without recommendations (not recommended drugs, NRD) are often used to treat patients with cognitive impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost, and implications of NRD used for the treatment of CI in the INSSJyP.This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared with the same database in 2009. The number of "prescriptions" always refers to dispensed packages.A total of 3 255 438 packages of drugs usually indicated for CI were prescribed during 2015: 1 912 476 packages of RD (59%) and 1 342 962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 million USD. NRD cost represented approximately 20 million USD.Inappropriate drug use increases health costs in developing countries. We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modify behavioral insights about appropriate prescription for specific dementias.

Alzheimer's disease is the most frequent cause of cognitive disorders and dementia in older adults and is considered a new epi- demic. Due to its different cognitive, behavioral and functional manifestations, the detection, and diagnosis of patients with Alzheimer's Disease Dementia can represent a challenge. In this Clinical Practice Recommendation, management are given with levels based on the best scientific evidence available. Likewise, indications for study, or referral to a higher level of sanitary assistance are presented, according to the complexity of each clinical case. In this way, a set of practical recommendations of support is provided for decision making by health professionals at each sanitary level, from primary care to medical specialists. Through an operational and dynamic approach, this recommendations propose a global strategy based on evidence for patients, family members and health agents involved in this pathology, of great social relevance.

Resumen El uso racional de medicamentos (URM) implica tener un conocimiento actualizado de los tratamientos, asi como de las normativas dadas por las agencias regulatorias nacionales. Mediante la educacion medica y la actualizacion de los conocimientos, es posible modificar de manera gradual conductas prescriptivas que no resultan optimas para el manejo clinico del paciente ni para la correcta administracion de recursos de los sistemas de salud. Con este objetivo, el Grupo de Trabajo de Neurofarmacologia de la Sociedad Neurologica Argentina presenta esta revision sobre URM para su aplicacion en nuestro medio y, eventualmente, en el resto de los paises hispanoparlantes del Cono Sur. Para la revision que hoy publicamos se tuvieron en cuenta los conocimientos de regulacion de medicamentos, investigacion clinica, medicina basada en evidencia y experiencia clinica neurologica. Provee a los profesionales los estandares necesarios para una adecuada prescripcion racional de medicamentos.

The Argentina-Alzheimer's disease neuroimaging initiative (Arg-ADNI) study is a longitudinal prospective cohort of 50 participants at a single institution in Buenos Aires, Argentina. Longitudinal assessments on a neuropsychological test battery were performed on 15 controls, 24 mild cognitive impairment (MCI) patients and 12 Alzheimer's disease (AD) dementia patients. In our study population, there was a high prevalence of positive AD biomarkers in the AD group, 92.3% (12/13); and a low prevalence in the normal controls, 20%; almost half (48%) of the patients diagnosed with MCI had positive amyloid detection. After a one year, the significant differences found at baseline on neuropsychological testing were similar at the follow-up assessment even though the AD group had significantly altered its functional performance (FAQ and CDR). The exception was semantic fluency, which showed greater impairment between the AD group and MCI and normal controls respectively. For these tests, the addition of AD biomarkers as a variable did not significantly alter the variations previously found for the established clinical group's model. Finally, the one-year conversion rate to dementia was 20% in the MCI cohort.

