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Abstract

BACKGROUND: In cocaine-dependent individuals, executive function (EF) deficits are associated with poor treatment outcomes. Psychological interventions and pharmacological approaches have produced only modest effect sizes. To date, studies of this topic have been few and limited. The aim of this study was to examine the effects of a new model of intervention, which integrates chess and Motivational Interviewing, Motivational Chess (MC) METHODS: We evaluated 46 cocaine-dependent inpatients (aged 18-45), in two groups-MC (n=26); and active comparison-AC (n=20). Using neuropsychological tests and an impulsivity scale, we assessed the subjects before and after the study period (one month of abstinence monitored by urine toxicology screening). RESULTS: The MC and AC groups did not differ at baseline. In the post-intervention assessment (after one month), both groups showed significant improvements in attention, mental flexibility, inhibitory control, abstraction abilities, and decision-making (p<0.01). In addition, the improvement in working memory was more significant in the MC group than in the AC group (group-by-time interaction, p=01). CONCLUSIONS: One month of abstinence was sufficient to improve various attentional and executive domains in cocaine-dependent subjects. The MC intervention was associated with greater improvements in EFs, especially working memory, suggesting that tailored interventions focusing on complex EFs accelerate the process of cognitive recovery during the initial period of abstinence.

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Crack cocaine-dependent individuals (CCDI) present abnormalities in both social adjustment and decision making, but few studies have examined this association. This study investigated cognitive and social performance of 30 subjects (CCDI × controls); CCDI were abstinent for 2 weeks. We used the Social Adjustment Scale (SAS), Wisconsin Card Sorting Test (WCST), and Iowa Gambling Task (IGT). Disadvantageous choices on the IGT were associated with higher levels of social dysfunction in CCDI, suggesting the ecological validity of the IGT. Social dysfunction and decision making may be linked to the same underlying prefrontal dysfunction, but the nature of this association should be further investigated. 
Article
Excessive discounting of future rewards has been observed in a variety of disorders and has been linked both to valuation of the past and to memory of past events. To explore the functionality of discounting and memory, we examined whether training of working memory would result in less discounting of future rewards. In this study, 27 adults in treatment for stimulant use were randomly assigned to receive either working memory training or control training according to a yoked experimental design. Measures of delay discounting and several other cognitive behaviors were assessed pre- and posttraining. Rates of discounting of delayed rewards were significantly reduced among those who received memory training but were unchanged among those who received control training; other cognitive assessments were not affected by memory training. Discount rates were positively correlated with memory training performance measures. To our knowledge, this is the first study demonstrating that neurocognitive training on working memory decreases delay discounting. These results offer further evidence of a functional relationship between delay discounting and working memory.
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Following damage to the ventromedial prefrontal cortex, humans develop a defect in real-life decision-making, which contrasts with otherwise normal intellectual functions. Currently, there is no neuropsychological probe to detect in the laboratory, and the cognitive and neural mechanisms responsible for this defect have resisted explanation. Here, using a novel task which simulates real-life decision-making in the way it factors uncertainty of premises and outcomes, as well as reward and punishment, we find that prefrontal patients, unlike controls, are oblivious to the future consequences of their actions, and seem to be guided by immediate prospects only. This finding offers, for the first time, the possibility of detecting these patients' elusive impairment in the laboratory, measuring it, and investigating its possible causes.
Article
Little data exist on the neuropsychological effects of crack-cocaine dependence or crack-cocaine and alcohol dependence. This study examined cognitive function in abstinent crack dependent and crack and alcohol dependent individuals at 6 weeks and 6 months abstinence. a comprehensive neuropsychological battery, including the MicroCog computerized assessment, was administered to 20 abstinent crack dependent subjects, 37 abstinent crack and alcohol dependent subjects, and 29 normal controls. Depression was examined as a covariate, and the association between substance use variables and neuropsychological performance was examined. the two substance dependent groups had similar neuropsychological profiles at 6 weeks abstinent, with both groups exhibiting significant cognitive impairment in a wide range of functions compared to controls. The substance dependent groups were still impaired significantly at 6 months of abstinence. Only mild effects of depression on neuropsychological performance were observed. crack dependence and crack and alcohol dependence may lead to severe and persistent neuropsychological deficits over a wide range of domains. The strongest predictor of brain damage associated with substance dependence in this sample was dose (particularly quantity and duration of peak dose).
