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1.
PLoS One ; 19(6): e0304272, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38843210

RESUMEN

Dementia can disrupt how people experience and describe events as well as their own role in them. Alzheimer's disease (AD) compromises the processing of entities expressed by nouns, while behavioral variant frontotemporal dementia (bvFTD) entails a depersonalized perspective with increased third-person references. Yet, no study has examined whether these patterns can be captured in connected speech via natural language processing tools. To tackle such gaps, we asked 96 participants (32 AD patients, 32 bvFTD patients, 32 healthy controls) to narrate a typical day of their lives and calculated the proportion of nouns, verbs, and first- or third-person markers (via part-of-speech and morphological tagging). We also extracted objective properties (frequency, phonological neighborhood, length, semantic variability) from each content word. In our main study (with 21 AD patients, 21 bvFTD patients, and 21 healthy controls), we used inferential statistics and machine learning for group-level and subject-level discrimination. The above linguistic features were correlated with patients' scores in tests of general cognitive status and executive functions. We found that, compared with HCs, (i) AD (but not bvFTD) patients produced significantly fewer nouns, (ii) bvFTD (but not AD) patients used significantly more third-person markers, and (iii) both patient groups produced more frequent words. Machine learning analyses showed that these features identified individuals with AD and bvFTD (AUC = 0.71). A generalizability test, with a model trained on the entire main study sample and tested on hold-out samples (11 AD patients, 11 bvFTD patients, 11 healthy controls), showed even better performance, with AUCs of 0.76 and 0.83 for AD and bvFTD, respectively. No linguistic feature was significantly correlated with cognitive test scores in either patient group. These results suggest that specific cognitive traits of each disorder can be captured automatically in connected speech, favoring interpretability for enhanced syndrome characterization, diagnosis, and monitoring.


Asunto(s)
Enfermedad de Alzheimer , Demencia Frontotemporal , Habla , Humanos , Demencia Frontotemporal/psicología , Demencia Frontotemporal/diagnóstico , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/psicología , Femenino , Masculino , Anciano , Persona de Mediana Edad , Estudios de Casos y Controles , Biomarcadores , Procesamiento de Lenguaje Natural , Aprendizaje Automático , Pruebas Neuropsicológicas , Función Ejecutiva/fisiología
2.
Neuroimage ; 295: 120636, 2024 Jul 15.
Artículo en Inglés | MEDLINE | ID: mdl-38777219

RESUMEN

Diversity in brain health is influenced by individual differences in demographics and cognition. However, most studies on brain health and diseases have typically controlled for these factors rather than explored their potential to predict brain signals. Here, we assessed the role of individual differences in demographics (age, sex, and education; n = 1298) and cognition (n = 725) as predictors of different metrics usually used in case-control studies. These included power spectrum and aperiodic (1/f slope, knee, offset) metrics, as well as complexity (fractal dimension estimation, permutation entropy, Wiener entropy, spectral structure variability) and connectivity (graph-theoretic mutual information, conditional mutual information, organizational information) from the source space resting-state EEG activity in a diverse sample from the global south and north populations. Brain-phenotype models were computed using EEG metrics reflecting local activity (power spectrum and aperiodic components) and brain dynamics and interactions (complexity and graph-theoretic measures). Electrophysiological brain dynamics were modulated by individual differences despite the varied methods of data acquisition and assessments across multiple centers, indicating that results were unlikely to be accounted for by methodological discrepancies. Variations in brain signals were mainly influenced by age and cognition, while education and sex exhibited less importance. Power spectrum activity and graph-theoretic measures were the most sensitive in capturing individual differences. Older age, poorer cognition, and being male were associated with reduced alpha power, whereas older age and less education were associated with reduced network integration and segregation. Findings suggest that basic individual differences impact core metrics of brain function that are used in standard case-control studies. Considering individual variability and diversity in global settings would contribute to a more tailored understanding of brain function.