Objetivo: Examinar la relación de la sobrecarga del cuidador familiar con: la presencia de síntomas neuropsiquiátricos en el paciente y el estado de ánimo y calidad de vida percibidos del cuidador. Método: Estudio correlacional/transversal. 32 cuidadores urbanos, residentes en Argentina, respondieron a los inventarios de Sobrecarga (ZBI), Depresión de Beck, Manifestaciones Neuropsiquiátricas (NPI-Q) y al Cuestionario de Calidad de Vida de la OMS. Resultados: La tendencia indica que a mayor gravedad de síntomas psiquiátricos en el paciente, menor calidad de vida en la salud física del cuidador; y, a mayor depresión, mayor sobrecarga del cuidador. Discusión: Se aporta información de interés sobre la necesidad de incluir la evaluación del estado psicosocial de los cuidadores familiares de pacientes con enfermedad cerebro vascular, con el fin de preservar su salud. Objective: To examine the relationship of family caregiver´s feeling of burden with: the presence of neuropsychiatric symptoms in the patient, caregiver´s general mood and perceived quality of life. Method: Cross-sectional research performed on 32 urban Argentinian caregivers. They answered the Zarit Burden Interview (ZBI), the Beck Depression Inventory, the Neuropsychiatric Inventory Questionnaire (NPI-Q), and the World Health Organization Quality of Life Assessment (WHOQOL.) Results: As psychiatric symptoms on the patient increase, a decrease can be observed on the quality of life of the family caregiver. As depression on the patient deepens, the caregiver experiences a greater burden. Discussion: Supplemental information on the need to include the assessment of the psycosocial condition of family caregivers of patients who had suffered strokes is added with the sole intention of preserving their health. Fil: Feldberg, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Saux, Gaston Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Facultad de Psicología y Psicopedagogía; Argentina Fil: Tartaglini, Maria Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentina Fil: Irrazabal, Natalia Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Palermo. Facultad de Ciencias Sociales. Departamento de Psicología; Argentina Fil: Leis, Adriana Mónica. Instituto de Neurociencias Buenos Aires S. A.; Argentina Fil: Rojas, Galeno. Instituto de Neurociencias Buenos Aires S. A.; Argentina Fil: Somale, Verónica. Instituto de Neurociencias Buenos Aires S. A.; Argentina Fil: Cáceres, Fernando. Instituto de Neurociencias Buenos Aires S. A.; Argentina Fil: Demey, Ignacio. Instituto de Neurociencias Buenos Aires S. A.; Argentina Fil: Allegri, Ricardo Francisco. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Stefani, Dorina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Cardiológicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Cardiológicas; Argentina

El deterioro de las funciones cognitivas puede afectar a las habilidades de conducción vehicular representando un riesgo de salud pública al incrementar los accidentes de tránsito. El deterioro cognitivo leve y las demencias se caracterizan por presentar alteraciones cognitivas que afectan, en mayor o menor grado, a las actividades instrumentales de la vida diaria e influyen en la conducción segura. El Grupo de Trabajo de Neurología de la Conducta y Neurociencias Cognitivas de la Sociedad Neurológica Argentina ha elaborado esta Guía de práctica clínica para facilitar a los profesionales médicos la evaluación de pacientes en quienes se sospecha deterioro cognitivo o demencia y para detectar y prevenir eventuales conductas de riesgo. Cognitive impairment may compromise driving skills and represent a public health risk by increasing traffic accidents. Mild Cognitive Impairment and Dementia are characterized by cognitive impairment affecting to a greater or lesser degree the instrumental activities of daily living and fitness to drive. The Argentine Neurologic Society Working Group on Behavioural Neurology and Cognitive Neurosciences has prepared this clinical practice guideline to help physicians evaluate patients suspected to present cognitive impairment or dementia and detect and prevent risky behaviors. Fil: Allegri, Ricardo Francisco. Sociedad Neurológica Argentina. Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Arizaga, Raúl Luciano. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Bavec, Claudia Veronica. Sociedad Neurológica Argentina; Argentina Fil: Barreto, María Dolores. Sociedad Neurológica Argentina; Argentina Fil: Brusco, Luis Ignacio. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Colli, Liliana Patricia. Sociedad Neurológica Argentina; Argentina Fil: Demey, Ignacio. Sociedad Neurológica Argentina; Argentina Fil: Fernandez, Maria Cecilia. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Frontera, Silvana A.. Sociedad Neurológica Argentina; Argentina Fil: Garau, Maria Laura. Sociedad Neurológica Argentina; Argentina Fil: Gimenez, Julio Jorge. Sociedad Neurológica Argentina; Argentina Fil: Golimstok, Angel. Sociedad Neurológica Argentina; Argentina Fil: Kremer, Janus. Sociedad Neurológica Argentina; Argentina Fil: Labos, Luisa Edit. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Leis, Adriana Mónica. Sociedad Neurológica Argentina; Argentina Fil: Lopez Llano, María Luz. Sociedad Neurológica Argentina; Argentina Fil: Mangone, Carlos Alberto. Sociedad Neurológica Argentina; Argentina Fil: Ollari, Juan Alberto. Sociedad Neurológica Argentina; Argentina Fil: Rojas, Zenón Galeno. Sociedad Neurológica Argentina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Russo, María Julieta. Sociedad Neurológica Argentina; Argentina Fil: Serrano, Mariela Cecilia. Sociedad Neurológica Argentina; Argentina Fil: Somale, Maria Veronica. Sociedad Neurológica Argentina; Argentina Fil: D. Souza, Leandro. Sociedad Neurológica Argentina; Argentina Fil: Ure, Jorge Alberto. Sociedad Neurológica Argentina; Argentina Fil: Zuin, Daniel Raul. Sociedad Neurológica Argentina; Argentina

