Dyslalia is a language disorder that is present in a wide percentage of children. This work proposes an intervention protocol in music therapy to improve attention, memory, and language for children with the dyslalia disorder. A confirmatory mixed-method design composed of two studies was conducted: the first included a quantitative and pre-experimental design with a sample of 20 children aged between 5 and 8 years (Mage=6.45, SD=1.23) diagnosed with dyslalia. The second study used a qualitative confirmatory methodology, where participants’ parents and therapists participated. Wepman’s and the initial Luria pre- and post-tests measurements were applied. The results of the pre-experiment found statistically significant improvements in verbal regulation t(19)=-5.03, p=<.001, d=.76, attention t(19)=-5.05, p=<.001, d=.76, and memory t(19)=-2.88, p=.009, d=.55. In the qualitative phase, narratives were found that affirmed the positive results of the pre-experiment. Moreover, data surrounding the benefits of the music therapy intervention protocol in the improvement of cognitive processes and the relationship with previous literature that found positive results with this type of intervention are discussed.
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Marcadores cognitivos, biológicos, anatómicos y conductuales del deterioro cognitivo leve y la enfermedad de Alzheimer. Una revisión sistemática. Cognitive, biological, anatomical and behavioral markers of mild cognitive impairment and Alzheimer’s disease. A systematic review
Alzheimer’s disease (AD) is a progressive neurodegenerative disease that affects 50% of people over 85 years of age and is one of the most common in adulthood and the most common cause of dementia in developed countries. The objective was to determine which have been the most studied cognitive, biological, anatomical and behavioral markers of mild cognitive impairment (MCI) and AD in the last 10 years. Observational studies were searched in the Scopus, Pubmed and Sciencedirect databases. 187 articles were identified, of which 23 with full text were finally selected. The studies corresponded to cognitive (15 studies), biological (8 studies), anatomical (3 studies) and behavioral (2 studies) markers. The identified markers will help guide the design of early detection programs and future interventions that reduce neuropathological effects and significant alterations in quality of life.
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Manifestaciones neurológicas del lupus eritematoso sistémico: Revisión de literatura. Neurological manifestations of systemic lupus erythematosus: A comprehensive literature review
Among autoimmune diseases, systemic lupus erythematosus (SLE) stands out. This disease is characterized by the involvement of several organs and systems, including the central nervous system, in which it produces various complications, some rare or documented in the literature, which makes its diagnosis difficult, resulting in delays for its treatment. Many of these complications occur after the initial diagnosis of SLE; for that reason, a neurological evaluation is recommended in the followup of patients with SLE.
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Calambres musculares relacionados con uso de donepezilo. Donepezil-related muscular cramps
Tuberculoma intramedular espinal que simulaba una lesión tumoral, en un paciente con desnutrición y consumo de estupefacientes. Spinal intramedullary tuberculoma that simulates a tumor lesion, in a patient with malnutrition and drug use
Intramedullary spinal tuberculoma is a rare form of extrapulmonary tuberculosis. In most cases the diagnosis is made by biopsy of the lesion and histopathological study. We present the case of a 28-year-old male with a history of malnutrition and drug use who presented progressive paraparesis with sphincter compromise secondary to a dorsal intramedullary tuberculoma. At the beginning a tumor lesion was suspected, however, findings of pulmonary tuberculosis, lymph node biopsy and a positive tuberculin protein derivative study confirmed the clinical diagnosis of spinal tuberculoma.
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Síndrome alcohólico fetal. Reporte de un caso. Fetal alcohol syndrome. Case report
Prenatal exposure to alcohol is one of the main preventable causes of birth defects and developmental disabilities. Fetal alcohol spectrum disorder (FASD) is a term used to describe the physical, behavioral, and neurodevelopmental disorders that can be detected in an individual who was prenatally exposed to alcohol.