Asunto(s)
Encéfalo , Cognición , Electroencefalografía , Humanos , Masculino , Femenino , Adulto , Cognición/fisiología , Persona de Mediana Edad , Encéfalo/fisiología , Anciano , Adulto Joven , Individualidad , Adolescente , Factores de Edad , Envejecimiento/fisiología
3.
J Exp Psychol Gen ; 2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38780562

RESUMEN

Processing action words (e.g., fork, throw) engages neurocognitive motor representations, consistent with embodied cognition principles. Despite age-related neurocognitive changes that could affect action words, and a rapidly aging population, the impact of healthy aging on action-word processing is poorly understood. Previous research suggests that in lexical tasks demanding semantic access, such as picture naming, higher motor-relatedness can enhance performance (e.g., fork vs. pier)-particularly in older adults, perhaps due to the age-related relative sparing of motor-semantic circuitry, which can support action words. However, motor-relatedness was recently found to affect performance in younger but not older adults in lexical decision. We hypothesized this was due to decreased semantic access in this task, especially in older adults. Here we tested effects of motor-relatedness on 2,174 words in younger and older adults not only in lexical decision but also in reading aloud, in which semantic access is minimal. Mixed-effects regression, controlling for phonological, lexical, and semantic variables, yielded results consistent with our predictions. In lexical decision, younger adults were faster and more accurate at words with higher-motor relatedness, whereas older adults showed no motor-relatedness effects. In reading aloud, neither age group showed such effects. Multiple sensitivity analyses demonstrated that the patterns were robust. Altogether, whereas previous research indicates that in lexical tasks demanding semantic access, higher motor-relatedness can enhance performance, especially in older adults, evidence now suggests that such effects are attenuated with decreased semantic access, which in turn depends on the task as well as aging itself. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

4.
Cereb Cortex ; 34(5)2024 May 02.
Artículo en Inglés | MEDLINE | ID: mdl-38741267

RESUMEN

The role of the left temporoparietal cortex in speech production has been extensively studied during native language processing, proving crucial in controlled lexico-semantic retrieval under varying cognitive demands. Yet, its role in bilinguals, fluent in both native and second languages, remains poorly understood. Here, we employed continuous theta burst stimulation to disrupt neural activity in the left posterior middle-temporal gyrus (pMTG) and angular gyrus (AG) while Italian-Friulian bilinguals performed a cued picture-naming task. The task involved between-language (naming objects in Italian or Friulian) and within-language blocks (naming objects ["knife"] or associated actions ["cut"] in a single language) in which participants could either maintain (non-switch) or change (switch) instructions based on cues. During within-language blocks, cTBS over the pMTG entailed faster naming for high-demanding switch trials, while cTBS to the AG elicited slower latencies in low-demanding non-switch trials. No cTBS effects were observed in the between-language block. Our findings suggest a causal involvement of the left pMTG and AG in lexico-semantic processing across languages, with distinct contributions to controlled vs. "automatic" retrieval, respectively. However, they do not support the existence of shared control mechanisms within and between language(s) production. Altogether, these results inform neurobiological models of semantic control in bilinguals.


Asunto(s)
Multilingüismo , Lóbulo Parietal , Habla , Lóbulo Temporal , Estimulación Magnética Transcraneal , Humanos , Masculino , Lóbulo Temporal/fisiología , Femenino , Adulto Joven , Adulto , Lóbulo Parietal/fisiología , Habla/fisiología , Señales (Psicología)
5.
Alzheimers Dement ; 2024 May 27.
Artículo en Inglés | MEDLINE | ID: mdl-38801124

RESUMEN

INTRODUCTION: While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS: In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS: Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. DISCUSSION: The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.

6.
Cortex ; 173: 34-48, 2024 04.
Artículo en Inglés | MEDLINE | ID: mdl-38359511

RESUMEN

Morphosyntactic assessments are important for characterizing individuals with nonfluent/agrammatic variant primary progressive aphasia (nfvPPA). Yet, standard tests are subject to examiner bias and often fail to differentiate between nfvPPA and logopenic variant PPA (lvPPA). Moreover, relevant neural signatures remain underexplored. Here, we leverage natural language processing tools to automatically capture morphosyntactic disturbances and their neuroanatomical correlates in 35 individuals with nfvPPA relative to 10 healthy controls (HC) and 26 individuals with lvPPA. Participants described a picture, and ensuing transcripts were analyzed via part-of-speech tagging to extract sentence-related features (e.g., subordinating and coordinating conjunctions), verbal-related features (e.g., tense markers), and nominal-related features (e.g., subjective and possessive pronouns). Gradient boosting machines were used to classify between groups using all features. We identified the most discriminant morphosyntactic marker via a feature importance algorithm and examined its neural correlates via voxel-based morphometry. Individuals with nfvPPA produced fewer morphosyntactic elements than the other two groups. Such features robustly discriminated them from both individuals with lvPPA and HCs with an AUC of .95 and .82, respectively. The most discriminatory feature corresponded to subordinating conjunctions was correlated with cortical atrophy within the left posterior inferior frontal gyrus across groups (pFWE < .05). Automated morphosyntactic analysis can efficiently differentiate nfvPPA from lvPPA. Also, the most sensitive morphosyntactic markers correlate with a core atrophy region of nfvPPA. Our approach, thus, can contribute to a key challenge in PPA diagnosis.