Article
Chess is a game that involves many aspects of high level cognition and requires sophisticated problem solving skills. However, there is little understanding of the neural basis of chess cognition. This study employed functional magnetic resonance imaging (fMRI) to identify cortical areas that are active during the analysis of chess positions compared with a spatial task with matched visual stimuli. Bilateral activation was revealed in the superior frontal lobes, the parietal lobes, and occipital lobes. Some small areas of activation were observed unilaterally in the left hemisphere. The left hemisphere showed more activation than the right. Results are discussed in relation to a similar brain imaging study on the game Go.
Article
The concept of working memory proposes that a dedicated system maintains and stores information in the short term, and that this system underlies human thought processes. Current views of working memory involve a central executive and two storage systems: the phonological loop and the visuospatial sketchpad. Although this basic model was first proposed 30 years ago, it has continued to develop and to stimulate research and debate. The model and the most recent results are reviewed in this article.
Article
Playing chess requires problem-solving capacities in order to search through the chess problem space in an effective manner. Chess should thus require planning abilities for calculating many moves ahead. Therefore, we asked whether chess players are better problem solvers than non-chess players in a complex planning task. We compared planning performance between chess ( N=25) and non-chess players ( N=25) using a standard psychometric planning task, the Tower of London (ToL) test. We also assessed fluid intelligence (Raven Test), as well as verbal and visuospatial working memory. As expected, chess players showed better planning performance than non-chess players, an effect most strongly expressed in difficult problems. On the other hand, they showed longer planning and movement execution times, especially for incorrectly solved trials. No differences in fluid intelligence and verbal/visuospatial working memory were found between both groups. These findings indicate that better performance in chess players is associated with disproportionally longer solution times, although it remains to be investigated whether motivational or strategic differences account for this result.
Article
Cocaine abstinence is associated with impaired performance in cognitive functions including attention, vigilance and executive function. Here we test the hypothesis that cognitive dysfunction during cocaine abstinence reflects in part impairment of cortical and subcortical regions modulated by dopamine. We used functional magnetic resonance imaging (fMRI) to study brain activation to a verbal working memory task in cocaine abusers (n=16) and healthy controls (n=16). Compared to controls, cocaine abusers showed: (1) hypoactivation in the mesencephalon, where dopamine neurons are located, as well as the thalamus, a brain region involved in arousal; (2) larger deactivation in dopamine projection regions (putamen, anterior cingulate, parahippocampal gyrus, and amygdala); and (3) hyperactivation in cortical regions involved with attention (prefrontal and parietal cortices), which probably reflects increased attention and control processes as compensatory mechanisms. Furthermore, the working memory load activation was lower in the prefrontal and parietal cortices in cocaine abusers when compared with controls, which might reflect limited network capacity. These abnormalities were accentuated in the cocaine abusers with positive urines for cocaine at time of study (as compared to cocaine abusers with negative urines) suggesting that the deficits may reflect in part early cocaine abstinence. These findings provide evidence of impaired function of regions involved with executive control, attention and vigilance in cocaine abusers. This widespread neurofunctional disruption is likely to underlie the cognitive deficits during early cocaine abstinence and to reflect involvement of dopamine as well as other neurotransmitters.
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Teste de classificaç ão de cartas: adaptaç ão e padronizaç ão brasileira
  • R K Heaton
  • G J Clelune
  • J L Talley
  • G G Kay
  • G Curtiss
Heaton, R.K., Clelune, G.J., Talley, J.L., Kay, G.G., Curtiss, G. Teste de classificaç ão de cartas: adaptaç ão e padronizaç ão brasileira. Primeira Ediç ão. Cunha, J.A.,