Síndrome disejecutivo en paciente con tumor cerebral no frontal. Estudio de caso
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Fecha
2022
Autores
Acevedo Vergara, Kaleb Yizhak
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
La neuropsicología es la ciencia que estudia la relación entre los
factores de la mente y los sistemas cerebrales (Alfredo Ardila & Bernal, 2007;
Xomskaya, 2002). El análisis sindrómico o análisis del síndrome neuropsicológico
propuesto por A. Luria, suele ser una forma muy precisa para evaluar y analizar de
manera clínica los procesos mentales del ser humano, en relación a diversos
dominios cognitivos cómo la atención, la memoria, el lenguaje, la cognición social
y el funcionamiento ejecutivo (Alfredo Ardila, 2019; Alfredo Ardila & Bernal, 2007;
Xomskaya, 2002). Sin embargo, a pesar de los grandes avances sobre la
comprensión de los procesos de memoria, atención o lenguaje (Campanella et al.,
2018; Lang et al., 2017b; Liu et al., 2019). Actualmente existen muchos vacíos
teóricos sobre concepción de las funciones ejecutivas, su evaluación, sus
síndromes o disfunciones, e incluso, sobre sus bases anatómicas. Por lo que
resolver el enigma teórico que plantean las funciones ejecutivas sigue siendo una
meta primordial en el estudio de las neurociencias (Alfredo Ardila, 2019).
Un concepto que puede ajustarse, indica que las funciones ejecutivas son un
conjunto de habilidades y procesos cognitivos que sirven para planificar, regular y
dirigir la conducta y la cognición humana, con el fin de alcanzar metas específicas
(Alfredo Ardila, 2019; Alfredo Ardila & Ostrosky, 2012; Flores-Lázaro et al., 2014;
Pineda-Alhucema et al., 2018). Ayudan al individuo a modular el comportamiento,
haciendo que la actividad humana pueda tener sentido (Puentes, 2015).
Históricamente han estado relacionado con la actividad de la corteza prefrontal
(Alfredo Ardila, 2012; Puentes, 2015). Las lesiones en estas áreas suelen producir
trastornos metacognitivos y comportamentales, conocidos como síndromes
disejecutivos (Alfredo Ardila, 2019; Pineda & Merchan, 2003; Portellano, 2005).
Sin embargo, algunas investigaciones recientes han demostrado que lesiones
focales como los tumores cerebrales en zonas no frontales pueden causar
síndromes disejecutivos (Hansel Soto Hernández et al., 2016). La teoría sugiere
que este estos síndromes están asociados a la ruptura de la comunicación
neuronal, producto de la infiltración de la lesión en los tractos de sustancia blanca
(Cochereau et al., 2020) que sustentan la conectividad cerebral (Xomskaya, 2002).
Las descripciones más frecuentes de estos síndromes, los presentan con
características de desinhibición y trastornos de conducta (Dubey et al., 2021),
aunque exista un vacío teórico sobre la presentación clínica de estas patologías
en pacientes con tumores cerebrales (Alfredo Ardila, 2019).
