SLACHEVSKY CHONCHOL, ANDREA MARÍA
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SLACHEVSKY CHONCHOL, ANDREA MARÍA
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aslachevsky@med.uchile.cl
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56394322900

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Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population

2022 , Fabrissio Grandi , David Martínez-Pernía , Mario Parra , Loreto Olavarria , David Huepe , Patricia Alegria , Álvaro Aliaga , Patricia Lillo , Carolina Delgado , Marcela Tenorio , Ricardo Rosas , Oscar López , James Becker , Andrea Slachevsky

ABSTRACT. The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives: This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods: A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results: FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions: This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.

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Assessing subjective cognitive decline in older adults attending primary health care centers: what question should be asked?

2023 , Matías Molina-Donoso , Teresa Parrao , Céline Meillon , Daniela Thumala , Patricia Lillo , Roque Villagra , Agustín Ibañez , Mauricio Cerda , Pedro Zitko , Hélène Amieva , SLACHEVSKY CHONCHOL, ANDREA MARÍA

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Does culture shape our understanding of others’ thoughts and emotions? An investigation across 12 countries.

2022 , François Quesque , Antoine Coutrot , Sharon Cox , Leonardo Cruz de Souza , Sandra Baez , Juan Felipe Cardona , Hannah Mulet-Perreault , Emma Flanagan , Alejandra Neely-Prado , Maria Florencia Clarens , Luciana Cassimiro , Gada Musa , Jennifer Kemp , Anne Botzung , Nathalie Philippi , Maura Cosseddu , Catalina Trujillo-Llano , Johan Sebastián Grisales-Cardenas , Sol Fittipaldi , Nahuel Magrath Guimet , Ismael Luis Calandri , Lucia Crivelli , Lucas Sedeno , Adolfo M. Garcia , Fermin Moreno , Begoña Indakoetxea , Alberto Benussi , Millena Vieira Brandão Moura , Hernando Santamaria-Garcia , Diana Matallana , Galina Pryanishnikova , Anna Morozova , Olga Iakovleva , Nadezda Veryugina , Oleg Levin , Lina Zhao , Junhua Liang , Thomas Duning , Thibaud Lebouvier , Florence Pasquier , David Huepe , Myriam Barandiaran , Andreas Johnen , Elena Lyashenko , Ricardo F. Allegri , Barbara Borroni , Frederic Blanc , Fen Wang , Mônica Sanches Yassuda , Patricia Lillo , Antônio Lúcio Teixeira , Paulo Caramelli , Carol Hudon , Andrea Slachevsky , Agustin Ibáñez , Michael Hornberger , Maxime Bertoux

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Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges

2022 , SANCHEZ HENRIQUEZ, FERNANDO GABRIEL , Victoria Cabello , Sandra Baez , Leonardo Cruz de Souza , Patricia Lillo , David Martínez-Pernía , Loreto Olavarría , Teresa Torralva , SLACHEVSKY CHONCHOL, ANDREA MARÍA

Frontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.

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Aging and Health Policies in Chile: New Agendas for Research

2017 , Daniela Thumala , Brian K. Kennedy , Esteban Calvo , Christian Gonzalez-Billault , Pedro Zitko , Patricia Lillo , Roque Villagra , Agustín Ibáñez , Rodrigo Assar , Maricarmen Andrade , Andrea Slachevsky

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Inside minds, beneath diseases: social cognition in amyotrophic lateral sclerosis-frontotemporal spectrum disorder

2020 , Patricia Lillo , Paulo Caramelli , Gada Musa , Teresa Parrao , Ricardo Hughes , Andres Aragon , Daniel Valenzuela , Gabriel Cea , Rafael Aranguiz , Henrique Cerqueira Guimarães , Laura Rousseff , Leandro Boson Gambogi , Luciano Inácio Mariano , Antônio Lúcio Teixeira , Andrea Slachevsky , Leonardo Cruz de Souza

ObjectiveTo compare social cognition performance between patients with amyotrophic lateral sclerosis (ALS) and those patients with behavioural variant frontotemporal dementia (bvFTD).MethodsWe included 21 participants with ALS, 20 with bvFTD and 21 healthy controls who underwent a comprehensive cognitive battery, including the short version of the Social Cognition and Emotional Assessment (Mini-SEA), which comprises the faux pas test and Facial Emotion Recognition Test (FERT); Mini-Mental State Examination; Frontal Assessment Battery; lexical fluency (F-A-S), category fluency (animals/minute), digit span (direct and backwards) tests and the Hayling test. A post hoc analysis was conducted with the patients with ALS divided into two subgroups: patients without cognitive impairment (ALScn; n=13) and patients with cognitive impairment (ALSci; n=8).ResultsNo significant difference was noted between participant groups in terms of the age, sex and education. ALS-total group and patients with bvFTD had similar disease durations. Patients with ALSci performed poorly when compared with controls with regard to the FERT (p<0.001), the faux pas (p<0.004) and the Mini-SEA (p<0.002) total scores. Moreover, patients with bvFTD performed poorly in comparison with controls in executive and social cognition tests. The performance of patients with ALSci was similar to that of patients with bvFTD, while the performance of patients with ALScn was similar to that of controls.DiscussionOur findings support a cognitive continuum between ALS and bvFTD and shed light on the cognitive heterogeneity of ALS, expanding its possible neuropsychological profiles.