Los costos originados por trastornos cognitivos y demencias son significativos para los sistemas de salud. Según guías nacionales e internacionales, los fármacos recomendados para su tratamiento son inhibidores de colinesterasa (donepecilo, galantamina y rivastigmina) y memantina. En la Argentina también son utilizados otros nootrópicos, galantamina, rivastigmina, vasodilatadores, vitaminas y antioxidantes. El objetivo del presente estudio es describir y comparar el patrón de prescripción de drogas para el tratamiento de trastornos cognitivos y demencias en las distintas regiones del país. Se realizó un estudio observacional retrospectivo a partir de las prescripciones (1 814 108 envases) realizadas en la práctica clínica habitual durante el segundo semestre del 2008 y el primer y segundo semestre del 2009. El trabajo fue realizado sobre la población total del Instituto Nacional de Servicios Sociales para Jubilados y Pensionados. Se analizaron variables demográficas, cantidad y tasa de prescripciones, presentaciones y dosis utilizadas por regiones. Considerando todo el país, memantina fue la droga más prescripta en esos períodos, con un total de 570 893 envases. Memantina, donepecilo, rivastigmina e idebenona presentaron un incremento en las tasas de prescripción 2008-2009. Analizando los cambios regionales en tasas de prescripción, la memantina aumentó en el Noroeste y Noreste argentino, la idebenona en el Noroeste y la Patagonia y el donepecilo en el Noreste. Grupos de fármacos no recomendados fueron altamente prescriptos en todas las regiones del país. Algunos fueron indicados en adultos jóvenes o de mediana edad.

Resumen Introduccion Se ha publicado que los tratamientos de Intervencion Cognitiva (IC) resultan eficaces en pacientes con deterioro secundario a dano neurologico focal (DNF), no sucediendo lo mismo en pacientes con enfermedades neurodegenerativas (EN). Objetivo Estudiar la efectividad de los tratamientos de IC comparando los resultados entre pacientes con DNF y EN. Diseno/metodos Se seleccionaron para el screening un total de 144 pacientes, que fueron divididos en 3 grupos: DNF (G1), EN (G2) y causas mixtas (G3). En G1 se incluyeron particularmente pacientes con secuelas cognitivas postraumatismo de craneo y accidente cerebrovascular. En G2 se incluyeron pacientes con demencias y deterioro cognitivo leve de etiologia degenerativa. Los grupos fueron pareados segun edad/escolaridad. Se compararon variables cognitivas, conductuales, funcionales y calidad de vida al inicio y al final del tratamiento. Resultados Con posterioridad al tratamiento se encontraron diferencias significativas entre los grupos en algunos aspectos de calidad de vida y memoria subjetiva. Con respecto a la evolucion en G1 (n = 43) se produjeron mejorias en actividades basicas (-1,55; p = 0,04) e instrumentales (AIVD) (-1,63; p = 0,007) de la vida diaria, escala de memoria subjetiva (13,36; p = 0,02) e inventario neuropsiquiatrico (7,73; p = 0,03). En G2 (n = 34) se encontro una tendencia en mejorar AIVD (-1,3; p = 0,08) y aspectos de calidad de vida (-1,591; p = 0,06). En G3 (n = 12) no se evidenciaron cambios significativos. Conclusiones En nuestra muestra la IC produjo mejorias significativas en algunos aspectos cognitivos, conductuales, funcionales y de calidad de vida. El beneficio fue mayor en pacientes con DNF. Este trabajo representa los resultados preliminares de un estudio a mayor escala poblacional.