Asunto(s)
Afasia Progresiva Primaria , Humanos , Afasia Progresiva Primaria/diagnóstico por imagen , Habla , Imagen por Resonancia Magnética , Lenguaje , Atrofia
7.
Ann N Y Acad Sci ; 1534(1): 106-117, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38419368

RESUMEN

Can lifelong bilingualism be robustly decoded from intrinsic brain connectivity? Can we determine, using a spectrally resolved approach, the oscillatory networks that better predict dual-language experience? We recorded resting-state magnetoencephalographic activity in highly proficient Spanish-Basque bilinguals and Spanish monolinguals, calculated functional connectivity at canonical frequency bands, and derived topological network properties using graph analysis. These features were fed into a machine learning classifier to establish how robustly they discriminated between the groups. The model showed excellent classification (AUC: 0.91 ± 0.12) between individuals in each group. The key drivers of classification were network strength in beta (15-30 Hz) and delta (2-4 Hz) rhythms. Further characterization of these networks revealed the involvement of temporal, cingulate, and fronto-parietal hubs likely underpinning the language and default-mode networks (DMNs). Complementary evidence from a correlation analysis showed that the top-ranked features that better discriminated individuals during rest also explained interindividual variability in second language (L2) proficiency within bilinguals, further supporting the robustness of the machine learning model in capturing trait-like markers of bilingualism. Overall, our results show that long-term experience with an L2 can be "brain-read" at a fine-grained level from resting-state oscillatory network organization, highlighting its pervasive impact, particularly within language and DMN networks.


Asunto(s)
Multilingüismo , Humanos , Mapeo Encefálico/métodos , Imagen por Resonancia Magnética , Encéfalo , Lenguaje
8.
Neurobiol Aging ; 136: 78-87, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38330642

RESUMEN

Assessments of action semantics consistently reveal markers of Parkinson's disease (PD). However, neurophysiological signatures of the domain remain under-examined in this population, especially under conditions that allow patients to process stimuli without stringent time constraints. Here we assessed event-related potentials and time-frequency modulations in healthy individuals (HPs) and PD patients during a delayed-response semantic judgment task involving related and unrelated action-picture pairs. Both groups had shorter response times for related than for unrelated trials, but they exhibited discrepant electrophysiological patterns. HPs presented significantly greater N400 amplitudes as well as theta enhancement and mu desynchronization for unrelated relative to related trials. Conversely, N400 and theta modulations were abolished in the patients, who further exhibited a contralateralized cluster in the mu range. None of these patterns were associated with the participants' cognitive status. Our results suggest that PD involves multidimensional neurophysiological disruptions during action-concept processing, even under task conditions that elicit canonical behavioral effects. New constraints thus emerge for translational neurocognitive models of the disease.


Asunto(s)
Enfermedad de Parkinson , Semántica , Humanos , Masculino , Femenino , Potenciales Evocados/fisiología , Electroencefalografía , Enfermedad de Parkinson/psicología , Tiempo de Reacción/fisiología
9.
Alzheimers Dement ; 20(4): 2353-2363, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38284802

RESUMEN

INTRODUCTION: Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS: We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS: Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION: This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. HIGHLIGHTS: Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.


