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Relación de la periodontitis con la neuroinflamación. Relationship of periodontitis with neuroinflammation
Palabras clave: Neuroinflamación,
Periodontitis,
Inclusión educativa del alumnado universitario con discapacidad intelectual en Honduras. Una deuda pendiente. Educational inclusion of university students with intellectual disabilities in Honduras. A pending debt
Palabras clave: Honduras,
inclusión educativa,
Limited value of blood pressure levels in predicting white matter hyperintensities progression among community dwelling older adults living in a rural setting. Utilidad limitada de los niveles de presión arterial como predictor de progresión de hiperintensidades de sustancia blanca en adultos mayores que viven en un entorno rural
Introduction: This study aims to assess the impact of blood pressure (BP) on progression of white matter hyperintensities (WMH) of presumed vascular origin in community-dwelling older adults living in rural Ecuador.
Methods: Atahualpa residents aged ≥60 years receiving baseline and follow-up brain MRIs after a median of 6.5 years were included. Multilevel logistic regression models, which accounted for WMH severity at baseline, were fitted to assess the risk of WMH progression according to BP levels and other covariates.
Results: Analysis included 263 participants. WMH progression increased 3.45 times (95% C.I.: 1.94 – 4.96) among non-hypertensive individuals but 6.15 times (95% C.I.: 3.18 – 9.12) among those with arterial hypertension. However, overlapping of confidence intervals make such difference non-significant. Likewise, no differences in WMH progression were noticed when steady and pulsatile components of BP were used as independent variables.
Conclusions: High BP is not an independent predictor of WMH progression in the study population.
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Conducta adaptativa en estudiantes chilenos sin discapacidad intelectual: Diferencias por género y edad. Adaptative behavior in chilean students with intellectual disability: Differences by gender and age
Adaptive Behavior (CA) is a set of skills learned and performed by people in their daily lives, which are categorized in the conceptual, social and practical domains. The objective of the research was to compare the CA skills according to sex and age range (under 10, between 10 and 16 and over 16) of the participants. A comparative-correlational design was used, which evaluated 457 students (between 5 and 18 years old) with the ABAS-II questionnaire. The results report that CA does not have significant differences when compared by sex, but in age ranges. Downward associations were observed as age increases when relating conceptual skills to social and practical domains. It is concluded that there are no differences in skills according to sex, but there are differences by age ranges and high positive correlations in the younger group, which tend to decrease in the other groups as they advance in age. It is believed necessary to continue deepening the evaluation of CA in children of typical development using the four dimensions of the instrument (conceptual, social, practical, work) in order to obtain results that allow generating comprehensive support for the better development of boys and girls.
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Rehabilitación neuropsicológica en memoria declarativa y la funcionalidad en un adulto con epilepsia y lobectomía temporal izquierda. Neuropsychological rehabilitation program on declarative memory and functionality in an adult with epilepsy and left temporary lobectomy
Introduction: Surgical intervention is a treatment option for refractory epilepsy, and after this procedure cognitive alterations may occur. Software-based intervention approaches represent an alternative to traditional approaches.
Objective: To identify the effect of a neuropsychological rehabilitation plan for declarative memory in an adult with left temporal lobectomy, on their functional abilities.
Methodology: A single-case quasi-experimental design was used; the participant was a 45-year-old woman with memory problems and difficulties in performing daily activities. The intervention was carried out using the CogniFit rehabilitation software, and the Functioning Classification Scale and the Quality of Life Questionnaire in Epilepsy were used for the measurement.
Results: A large effect (NAP; 95%) was found in both indices.
Conclusions: The implementation of a software-based program allows a comprehensive rehabilitation.
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Propiedades psicométricas del test de evaluación neuropsicológica – Neuropsi en población peruana. Psychometric properties of the neuropsychological evaluation test – Neuropsi in peruvian population
This research aims to estimate the psychometric properties of the neuropsychological assessment instrument – Neuropsi in patients treated in the Neurology area of a public hospital in Peru. The study is of a technological, psychometric type, of a non-experimental and cross-sectional design and is oriented through a quantitative approach. We worked with a non-probabilistic sample of 432 medical records of elderly patients who were diagnosed with or without cognitive disorders or dementia, to whom the brief neuropsychological assessment instrument in Spanish – Neuropsi was applied. A factor analysis was found that reports a good fit in a 6-factor model with X2 = 2.825, CFI = 0.990, GFI = 0.986, PNFI = 0.460, AIC = 47.774, SRMR = 0.0196, RMSEA = 0.065 and the Cognitive performance differs according to the age range of the patient. In addition, it has a Cronbach’s alpha reliability of .863. These findings suggest that the instrument is valid, short, accurate, and adequate for measuring cognitive performance.