Resumen El Grupo de Trabajo de Neurologia de la Conducta y Neurociencias Cognitivas de la Sociedad Neurologica Argentina publico en 2006 la primera Guia de practica clinica sobre la enfermedad de Alzheimer para su aplicacion en nuestro medio y, eventualmente, en el resto de los paises hispanoparlantes del Cono Sur. La Guia que hoy publicamos, mediante la revision y actualizacion del estado actual del conocimiento sobre la enfermedad de Alzheimer y su manejo clinico y neurologico, provee a los profesionales los estandares surgidos de la medicina basada en la evidencia para una adecuada implementacion de las conductas diagnosticas y terapeuticas a su alcance en nuestro medio.

Resumen Introduccion La rehabilitacion cognitiva es una practica prescrita cada vez con mayor asiduidad en pacientes neurologicos con trastornos en sus funciones mentales superiores. Objetivo Describir las caracteristicas principales y efectuar un analisis comparativo de los puntajes obtenidos en diferentes escalas en pacientes que iniciaron tratamiento de estimulacion/rehabilitacion cognitiva en INEBA. Materiales y metodos Bateria de pruebas que incluyeron memoria episodica verbal, memoria subjetiva, actividades de la vida diaria, calidad de vida y rasgos depresivos. Descripcion y comparacion entre diferentes grupos etiologicos. Resultados Se analizaron los datos de 73 pacientes (38 varones y 35 mujeres; edad media: 59,89 anos [SD 19,42], educacion formal: media 13 anos [SD 3,74]). Dentro de la poblacion predominaron las causas vasculares (20 casos, 27%), los traumatismos encefalocraneanos (9 casos, 12%) y el deterioro cognitivo leve de causa no vascular (8 casos, 11%). En el analisis de los resultados de la bateria administrada se observo una diferencia significativa entre la percepcion subjetiva de memoria de los pacientes vasculares, con traumatismos y con deterioro cognitivo leve en algunas de las dimensiones estudiadas, entre ellas recuerdo de libros y peliculas, conversaciones y acciones a realizar. Conclusiones Se encontraron diferencias en la percepcion subjetiva de memoria entre los grupos considerados. Resulta importante dentro de los programas de rehabilitacion cognitiva considerar junto a la evaluacion del desempeno objetivo, aspectos metacognitivos y de creencias de memoria para asi conocer las fortalezas y debilidades del paciente de manera integral. Esto permitira el empleo de estrategias compensatorias que apunten a mejorar el desempeno funcional del paciente.

The term vascular cognitive impairment refers to a clinical and etiological heterogeneous group of entities that may appear as a result of brain lesions caused by vascular disease.To update the evidence and recommendations on the diagnosis and management of vascular cognitive impairment.vascular mild cognitive impairment and vascular dementia are entities that capture the entire spectrum of cognitive impairment following stroke or subclinical vascular brain injury. The recent update on the diagnostic criteria of these entities, with the incorporation of biomarkers and genetic tests for concomitant disorders such as Alzheimer's disease, may lead to the development of new epidemiological and therapeutics studies. Different aspects should be considered in the management of these entities: control of vascular risk factors, inclusion in rehabilitation programs, secondary prevention and symptomatic pharmacological therapy. Donepezil can be useful for cognitive enhancement in patients with vascular dementia (Class IIa; Level of Evidence A) and Galantamine can be beneficial for patients with mixed Alzheimer's disease/vascular dementia (Class IIa; Level of Evidence A).Early detection and accurate diagnosis and management of vascular cognitive impairment can benefit the quality of life of the affected patients. Prevention is still the best medical strategy in cerebrovascular disorders.