Asunto(s)
Afasia Progresiva Primaria , Humanos , Afasia Progresiva Primaria/diagnóstico , Lenguaje , Sustancia Gris , Corteza Cerebral
12.
NPJ Parkinsons Dis ; 10(1): 15, 2024 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-38195756

RESUMEN

Cognitive studies on Parkinson's disease (PD) reveal abnormal semantic processing. Most research, however, fails to indicate which conceptual properties are most affected and capture patients' neurocognitive profiles. Here, we asked persons with PD, healthy controls, and individuals with behavioral variant frontotemporal dementia (bvFTD, as a disease control group) to read concepts (e.g., 'sun') and list their features (e.g., hot). Responses were analyzed in terms of ten word properties (including concreteness, imageability, and semantic variability), used for group-level comparisons, subject-level classification, and brain-behavior correlations. PD (but not bvFTD) patients produced more concrete and imageable words than controls, both patterns being associated with overall cognitive status. PD and bvFTD patients showed reduced semantic variability, an anomaly which predicted semantic inhibition outcomes. Word-property patterns robustly classified PD (but not bvFTD) patients and correlated with disease-specific hypoconnectivity along the sensorimotor and salience networks. Fine-grained semantic assessments, then, can reveal distinct neurocognitive signatures of PD.

13.
Alzheimers Dement ; 20(2): 925-940, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37823470

RESUMEN

INTRODUCTION: Verbal fluency tasks are common in Alzheimer's disease (AD) assessments. Yet, standard valid response counts fail to reveal disease-specific semantic memory patterns. Here, we leveraged automated word-property analysis to capture neurocognitive markers of AD vis-à-vis behavioral variant frontotemporal dementia (bvFTD). METHODS: Patients and healthy controls completed two fluency tasks. We counted valid responses and computed each word's frequency, granularity, neighborhood, length, familiarity, and imageability. These features were used for group-level discrimination, patient-level identification, and correlations with executive and neural (magnetic resonanance imaging [MRI], functional MRI [fMRI], electroencephalography [EEG]) patterns. RESULTS: Valid responses revealed deficits in both disorders. Conversely, frequency, granularity, and neighborhood yielded robust group- and subject-level discrimination only in AD, also predicting executive outcomes. Disease-specific cortical thickness patterns were predicted by frequency in both disorders. Default-mode and salience network hypoconnectivity, and EEG beta hypoconnectivity, were predicted by frequency and granularity only in AD. DISCUSSION: Word-property analysis of fluency can boost AD characterization and diagnosis. HIGHLIGHTS: We report novel word-property analyses of verbal fluency in AD and bvFTD. Standard valid response counts captured deficits and brain patterns in both groups. Specific word properties (e.g., frequency, granularity) were altered only in AD. Such properties predicted cognitive and neural (MRI, fMRI, EEG) patterns in AD. Word-property analysis of fluency can boost AD characterization and diagnosis.


Asunto(s)
Enfermedad de Alzheimer , Demencia Frontotemporal , Humanos , Enfermedad de Alzheimer/diagnóstico , Pruebas Neuropsicológicas , Encéfalo/diagnóstico por imagen , Memoria , Imagen por Resonancia Magnética , Demencia Frontotemporal/diagnóstico , Trastornos de la Memoria
14.
Brain ; 147(2): 607-626, 2024 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-37769652

RESUMEN

The non-fluent/agrammatic variant of primary progressive aphasia (nfvPPA) is a neurodegenerative syndrome primarily defined by the presence of apraxia of speech (AoS) and/or expressive agrammatism. In addition, many patients exhibit dysarthria and/or receptive agrammatism. This leads to substantial phenotypic variation within the speech-language domain across individuals and time, in terms of both the specific combination of symptoms as well as their severity. How to resolve such phenotypic heterogeneity in nfvPPA is a matter of debate. 'Splitting' views propose separate clinical entities: 'primary progressive apraxia of speech' when AoS occurs in the absence of expressive agrammatism, 'progressive agrammatic aphasia' (PAA) in the opposite case, and 'AOS + PAA' when mixed motor speech and language symptoms are clearly present. While therapeutic interventions typically vary depending on the predominant symptom (e.g. AoS versus expressive agrammatism), the existence of behavioural, anatomical and pathological overlap across these phenotypes argues against drawing such clear-cut boundaries. In the current study, we contribute to this debate by mapping behaviour to brain in a large, prospective cohort of well characterized patients with nfvPPA (n = 104). We sought to advance scientific understanding of nfvPPA and the neural basis of speech-language by uncovering where in the brain the degree of MRI-based atrophy is associated with inter-patient variability in the presence and severity of AoS, dysarthria, expressive agrammatism or receptive agrammatism. Our cross-sectional examination of brain-behaviour relationships revealed three main observations. First, we found that the neural correlates of AoS and expressive agrammatism in nfvPPA lie side by side in the left posterior inferior frontal lobe, explaining their behavioural dissociation/association in previous reports. Second, we identified a 'left-right' and 'ventral-dorsal' neuroanatomical distinction between AoS versus dysarthria, highlighting (i) that dysarthria, but not AoS, is significantly influenced by tissue loss in right-hemisphere motor-speech regions; and (ii) that, within the left hemisphere, dysarthria and AoS map onto dorsally versus ventrally located motor-speech regions, respectively. Third, we confirmed that, within the large-scale grammar network, left frontal tissue loss is preferentially involved in expressive agrammatism and left temporal tissue loss in receptive agrammatism. Our findings thus contribute to define the function and location of the epicentres within the large-scale neural networks vulnerable to neurodegenerative changes in nfvPPA. We propose that nfvPPA be redefined as an umbrella term subsuming a spectrum of speech and/or language phenotypes that are closely linked by the underlying neuroanatomy and neuropathology.