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Práctica de la neuropsicología en Ecuador. Practice of neuropsychology in Ecuador
Objectives: To explore the current state of neuropsychology practice in Ecuador through the administration of an online survey.
Methods: A total of 48 professionals working in the field of neuropsychology completed an online survey between August 2018 and December 2019.
Results: The majority of the participants were female (62.5%), with a mean age of 37.23. 87.5% report having received postgraduate neuropsychology training. Most are employed in private practice, universities and/or clinics, and report being satisfied with their work. The most commonly treated diagnoses are Attention Deficit with Hyperactivity Disorder (ADHD), learning disabilities and language disorders. The three main barriers identified for the development of neuropsychology are the lack of academic training programs, the lack of clinical training programs and the lack of willingness to collaborate among professionals.
Conclusions: The practice of neuropsychology in Ecuador is on par with that of Latin America. However, certain changes are needed, such as increasing academic and clinical training programs in the area, formalizing regulations that guarantee quality and standards in practice, and continuing to standardize and validate neuropsychological tests in the country.
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Cerebro, hormonas y genes: conocimientos biológicos de la homosexualidad y transexualidad en una muestra chilena. Brain, hormones, and genes: biological knowledge of homosexuality and transsexuality in a Chilean sample
Introduction: Sexual orientation and gender identity have some biological bases based on genes, perinatal hormones and brain dimorphisms that have been studied in recent decades. The objectives of this study are to know the psychometric properties of a questionnaire to evaluate biological knowledge of homosexuality and transsexuality and to investigate such knowledge in a Chilean sample.
Methodology: 144 people from three regions of Chile were surveyed. A sociodemographic survey and the Biological Knowledge of Homosexuality and Transsexuality Questionnaire (BKHT) were applied. The results show that the instrument is valid and reliable for the sample used. It is also noted that 75,7% of the respondents obtained between 1 and 6 correct answers out of a maximum of 18. Of the sociodemographic variables, only religious beliefs and having dealt with homosexuality and transsexuality in their sex education classes are predictors of the BKHT scores.
Conclusions and Recommendations: BKTH is valid and reliable to be applied in Chilean population samples. The sample evaluated has low levels of knowledge about the biological basis of homosexuality and transsexuality. It is recommended to replicate this research in larger samples, in other regions of Chile and in other Latin American countries.
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Test de Lectura de la Mente a través de la Mirada: Primera aproximación a las propiedades psicométricas en población peruana. Reading the Mind in the Eyes Test: A first approximation to the psychometric properties in the Peruvian Population
Theory of mind (ToM) is a central cognitive process of social cognition, with great importance in neuroscience and neuropsychiatric disorders. One method used to evaluate advanced ToM in adults is the Reading the Mind in the Eyes Test (RMET), which despite being widely known in Peru, still lacks standardized and adequately validated measures for its application in the clinical area and not clinical. Objectives: 1. Explore the psychometric properties of RMET in Peruvians, as well as the percentage of precision for each item among the different versions of the RMET; 2. Evaluate the test-retest reliability after one year of follow-up. Two hundred eighty-eight participants between 17 and 55 years old, of both sexes, were recruited. Results: The RMET shows a medium validity and consistency according to the KR-20, Cronbach’s Alpha, and Omega tests (0.645 – 0.666). Women perform better than men (p <0.041*), and scores remain stable after one year of follow-up. Conclusions: The RMET shows good psychometric properties, similar to other versions and different countries, with women showing better mental capacity.
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Localización cerebral y actividad eléctrica del razonamiento abstracto mediante electroencefalografía cuantitativa: Una revisión sistemática. Brain localization and electrical activity of abstract reasoning using quantitative electroencephalography: A systematic review
Abstract reasoning is the ability to process and solve tasks by means of cognitive tools, based on analysis, synthesis, pattern recognition, among others, being classified as a characteristic of human intelligence. From neuropsychology it is important to know studies that have determined through neuroimaging techniques the location of the functional architecture of this cognitive ability. Therefore, the aim of this study is to identify brain areas and electrical activity using electroencephalography from abstract reasoning tasks.
