Fernanda Loureiro

While exteroceptive sensory processing is a hallmark of autism spectrum disorder, how interoceptive processing may impact and contribute to symptomatology remains unclear. In this comprehensive narrative review on interoception in autism, we discuss: 1) difficulties with assessing interoception; 2) potential interoceptive differences; 3) interactions between neural systems for interoception, attention, sensorimotor processing, and cognition; and 4) potential differences in neural circuits involved in interoception. In general, there are mixed findings on potential interoception differences in autism. Nevertheless, some data indicate differences in integration of interoceptive and exteroceptive information may contribute to autism symptomatology. Neurologically, interoceptive processing in autism may be impacted by potential differences in the development, morphometry, and connectivity of key interoceptive hubs (vagal processing, brainstem, thalamus, insula), though much work is needed on this topic.

Summary of the 20th Winter Journey of the Brazilian Society of Geriatrics and Gerontology of Rio Grande do Sul (SBGG-RS)

O objetivo foi investigar a prevalência do uso de medicamentos cardiovasculares e sua associação com variáveis sociodemográficas e clínicas em idosos atendidos na Estratégia Saúde da Família por meio de um estudo transversal realizado no município de Porto Alegre. A coleta de dados foi feita com um questionário que observou aspectos sociodemográficos, econômicos, relacionados a doenças autorreferidas e uso de medicamentos. Foram avaliados 761 idosos, que tiveram 67,7% de prevalência de uso de medicamentos cardiovasculares. As características que mostraram uma associação significativa, de forma independente, com o uso de alguma medicação cardiovascular foram: sexo feminino, cor negra, consulta nos últimos seis meses, hipertensão, diabetes e doença cerebrovascular. Os medicamentos cardiovasculares e as classes mais utilizadas, respectivamente, foram: hidroclorotiazida (34,8%) e captopril (33,5%); agentes que atuam sobre o sistema renina-angiotensina (46,8%) e diuréticos (42%). Esses dados são importantes, pois a população idosa é afetada sobretudo por doenças cardiovasculares, e dados populacionais podem auxiliar na formulação de estratégias e políticas públicas voltadas, principalmente, para a população idosa atendida pelo Sistema Único de Saúde.

Introduction: Research with left-brain damaged (LBD) participants suggests they present difficulties in comprehending words and sentences (Ortiz, 2010). Little is known about the influence of a lesion at the textual/discursive level, including comparisons between oral and written presentation modalities. It seems that LBD participants lack comprehension mainly at macrolinguistic structures (Karaduman, Göksun & Chatterjee, 2017). In addition, brain areas from frontal, temporal and parietal lobes of both hemispheres seem to be involved in the text comprehension (Babajani-Feremi, 2017; Barbey; Colom & Grafman, 2014). However, more conclusive data are necessary correlating behavioral and brain evidence in discourse processing in left brain lesion. Aim: to analyze comprehension of written and orally presented short narratives by LBD participants compared to controls in their performance at the micro- and macrolinguistic levels, and the correlated brain volumes in the areas involved in this type of processing. Method: Participants: 10 LBD participants (mean age 66,4, SD = 8,89, 1 F/ mean schooling 7,4 y/SD = 3,56), and 10 matched healthy controls (mean age 66,3, SD = 8,73, 9 F/ mean schooling 6,9 y/SD = 3,92). Instruments and procedures: Subjects were asked to retell in details six short narratives, presented in oral or written modalities. Following, they answered to five interpretation questions. Structural MRI sessions were used to collect brain volume data using voxel-based morphometry (VBM). Results: Controls showed significantly higher performance than LBD participants at the macrolinguistic level of oral narratives (p=0,04) as compared to written ones. This finding suggests LBD participants have difficulties in the application of macrolinguistic rules of deletion, construction and generalization to understand macrolinguistic structure of a text, with increased difficulty in dealing with the written modality. Morphometry data of brain regions indicated an integration of areas in the left and right hemispheres to perform text comprehension in oral and written modalities. In the left hemisphere, density variations were observed in precuneus, cerebellum white matter, superior frontal region and medial orbitofrontal region, while in the right hemisphere variations were seen in the accumbens and superior temporal sulcus. Density increase in the right superior temporal sulcus, left precuneus, left cerebellar white matter and superior frontal region positively correlate with higher performance. The left medial orbitofrontal region shows a negative correlation with performance. The right accumbens seems to compensate left hemisphere demands, showing increased density in the LBD participants and reduced volume in controls. Conclusions: Significant differences were observed in groups’ comparisons at the macrolinguistic level of oral texts. Although modalities differed, significant lower performance was observed only in the oral modality by the LBD group as compared to controls. Analysis of VBM demonstrated that a variation in density of different left and right hemisphere areas relates to performance in text comprehension. More specifically, the volume of left hemisphere regions such as precuneus, superior temporal sulcus, superior frontal, medial orbitofrontal areas and cerebellum white matter, and right hemisphere areas at the accumbens and superior temporal sulcus may impact LDB individual’s text comprehension.

Introduction: The rapid aging process in low and middle-income countries poses a major challenge and has special repercussions for mental health. This is especially true for diseases that impair cognition and emotion regulation such as depression and dementia. In Brazil, caring for the elderly is a public health priority. Aims: To describe the scientific methodology and practical applicability of a mental health study tailored to seniors; to provide data to improve mental health assessment and care; to describe a primary care methodology that is replicable in other regions. Methods: A cross sectional study using stratified randomized sampling. Study participants were residents of Porto Alegre, over 60 years, and enrolled in the Family Health Strategy program. Study prioritized the examination of psychiatric and cognitive characteristics by using multiprofessional indicators of mental health. Data was collected in two phases: screening and specialized diagnosis. Conclusion: The paper provides a methodological model to assist researchers in similar studies. Striking an adequate balance between assistance and research is a major challenge. Protocols that prospect and examine the leading mental health problems in the elderly could close the gap between identification of older adults with early symptoms and those at risk of developing depression and dementia. A stratified approach to screening and diagnosing cognitive and mood and disorders for all levels in public health that uses low cost instruments in a real setting will benefit communities and can provide local empowerment.