Browsing by Author "Baez, Sandra"
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Publication A Multidimensional, Person-Centered Framework for Functional Assessment in Dementia: Insights from the 'What', 'How', 'To Whom', and 'How Much' Questions(2024) Slachevsky Chonchol, Andrea; Grandi, Fabrissio; Thumala, Daniela; Baez, Sandra; Santamaria, Hernando; Schmitter, Maureen; Parra, MarioDementia is a syndrome characterized by cognitive and neuropsychiatric symptoms associated with progressive functional decline (FD). FD is a core diagnostic criterion for dementia, setting the threshold between its prodromal stages and the full-blown disease. The operationalization of FD continues to generate a great deal of controversy. For instance, the threshold of FD for the diagnosis of dementia varies across diagnostic criteria, supporting the need for standardization of this construct. Moreover, there is a need to reconsider how we are measuring FD to set boundaries between normal aging, mild cognitive impairment, and dementia. In this paper, we propose a multidimensional framework that addresses outstanding issues in the assessment of FD: i) What activities of daily living (ADLs) are necessary to sustain an independent living in aging? ii) How to assess FD in individuals with suspected neurocognitive disorders? iii) To whom is the assessment directed? and iv) How much does FD differentiate healthy aging from mild and major neurocognitive disorders? Importantly, the To Whom Question introduces a person-centered approach that regards patients and caregivers as active agents in the assessment process of FD. Thus, once impaired ADLs have been identified, patients can indicate how significant such impairments are for them in daily life. We envisage that this new framework will guide future strategies to enhance functional assessment and treatment of patients with dementia and their caregivers.Publication Author Correction: Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations(2024) Moguilner, Sebastian; Baez, Sandra; Hernandez, Hernan; Migeot, Joaquín; Legaz, Agustina; Gonzalez, Raul; Farina, Francesca; Prado, Pavel; Cuadros, Jhosmary; Tagliazucchi, Enzo; Altschuler, Florencia; Maito, Marcelo; Godoy, María; Cruzat, Josefina; Valdes, Pedro; Lopera, Francisco; Ochoa, John; Gonzalez, Alfredis; Bonilla, Jasmin; Gonzalez, Rodrigo; Anghinah, Renato; d'Almeida, Luís; Fittipaldi, Sol; Medel, Vicente; Olivares, Daniela; Yener, Görsev; Escudero, Javier; Babiloni, Claudio; Whelan, Robert; Güntekin, Bahar; Yırıkoğulları, Harun; Santamaria, Hernando; Fernández, Alberto; Huepe, David; Di Caterina, Gaetano; Soto, Marcio; Birba, Agustina; Sainz, Agustin; Coronel, Carlos; Yigezu, Amanuel; Behrens, Maria IsabelLos relojes cerebrales capturan la diversidad y las disparidades en el envejecimiento y la demencia en poblaciones geográficamente diversas. Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations. Brain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging.Publication Brain clocks capture diversity and disparities in aging and dementia across geographically diverse populations(2024) Moguilner, Sebastian; Baez, Sandra; Hernandez, Hernan; Migeot, Joaquín; Legaz, Agustina; Gonzalez, Raul; Farina, Francesca; Prado, Pavel; Cuadros, Jhosmary; Tagliazucchi, Enzo; Altschuler, Florencia; Maito, Marcelo; Godoy, María; Cruzat, Josefina; Valdes, Pedro; Lopera, Francisco; Ochoa, John; González, Alfredis; Bonilla, Jazmín; Gonzalez, Rodrigo; Anghinah, Renato; d'Almeida, Luis; Fittipaldi, Sol; Medel, Vicente; Olivares, Daniela; Yener, Görsev; Escudero, Javier; Babiloni, Claudio; Whelan, Robert; Guntekin, Bahar; Yırıkoğulları, Harun; Santamaria, Hernando; Fernández, Alberto; Huepe, David; Di Caterina, Gaetano; Soto, Marcio; Birba, Agustina; Sainz, Agustin; Coronel, Carlos; Yigezu, Amanuel; Behrens, Maria IsabelBrain clocks, which quantify discrepancies between brain age and chronological age, hold promise for understanding brain health and disease. However, the impact of diversity (including geographical, socioeconomic, sociodemographic, sex and neurodegeneration) on the brain-age gap is unknown. We analyzed datasets from 5,306 participants across 15 countries (7 Latin American and Caribbean countries (LAC) and 8 non-LAC countries). Based on higher-order interactions, we developed a brain-age gap deep learning architecture for functional magnetic resonance imaging (2,953) and electroencephalography (2,353). The datasets comprised healthy controls and individuals with mild cognitive impairment, Alzheimer disease and behavioral variant