Cognitive dysfunction may occur in 17-40% of patients with multiple system atrophy (MSA). It has been suggested a milder cognitive impairment in cerebellar (MSA-C) than in parkinsonian variant (MSA-P). However, differences in cognitive profiles remain under discussion. Objective To evaluate cognitive features in a series of patients with “probable MSA” from Argentina. Method After informed consent was obtained, an extensive cognitive tests battery was administered. Nine patients (6 MSA-P and 3 MSA-C) composed the sample. Results Depression was detected in 43% of patients. Seven patients showed at least one cognitive domain impairment. Temporospatial orientation, visuospatial abilities, executive and attentional functions, episodic memory and language were compromised in MSA-P, while MSA-C dysfunction was restricted to attentional and executive domains. Conclusion Despite the small sample size, our findings could suggest a more widespread cognitive impairment in MSA-P than MSA-C. Disfunção cognitiva pode ocorrer em 17-40 % dos pacientes com atrofia de múltiplos sistemas (AMS). Alguns estudos têm sugerido a presença de disfunção cognitiva mais leve nos pacientes com AMS do tipo cerebelar (AMS-C) do que na variante parkinsoniana (AMS-P). Objetivo Avaliar os perfis cognitivos de uma série de pacientes argentinos com “Provável AMS”. Método Foram selecionados 6 AMS-P e 3 AMS–C aos quais foi aplicada uma extensa bateria de testes cognitivos. Resultados Depressão foi detectada em 43% dos pacientes. Sete pacientes apresentaram comprometimento de pelo menos um domínio cognitivo. As funções de orientação temporo-espacial, habilidades visuo-espaciais, função executiva e de atenção, memória episódica e linguagem foram comprometidas em pacientes com AMS-P. Nos pacientes com AMS-C as dificuldades cognitivas ficaram restritas às funções executivas e de atenção. Conclusão Apesar do pequeno tamanho da amostra, nossos achados sugerem que pacientes com AMS-P apresentam um comprometimento cognitivo mais amplo do que pacientes com AMS-C.

To examine the effect of cognitive rehabilitation therapy (CRT) on psychosocial outcomes in Argentinean patients with acquired brain injury (ABI), in connection with the time elapsed between injury and treatment initiation.Self-reported data from patients in a naturalistic setting was collected before and after CRT.An outpatient sample of 75 Spanish-speaking patients with cognitive disturbances secondary to ABI (49 male/26 female, age: 50.2 ± 20.1 years; education 14.3 ± 3.2 years) completed a set of scales on their daily living activities, memory self-perception, quality-of-life and mood. Single and multi-group analyses were conducted, considering pre- and post- responses and the time elapsed between injury and treatment initiation. The influence of socio-demographic moderators was controlled during comparisons.Results suggest an improvement in several psychosocial indicators after treatment. Additionally, correlations and group comparisons showed greater improvement in subjective memory and quality-of-life self-reports in patients who began treatment earlier than those who began treatment after a longer time period.Overall, results suggest that CRT is associated with positive results in different areas of the psychosocial domain and that post-injury time can mediate this effect.

between adiposity and brain structure has not yet been fully elucidated. We aimed to evaluate the association of body fat composition with cortical thickness in cognitively normal subjects. Methods: In total, 1,777 (887 men and 890 women) cognitively normal subjects, aged 45 years or older, were enrolled from Health Promotion Center in Korea. Normal cognition was determined by the results of an interview conducted by a qualified neurologist and scores on the Mini-Mental Status Exam that were above the 16th percentile for age-, gender-, and education-matched norms. Medical records including 3D magnetic resonance imaging, body fat percentage, waist-hip ratio (WHR), and other factors were reviewed. The WHR was categorized into six groups based on gender-specific percentile, and surface-based morphometric analysis was used to estimate cortical thickness. Multiple linear regressions and generalized additive models were used to investigate the linear and non-linear relationship of fat percentage and WHR with cortical thickness. Results: In men, the percentage of fat was positively associated with cortical thickness and the highest WHR group showed significant cortical thinning; in imaging analysis, cortical thinning was observed in the bilateral paracentral lobule, posterior cingulate gyrus, and left medial frontal areas. The WHR showed an inverted U-shaped association with total cortical thickness and frontal lobe thickness in men. Among women, there was no significant association of body fat percentage andWHRwith cortical thickness.Conclusions:Our finding suggests that in men, body fat percentagemight have a beneficial effect, while abdominal fat might have a harmful effect on cortical thickness.