Asunto(s)
Afasia Progresiva Primaria , Apraxias , Afasia Progresiva Primaria no Fluente , Humanos , Afasia de Broca/patología , Estudios Prospectivos , Disartria , Habla , Estudios Transversales , Apraxias/patología , Afasia Progresiva Primaria/patología , Afasia Progresiva Primaria no Fluente/complicaciones
15.
Sci Data ; 10(1): 889, 2023 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-38071313

RESUMEN

The Latin American Brain Health Institute (BrainLat) has released a unique multimodal neuroimaging dataset of 780 participants from Latin American. The dataset includes 530 patients with neurodegenerative diseases such as Alzheimer's disease (AD), behavioral variant frontotemporal dementia (bvFTD), multiple sclerosis (MS), Parkinson's disease (PD), and 250 healthy controls (HCs). This dataset (62.7 ± 9.5 years, age range 21-89 years) was collected through a multicentric effort across five Latin American countries to address the need for affordable, scalable, and available biomarkers in regions with larger inequities. The BrainLat is the first regional collection of clinical and cognitive assessments, anatomical magnetic resonance imaging (MRI), resting-state functional MRI (fMRI), diffusion-weighted MRI (DWI), and high density resting-state electroencephalography (EEG) in dementia patients. In addition, it includes demographic information about harmonized recruitment and assessment protocols. The dataset is publicly available to encourage further research and development of tools and health applications for neurodegeneration based on multimodal neuroimaging, promoting the assessment of regional variability and inclusion of underrepresented participants in research.


Asunto(s)
Enfermedad de Alzheimer , Encéfalo , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Adulto Joven , Enfermedad de Alzheimer/diagnóstico por imagen , Encéfalo/patología , Imagen de Difusión por Resonancia Magnética/métodos , Imagen por Resonancia Magnética/métodos , Neuroimagen
16.
Cir Cir ; 2023 Dec 20.
Artículo en Español | MEDLINE | ID: mdl-38122825

RESUMEN

Background: Robot-assisted radical prostatectomy has positioned itself as the approach of choice in the treatment of prostate cancer. Objective: To compare the outcomes of robot-assisted radical prostatectomy using the Retzius-Sparing (RS) approach against the modified Frankfurt (MF) technique. Method: To describe the perioperative, functional and oncological outcomes of 13 patients with prostate cancer who underwent RS robotic radical prostatectomy compared to MF, evaluating pathological results, urinary continence, sexual function and oncological control in 1 year of follow-up. Results: The average age was 64 years in RS group vs. 61 years in MF group. The values of total prostate antigen were higher in the RS group (25 ng/dl) vs. MF group (11 ng/dl). The volume of gland in RS group was 40.62 ml vs. 63.33 ml in the RS group. All patients were bilaterally neuropreserved, being statistically significant in favor of MF group (p = 0.016). Positive surgical margins were higher in R-S group (38.4%) vs. MF group (33.3%). Conclusions: With RS the same tendency to urinary continence is observed, with a significant difference in erectile function in favor of MF. This preliminary study shows better impact on erectile function.