Through a systematic literature review based on the criteria of the PRISMA methodology, the academic databases PubMed, Sciencedirect, Scopus, Hinari, Dialnet, EBSCOhost were examined. The studies included in the review consist of articles from studies reviewed and published in the period 2016 to 2021. Ninety-six preliminary articles were identified, from which 16 studies were selected following the research inclusion and exclusion criteria. The results show that by performing different abstract reasoning tasks, synchronous neuronal interactions in the Theta-Alpha frequency range with main activation in frontal and parietal areas are observed by means of electroencephalography.
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Palabras clave: EEG,
Electroencefalografía,
inteligencia fluida,
razonamiento,
razonamiento abstracto,
Abordaje prequirúrgico en epilepsia de difícil control. Presurgical approach in drug-resistant epilepsy
Epilepsy is one of the main reasons for consultation in general neurology. It is a highly prevalent pathology, with a high impact on the quality of life of these patients. There is a percentage of drug resistance between 30% and 40% of epilepsy cases, and therefore it is very important to know the surgical alternative, as well as the importance of a timely and prompt referral to a specialized surgery center of epilepsy given the high possibility of seizure remission or improvement towards less disabling seizures, with a notable improvement in quality of life. The evaluation process of a patient with drug-resistant focal epilepsy who is a candidate for epilepsy surgery is based on a set of non-invasive diagnostic techniques. The evaluation process is based on the seizure locating semiology, an adequate protocol for the imaging study, electroencephalogram, and interictal and ictal video-monitoring, and neuropsychological evaluation in all cases, and in other functional studies such as computed tomography are necessary, ictal and interictal single-photon emission, positron emission tomography, and also invasive monitoring techniques, through which it is possible to proceed to surgery. A review of the literature is made.
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Relación entre la depresión y la demencia. Relationship between depression and dementia
The high association of depression and dementia in the elderly has motivated to investigate the type of relationship that exists between them. The objective of this narrative review was to describe the relationship between depression and dementia, for which the Medline, Science Direct, Dialnet, Redalyc databases were reviewed between 2000 and 2021, with the verbal descriptors “dementia” AND “depression” AND “relationship” AND “older adult” OUT “caregiver depression” to locate the candidate documents and then select the final sample made up of 60 published articles, which were reviewed by three judges for selection. Seven explanations of the relationship between dementia and depression were identified in which depression is considered a risk factor for dementia, a prodrome, a consequence, among others. Likewise, there was evidence that, although all the hypotheses have scientific support, there are also indications of their refutability. The types of relationship with the greatest scientific support were “depression as a risk factor” and “as a prodrome of dementia”, although the limitations in the studies prevent clarifying the relationship between these entities. Longitudinal studies that review the history of depression are suggested as a useful methodology to determine the relationship between them.
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Palabras clave: adulto mayor,
demencia,
depresión,
depresión geriátrica,
factor de riesgo,
pródromo,
Bilateral necrosis of the globus pallidus after binge-drinking. Necrosis bilateral de globos pálidos luego de ingesta excesiva y sostenida de alcohol
A 77-year-old man developed progressive slurry speech, action tremor in both upper limbs, generalized bradykinesia, and unsteady and shuffling gait several weeks after heavy binge-drinking followed by an unconsciousness state in which the patient did not respond to verbal commands or painful stimuli. MRI disclosed bilateral and symmetrical necrosis of globus pallidus as well as severe cortical and hippocampal atrophy. Damage of the globus pallidus was likely related to respiratory acidosis during the event. Pallidal Parkinsonism should be considered in the differential diagnosis of a progressive movement disorder after an acute toxic or hypoxic insult to the nervous system.
