L Abad-Mas’s scientific contributions

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with impairments in executive function, language, emotional function, and social function. Its anatomofunctional substrate is related to a disorganization of the brain's functional connections. The aim is to investigate the cerebral connections in subjects with ASD through the analysis of the interhemispheric coherence (IHC) of the quantified electroencephalogram and its changes after dolphin assisted therapy (DAT) versus therapeutical intervention without dolphins (TIWD). Patients and methods: The IHC was determined in 44 subjects with ASD before randomly assigning them to two therapeutic groups: DAT (n = 22) and TIWD (n = 22). The results were statistically analyzed through the multi-measure ANOVA test for within-subject (time) and between-subject (DAT vs TIWD) factors. Results: The IHC showed a significant reduction (p < 0.05) for both groups in the delta, theta, beta, and alpha frequencies (p < 0.001) in the anterior frontal region (F3-F4), alpha in the central region (C3-C4) (p < 0.05), and alpha (p < 0.05) and beta (p < 0.001) in the temporal region (T3-T4). In the intersection with the specific treatment (DAT), the coherence in the alpha band increased in Fp1-Fp2 (p < 0.05), and the delta did not decline in F3-F4 (p < 0.05). Conclusion: In 5-year-old children with ASD, DAT increases the IHC in the anterior frontal region and stabilizes the tendency to reduce the delta band in the posterior frontal region.

Introduction: The attention deficit-hyperactivity disorder (ADHD) has a prevalence among 3-7% in scholar population and it is associated with learning disabilities and executive dysfunctions. Aim: To study the relationship between the ADHD diagnostic through DSM-5 criteria and the neuropshychology evaluation of executive functions. Subjects and methods: The sample of this study consisted in 50 subjects, 12 females and 38 males, with an age between 8 and 10 years old. To evaluate the inhibitory control, we used the Stroop Test and the Continuous Performance Test (CPT), to evaluate intelligence and working memory we use the Wechsler Intelligence Scale WISC-IV, to evaluate attention we used the CPT and Selective Attention Test. Results: There weren't significant differences between both subtypes of ADHD regarding working memory, on the other hand the female group had better abilities in cognitive flexibility task than males and subjects diagnosed with combined ADHD had more difficulties in inhibitory control. Conclusions: We can confirm that the definition of ADHD in DSM-5 isn't enough as them are imprecise. Therefore, the disease definition it's performed by a specific evaluation of attention and inhibitory control mechanisms and its necessary a neuropshychological evaluation of these brain functions.

Today, the fact that sensory integration difficulties with a neurological basis exist and that they seriously condition the development of those individuals who suffer from them is widely accepted and acknowledged as being obvious by the vast majority of professionals working in the field of community healthcare. However, less is known and there is more controversy about effective treatments that can be applied to them. This is because many professionals criticise the fact that there is not enough scientific evidence to prove, both quantitatively and empirically, the outcomes of the interventions implemented as alternatives to pharmacological therapy. Consequently, when the symptoms and repercussions on the quality of life deriving from a distorted sensory integration are really disabling for the person, pharmacological treatment is used as the only possible approach, with the side effects that this entails. The reason for this is largely the fact that little is known about other effective therapeutic approaches, such as occupational therapy based on sensory integration.

Introduction: Attention deficit hyperactivity disorder (ADHD) is a disorder of a biological origin affecting the neurodevelopment of the brain. It is estimated that 3-7% of school-age children present ADHD. The most commonly used pharmacological treatments are amphetamines and methylphenidate (MPH). Although response rates to MPH are high, full remission rates reach only 56%. The 25% of patients who do not respond to MPH would show a response to other stimulants and vice-versa. AIMS. To clinically evaluate patients by detecting inadequate responses and the efficacy of a change to lisdexamfetamine dimesylate (LDX). Patients and methods: The study was prospective and observation-based. Inadequate responses were considered to be those that presented non-coverage or no effect. The Attention-Deficit/Hyperactivity Disorder Rating Scale IV (ADHD-RS-IV) and Clinical Global Impression-Severity (CGI-S) assessment scales were used for the clinical assessment, together with the Weiss Functional Impairment Rating Scale (WFIRS) and the Child Health and Illness Profile (CHIP-AE). Data regarding adverse side effects were also collected. Results: Forty-one patients met criteria for inadequate response to treatment: 13.6 ± 3.4 years, 54.6 ± 13.2 kg, 158.5 ± 17.2 cm and body mass index of 20.9 ± 3.5 kg/m2. Reasons for change (non-exclusive): non-coverage (76%), lack of intensity of effect (68%) and presence of adverse side effects with the previous medication (16%). The mean score both at baseline and at nine months, on the ADHD-RS, was 24.54 ± 6.3 versus 12.01 ± 3.2 (p < 0.01), respectively, and for the CGI-S values were 5.09 ± 0.5 versus 2.91 ± 0.8 (p < 0.01), respectively. The safety profile coincided with that of other stimulant-based treatments for ADHD. Conclusions: When the response to MPH presents non-coverage or lack of effect, changing to LDX has proved to be effective, with an improvement in 86.7% of cases, which is similar to that of other studies. It is therefore a good therapeutic option in these patients.

