Pyramidal tract is affected in tropical spastic paraparesis (HAM/TSP) and AIDS; the best paraclinic tool so far known to evaluate such involvement, in humans, is transcranial magnetic stimulation. A thorough investigation was done in MEDLINE database for the period between 1985 and 2009, and in Scielo.org between 1996 and 2009 using the terms “HTLV-I, HTLV-II, HTLV-III, HIV; HIV1, HIV2, evoked potential, motor evoked potential, transcranial magnetic stimulation, magnetic stimulation, corticomotor physiology, motor tracts, pyramidal tract, corticospinal tract, myelopathy, acquired immunodeficiency syndrome, AIDS, SIDA, tropical spastic paraparesis, HTLV-I associated myelopathy, HAM, TSP, HAM/TSP”. Papers in English, Spanish, Portuguese, French and Japanese were reviewed. Thirteen manuscripts reporting motor evoked potentials obtained by transcranial magnetic stimulation were identified. In HAM/TSP the pyramidal tract involvement is mainly at low thoracic levels, following a centripetal pattern; in HIV, such involvement follows a centrifugal pattern which is greater at brain level. These findings should allow to redirect neurohabilitation and neuromodulation measures hopefully before fatal outcome or disability take place in these retroviruses-associated neurodegenerative disorders.
The main purpose of this paper is to present a general view of the advances in the last three decades concerning the conceptualization and treatment of the OCD phenomena. This disorder is more frequent and heterogeneous than it was thought before. Biological and psychological aspects suggest a crucial task for both, clinicians and researchers: to develop integrated models. Emphasis should be made on the importance of combined treatments to increase well being, social and personal functioning and quality of life.