frontotemporal dementia. LAC models evidenced older brain ages (functional magnetic resonance imaging: mean directional error = 5.60, root mean square error (r.m.s.e.) = 11.91; electroencephalography: mean directional error = 5.34, r.m.s.e. = 9.82) associated with frontoposterior networks compared with non-LAC models. Structural socioeconomic inequality, pollution and health disparities were influential predictors of increased brain-age gaps, especially in LAC (R² = 0.37, F² = 0.59, r.m.s.e. = 6.9). An ascending brain-age gap from healthy controls to mild cognitive impairment to Alzheimer disease was found. In LAC, we observed larger brain-age gaps in females in control and Alzheimer disease groups compared with the respective males. The results were not explained by variations in signal quality, demographics or acquisition methods. These findings provide a quantitative framework capturing the diversity of accelerated brain aging. Los relojes cerebrales, que cuantifican las discrepancias entre la edad cerebral y la edad cronológica, son prometedores para comprender la salud y la enfermedad cerebral. Sin embargo, se desconoce el impacto de la diversidad (incluida la geográfica, socioeconómica, sociodemográfica, sexual y neurodegenerativa) en la brecha de edad cerebral. Analizamos conjuntos de datos de 5306 participantes en 15 países (7 países de América Latina y el Caribe (ALC) y 8 países no pertenecientes a ALC). Con base en interacciones de orden superior, desarrollamos una arquitectura de aprendizaje profundo de brecha de edad cerebral para imágenes de resonancia magnética funcional (2953) y electroencefalografía (2353). Los conjuntos de datos comprendían controles sanos e individuos con deterioro cognitivo leve, enfermedad de Alzheimer y demencia frontotemporal variante conductual. Los modelos LAC evidenciaron edades cerebrales más avanzadas (imágenes por resonancia magnética funcional: error direccional medio = 5,60, error cuadrático medio (rmse) = 11,91; electroencefalografía: error direccional medio = 5,34, rmse = 9,82) asociadas con redes frontoposteriores en comparación con los modelos no LAC. La desigualdad socioeconómica estructural, la contaminación y las disparidades en la salud fueron predictores influyentes de mayores brechas de edad cerebral, especialmente en LAC (R² = 0,37, F² = 0,59, rmse = 6,9). Se encontró una brecha ascendente de edad cerebral desde controles sanos hasta deterioro cognitivo leve y enfermedad de Alzheimer. En LAC, observamos brechas de edad cerebral más grandes en mujeres en los grupos de control y enfermedad de Alzheimer en comparación con los respectivos hombres. Los resultados no se explicaron por variaciones en la calidad de la señal, la demografía o los métodos de adquisición. Estos hallazgos proporcionan un marco cuantitativo que captura la diversidad del envejecimiento cerebral acelerado.Publication Does culture shape our understanding of others' thoughts and emotions? An investigation across 12 countries(2022) Quesque, François; Coutrot, Antoine; Cox, Sharon; Cruz de Souza, Leonardo; Baez, Sandra; Cardona, Juan; Mulet, Hannah; Flanagan, Emma; Neely, Alejandra; Clarens, María; Cassimiro, Luciana; Musa, Gada; Kemp, Jennifer; Botzung, Anne; Philippi, Nathalie; Cosseddu, Maura; Trujillo, Catalina; Grisales, Johan; Fittipaldi, Sol; Magrath, Nahuel; Calandri, Ismael; Crivelli, Lucia; Sedeno, Lucas; Sedeno, Lucas; Garcia, Adolfo; Moreno, Fermin; Indakoetxea, Begoña; Benussi, Alberto; Brandão, Millena; Santamaria, Hernando; Matallana, Diana; Pryanishnikova, Galina; Morozova, Anna; Iakovleva, Olga; Veryugina, Nadezda; Levin, Oleg; Zhao, Lina; Liang, Junhua; Duning, Thomas; Lebouvier, Thibaud; Pasquier, Florence; Huepe, David; Barandiaran, Myriam; Johnen, Andreas; Lyashenko, Elena; Allegri, Ricardo; Borroni, Barbara; Blanc, Frederic; Wang, Fen; Sanches, Monica; Lillo, Patricia; Teixeira, Antonio; Caramelli, Paulo; Hudon, Carol; Andrea Slachevsky; Ibáñez, Agustin; Hornberger, Michael; Bertoux, MaximeMeasures of social cognition have now become central in neuropsychology, being essential for early and differential diagnoses, follow-up, and rehabilitation in a wide range of conditions. With the scientific world becoming increasingly interconnected, international neuropsychological and medical collaborations are burgeoning to tackle the global challenges that are mental health conditions. These initiatives commonly merge data across a diversity of populations and countries, while ignoring their specificity. Objective: In this context, we aimed to estimate the influence of