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Encefalitis autoinmune. Autoimmune encephalitis
Autoimmune encephalitis is a recently described pathology as inflammatory disease of the central nervous system, previously characterized as a paraneoplastic syndrome. However, advances in technology have allowed to categorize it as an entity, with an specific physiopathology, and a clinical presentation based on the developed auto-antibody, but, the wide clinical presentation, the insidious development of the symptoms, the mimic with other pathologies and the lack of knowledge of this condition in the emergency room and hospitalization services, does not permit to diagnose this condition, leading to potentially fatal complications. We report the case of a 26-years-old female with autoimmune encephalitis, and a literature review regarding this topic.
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Discapacidad asociada a manifestaciones neurológicas de COVID-19. Disability associated with COVID-19’s neurological manifestations
Introduction: COVID-19 is mainly a respiratory illness, however, with an incidence in nearly a third of patients of neurological manifestations secondary to affection to the central or peripheral nervous system, used to be more frequent in severe illness, having a wide range of disability and mortality.
Clinical case: We present the clinical case of a 39 years old female ,previously healthy, with diagnosis of COVID-19, initiating her illness with encephalitis and status epilepticus, posteriorly longitudinally extensive myelitis and anoxic-ischemic encephalopathy, which, despite of opportune diagnosis and treatment, she had a poor outcome developing persistent vegetative state.
Conclusions: COVID-19’s neurological manifestations could lead to a high risk of disability and mortality, needing an opportune detection and treatment, with a high suspicion of encephalitis and status epilepticus in patients with decrease of alertness and focal motor symptoms.
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Estatus epiléptico no convulsivo por Lupus Eritematoso Sistémico y Síndrome Antifosfolípido. Non convulsive status epilepticus due to Systemic Lupus Erythematosus and Anti- phospholipid syndrome
Systemic Lupus Erythematosus is a chronic disease, with the presence of autoantibodies and lymphocyte hyperactivity. The presence of antiphospholipid antibodies is associated with seizures and vasculocerebral disease. We present the case of a patient with atypical absence seizures and mild cognitive impairment.
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Instrumentos que evalúan la inteligencia emocional en estudiantes universitarios: Una revisión sistemática. Instruments that assess emotional intelligence in college students: A systematic review
Objective: To identify the studies that have applied Emotional Intelligence instruments in university students in the last 20 years (2001 to 2020).
Methodology: A desk study (systematic review) was carried out. The selection of primary studies was carried out in the Scopus and Scielo databases. The range of years systematized was from 2001 to 2020. The studies are published in English, Spanish, Portuguese and French. The keywords in English were used: Instruments, emotion intelligence, evaluation; in Spanish: instruments, emotional intelligence, evaluation. The observation technique was used to record the information, and the instrument was an observation record.
Results: 75% (n = 12) of the primary studies were published in English, 18.8% (n = 3) in Spanish and 6% (n = 1) in French. Also, it is highlighted that 81.3% (n = 13) of the articles were published in the Scopus database, 18.8% (n = 3) in the Scielo database. The highest number of publications were in the last 5 years (62.5%, n = 10). The instruments that were used to evaluate EI were MSCEIT, Bar-On and TMMS.
Conclusion: It was verified that the Emotional Intelligence (EI) instruments that were most applied to university students were the MSCEIT, the Bar-On and TMMS, in addition, the studies from 2001 to 2020 were gradually increasing. The results suggest the use and application of these instruments for samples of young university students.
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Síndrome de Down y COVID-19: Una Breve Perspectiva. Down Syndrome And COVID-19: A Brief Perspective
Un Ejemplo del Factor Bayes Para el Contraste de Hipótesis en la Investigación de Neurología. An Example Of The Bayes Factor In Hypothesis Contrasting In Neurology Research
Ronquido, Eventos Respiratorios y Cardíacos Después de la Colocación de un Dispositivo de Avance Mandibular. Snoring, Respiratory And Cardiac Events After The Placement Of A Mandibular Advancement Device.
Objective: To compare snoring levels, respiratory and cardiac events before and after the placement of a new mandibular advancement device (MAD) designed for snoring control, placed as an option for the control of pathological mechanisms respiratory disorders that have been associated with cognitive dysfunction, excessive daytime sleepiness and as an aggravator of the development of Alzheimer’s and Parkinson’s.
