No abstract

, FÁTIMA AZEVEDO IGNÁCIO 7 , ROGÉRIO PAYSANO MARROCOS 8 ABSTRACT -We tested the hypothesis that Part B of the Trail Making Test (TMT) is a measure of cognitive setshifting ability in 55 normal subjects with the conventional (written) TMT and a verbal adaptation, the "verbal TMT" (vTMT). The finding of a significant association between Parts B of TMT and vTMT (r = 0,59, p < 0,001), after correcting for age and education, supports the view that Part B of TMT is a valid measure of the ability to alternate between cognitive categories.KEY WORDS: trail making test, verbal trail making test, set-shifting cognition. . In Part A, the circles are numbered from 1 to 25, whereas in Part B numbers from 1 to 13 and letters from A to M must be connected in alternating fashion, beginning at 1-A and ending at M-13. Total score is given by time spent to complete each part. Factor analysis has shown that the TMT loads on both a rapid visual search and a visuospatial sequencing factor 3 . Whether it also superimposes on a third, "cognitive set-shifting", factor has been debated [4][5][6] . If true, however, this would be an important attribute of the test, as the ability to switch between categories is one of the most reliable indexes of normal neurobehavioral functioning 7 .In this study we administered a verbal adaptation of TMT-the "verbal Trail Making Test" (vTMT)-to normal individuals to see whether Part B of Trail Making Test (TMTB) also gauges the ability to shift between cognitive sets. Since in vTMT the visuospatial and visuomotor factors intrinsic to the conventional (written) TMT are reduced to a minimum, a lack of correlation between Parts B

No abstract

No abstract

Dementia with Lewy bodies (DLB) is commonly associated with excessive daytime somnolence (EDS). Modafinil is a wakefulness-promoting agent that is considered to have limited interaction with the dopaminergic system. As individuals with DLB are predisposed to psychotic symptoms which might be exacerbated by dopaminergic stimulation, modafinil is considered to be an attractive option for the treatment of EDS in DLB. We describe two cases in which administration of modafinil exacerbated agitation and hallucinations in DLB, and we also review data that may explain the mechanisms underlying this effect. In both cases, psychotic symptoms emerged concomitantly with modafinil administration, and remitted following its discontinuation. Although definitive data regarding the benefits and adverse effects of modafinil for the treatment of EDS in DLB await controlled prospective randomized studies, our observations warrant caution regarding its use in this context.