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Hemorragia intracerebral espontánea en pacientes con Covid-19 severa: Reporte de dos casos. Spontaneous Intracerebral Hemorrhage in severe Covid-19 patients: Report of two cases
The respiratory system is mainly affected by the SARS-CoV-2 infection, producing a severe acute respiratory syndrome known as COVID-19 (Coronavirus disease 2019), patients with severe disease usually develop multiorgan failure; among these we can focus on the nervous system, due to its potential neurotropism. Recent clinical data reveal that patients may manifest symptoms such as anosmia, dysgeusia, impaired consciousness, headache, seizures, and cerebrovascular disease (CVD). We describe two physically active male patients with complicated SARS-CoV-2 infection without significant comorbidities related to the development of intracranial hemorrhage, nor a history of head trauma or documented anatomic malformations. Both were admitted by the emergency department and during their stay in the ICU they developed intracranial hemorrhage diagnosed by computed tomography. The paraclinical findings in the two cases were compatible with a prothrombotic state as possible etiologies of bleeding in both.
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Alteración del estado de conciencia secundario a intoxicación por litio. Altered state of consciousness secondary to lithium intoxication
Introduction: Lithium is a pharmacological molecule that is commonly used in patients with bipolar affective disorder. Due to its chemical similarity to sodium, alterations in the latter have a direct effect on its plasma concentrations. Among the complications that can occur are nephrogenic diabetes insipidus, thyroid dysfunction, and some central nervous system defects such as nystagmus, ataxia, tremor, fasciculations, seizures, and coma.
Objective: To present the case of a patient with a syndrome of altered state of consciousness secondary to lithium poisoning coincide.
Clinical case: 61-year-old woman with a history of bipolar affective disorder who presented the syndrome of altered state of consciousness associated with lithium poisoning, for which reason the drug was withdrawn and hemodialysis sessions were carried out, obtaining an adequate response. with improvement of renal function and normalization of serum lithium values (0.76 mmol / L).
Conclusions: Lithium may involve alterations at the renal level that are associated with modifications in serum electrolytes. This can facilitate the appearance of neurological symptoms or symptoms, as evidence in the present case.
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Canalopatía de calcio CACNA1E: Nueva encefalopatía epiléptica en un paciente pediátrico. CACNA1E calcium channelopathy: New epileptic encephalopathy in a pediatric patient
Introduction: Epileptic and developmental encephalopathies, related to voltage-associated calcium channel mutations, are heterogeneous entities recently described in pediatric population.
Objective: To describe the case of pediatric patient with epileptic and developmental encephalopathy caused by a mutation in the CACNA1E gene that codes for a calcium channel.
Clinical case: Preschool male patient with refractory epilepsy starting at two months of life, associated with global developmental delay, behavioral disorder, hyperkinetic movements (dystonia) and hypotonia, with multifocal interictal activity and normal brain resonance, with pathogenic mutation in the gene CACNA1E.
Conclusion: Mutations in the CACNA1E gene cause functional alteration of the calcium channel CaV2.3, originating a clinical picture of a recently described phenotype.
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Aplasia unilateral del nervio vestibulococlear. Unilateral Vestibulocochlear nerve aplasia
Introduction: Vestibulo cochlear aplasia is an embryological defect in the formation of the inner ear that causes a sensorineural hearing loss. We report the case of an 8 year-old boy with left sided hearing loss, not previously detected. On neurological examination, a hearing loss in the left ear was found. Through imaging studies, the diagnosis is confirmed.
Conclusion: When hearing loss is suspected, imaging studies are the ideal method for detecting pathological findings in the inner ear.
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Drip and ship: Una práctica usual en el tratamiento de ictus isquémico por oclusión de arterias proximales en países de altos ingresos pero anecdótica en Colombia. Drip and ship: a prevalent practice in acute stroke with large vessel occlusion in high-income countries but anecdotal in Colombia
The Drip and Ship consists of giving intravenous thrombolysis in the primary center and referral for mechanical thrombectomy.
Objective: To describe the experience of Drip and Ship in acute ischemic stroke in two regions of Colombia.
Methods: We conducted a retrospective case series study of patients undergoing Drip and Ship from 2019 to first quartile of 2021. We compared times: door-to-image, door-to-needle, door-to-groin and clinical outcomes. Measures of central tendency and descriptive statistics were calculated.
Results: Six patients with ischemic stroke and large vessel occlusion were registered. Median of 60 minutes of the onset of symptoms, 75 minutes for door-to-needle, 167.5 minutes for door-in door-out time, and 91.5 minutes for travel time referred from another city. Five patients received mechanical thrombectomy with TICI 2c-3. 50% of patients with favorable modified Rankin scale at discharge and 84% at three months.
