RESUMEN
Spinocerebellar ataxia 38 (SCA 38) is a very rare autosomal dominant inherited disorder caused by a mutation in ELOV5 gene, specifically expressed in cerebellar Purkinje cells, encoding an enzyme involved in the synthesis of fatty acids. Seven symptomatic SCA 38 patients of a Sardinian family were administered 15 sessions of cerebellar anodal transcranial direct current stimulation (tDCS) in a cross-over study, employing deltoid cerebellar-only (C-tDCS) and cerebello-spinal (CS-tDCS) cathodal montage. Clinical evaluation was performed at baseline (T0), after 15 sessions of tDCS (T1) and after 1 month of follow-up (T2). Modified International Cooperative Ataxia Rating Scale (MICARS) and the Robertson dysarthria profile were used to rate ataxic and dysarthric symptoms, respectively. Alertness and split attention tests from Zimmermann test battery for attentional performance were employed to rate attentive functions. Moreover, 3D computerized gait analysis was employed to obtain a quantitative measure of efficacy of tDCS on motor symptoms. While clinical data showed that both CS and C-tDCS improved motor, dysarthric, and cognitive scores, the quantitative analysis of gait revealed significant improvement in spatio-temporal parameters only for C-tDCS treatment. Present findings, yet preliminary and limited by the small size of the tested sample, confirm the therapeutic potential of cerebellar tDCS in improving motor and cognitive symptoms in spinocerebellar ataxias and underline the need to obtain quantitative and objective measures to monitor the efficacy of a therapeutic treatment and to design tailored rehabilitative interventions. ClinicalTrials.gov identifier: NCT05951010.
Asunto(s)
Anticonvulsivantes/efectos adversos , Encefalopatías/inducido químicamente , Carbamazepina/efectos adversos , Ritmo Delta/efectos de los fármacos , Lóbulo Frontal/efectos de los fármacos , Anciano , Encefalopatías/fisiopatología , Electroencefalografía , Femenino , Estudios de Seguimiento , Humanos , Convulsiones/tratamiento farmacológicoAsunto(s)
Neoplasias del Sistema Nervioso Central/terapia , Irradiación Craneana/efectos adversos , Leucoencefalopatías/etiología , Linfoma/terapia , Trastornos Parkinsonianos/etiología , Antineoplásicos/uso terapéutico , Femenino , Trasplante de Células Madre Hematopoyéticas , Humanos , Leucoencefalopatías/patología , Leucoencefalopatías/fisiopatología , Metotrexato/uso terapéutico , Persona de Mediana EdadAsunto(s)
Edema Encefálico/complicaciones , Edema Encefálico/fisiopatología , Hipertensión Intracraneal/complicaciones , Hipertensión Intracraneal/fisiopatología , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/fisiopatología , Adulto , Antihipertensivos/uso terapéutico , Encéfalo/irrigación sanguínea , Encéfalo/patología , Encéfalo/fisiopatología , Edema Encefálico/patología , Arterias Cerebrales/patología , Arterias Cerebrales/fisiopatología , Circulación Cerebrovascular/fisiología , Femenino , Homeostasis/fisiología , Humanos , Hipertensión Intracraneal/tratamiento farmacológico , Imagen por Resonancia Magnética , Microcirculación/patología , Microcirculación/fisiopatología , Paraparesia/etiología , Paraparesia/patología , Paraparesia/fisiopatología , Médula Espinal/irrigación sanguínea , Médula Espinal/patología , Médula Espinal/fisiopatología , Enfermedades de la Médula Espinal/patología , Resultado del TratamientoAsunto(s)
Anticonvulsivantes/efectos adversos , Carbamazepina/análogos & derivados , Leucopenia/inducido químicamente , Adulto , Recuento de Células Sanguíneas , Carbamazepina/efectos adversos , Epilepsias Parciales/complicaciones , Epilepsias Parciales/tratamiento farmacológico , Humanos , Leucopenia/fisiopatología , Masculino , OxcarbazepinaRESUMEN
Delusional parasitosis is an unusual psychiatric disorder characterized by the false and persistent belief of being infested by parasites. Treatments include haloperidol, pimozide, and at present, olanzapine and risperidone. We report a case of delusional parasitosis in an elderly man, in which the treatment with low doses of quetiapine induced the complete remission of the syndrome, without any considerable side effects. No such report has been described before.