Cognitive impairment and dementia treatment costs are significant for health systems. According to national and international guidelines, recommended drugs for treatment of dementias are cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine. Despite these guidelines recommendations, other nootropics, vasodilators and antioxidants are often used in Argentina. The purpose of this study was to describe and compare the prescription pattern of commonly used drugs for the treatment of cognitive disorders and dementia in different regions of Argentina. An observational, retrospective study of 1814108 recipes prescribed to National Institute of Social Services for Retired and Pensioners outpatients during the during the second half of 2008 and the first and second half of 2009 was performed, taking in count the whole country and also different Argentina's regions. Demographic variables, quantity and rate of prescriptions, dosage forms and strengths were analyzed. Considering the entire country, memantine was the most prescribed drug in these periods (570893 packages). An increase in the memantine, donepezil, rivastigmine and idebenone rates of prescription was observed. Prescription rate of memantine increased in the North-West and North-East regions, that of idebenone in the North-East region and Patagonia and donepezil in the North-East region. Non recommended drugs were highly prescribed in all the analyzed regions. Some of them were indicated to young and middle-aged patients.

The symptomatic predementia phase of Alzheimer's disease (AD), known as mild cognitive impairment (MCI) is a clinical and neuropsychological condition which defines the transitional state between normal aging and dementia, and is used as a clinical description of people at risk of developing AD. A review of the diagnostic criteria of MCI due to Alzheimer's disease was recently published by the Alzheimer's Association and the National Institute on Aging of the U.S. in order to ensure early diagnosis of the disease, useful for both clinical practice and clinical trials. The objectives of this paper are to review and analyze the revised diagnostic criteria for MCI due to Alzheimer's disease recently proposed, to compare with criteria for MCI available and to establish current strengths and limitations of the new proposal in clinical practice. The new diagnostic criteria for MCI due to AD have a radical importance since they are potentially applicable in the clinical or research protocols and in all clinical settings where such markers are available. They provide a useful, consistent and valuable tool to homogenize the subgroup of patients with MCI who already has AD in a predementia phase with inexorable progression to dementia by AD over the years.

Cognitive intervention involves training, stimulation and rehabilitation of higher brain functions, and stands as a non pharmacological treatment option for patients with cognitive symptoms and dementia. Mild Cognitive Impairment is a syndrome that appears to capture a group of individuals in a transitional state between normal aging and dementia. Patients with Mild Cognitive Impairment have a higher risk of progression to dementia. There are different subtypes of Mild Cognitive Impairment taking in consideration the cognitive domains that are affected, being the amnestic subtype the most common. This review examines the publications that explored the utility and efficacy of cognitive intervention in patients with Mild Cognitive Impairment. Although there is great variability in the studies design, in the type of intervention, in the treatment length and in the outcome measures selected, the majority of the papers reviewed reported a beneficial effect of the intervention, and none of them found an unfavorable result. Further adequately designed studies of cognitive treatment interventions in the different Mild Cognitive Impairment subtypes are needed to evaluate their potential benefits in ameliorating the patients' symptoms and in reducing the rate of progression to dementia.

The mild cognitive impairment (MCI), has emerged as an identifiable condition and in many cases is an intermediate state preceding diagnosable Alzheimer disease (AD) characterized by acquired cognitive deficits, without significant decline in functional activities of daily living. The aim of this study was to determine both the presence and type of neuropsychiatric manifestations in MCI patients and to compare them with both those suffering from mild AD and normal controls.86 subjects were assessed, 27 were classified as having MCI, 39 as having presumable mild AD, and 20 normal controls matched by age and education. The Neuropsychiatric inventory (NPI-Q) was used to assess the neuropsychiatric manifestations.The most common symptoms in the MCI group were irritability (55%), dysphoria (44%), apathy (37%), and anxiety (37%). Statistically significant differences were observed between the MCI and control groups regarding the above mentioned symptoms (p0.05). However, the differences between the MCI and mild AD groups were not found to be statistically significant.MCI is associated with a high rate of neuropsychiatric symptoms (irritability, depression, anxiety and apathy). These symptoms have serious adverse consequences and should be considered in diagnosis criteria.