Conclusions: According to the RES-Q registry, between 2019 and the first quartile of 2021, there were 5954 cases of ischemic stroke cases in Colombia, and 20 patients received Drip and Ship strategy (0.33%). In agreement to international guidelines, door-to-needle and remission times were longer than recommended, especially in patients from other cities. It is necessary to structure care networks to improve treatment times and the number of patients treated.
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The association between pineal gland calcification and intracranial atherosclerotic disease in older adults. Asociación entre calcificaciones de la glándula pineal y enfermedad aterosclerótica intracraneal en adultos mayores
Background: This study assesses whether pineal gland calcification (PGC) – a surrogate for reduced endogenous melatonin production – is associated with significant stenosis of large intracranial arteries – a biomarker of intracranial atherosclerotic disease (ICAD).
Methods: Individuals aged ≥60 years enrolled in the Three Villages Study received head CT to assess PGC and MRA to estimate stenosis of large intracranial arteries. Multivariate logistic regression models were fitted to assess the association between PGC and ICAD, after adjusting for relevant confounders. Inverse probability of exposure weighting was used to estimate the effect of PGC on ICAD.
Results: A total of 581 individuals were enrolled. PGC and ICAD were associated in a fully-adjusted logistic regression model (p=0.032). Inverse probability of exposure weighting showed an estimate for the proportion of ICAD among those without PGC of 3.7% and the adjusted-effect coefficient was 5.7% higher among those with PGC (p=0.031).
Conclusions: PGC is associated with ICAD. Study results provide grounds for evaluating the role of melatonin deficiency in ICAD progression.
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Niveles altos de hemoglobina glicosilada se asocian a hemorragia intracerebral espontánea: Estudio de casos y controles. High levels of glycated hemoglobin are associated with spontaneous intracerebral hemorrhage: A case control study
Introduction: Evidence shows that glycosylated hemoglobin (HbA1C) is associated with spontaneous intracerebral hemorrhage (ICH). However, reports in Latin-American patients are scarce.
Objective: To determine if HbA1C is a risk factor for ICH.
Methods: A case-control study was carried out. Cases were hospitalized patients with ICH, whereas the controls were diabetic patients within the same age range. Logistics regression was calculated to identify risk factors associated with ICH.
Results: A total of 45 cases and 45 controls were included. HbA1C values were higher in the ICH group (median 6.8%, IQR=5.8– 7.5) compared to the control group (median 5.8%, IQR=5.5–6.2%; P<0.001). High HbA1C values were identified as a risk factor for ICH (OR=2.75, 95% CI=1.41-5.41). Among the ICH patients, barely 29% had a confirmed previous diagnosis of diabetes. The hospital mortality rate in the ICH patients was 37.8%, while mortality was 15% in the patients with diabetes and 46% in those without a previous diabetes diagnosis.
Conclusions: High HbA1C levels were associated with the development of ICH. It is paramount to improve public policies for early detection of diabetes due to the potential to reduce the impact of spontaneous intracerebral hemorrhage in the general population.
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Uso de la Escala de Inteligencia de Adultos de Wechsler-IV para la evaluación neuropsicológicas en Ecuador. The Wechsler Adult Intelligence Scale-IV for use in Neuropsychological Assessments in Ecuador
An important part of cognitive status evaluation is the determination of general cognitive ability. However, the most common tests are not standardized for use in Ecuador. This has limited the extent and accuracy of clinical neuropsychological assessments within the country. We used the 7-subtest Wechsler Adult Intelligence Scale-IV (WAIS-IV) with 155 mainly city-living Ecuadorian adults, recruited from a range of socioeconomic backgrounds around 4 different sites in Ecuador. The sample was matched to the Ecuadorian urban population for gender, education, and ethnicity. We show that this version of the WAIS-IV is a reliable and valid assessment for this context. In addition, we provide a method to adjust standard scores derived from the Spanish population, and used in the WAIS-IV manual, so that they are more appropriate for use in Ecuador. These can potentially be used to calculate full IQ scores. We also describe methods of comparing the Ecuador-adjusted standard scores so that they can be used in clinical neuropsychological evaluations of Ecuadorian adults.