Introduction: Children with attention deficit hyperactivity disorder (ADHD) present alterations in both their attentional mechanisms and their inhibitory control processes (impulsiveness and hyperactivity), which have different effects on their academic, socio-emotional and behavioural achievement. Therefore it is essential to have access to intervention strategies in the field of psychopedagogics that can have a favourable effect on the developmental course of the patients. Aim: To review the psychopedagogical foundations underlying interventions in cases of ADHD, bearing in mind the relation between the functional anatomy and the clinical symptoms and the corresponding programmes of intervention. Development: Three syndromes stand out above the rest: orbitofrontal, dorsolateral and in the cingulate at the medial level. The phases of psychopedagogical intervention should cover both the child and his or her family and school. Neurocognitive training is focused on the child, and is based on programmes for training the executive functions and on interventions involving the academic, behavioural and socio-affective spheres. Behavioural modification programmes are complementary and on many occasions improve the compromised behaviour in children with ADHD. Psychopedagogical guidance at school must be considered necessary for an effective intervention in the academic environment. Conclusions: Psychopedagogical interventions in children with ADHD must include personalised treatment within a multidisciplinary methodology that takes into account all the contexts in which the child is developing, his or her cognitive performance and the appropriate pharmacological intervention in each case.

A number of different treatments have been proposed to treat attention deficit hyperactivity disorder (ADHD), yet little material has been published in the literature to improve the performance of the mechanisms behind attention, inhibitory control, cognitive flexibility and working memory in these children. We think that a working model that is effective in the treatment of persons with ADHD can only be consolidated by means of a thorough understanding of the syndromes involved in this deficit. In addition to reviewing the latest and most significant proposals aimed at improving the cognitive under-standing of the disorder, this work also refers to three neurobiological syndromes that are recognised as forming part of ADHD, i.e. medial cingulate syndrome, dorsolateral syndrome and orbitofrontal syndrome. Advances in neuroscientific research and the design of computerised treatment materials offer extremely valuable data that will undoubtedly help to improve the results of psychopedagogical and neuropsychological interventions in ADHD, since they provide information about the temporal and spatial equation.

Asperger's syndrome (AS) is characterised by its effects on reciprocal social interaction, verbal and non-verbal communication, difficulty in accepting changes, inflexible thinking and reduced fields of interest, but also by the presentation of special skills. On the occasion of the centenary of the birth of Hans Asperger, we briefly review the history of this researcher and offer a short description of the clinical features of the condition, including social interaction, communication, limited concerns and interests, routines and inflexibility, which are key points when it comes to reaching a diagnosis. Later, we also focus on Savant syndrome, which is a very common subgroup within AS and which is characterised by the patient's outstanding ability is certain special skills, such as hypermnesia, hyperlexia and hypercalculia, in mental feats concerning the perpetual calendar and in several branches of the arts, such as drawing, painting, sculpture and music. We discuss several famous cases of savants and explain some of the theories about its pathophysiology. Having special skills is a distinguishing mark of AS and identifying and facilitating them would provide us with a potential tool with which to accomplish suitable job opportunities.

The aim of this study is to report on the neuropsychological aspects of teenage patients with attention deficit hyperactivity disorder (ADHD), namely disorders affecting attention, memory, the executive functions and language. We also discuss how to perform neuropsychological and functional evaluation of the systems involved in attention, by means of haemodynamic (functional magnetic resonance imaging) and neurophysiological (magnetoencephalography) techniques. The comorbidities that most frequently occur in teenage patients with ADHD are also described. The fundamental symptoms, that is to say, inattention, hyperactivity and impulsiveness, continue to be present in the teenager with ADHD, although with mild variations, and are probably dependent on each individual's own genetic load. The disorders most commonly associated with ADHD are oppositional defiant disorder (33%), conduct disorders (25%), anxiety (25%), learning disabilities (22%) and depression (22%). During adolescence, patients with ADHD usually suffer disorders that are secondary to their inability to process information efficiently due to the inadequate development of the executive functions. The lack of inhibitory control and a poor capacity to learn from their own mistakes facilitate the appearance of comorbid neuropsychiatric disorders.

To review the evaluation of neuropsychological functions by using non-invasive functional neuroimaging methods. Non-invasive functional neuroimaging methods can be sorted into two broad categories: the first includes those that make use of electromagnetic techniques, such as event-related potentials and magnetoencephalography (MEG), and the second consists of those involving haemodynamic techniques, such as positron emission tomography and functional magnetic resonance imaging. These methods have been employed in particular to evaluate the following functions: attention, perception, imagination, language, working memory, semantic retrieval, episodic memory, episodic memory retrieval, priming and procedural memory. The capacity of MEG, both for analysis and for organising the information it receives, is so large that it takes only a few milliseconds to evaluate brain activity and to create functional maps of the brain in which the brain structure is set out in blocks of cubic centimetres or even millimetres. This makes it possible to generate functional maps of brain activity that are capable of being organised and represented in terms of both time and space. It also enables us to obtain images that result from the signalling activity of sets of nerve cells (especially from the dendritic currents) and the electromagnetic signal that carries this information to the outer surface of the head, where the magnetic flow can be recorded. With the findings from these studies it has become possible to establish a topographic correlation between the functions and the basic brain processes involved in each paradigm. A growing body of clinical evidence proves the value of using them (especially MEG) with cases of epilepsy, language, dyslexia, autism and attention deficit hyperactivity disorder.

To analyse the association between neuropsychological disorders and epilepsy in infancy by searching for the origin in the pathophysiology of epilepsy as a neurological disease and based on the adaptive plasticity of the brain. The existence of electrical discharges, both in the presence and the absence of clinical seizures, is linked to problems involving attention, recent memory, limitations in the linguistic, visuospatial and executive capabilities, with slowed psychomotor functioning, and this leads to learning difficulties. The early age of onset of epilepsy, the secondary causation, the fact it is refractory to treatment and therefore requires polytherapy, and the negative experience of the disease all have an effect on the association of neuropsychological disorders. The type of epilepsy that can determine the involvement of specific functions, such as memory, is affected in partial epilepsies of the temporal lobe and in generalised epilepsies attention is affected. Epileptic seizures are not the only manifestation of epilepsy, and children display associated symptoms that make it necessary to carry out a comprehensive neuropsychological evaluation that must include hemisphere-specific examinations of the brain functions.