Antecedentes: La prostatectomía radical asistida por robot se ha posicionado como el abordaje de elección en el tratamiento del cáncer de próstata. Objetivo: Comparar los resultados de la prostatectomía radical asistida por robot utilizando el abordaje Retzius-Sparing (RS) contra el Frankfurt modificado (FM). Método: Se describen los desenlaces perioperatorios, funcionales y oncológicos de 13 pacientes con cáncer de próstata que fueron llevados a prostatectomía radical robótica con RS, en comparación con FM, y se evalúan los resultados patológicos, continencia urinaria, función sexual y control oncológico a 1 año de seguimiento. Resultados: La media de edad fue de 64 años en el grupo RS y de 61 años en el grupo FM. Los valores de antígeno prostático total fueron mayores en el grupo RS (25 ng/dl) que en el FM (11 ng/dl). El volumen de la glándula fue menor en el grupo RS (40.62 ml) que en el FM (63.33 ml). Todos los pacientes fueron neuropreservados bilateralmente, siendo la diferencia estadísticamente significativa a favor de FM (p = 0.016). Los márgenes quirúrgicos positivos fueron mayores en el grupo RS (38.4%) que en el FM (33.3%). Conclusiones: Con RS se observa la misma tendencia a la continencia urinaria, con diferencia significativa en la función eréctil a favor de FM. Este estudio preliminar muestra mejor impacto en la función eréctil.

17.
Cir. Esp. (Ed. impr.) ; 101(10): 684-692, oct. 2023. tab, graf
Artículo en Inglés | IBECS | ID: ibc-226494

RESUMEN

Background: Massive blood transfusion (MBT) is a common occurrence in liver transplant (LT) patients. Recipient-related risk factors include cirrhosis, history of multiple surgeries and suboptimal donors. Despite advances in surgical techniques, anesthetic management and graft preservation have decreased the need for transfusions, this complication has not been completely eliminated. Methods: One thousand four hundred and sixty-nine LT were performed at our institution between May 2003 and December 2020, and data was available regarding transfusion for 1198 of them. We divided the patients into two groups, with regards to transfusion of 6 or more units of packed red blood cells in the first 24 h posttransplant, and we analyzed the differences between the groups. Results: Out of the 1198 patients, 607 (50.7%) met criteria for MBT. Survival was statistically lower at 1, 3, and 5 years when comparing the groups that had MBT to those that did not (92.6%, 85.2% and 79.7%, respectively, in the non MBT group, vs. 78.1%, 71.6% y 66.8%, respectively, in the MBT group). MBT was associated with a 1.5 mortality risk as opposed to non-MBT patients. Logistical regression analysis of our variables yielded the following results for a new model, including serum creatinine (OR 1.97), sodium (OR 1.73), hemoglobin (OR 1.99), platelets (OR 1.37), INR (OR 1.4), uDCD (OR 2.13) and split liver donation. Conclusion: Massive blood transfusion impacts patient survival in a statistically significant way. The most significant risk factors are preoperative hemoglobin, INR and serum creatinine. (AU)


Introducción: La transfusión masiva de hemoderivados (TMH) es un hecho frecuente en el trasplante hepático (TH). A pesar de los avances en la técnica quirúrgica, manejo anestésico y preservación de órganos, la politransfusión no ha desaparecido. Métodos: 1469 TH fueron realizados en nuestro centro entre mayo de 2003 y diciembre de 2020, obteniéndose datos completos de trasfusión de 1198. Dividimos a los pacientes en dos grupos de acuerdo a la necesidad de trasfusión de 6 o más unidades de sangre en las primeras 24 horas después del trasplante, y analizamos las diferencias entre los grupos. Resultados: De los 1198 pacientes, 607 (50.7%) cumplieron criterios de TMH· La supervivencia fue estadísticamente inferior a 1, 3, y 5 años cuando comparamos los grupos en función de TMH o no (92·6%, 85·2% y 79·7%, respectivamente, en el no TMH, vs. 78·1%, 71·6% y 66·8%, respectivamente, en el grupo de TMH). Respecto al análisis de supervivencia, la TMH se asoció a un riesgo 1.5 veces mayor de mortalidad en contra de los pacientes sin TMH· El análisis de regresión logística nos permitió la creación de un nuevo modelo incluyendo creatinina sérica (OR 1.97), sodio (OR 1.73), hemoglobina (OR 1.99), plaquetas (OR 1.37), INR (OR 1.4), uDCD (OR 2.13) y trasplante procedente de split. Conclusión: La transfusión masiva de hemoderivados impacta en la supervivencia del paciente de forma estadísticamente significative. Los factores de riesgo preoperatorios más significativos han sido la hemoglobina, el INR y la creatinine. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Trasplante de Hígado , Transfusión Sanguínea , Factores de Riesgo , Supervivencia , Hemoglobinas , Creatinina
18.
Sci Rep ; 13(1): 15709, 2023 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-37735251