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Palabras clave: CI,
evaluación cognitiva,
evaluación neuropsicológica,
inteligencia,
neuropsicología,
Cognición, afectividad y resiliencia en el perdón de una transgresión en la pareja. Cognition, affectivity and resilience in the forgiveness of a transgression in the couple
The transgression of the agreements between the couple is a current problem that generates discomfort on a personal, family and social level. In this article, an investigation is reported that analyzes a model that proposes the interaction between the variables positive cognition, positive affect and resilience as predictive factors that contribute to the understanding of the process of forgiveness of a transgression in the couple. 203 adults (103 women 60%, 88 men 40%) between 18 and 26 years of age participated in the research (Mage = 20.4, SD = 1.68). The hypothesized model was tested through the process of structural equations, finding adequate levels of goodness of fit x2 = 113.87, GL = 84, p = .02, SRMR = .05, RMSEA = .04 (.03 – .06), CFI = .97. The results found contribute to two essential levels in the line of investigation of the interaction between couples, firstly, at a theoretical level, it is provided with an innovative theory that allows us to understand the process of forgiveness in the couple and, secondly, to clinical level, for psychotherapeutic intervention in variables such as cognition and positive affect that would benefit a couple to overcome a conflict and reach a forgiveness.
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Estudio piloto sobre el funcionamiento sexual en mujeres con Esclerosis Múltiple en México. Pilot Study on Sexual Functioning in Women with Multiple Sclerosis in Mexico
Introduction: Sexual dysfunction in women with Multiple Sclerosis (MS) is frequent. The way it is approached by physicians and communication with patients has not been widely explored.
Objective: Describe the sexuality of women with MS, their satisfaction with their relationship and communication with doctors.
Material and Methods: Descriptive cross-sectional study, carried out in the MS Clinic in the main concentration center in Mexico, with self-administered questionnaires through an online survey, on mental health, couple relationships, doctor-patient interaction on the subject of health sexual and reproductive, female sexual functioning, intimacy and sexuality.
Results: 37 women participated, average age 35.0 ± 8.25 years. They have been with the disease for 4.3 ± 3.8 years and the main course is relapsing remitting MS (79.2%). 89.1% report sexual intercourse and 43.8% used contraceptives in their first relationship. Out of self-interest, 40% spoke to a doctor about sexuality. Women who are not in a relationship and have not spoken to a doctor about sexuality score low in the domains of sexual functioning.
Discussion and Conclusions: Communication about sexual health is fundamental and for this the doctor-patient relationship is central.
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Actualización y aproximación clínica a los modelos teóricos de la apraxia de extremidades. Approaching theorical models of limb apraxia: a clinical update
Apraxia is a common disorder in people who have suffered a left hemispheric stroke, with significant impact on their quality of life. Although several models have been proposed for its interpretation and approach, some aspects are still under study. The objective of this study is to review the current models of limb apraxia, to analyze the available evaluation tools and to make recommendations for clinical practice. The review shows that in the literature there is a greater interest in the conceptual system within the lexical-semantic route, without developing in detail the conceptual system within the visuomotor route. This article proposes a model of apraxia that overcomes these limitations and describes an assessment method focused on body knowledge within the visuomotor route. Finally, it is concluded that more studies are necessary to experimentally validate the proposed model and the associated evaluation methods.
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Estado Epiléptico Refractario de Aparición Reciente (NORSE): Revisión y actualización. New-Onset Refractory Status Epilepticus (NORSE): Review and Update
The New-Onset Refractory Status Epilepticus (NORSE) is a rare entity that is defined as a clinical presentation, in a patient without active epilepsy or other relevant neurological disorder, who presents a refractory status epilepticus (RSE) without an acute or active structural, toxic, or metabolic cause. NORSE constitutes a diagnostic challenge that implies high morbidity and mortality in the short and long term. Clinically, NORSE is characterized by a prodromal phase, an acute phase, where seizures with diverse semiology that evolve to an RSE occur, and a chronic phase, with neurological deterioration and drug-resistant epilepsy. After an extensive work-up, the cause of NORSE is identified in only half of the cases. The initial treatment is based on the use of conventional anti-seizure drugs, requiring most of patients the use of anesthetics and mechanical ventilation. Better results have been observed with immunotherapy, more recently with anti-cytokine drugs, such as tocilizumab and anakinra, consistent with the immunological/inflammatory mechanisms proposed for the pathophysiology of NORSE.
