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Abstract(s)
Introdução Tradicionalmente, a Esclerose Lateral Amiotrófica (ELA) é vista como uma Doença do Neurónio Motor (DNM) com impacto principalmente no sistema motor, como o próprio nome indica. No entanto, descobertas recentes têm vindo a desfiar esta visão, revelando que os défices cognitivos são uma característica significativa desta doença. O conceito da Reserva Cognitiva (RC), que se refere à resiliência do cérebro para lidar com danos neuropatológicos, tem vindo a ser explorado em várias condições neurológicas, neuro degenerativas e não só, e a ELA não é exceção. Porém, uma Revisão Sistemática (RS) deste conceito nesta população nunca foi realizada. Assim o presente trabalho tem como objetivo rever sistematicamente a literatura relativa ao impacto da RC no funcionamento cognitivo de indivíduos com ELA. Metodologia Realizou-se uma RS da literatura que seguiu a metodologia definida pelo PRISMA guidelines. Foi efetuada uma pesquisa de literatura em revistas científicas de estudos publicados nas bases de dados PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology & Behavioral Sciences Collection, Cochrane Library, Web of Science Core Collection até maio de 2024, tendo posteriormente sido adicionado um estudo de agosto relevante para a RS. Resultados Foram selecionados e analisados dezasseis estudos publicados entre 1996 e 2024. A análise dos estudos incluídos na RS permite constatar que a RC tem um efeito positivo sobre o estado cognitivo de indivíduos com ELA, sendo que maiores níveis de RC, ou proxies de RC, estão associados a menores défices cognitivos nestes indivíduos e a um melhor prognóstico da doença. Para além disto, evidenciou-se um papel positivo da RC consoante o tipo de ELA, sendo no fenótipo bulbar que a RC apresenta maior benefício. Conclusões Apesar de ser necessária mais investigação para uma melhor compreensão do impacto da RC na cognição dos indivíduos com ELA, pode-se concluir que a RC tem influência na proteção do estado cognitivo na ELA. Estes resultados suportam o papel da RC no estado cognitivo nestes doentes, o que fornece informação relevante face ao prognóstico dos pacientes, e promove uma melhor tomada de decisão relativamente à abordagem dos planos de reabilitação.
Introduction Traditionally, Amyotrophic Lateral Sclerosis (ALS) is seen as a Motor Neuron Disease (MND) with an impact mainly on the motor system, as the name implies. However, recent discoveries have been unraveling this view, revealing that cognitive deficit are a significant feature of this disease. The concept of Cognitive Reserve (CR), which refers to brain´s resilience to deal with neuropathological damage, has been explored in various neurological conditions, neurodegenerative and others, and ALS is no exception. However, a Systematic Review (SR) of this concept in this population has never been carried out. The aim of this paper is to systematically review the literature on the impact of CR on cognitive functioning individuals with ALS. Methodology SR was carried out following the methodology defined by the PRISMA guidelines. A literature search was carried out in scientific journals of studies published in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology & Behavioral Sciences Collection, Cochrane Library, Web of Science Core Collection, until May 2023, after which an August study relevant to the SR was added. Results Sixteen studies published between 1996 and 2024 were selected and analyzed. The analysis of the studies included in the SR shows that CR has a positive effect on the cognitive status of individuals with ALS, with higher levels of CR being associated with lower cognitive deficits in these individuals and a better prognosis of the disease. In addition, a positive role for CR was found depending on the type of ALS, with the bulbar phenotype showing the greatest benefit from CR. Conclusions Althought more research is needed to better understand the impact of CR on cognition, it can be concluded that CR has an influence on protecting cognitive status in ALS. These results support the role of CR in cognitive status in these patients, which provides relevant information regarding patient prognosis and promotes better decision-making regarding the approach to rehabilitation plans.
Introduction Traditionally, Amyotrophic Lateral Sclerosis (ALS) is seen as a Motor Neuron Disease (MND) with an impact mainly on the motor system, as the name implies. However, recent discoveries have been unraveling this view, revealing that cognitive deficit are a significant feature of this disease. The concept of Cognitive Reserve (CR), which refers to brain´s resilience to deal with neuropathological damage, has been explored in various neurological conditions, neurodegenerative and others, and ALS is no exception. However, a Systematic Review (SR) of this concept in this population has never been carried out. The aim of this paper is to systematically review the literature on the impact of CR on cognitive functioning individuals with ALS. Methodology SR was carried out following the methodology defined by the PRISMA guidelines. A literature search was carried out in scientific journals of studies published in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychology & Behavioral Sciences Collection, Cochrane Library, Web of Science Core Collection, until May 2023, after which an August study relevant to the SR was added. Results Sixteen studies published between 1996 and 2024 were selected and analyzed. The analysis of the studies included in the SR shows that CR has a positive effect on the cognitive status of individuals with ALS, with higher levels of CR being associated with lower cognitive deficits in these individuals and a better prognosis of the disease. In addition, a positive role for CR was found depending on the type of ALS, with the bulbar phenotype showing the greatest benefit from CR. Conclusions Althought more research is needed to better understand the impact of CR on cognition, it can be concluded that CR has an influence on protecting cognitive status in ALS. These results support the role of CR in cognitive status in these patients, which provides relevant information regarding patient prognosis and promotes better decision-making regarding the approach to rehabilitation plans.
Description
Keywords
Esclerose lateral amiotrófica Reserva cognitiva Cognição Estado cognitivo Amyotrophic lateral sclerosis Cognitive reserve Cognition Cognitive function