Methodology: Study of a case series that considered 12 snoring adults initially identified with the Roncolab® App. A clinical history of sleep and initial (A) and final (D) polysomnography (PSG) was performed. A new design of intra-oral mandibular advancement device for snoring control was placed, which was reviewed every 20 days for two months. Neurophysiological, cardio-pulmonary and sleep parameters were analyzed. The statistical differences between the variables were established according to the distribution of the data with tests of t-student or Mann-Whitney U.
Results: The average snoring events according to PSG were (A: 198; D: 260) with p> 0.05; according to Roncolab® (A: 73.6; D: 22.6) with a p <0.05. There were no differences between the oximetry averages (A: 0.84; D: 0.83) or heart rate (A: 65; D: 66.9).
Conclusions: There was no statistically significant difference in respiratory, cardiac events, oximetry nor apnea episodes according to PSG, after the placement of the manufactured DAM. Roncolab® registered a significant decrease in snoring events.
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Evaluación de la Utilidad de las Escalas Pronósticas del Status Epiléptico Convulsivo en el Status Epiléptico no Convulsivo. Usefulness Of Status Convulsive Score In Prognosis Of Non-Convulsive Status Epilepticus
Introduction: The Non-Convulsive Status Epilepticus (NCSE) is a rare clinical entity. As of today, a predictive mortality scale has not been developed. Moreover, the risk factors that contribute to the prognosis have not been clearly defined. The aim of this study was to evaluate the usefulness of the prognostic scores for status epilepticus (SE): the epileptic status severity score (STESS), the modified RANKIN scale STESS (mRSTESS) and the epileptic status mortality score based on epidemiology (EMSE-EACEG) applied in patients diagnosed with NCSE.
Results: The sample analyzed for this study consisted of 66 patients with an average age of 59 years (SD 18.5).
The STESS and mRSTESS were significantly associated with higher odds for poor prognosis at the time of discharge in patients with NCSE (p<0.05 and p<0.05, respectively). However, none of the three was associated with mortality.
Conclusion: Considering that the scores used to predict prognosis in patients with SE have not shown equal diagnostic accuracy in the NCSE, we believe that a validated predictive scale of morbidity and mortality would be of great help for these patients.
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Estructura Factorial del Funcionamiento Neuropsicológico en la Discapacidad Intelectual Leve en Niños. Factorial Structure Of Neuropsychological Functioning In Mild Intellectual Disability In Children.
An exploratory factor analysis was performed to establish the factor structure of neuropsychological functioning in mild intellectual disability in children. It was a quantitative, descriptive and cross-sectional study. Eighty children with a diagnosis of mild intellectual disability were included. An extensive battery of neuropsychological tests was applied. An Exploratory Factor Analysis was performed to identify the main factors. The results showed that mild intellectual disability in children has a structure in which the neuropsychological functions associated with executive functioning explain 56% of the variance and have a factor priority over 13%, which explains the variables associated with two traditional tests for assess intelligence. Each factor is analyzed and discussed from clinical and experimental neuropsychology. The study findings have theoretical and clinical implications for differential diagnosis.
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Epilepsia Como Factor Pronóstico de Refractariedad y Funcionalidad en Estado Epiléptico en Pacientes Mexicanos. Epilepsy As Prognostic Factor Of Refractoriness And Functionality In Status Epilepticus In Mexican Patients.
Introduction: Status epilepticus is a medical condition which could lead to a great disability and be mortal. Background of epilepsy could prevent a progression to a refractory status epilepticus and predict a good functional prognosis. Nevertheless, in Mexican population there are no studies about that.
Materials and methods: An observational, analytic, retrospective, cohort study was performed with patients with status epilepticus in Specialities Hospital of “Siglo XXI” National Medical Center, in Mexico. It was evaluated the probability of presenting refractory status epilepticus and a good functional outcome in patients with a background of epilepsy, performing Pearson Chi-square.
