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

hipocampo

 

Memoria Episódica en las Etapas Preclínicas de la Enfermedad de Alzheimer Genética. Episodic Memory In The Preclinical Stages Of Genetic Alzheimer’s Disease

Introduction: Episodic memory (EM) allows us to recall events or lived experiences. EM is associated to the medial temporal lobe (MTL) activity, which has circuits integrated by different cortical association areas. EM impairment is the first symptom of Alzheimer’s disease (AD), which is explained by the abnormal beta amyloid (βA) and phosphorylated tau protein (PTF) deposition in the MTL.

Development: A review about EM components and its assessment is done, especially related to preclinical stages of genetic AD. The relationship of EM components to βA and TFP deposition and the activity of MTL networks, using positron emission tomography (PET) of the brain, particularly in asymptomatic members of families at genetic risk for early AD, caused by the E280A mutation in preseniline 1 (PSN1), is revised.

Conclusions: The reviewed studies trend to validate the hypothesis, which would suggest that EM allows us to consolidate and recalling lived subjective experiences, which also allows us learning from the past. EM has been assessed with verbal declarative memory tasks. The asymptomatic members, carrying the E280A PSN1 mutation for genetic AD, have showed lower scores than asymptomatic non carriers on these memory tasks, which significantly correlates to PET-amyloid and PET-tau of MTL signals, up to 20 years before dementia onset.

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Tipificación del Trastorno Afectivo en Pacientes con Epilepsia del Lóbulo Temporal.

 

Introduction: Affective disorders in people with epilepsy seem to be different from patients with primary mood disorders.

Objective: to determine the clinical characteristics that typifies depression in patients with temporal Lobe Epilepsy.

Patients and methods: Forty patients with Temporal Lobe Epilepsy and depression were enrolled in the study. Thirty one patients with primary depressive disorder were recruited as control group. Depression was clinically evaluated in both groups. The discriminate analysis was used to determine the main clinical features of depression in patients with epilepsy. The differentiation between groups in total scores of Mood disorders through the International Psychiatry Interview was used to determine the atypical sign of depressive symptoms in patients with epilepsy. Logistic regression was utilized to analyze the possible relationship between neurobiological functioning and depressive symptoms in patients with epilepsy. Results: Sixty two percent of patients had a mood disorder not classified in CIE-10 and DSM-IV. Perictal anhedonia associated with insomnia, guilty thoughts, psychomotor slowness, inattention, restlessness, irritability, faintness  became the clinical profiles of depression in patients with epilepsy. Age of onset of epilepsy, family history of psychiatric disorders, number of seizures per month, left temporal Lobe Epilepsy, and bilateral hippocampal atrophy were the most important determinants of mood disorders in our study.

Conclusion: Brief perictal depressive symptoms associated with dysphoria, anxiety and phobias, typify the clinical profile of depressive syndrome in patients with Temporal Lobe Epilepsy.

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