participants' nationality on social cognition evaluation. This issue is of particular importance as most cognitive tasks are developed in highly specific contexts, not representative of that encountered by the world's population. Method: Through a large international study across 18 sites, neuropsychologists assessed core aspects of social cognition in 587 participants from 12 countries using traditional and widely used tasks. Results: Age, gender, and education were found to impact measures of mentalizing and emotion recognition. After controlling for these factors, differences between countries accounted for more than 20% of the variance on both measures. Importantly, it was possible to isolate participants' nationality from potential translation issues, which classically constitute a major limitation. Conclusions: Overall, these findings highlight the need for important methodological shifts to better represent social cognition in both fundamental research and clinical practice, especially within emerging international networks and consortia. (PsycInfo Database Record (c) 2022 APA, all rights reserved)Publication Educational disparities in brain health and dementia across Latin America and the United States(2024) Gonzalez, Raul; Legaz, Agustina; Moguilner, Sebastián; Cruzat, Josephine; Hernández, Hernán; Baez, Sandra; Cocchi, Rafael; Coronel, Carlos; Medel,Vicente; Tagliazuchi, Enzo; Migeot, Joaquín; Ochoa, Carolina; Maito, Marcelo; Reyes, Pablo; Santamaria, Hernando; Godoy, Maria; Javande, Shireen; García, Adolfo; Matallana, Diana; Avila, José; Slachevsky Chonchol, Andrea; Behrens, María; Custodio, Nilton; Cardona, Juan; Brusco, Ignacio; Bruno, Martín; Sosa, Ana; Pina, Stefanie; Takada, Leonel; França, Elisa; Valcour, Victor; Possin, Katherine; De Oliveira, Maira; Lopera, Francisco; Lawlor, Brian; Hu, Kun; Miller, Bruce; Yokoyama, Jennifer; Gonzalez, Cecilia; Ibañez, AgustinBackground: Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown. Methods: A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type. Results: Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions. Discussion: The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research. Highlights: Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.Item Explicit and implicit markers of fairness preeminence in criminal judges(2021) Santamaría‐García, Hernando; Martínez Cotrina, Jorge; FlorezTorres, Nicolás; Buitrago, Carlos; Aponte‐Canencio, Diego Mauricio; Caicedo, Juan Carlos; Billeke, Pablo; Gantiva, Carlos; Baez, SandraAchieving justice could be considered a complex social decision-making scenario. Despite the relevance of social decisions for legal contexts, these processes have still not been explored for individuals who work as criminal judges dispensing justice. To bridge the gap, we used a complex social decision-making task (Ultimatum game) and tracked a heart rate variability measurement: the square root of the mean squared differences of successive NN intervals (RMSSD) at their baseline (as an implicit measurement that tracks emotion regulation behavior) for criminal judges (n = 24) and a control group (n = 27). Our results revealed that, compared to controls, judges were slower and rejected a bigger proportion of unfair offers. Moreover, the rate of rejections and the reaction times were predicted by higher RMSSD scores for the judges. This study provides evidence about the impact of legal background and expertise in complex social decision-making. Our results contribute to understanding how expertise can shape criminal judges’ social behaviors and pave the way for promising new research into the cognitive and physiological factors associated with social decision-making.Publication Multidimensional Clinical Assessment in Frontotemporal Dementia and Its Spectrum in Latin America and the Caribbean: A Narrative Review and a Glance at Future Challenges(2022) Henríquez, Fernando; Cabello, Victoria; Baez, Sandra; Cruz de Souza, Leonardo; Lillo, Patricia; Martínez, David; Olavarría, Loreto; Torralva, Teresa; Slachevsky, AndreaFrontotemporal dementia (FTD) is the third most common form of dementia across all age groups and is a leading cause of early-onset dementia. The Frontotemporal dementia (FTD) includes a spectrum of diseases that are classified according to their clinical presentation and patterns of neurodegeneration. There are two main types of FTD: behavioral FTD variant (bvFTD), characterized by a deterioration in social function, behavior, and personality; and primary progressive aphasias (PPA), characterized by a