Results: 40 patients with status epilepticus were included, 32 with refractory status epilepticus and 14 with a background of epilepsy. The probability of presenting a refractory status epilepticus with a background of epilepsy was OR 1.29 (p 0.53), and for a good functional outcome was OR 3.63 (p 0.10).
Conclusions: Background of epilepsy is not a protective factor for preventing the progression to a refractory status epilepticus, neither a factor for predicting a good functional outcome in our study with Mexican population. Nevertheless, further studies with a bigger sample are needed in order to prove these results.
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Magnetic Resonance Poor Prognostic Factors In Mexican Multiple Sclerosis Patients. Factores de Mal Pronóstico Por Resonancia Magnética en Pacientes Mexicanos Con Esclerosis Múltiple.
Introduction: Multiple sclerosis is one of the main causes of disability in young people. It has characteristic lesions in magnetic resonance images which are part of diagnosis criteria, and some of them could predict a long-term disability. In mexican population there is no description about multiple sclerosis imaging characteristics.
Materials and methods: We performed an observational, descriptive, cross-sectional, and retrolective study at the Neurology Service of Specialties Hospital of Siglo XXI National Medical Center of Mexican Social Security Institute, in Mexico, evaluating magnetic resonance images characteristics of patients with multiple sclerosis diagnosis between January 2017 and January 2020.
Results: 75 patients were included, 8% had 1-3 T2-weighted lesions, 18.6% had 4-9 T2-weighted lesions, and 73.3% had 10 or more T2-weighted lesions. 50.6% had infratentorial lesions and 61.3% had spinal cord lesions. Gadolinium enhancing lesions were found in 48%, with a median of lesions 2 (IQR 1,3).
Conclusions: Mexican patients with multiple sclerosis have a great incidence of magnetic resonance image poor prognosis factors, which should lead to a closer follow-up and influence treatment options.
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Prescription Patterns Of Antimigraine Drugs. Patrones de Utilización de Antimigrañosos.
Introduction: The objective was to determine the prescription patterns of antimigraine drugs in a Colombian population.
Methods: A cross-sectional study of a population database that recorded all patients diagnosed with migraine and the drugs used for crisis and prophylaxis treatment for at least three months during 2018. Multivariate analysis was performed to identify variables associated with the use of prophylaxis.
Results: A total of 5973 patients diagnosed with migraine were identified, with a mean age of 37.7±14.5 years and female predominance (81.3%). The most common diagnosis was migraine without aura (36.9%), followed by migraine with aura (28.4%). Overall, 7.3% of patients were treated by neurologists and 92.8% by general practitioners, and 85.4% (n=5101) received treatment for acute episodes. Nonsteroidal anti-inflammatory drugs (52.1%) were the most prescribed drugs, followed by ergotamine (42.1%). The 46.3% of patients were receiving prophylactic therapy. Women older than 35 years and patients treated by neurologists were more likely to receive prophylactic therapy.
Conclusions: The use of medications for acute migraine management prevailed, with a very low proportion of triptans. Despite the significant undesirable effects, ergotamine continues to be used frequently. Physicians should evaluate the need for prophylaxis, focusing on finding an effective therapy that reduces disabilities.
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Prevalence Of Major Depressive Disorder In Portoviejo, Ecuador. Prevalencia del Trastorno Depresivo Mayor en Portoviejo, Ecuador.
