Publicación Oficial de la Sociedad Ecuatoriana de Neurología, de la Liga Ecuatoriana Contra la Epilepsia y de la Sociedad Iberoamericana de Enfermedad Cerebrovascular

Estimulación magnética transcraneal

 

Estimulación Magnética Transcraneal “Theta-Burst Intermitente” en un Paciente con Trastorno del Espectro Autista: Reporte de un Caso. Transcranial Magnetic Stimulation “Theta-Burst Intermittent” In A Patient With Autism Spectrum Disorder: Case Report.

Background. Transcranial magnetic stimulation (TMS) is a potential treatment option for autism spectrum disorder (ASD) symptomatology.

Objectives. To determine the efficacy of the TMS intermittent theta-burst stimulation (iTBS) protocol over the left dorsolateral prefrontal cortex (DLPFC) in the management of pathological behaviors associated with ASD.

Patient/Methods. A 10-year-old male diagnosed with ASD by the Autism Diagnostic Observation Schedule (ADOS) presented with a family history of ASD with a younger sister diagnosed with the same disorder. Both magnetic resonance imaging (MRI) and functional MRI (fMRI) scans for emotional paradigms were performed before the iTBS treatment, immediately after the iTBS treatment, and after 6 months of iTBS treatment.

Results. The Autism Treatment Evaluation Checklist (ATEC) reports revealed improvement in communication, cognition, sociability, and behavior scales by 83%, 81%, 72%, and 52%, respectively. The overall score improved by 66% immediately after the treatment and by 55% lasting over a 6-month period. The fMRI revealed the activation of the frontal, parietal, and occipital cortex before iTBS treatment, and a better integration and activation of the frontal, temporal, and occipital cortex after iTBS treatment and persisted after 6 months.

Conclusions. iTBS is a well-tolerated, non-invasive neuromodulation technique that requires relatively less administration than the standard treatment.

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Valor del Potencial Evocado Auditivo de Latencia Media en el estudio de personas con Esclerosis Múltiple Forma Brote–Remisión.

A prospective study was carried out to establish the utility of Auditory Middle Latency Response (AMLR) in the evaluation of patients with relapsing- remitting multiple sclerosis. Twenty subjects were evaluated with the multimodal battery of auditory, visual and somatosensory evoked potentials, AMLR, and motor evoked potential by transcraneal magnetic stimulation. The results showed the following  abnormalities: 60 % in the AMLR, (only 50 % of them with clinical symptoms), 25% in the auditory brainstem response, 85 % in the visual response and 90 % in somatosensorial and motor potentials. We found significant differences between the auditory tests and the  rest of the electrophysiological techniques (rate comparison, p<.05). Those differences disappeared when auditory tests were considered together. There was a significant association between anatomical and functional tests in the evaluation of the auditory pathway, and a positive  correlation between the absolute latency of Na, Pa, and Pb components and the temporal course of the disease. The results suggest the convenience of including AMLR in the battery of evoked potentials for the study of relapsing- remitting multiple sclerosis patients.

 

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El marcapasos del parpadeo en un abrir y cerrar de ojos.

Clinical and functional neurological studies have suggested that the motor cortex, M1, does not control facial muscles, mostly the superior ones. Recent studies including current transcranial magnetic stimulation, showed that neural structures related with the cingulate cortex is the main brain region controlling facial muscles in humans. These facts will help clarifying discrepant findings in clinical neurology related to the well known -but not well understood- central facial palsy, among other applications.

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