Laia Farràs-Permanyer

Antecedentes: La Musicoterapia Neurológica (MTN) se ha desarrollado durante las últimas décadas como una disciplina estructurada, basada en la evidencia y con bases teóricas surgidas de estudios neurocientíficos. Se aplica a Personas con Demencia Grave (PcDG) para estimular funciones cognitivas y mejorar el estado emocional y conductual. Objetivos: estudiar los efectos cognitivos, emocionales y conductuales de la MTN en PcDG e introducir el uso de la escala de musicoterapia validada al español: Music in Dementia Assessment Scale (MiDAS-ESP). Método: Estudio cuasi experimental de medidas repetidas pre-post con un grupo experimental de 30 personas. Se registraron variables sociodemográficas, clínicas, cognitivas, de comportamiento, emocionales y de calidad de vida. La intervención consistió en 10 sesiones de MTN, realizada por un musicoterapeuta acreditado. Resultados: Se objetivaron diferencias estadísticamente significativas entre las puntuaciones registradas antes y después de la intervención, indicando mejoría emocional, comportamental y de calidad de vida. No se encontraron diferencias estadísticamente significativas en cognición global, a pesar de observar mejoría. Se objetivaron diferencias significativas en la escala MiDAS-ESP, mostrando incremento de satisfacción durante la terapia. Conclusiones: La MTN contribuye positivamente a mejorar el estado de ánimo, el comportamiento, la calidad de vida y la satisfacción en PcDG.

Mild cognitive impairment is defined as greater cognitive decline than expected for a person at a particular age and is sometimes considered a stage between healthy aging and Alzheimer’s disease or other dementia syndromes. It is known that functional connectivity patterns change in people with this diagnosis. We studied functional connectivity patterns and functional segregation in a resting-state fMRI paradigm comparing 10 MCI patients and 10 healthy controls matched by education level, age and sex. Ninety ROIs from the automated anatomical labeling (AAL) atlas were selected for functional connectivity analysis. A correlation matrix was created for each group, and a third matrix with the correlation coefficient differences between the two matrices was created. Functional segregation was analyzed with the 3-cycle method, which is novel in studies of this topic. Finally, cluster analyses were also performed. Our results showed that the two correlation matrices were visually similar but had many differences related to different cognitive functions. Differences were especially apparent in the anterior default mode network (DMN), while the visual resting-state network (RSN) showed no differences between groups. Differences in connectivity patterns in the anterior DMN should be studied more extensively to fully understand its role in the differentiation of healthy aging and an MCI diagnosis.

Age-related changes in the brain connectivity of healthy older adults have been widely studied in recent years, with some differences in the obtained results. Most of these studies showed decreases in general functional connectivity, but they also found increases in some particular regions and areas. Frequently, these studies compared young individuals with older subjects, but few studies compared different age groups only in older populations. The purpose of this study is to analyze whole-brain functional connectivity in healthy older adult groups and its network characteristics through functional segregation. A total of 114 individuals, 48 to 89 years old, were scanned using resting-state functional magnetic resonance imaging in a resting state paradigm and were divided into six different age groups (< 60, 60–64, 65–69, 70–74, 75–79, ≥ 80 years old). A partial correlation analysis, a pooled correlation analysis and a study of 3-cycle regions with prominent connectivity were conducted. Our results showed progressive diminution in the functional connectivity among different age groups and this was particularly pronounced between 75 and 79 years old. The oldest group (≥ 80 years old) showed a slight increase in functional connectivity compared to the other groups. This occurred possibly because of compensatory mechanism in brain functioning. This study provides information on the brain functional characteristics of every age group, with more specific information on the functional progressive decline, and supplies methodological tools to study functional connectivity characteristics. Approval for the study was obtained from the ethics committee of the Comisión de Bioética de la Universidad de Barcelona (approval No. PSI2012-38257) on June 5, 2012, and from the ethics committee of the Barcelona’s Hospital Clínic (approval No. 2009-5306 and 2011-6604) on October 22, 2009 and April 7, 2011 respectively.

WHOQOL-BREF measures the individual's perception on their personal situation in contrast to their expectations, goals, standards and concerns. Previous results did not support the original factor structure in a sample of 9 Iberoamerican countries. However, Differential Item Functioning (DIF) has yet to be thoroughly addressed in these populations. Therefore, the main purpose of this study was to analyze DIF in Iberoamerican countries. WHOQOL-BREF was administered to a sample of 1972 individuals from nine Spanish-speaking countries and ages between 17 and 34 years (mean=21.21, SD=3.40, 62.5% women). In order to assess the DIF, each item was modeled through a proportional odds logistic regression with nationality in the linear predictor. All models were statistically non-equivalent to the null models and the proportion of correct classification of the models ranging from 0.336 to 0.473, which leads us to conclude that the nationality of the participants plays a relevant role on the response in the items of WHOQOL-BREF. In spite of a common language, differences in cultural, historical, and social variables across these nine countries could be influencing the individual's perception of quality of life. In order to minimize those differences, specific adaptations of the Spanish-version of WHOQOL-BREF for each country should be considered

In the last fifteen years, many articles have studied brain connectivity in Mild Cognitive Impairment patients with fMRI techniques, seemingly using different connectivity statistical models in each investigation to identify complex connectivity structures so as to recognize typical behavior in this type of patient. This diversity in statistical approaches may cause problems in results comparison. This paper seeks to describe how researchers approached the study of brain connectivity in MCI patients using fMRI techniques from 2002 to 2014.The focus is on the statistical analysis proposed by each research group in reference to the limitations and possibilities of those techniques to identify some recommendations to improve the study of functional connectivity. The included articles came from a search of Web of Science and PsycINFO using the following keywords: fMRI, MCI and functional connectivity. Eighty-one papers were found, but 2 of them were discarded because of the lack of statistical analysis. Accordingly, 79 articles were included in this review. We summarized some parts of the articles, including the goal of every investigation, the cognitive paradigm and methods used, brain regions involved, use of ROI analysis and statistical analysis, emphasizing on the connectivity estimation model used in each investigation. The present analysis allowed us to confirm the remarkable variability of the statistical analysis methods found. Additionally, the study of brain connectivity in this type of population is not providing, at the moment, any significant information or results related to clinical aspects relevant for prediction and treatment. We propose to follow guidelines for publishing fMRI data that would be a good solution to the problem of study replication. The latter aspect could be important for future publications because a higher homogeneity would benefit the comparison between publications and the generalization of results.