Major depressive disorder (MDD) is a debilitating neuropsychiatric disorder that affects more than 300 million people, causing enormous socioeconomic burden. Little data has been known about prevalence of MDD in Ecuador. Thus, the aim of this study was to describe the prevalence of MDD in the population in a highly populated city in Ecuadorian Coast. This population-based study was accomplished in Portoviejo, Manabí. Here, we analyzed 114.239 records about MDD using Structured Clinical Interview for the Diagnosis of DSM-IV Disorders in younger, adults, and older peoples. We observed that the MDD score of 8.6% of the studied population. There was a suitable agreement between mild MDD and residence location scores (urban or rural zone). Both models had a good standard of fit (R2 = 0.91 and 0.95) and a mean p-value of 0.04 for both locations. A significant positive correlation between marital status and MDD scores, particularly for single (p = 0.001361, r = 0.94), and education levels (p = 0.00102, r = 0.95) was also demonstrated. Moreover, both age (p = 0.001067, r = -0.94) and widowed (p = 0.009662, r = -0.87) were negatively correlated with MDD scores. Collectively, our results revealed a high prevalence of MDD in the Portoviejo population, an effect more prominent in man, living alone, young and resident of the urban zone.
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Adaptación Lingüística de la Batería de Evaluación Neuropsicológica “BREV” en Una Población de Escolares Ecuatorianos. Linguistic Adaptation Of The Neuropsychological Evaluation Battery “BREV” In A Population Of Ecuadorian Schoolchildren.
This article reports the process followed for the linguistic adaptation of the Neuropsychological Assessment Battery “BREV” in a population of Ecuadorian school children. The translation-back-translation method was used. The final version of the test was applied to a pilot sample of 100 schoolchildren from the city of Cuenca – Ecuador. The piloting revealed results similar to the original version in most of the subtests, however, there are still certain adaptation errors at the level of some terms and stimuli of the test that must be corrected. The statistical results demonstrated a significance of 5% (p <0.05) in the correlations between the performance of each subtest and the age of the Ecuadorian children. It was concluded that the final version of the linguistic adaptation of the Battery “BREV” obtained in this first part of the investigation similar results to the original version; but a statistical analysis by retest is necessary to ensure the equivalence and reliability of the adapted instrument with respect to the original French test.
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Correlación Entre Calidad de Sueño y Calidad de Vida en Estudiantes de Medicina. Correlation Between Quality Of Sleep And Quality Of Life In Medical Students.
Introduction: Sleep is important for the proper performance of the individual since it participates in many biological processes. Medical students often do not get the recommended amount of sleep per day, this affects their quality of sleep, with repercussions on their quality of life.
Objective: To identify the association between sleep quality according to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and quality of life according to the World Health Organization Quality of Life (WHOQOL–BREF) questionnaire of the World Health Organization (WHO) and describe the most prevalent risk factors for sleep disorders in medical students from the Catholic University Santiago de Guayaquil (UCSG).
Methods: Cross-sectional observational study in UCSG medical students.
Results: The questionnaires were completed by 211 students; the mean age was 20,8 ± 2,6 years; 62,1% were women. The mean BMI was 23,1 ± 3,8, 20,4% of the students were overweight and 4,3% were obese. The mean score in the PSQI obtained in the study population was 7,2 ± 3,1 and in the WHOQOL – BREF was 60,9%. Pearson’s correlation coefficient, r2, between both variables was -0.33 (p: <0.01).
Conclusion: Poor quality of sleep is inversely correlated with quality of life. The quality-of-life domain most associated with poor sleep quality was the physical domain. The most frequent risk factor for poor quality sleep was snoring.
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Empatía: Medidas Cognitivas y Psicofisiológicas en Población Infantil Empathy: Cognitive And Psychophysiological Measures In The Child Population
Empathy has an important research trajectory since the last century in cognitive neurosciences. From the definition as a concept, the construction of evaluation instruments for different ages and the search for domains and aspects that address this component are still in force. This review aims to collect representative findings in the history of the conceptualization of the term and the development of measurement in empathy in populations, with special emphasis on the work carried out with the child population with self-report tools and psychophysiological measures. The review showed that there is a promising research horizon with psychophysiological techniques such as the EEG for the evaluation of the construct. The need to deepen the search for patterns in the ontogeny of empathy in childhood is discussed, as well as the design of new forms of measurement through self-report for research practice in Spanish-speaking countries that involve social dynamics and demographics of these populations.