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Multidimensional inhibitory signatures of sentential negation in behavioral variant frontotemporal dementia

2022 , Mariano N Díaz-Rivera , Agustina Birba , Sol Fittipaldi , Débora Mola , Yurena Morera , Manuel de Vega , Sebastian Moguilner , Patricia Lillo , SLACHEVSKY CHONCHOL, ANDREA MARÍA , Cecilia González Campo , Agustín Ibáñez , Adolfo M García

Abstract Background Processing of linguistic negation has been associated to inhibitory brain mechanisms. However, no study has tapped this link via multimodal measures in patients with core inhibitory alterations, a critical approach to reveal direct neural correlates and potential disease markers. Methods Here we examined oscillatory, neuroanatomical, and functional connectivity signatures of a recently reported Go/No-go negation task in healthy controls and behavioral variant frontotemporal dementia (bvFTD) patients, typified by primary and generalized inhibitory disruptions. To test for specificity, we also recruited persons with Alzheimer's disease (AD), a disease involving frequent but nonprimary inhibitory deficits. Results In controls, negative sentences in the No-go condition distinctly involved frontocentral delta (2–3 Hz) suppression, a canonical inhibitory marker. In bvFTD patients, this modulation was selectively abolished and significantly correlated with the volume and functional connectivity of regions supporting inhibition (e.g. precentral gyrus, caudate nucleus, and cerebellum). Such canonical delta suppression was preserved in the AD group and associated with widespread anatomo-functional patterns across non-inhibitory regions. Discussion These findings suggest that negation hinges on the integrity and interaction of spatiotemporal inhibitory mechanisms. Moreover, our results reveal potential neurocognitive markers of bvFTD, opening a new agenda at the crossing of cognitive neuroscience and behavioral neurology.

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Construction and validation of a scale of losses experienced in old age (SLO)

2021 , Daniela Thumala-Dockendorff , Rodrigo Assar , Elisabeth Wenk , Marcelo Arnold-Cathalifaud , Roque Villagra , Patricia Lillo , Andrea Slachevsky

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Mapping the neuroanatomy of functional decline in Alzheimer's disease from basic to advanced activities of daily living

2019 , Andrea Slachevsky , Gonzalo Forno , Paulo Barraza , Eneida Mioshi , Carolina Delgado , Patricia Lillo , Henriquez, Fernando , Eduardo Bravo , Mauricio Farias , Carlos Muñoz-Neira , Agustin Ibañez , Mario A. Parra , Michael Hornberger

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Apathy, Executive Function, and Emotion Recognition Are the Main Drivers of Functional Impairment in Behavioral Variant of Frontotemporal Dementia

2022 , Gada Musa Salech , Patricia Lillo , Karin van der Hiele , Carolina Méndez-Orellana , Agustín Ibáñez , Andrea Slachevsky

Background: The cognitive and neuropsychiatric deficits present in patients with behavioral variant frontotemporal dementia (bvFTD) are associated with loss of functionality in the activities of daily living (ADLs). The main purpose of this study was to examine and explore the association between the cognitive and neuropsychiatric features that might prompt functional impairment of basic, instrumental, and advanced ADL domains in patients with bvFTD.Methods: A retrospective cross-sectional study was conducted with 27 patients with bvFTD in its early stage (&lt;2 years of evolution) and 32 healthy control subjects. A neuropsychological assessment was carried out wherein measures of cognitive function and neuropsychiatric symptoms were obtained. The informant-report Technology–Activities of Daily Living Questionnaire was used to assess the percentage of functional impairment in the different ADL domains. To identify the best determinants, three separate multiple regression analyses were performed, considering each functional impairment as the dependent variable and executive function, emotion recognition, disinhibition, and apathy as independent variables.Results: For the basic ADLs, a model that explains 28.2% of the variability was found, in which the presence of apathy (β = 0.33, p = 0.02) and disinhibition (β = 0.29, p = 0.04) were significant factors. Concerning instrumental ADLs, the model produced accounted for 63.7% of the functional variability, with the presence of apathy (β = 0.71, p &lt; 0.001), deficits in executive function (β = −0.36, p = 0.002), and lack of emotion recognition (β = 0.28, p = 0.017) as the main contributors. Finally, in terms of advanced ADLs, the model found explained 52.6% of the variance, wherein only the presence of apathy acted as a significant factor (β = 0.59, p &lt; 0.001).Conclusions: The results of this study show the prominent and transverse effect of apathy in the loss of functionality throughout all the ADL domains. Apart from that, this is the first study that shows that the factors associated with loss of functionality differ according to the functional domain in patients with bvFTD in its early stage. Finally, no other study has analyzed the impact of the lack of emotion recognition in the functionality of ADLs. These results could guide the planning of tailored interventions that might enhance everyday activities and the improvement of quality of life.

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