Objective: To evaluate social cognition (SC) and theory of mind (TOM) in Huntington9s disease (HD). Background SC embraces several sub-domains related with the ability to predict what others will think, feel or do in novel situations. TOM is the core component of social functioning and relies on the ability to represent the mental states of others and to predict their possible behaviors. HD is characterized by involuntary movements and psychiatric, behavioral and cognitive dysfunctions. HD patients are often socially aloof, show lack of empathy, cognitive rigidity and mood disturbances. Design/Methods: After giving informed consent, 5 patients were diagnosed with HD by clinical findings and genetic testing and composed the sample of this study. The mean age was 47±22.2 years, the average duration of the illness was 7.4±10.5 years, and the mean CAG repeats in the expanded allele was 47, 8±10, 4. The mean level of education was 14, 4±2.6 years. An SC / TOM battery that included Wisconsin Card Sorting Test (WCST), Reading the Eyes in the Mind Test (REMT), Iowa Gambling Task (IGT), Faux Pas test (FPT) and reversion test was administered. All data were compared with control individuals.Statistical analysis was carried out using one-way ANOVA and correlation coefficients. Results: HD patients performed poorly as compared with control subjects in IGT and FPT, respectively (p Conclusions: The SC and TOM impairment in our HD patients agree with previously reported series and contribute to support a fronto-striatal involvement.Interestingly, in these patients an inverse correlation was observed among SC, TOM and nCAG repeats and disease duration, which may predict a more severe evolution of the disease. Disclosure: Dr. Etcheverry has nothing to disclose. Dr. Demey has nothing to disclose. Dr. Ruotolo has nothing to disclose. Dr. Leis has nothing to disclose. Dr. Orellano has nothing to disclose. Dr. Vanotti has nothing to disclose. Dr. Vilas has nothing to disclose. Dr. Villar has nothing to disclose. Dr. Rojas has nothing to disclose. Dr. Parisi has nothing to disclose. Dr. Persi has nothing to disclose. Dr. Allegri has nothing to disclose. Dr. Gatto has nothing to disclose.

Introduccion. La encefalitis herpetica (EH) es la causa mas comun de encefalitis infecciosa en todas las edades. La presentacion habitual incluye fiebre, cefalea y confusion asociadas a convulsiones y signos de deficit neurologico focal. En los estudios por resonancia magnetica (RM) los hallazgos tipicos consisten en lesiones hiperintensas en secuencias T2 y FLAIR, especialmente del lobulo temporal medial e inferior. Objetivo. Presentar un caso de EH que se asocio con hematoma cerebral (HC) en su curso evolutivo. Caso clinico. Paciente de sexo femenino y 69 anos que ingresa por sindrome febril, confusion e infeccion urinaria. Los estudios del liquido cefalorraquideo mostraron solo una escasa pleocitosis. Se solicito una prueba de reaccion en cadena de la polimerasa (PCR) para el virus del herpes simple (VHS). Una primera RM mostro una imagen compatible con cerebritis parietooccipital izquierda. En una RM ulterior se observo un hematoma cerebral parietooccipital izquierdo, asi como nuevos focos hemorragicos bifrontales y temporal derecho. Se procede al drenaje quirurgico del hematoma y se inicia un tratamiento empirico con aciclovir; mas tarde se recibe PCR positiva para el VHS. La paciente responde favorablemente al tratamiento y se le da de alta hospitalaria. Discusion. Se han descrito diversas presentaciones atipicas en la EH. Nuestro caso presento escasa pleocitosis, topografia lesional poco frecuente y evolucion con HC. Esta ultima eventualidad se ha referido en pocos casos en la literatura. Conclusion. La presencia de caracteristicas infrecuentes, como un HC, en el marco de un cuadro clinico de encefalopatia no debe excluir la posibilidad de una EH.