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Ethnic Variations Are Still Underrepresented In Neuropharmacogenomics: A Systematic Review. Las Variaciones Étnicas Todavía Están Infrarrepresentadas en la Neuro Farmacogenómica: Una Revisión Sistemática
Context: There is a growing amount of evidence suggesting that specific medication responses can be linked to everyone’s genetic makeup. The advent of fast genomics and more accurate genetics has only fueled the research in understanding that link. This situation has opened exciting research fields, namely, pharmacogenetics and pharmacogenomics. Studies regarding treatment response to mental health conditions using new tools have caught much attention, especially for conditions such as bipolar disorder (BP), schizophrenia (SP), mania, and hypomania, in which the treatment response can vary significantly among patients. One-way to associate a patient’s genetics and his/her treatment response is by recalling the patient’s ethnicity. Exciting results have been found for different ethnic groups where Asian and Caucasian populations are the most studied. However, there is a profound lack of studies on African and Latin-American populations. This paper aims to show some pharmacogenetics/genomics studies of mental health disease and contrast the significant difference between population studies in this regard.
Methods: We follow the PRISMA methodology, a systematic search was performed on PubMed, Medline, Web of Science, Scopus, and Google Scholar, taking into consideration any type of studies published up to November 30, th 2019. The search contained the following terms: pharmacogenetics, pharmacogenomics, ethnicity, and ethnic groups combined with their respective treatment (antidepressants, lithium, anticonvulsant, and various types of antipsychotics) and the condition (bipolar disorder (BP), schizophrenia (SP), mania, hypomania, and major depressive disorders (MDD). In each database, an input contained terms as pharmacogenetics OR pharmacogenomics AND ethnicity OR “ethnic groups” AND “bipolar disorders” AND “lithium.”
Results: We found only 29 studies on studies on pharmacogenetics/pharmacogenomics and ethnicity/ethnic groups, 14 related to schizophrenia, 7 related to mania and major depressive disorder and, 8 with bipolar disorders. These research fields have continuously explored the link between an individual’s genetics and the treatment side effects. Even though nearly twenty genes were associated with treatment response, small changes such as a single nucleotide polymorphism can also influence the treatment response. Clozapine was the most used drug to explore its pharmacogenetics/genomics. More than half of the studies found were done on Europeans and more than three-quarters on Asians.
Conclusion: We found only five studies on pharmacogenetics of mania and major depressive disorder linked to ethnicity that involve the genes SLC6A4, ABCB1, NTRK2, SLC6A2, BDNF, PDE11A, and PDE9A, genes related to the use of fluoxetine and desipramine. Some studies suggest that the precision of using Single Nucleotide Polymorphisms (SNPs) as pharmacogenomics markers of treatment outcome, if appropriately used, could represent a significant advance in personalized medicine as two SNPs found in the same gene can yield different treatment outcomes. One expected result was that the vast amount of information found mainly reflected studies performed in Europe and Asia. However, we observed that the studies in Latino or Hispanic ethnic groups are very few, which constitutes a strong bias when choosing the appropriate drug in treating neuropsychiatric diseases, especially to understand any ethnic drug responses and take advantage of this growing and exciting field.
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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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Parálisis Cerebral en Pediatría: Problemas Asociados. Cerebral Palsy In Pediatrics: Associated Problems
Introduction: Cerebral palsy is the most frequent cause of childhood disability. Children with CP will associate, in addition to neurological problems, other non-neurological disorders that will be more frequent with a greater degree of CP involvement.
Objective: To address the clinical manifestations of children with cerebral palsy and their diagnostic and therapeutic management in order to provide a comprehensive approach to these patients in a single document.
Development: A review is made of the clinical manifestations of the child with cerebral palsy including neurological disorders, orthopedic problems, digestive disorders, respiratory problems, bone health, visual and hearing problems, urological and sexual disorders, oral health, hypersalivation, sleep disorder and pain.
Conclusions: The approach to the patient with CP has changed in recent years. Care provided by an specialized multidisciplinary team is essential. However, from our experience, the role of a pediatrician who knows all the associated problems seems essential to coordinate all the follow-up.