deficit in language skills. There are other types of FTD-related disorders that present motor impairment and/or parkinsonism, including FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP), and corticobasal syndrome (CBS). The FTD and its associated disorders present great clinical heterogeneity. The diagnosis of FTD is based on the identification through clinical assessments of a specific clinical phenotype of impairments in different domains, complemented by an evaluation through instruments, i.e., tests and questionnaires, validated for the population under study, thus, achieving timely detection and treatment. While the prevalence of dementia in Latin America and the Caribbean (LAC) is increasing rapidly, there is still a lack of standardized instruments and consensus for FTD diagnosis. In this context, it is important to review the published tests and questionnaires adapted and/or validated in LAC for the assessment of cognition, behavior, functionality, and gait in FTD and its spectrum. Therefore, our paper has three main goals. First, to present a narrative review of the main tests and questionnaires published in LAC for the assessment of FTD and its spectrum in six dimensions: (i) Cognitive screening; (ii) Neuropsychological assessment divided by cognitive domain; (iii) Gait assessment; (iv) Behavioral and neuropsychiatric symptoms; (v) Functional assessment; and (vi) Global Rating Scale. Second, to propose a multidimensional clinical assessment of FTD in LAC identifying the main gaps. Lastly, it is proposed to create a LAC consortium that will discuss strategies to address the current challenges in the field.Item Your perspective and my benefit: multiple lesion models of self-other integration strategies during social bargaining(01/09/2016) Melloni, Margherita; Billeke, Pablo; Baez, Sandra; Hesse, Eugenia; De la Fuente, Laura; Forno, Gonzalo; Birba, Agustina; García-Cordero, Indira; Serrano, Cecilia; Plastino, Angelo; Slachevsky, Andrea; Huepe, David; Sigman, Mariano; Manes, Facundo; García, Adolfo; Sedeño, Lucas; Ibáñez, AgustínRecursive social decision-making requires the use of flexible, context-sensitive long-term strategies for negotiation. To succeed in social bargaining, participants' own perspectives must be dynamically integrated with those of interactors to maximize self-benefits and adapt to the other's preferences, respectively. This is a prerequisite to develop a successful long-term self-other integration strategy. While such form of strategic interaction is critical to social decision-making, little is known about its neurocognitive correlates. To bridge this gap, we analysed social bargaining behaviour in relation to its structural neural correlates, ongoing brain dynamics (oscillations and related source space), and functional connectivity signatures in healthy subjects and patients offering contrastive lesion models of neurodegeneration and focal stroke: behavioural variant frontotemporal dementia, Alzheimer's disease, and frontal lesions. All groups showed preserved basic bargaining indexes. However, impaired self-other integration strategy was found in patients with behavioural variant frontotemporal dementia and frontal lesions, suggesting that social bargaining critically depends on the integrity of prefrontal regions. Also, associations between behavioural performance and data from voxel-based morphometry and voxel-based lesion-symptom mapping revealed a critical role of prefrontal regions in value integration and strategic decisions for self-other integration strategy. Furthermore, as shown by measures of brain dynamics and related sources during the task, the self-other integration strategy was predicted by brain anticipatory activity (alpha/beta oscillations with sources in frontotemporal regions) associated with expectations about others' decisions. This pattern was reduced in all clinical groups, with greater impairments in behavioural variant frontotemporal dementia and frontal lesions than Alzheimer's disease. Finally, connectivity analysis from functional magnetic resonance imaging evidenced a fronto-temporo-parietal network involved in successful self-other integration strategy, with selective compromise of long-distance connections in frontal disorders. In sum, this work provides unprecedented evidence of convergent behavioural and neurocognitive signatures of strategic social bargaining in different lesion models. Our findings offer new insights into the critical roles of prefrontal hubs and associated temporo-parietal networks for strategic social negotiation