RESUMEN

Situated models suggest that social concepts are grounded in interpersonal experience. However, few studies have tested this notion experimentally, and none has targeted individuals with reduced social interaction. Here, we assessed comprehension of text-level social and non-social concepts in persons with and without autistic-like traits. Participants read a social and a non-social text and answered questionnaires targeting social and non-social concepts, respectively. We compared behavioral outcomes, gauged their contribution to subject-level classification, and examined their association with validated measures of autism. Persons with autistic-like traits showed selective deficits in grasping text-level social concepts, even adjusting for intelligence, memory, and vocabulary. Also, social concept comprehension was the only variable that significantly classified between groups. Finally, social concept outcomes correlated negatively with measures of autism, including social interaction. Our results suggest that reduced interpersonal experience selectively compromises text-level social concept processing, offering empirical constraints for situated models of social semantics.


Asunto(s)
Trastorno Autístico , Humanos , Fenotipo , Inteligencia , Semántica , Interacción Social
19.
Cir Esp (Engl Ed) ; 101(10): 684-692, 2023 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-37739219

RESUMEN

BACKGROUND: Massive blood transfusion (MBT) is a common occurrence in liver transplant (LT) patients. Recipient-related risk factors include cirrhosis, history of multiple surgeries and suboptimal donors. Despite advances in surgical techniques, anesthetic management and graft preservation have decreased the need for transfusions, this complication has not been completely eliminated. METHODS: One thousand four hundred and sixty-nine LT were performed at our institution between May 2003 and December 2020, and data was available regarding transfusion for 1198 of them. We divided the patients into two groups, with regards to transfusion of 6 or more units of packed red blood cells in the first 24 h posttransplant, and we analyzed the differences between the groups. RESULTS: Out of the 1198 patients, 607 (50.7%) met criteria for MBT. Survival was statistically lower at 1, 3, and 5 years when comparing the groups that had MBT to those that did not (92.6%, 85.2% and 79.7%, respectively, in the non MBT group, vs. 78.1%, 71.6% y 66.8%, respectively, in the MBT group). MBT was associated with a 1.5 mortality risk as opposed to non-MBT patients. Logistical regression analysis of our variables yielded the following results for a new model, including serum creatinine (OR 1.97), sodium (OR 1.73), hemoglobin (OR 1.99), platelets (OR 1.37), INR (OR 1.4), uDCD (OR 2.13) and split liver donation. CONCLUSION: Massive blood transfusion impacts patient survival in a statistically significant way. The most significant risk factors are preoperative hemoglobin, INR and serum creatinine.


Asunto(s)
Trasplante de Hígado , Humanos , Trasplante de Hígado/efectos adversos , Trasplante de Hígado/métodos , Creatinina , Transfusión Sanguínea , Factores de Riesgo , Hemoglobinas
20.
Behav Res Methods ; 2023 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-37759106

RESUMEN

Automated speech and language analysis (ASLA) is a promising approach for capturing early markers of neurodegenerative diseases. However, its potential remains underexploited in research and translational settings, partly due to the lack of a unified tool for data collection, encryption, processing, download, and visualization. Here we introduce the Toolkit to Examine Lifelike Language (TELL) v.1.0.0, a web-based app designed to bridge such a gap. First, we outline general aspects of its development. Second, we list the steps to access and use the app. Third, we specify its data collection protocol, including a linguistic profile survey and 11 audio recording tasks. Fourth, we describe the outputs the app generates for researchers (downloadable files) and for clinicians (real-time metrics). Fifth, we survey published findings obtained through its tasks and metrics. Sixth, we refer to TELL's current limitations and prospects for expansion. Overall, with its current and planned features, TELL aims to facilitate ASLA for research and clinical aims in the neurodegeneration arena. A demo version can be accessed here:  https://demo.sci.tellapp.org/ .

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