Neuropsychology is the science that studies the relationship between factors of the mind and brain systems (Alfredo Ardila & Bernal, 2007; Xomskaya, 2002). The syndromic analysis or analysis of the neuropsychological syndrome proposed by A. Luria, is usually a very precise way to clinically evaluate and analyze the mental processes of the human being, in relation to various cognitive domains such as attention, memory, language, social cognition and executive functioning (Alfredo Ardila, 2019; Alfredo Ardila & Bernal, 2007; Xomskaya, 2002). However, despite the great advances in understanding memory, attention or language processes (Campanella et al., 2018; Lang et al., 2017b; Liu et al., 2019). Currently there are many theoretical gaps on the conception of executive functions, their evaluation, their syndromes or dysfunctions, and even on their anatomical bases. Therefore, solving the theoretical enigma posed by executive functions remains a primary goal in the study of neuroscience (Alfredo Ardila, 2019). A concept that can be adjusted indicates that executive functions are a set of cognitive skills and processes that serve to plan, regulate and direct human behavior and cognition, in order to achieve specific goals (Alfredo Ardila, 2019; Alfredo Ardila & Ostrosky, 2012; Flores-Lázaro et al., 2014; Pineda-Alhucema et al., 2018). They help the individual to modulate behavior, making human activity meaningful (Puentes, 2015). Historically they have been related to the activity of the prefrontal cortex (Alfredo Ardila, 2012; Puentes, 2015). Lesions in these areas usually produce metacognitive and behavioral disorders, known as dysexecutive syndromes (Alfredo Ardila, 2019; Pineda & Merchan, 2003; Portellano, 2005). However, some recent research has shown that focal lesions such as brain tumors in non-frontal areas can cause dysexecutive syndromes (Hansel Soto Hernández et al., 2016). The theory suggests that these syndromes are associated with the breakdown of neuronal communication, product of the infiltration of the lesion in the white matter tracts (Cochereau et al., 2020) that support brain connectivity (Xomskaya, 2002). The most frequent descriptions of these syndromes present them with characteristics of disinhibition and behavioral disorders (Dubey et al., 2021), although there is a theoretical gap on the clinical presentation of these pathologies in patients with brain tumors (Alfredo Ardila, 2019).
Neuropsychology is the science that studies the relationship between factors of the mind and brain systems (Alfredo Ardila & Bernal, 2007; Xomskaya, 2002). The syndromic analysis or analysis of the neuropsychological syndrome proposed by A. Luria, is usually a very precise way to clinically evaluate and analyze the mental processes of the human being, in relation to various cognitive domains such as attention, memory, language, social cognition and executive functioning (Alfredo Ardila, 2019; Alfredo Ardila & Bernal, 2007; Xomskaya, 2002). However, despite the great advances in understanding memory, attention or language processes (Campanella et al., 2018; Lang et al., 2017b; Liu et al., 2019). Currently there are many theoretical gaps on the conception of executive functions, their evaluation, their syndromes or dysfunctions, and even on their anatomical bases. Therefore, solving the theoretical enigma posed by executive functions remains a primary goal in the study of neuroscience (Alfredo Ardila, 2019). A concept that can be adjusted indicates that executive functions are a set of cognitive skills and processes that serve to plan, regulate and direct human behavior and cognition, in order to achieve specific goals (Alfredo Ardila, 2019; Alfredo Ardila & Ostrosky, 2012; Flores-Lázaro et al., 2014; Pineda-Alhucema et al., 2018). They help the individual to modulate behavior, making human activity meaningful (Puentes, 2015). Historically they have been related to the activity of the prefrontal cortex (Alfredo Ardila, 2012; Puentes, 2015). Lesions in these areas usually produce metacognitive and behavioral disorders, known as dysexecutive syndromes (Alfredo Ardila, 2019; Pineda & Merchan, 2003; Portellano, 2005). However, some recent research has shown that focal lesions such as brain tumors in non-frontal areas can cause dysexecutive syndromes (Hansel Soto Hernández et al., 2016). The theory suggests that these syndromes are associated with the breakdown of neuronal communication, product of the infiltration of the lesion in the white matter tracts (Cochereau et al., 2020) that support brain connectivity (Xomskaya, 2002). The most frequent descriptions of these syndromes present them with characteristics of disinhibition and behavioral disorders (Dubey et al., 2021), although there is a theoretical gap on the clinical presentation of these pathologies in patients with brain tumors (Alfredo Ardila, 2019).
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Palabras clave
Evaluación neuropsicológica, Análisis sindrómico, Síndromes disejecutivos, Funciones ejecutivas, Tumores cerebrales, Neuropsychological evaluation, Syndromic analysis, Dysexecutive syndromes, Executive functions, Brain tumors
