Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 502
Filtrar
1.
Am J Phys Med Rehabil ; 100(9): 821-830, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34091465

RESUMO

OBJECTIVES: The aim of this study was to determine the impact of the COVID-19 pandemic on access to rehabilitation therapies and the impact of changes in therapy access on the physical and mental well-being of children with motor impairment and their caregivers. DESIGN: Caregivers of children younger than 18 yrs with childhood-onset motor impairment (primarily cerebral palsy) completed an anonymous survey through the online platform REDCap between May 5 and July 13, 2020. RESULTS: The survey was completed by 102 participants. Before the pandemic, 92 of 102 children (90%) were receiving one or more therapies; at the time surveyed, 55 children (54%) were receiving any therapies (P < 0.001). More than 40% of the sample reported increased child stress, decreased physical activity, and/or decline in mobility/movement. Participants who reported a decrease in number of therapies at the time surveyed more frequently reported lower satisfaction with treatment delivery (P < 0.001), a decline in child's mobility (P = 0.001), and increased caregiver stress (P = 0.004). Five qualitative themes were identified from open-ended question responses related to therapies and well-being. CONCLUSIONS: Access to pediatric rehabilitation therapies was disrupted during COVID-19. Disrupted access may be related to impact on physical and mental health. With the expansion of telehealth, caregiver and child feedback should be incorporated to optimize benefit.


Assuntos
COVID-19 , Paralisia Cerebral/reabilitação , Acesso aos Serviços de Saúde/estatística & dados numéricos , Transtornos dos Movimentos/reabilitação , Quarentena/psicologia , Adolescente , Adulto , Fardo do Cuidador/epidemiologia , Cuidadores/psicologia , Paralisia Cerebral/psicologia , Criança , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Feminino , Humanos , Masculino , Limitação da Mobilidade , Transtornos dos Movimentos/psicologia , Pesquisa Qualitativa , SARS-CoV-2 , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários
2.
J Clin Neurosci ; 89: 139-143, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34119257

RESUMO

Functional movement disorder (FMD) presents as disabling motor symptoms that cannot be explained by organic processes. Despite the lack of lesion or known central nervous system dysfunction, distortion in sensorimotor processing in movement generation and execution is often observed. A person's capacity to judge laterality of a body part requires processing of sensorimotor information. This prospective observational study compared reaction time (RT) and accuracy (ACC) of hand laterality recognition between 30 people diagnosed with FMD and 30 age-matched healthy control participants. The association of RT and ACC with severity of FMD as measured by the Simplified Functional Movement Disorders Rating Scale (SFMDRS) was also explored. RT was on average 0.6 s slower (95% CI 0.4 - 0.8 s, p < 0.001) in patients with FMD (mean 2.2 s, standard deviation (SD) 0.5) than controls (mean 1.7 s, SD 0.3). ACC was on average 8.9% lower (95% CI -15.7 - -2.2, p = 0.01) in patients with FMD (mean 79.6%, SD 16.6) than controls (mean 88.5%, SD 8.1). When adjusted for SFMDRS using robust regression, RT was 0.3 s slower (95% CI 0.01 - 0.5, p = 0.04) in cases than in controls, but ACC was no longer different between groups. There was a moderate negative correlation between RT and ACC in FMD patients (ρ -0.58, p < 0.001 but not in controls (ρ -0.26, p = 0.17). People with FMD had significantly slower RT and lower ACC compared to the control group. These results provide new insights into underlying sensorimotor processing deficits in those with FMD.


Assuntos
Lateralidade Funcional/fisiologia , Mãos/fisiologia , Imaginação/fisiologia , Transtornos dos Movimentos/fisiopatologia , Movimento/fisiologia , Reconhecimento Psicológico/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/psicologia , Estudos Prospectivos , Tempo de Reação/fisiologia
3.
Parkinsonism Relat Disord ; 86: 135-138, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34049812

RESUMO

The evaluation and management of patients with movement disorders has evolved considerably due to the COVID-19 pandemic, including the assessment of candidates for deep brain stimulation (DBS) therapy. Members of the Neuropsychology Focus Group from the Parkinson Study Group Functional Neurosurgical Working Group met virtually to discuss current practices and solutions, build consensus, and to inform the DBS team and community regarding the complexities of performing DBS neuropsychological evaluations during COVID-19. It is our viewpoint that the practice of neuropsychology has adapted successfully to provide tele-neuropsychological pre-DBS evaluations during the global pandemic, thus permanently changing the landscape of neuropsychological services.


Assuntos
COVID-19 , Estimulação Encefálica Profunda/tendências , Transtornos dos Movimentos/psicologia , Transtornos dos Movimentos/cirurgia , Testes Neuropsicológicos , Neuropsicologia/tendências , Neurocirurgia/tendências , Pandemias , Doença de Parkinson/psicologia , Doença de Parkinson/cirurgia , Estimulação Encefálica Profunda/estatística & dados numéricos , Humanos , Telemedicina
4.
Neuropsychology ; 35(4): 451-459, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34043394

RESUMO

OBJECTIVES: Neurocognitive disorders in Parkinson's disease (PD) are common and heterogeneous. The aim of this study was to use a data-driven method to describe different cognitive phenotypes in PD and to explore anxiety, depression, and motor disturbances across the different cognitive profiles. METHOD: Latent profile analysis was applied to the neuropsychological performances of 65 patients with idiopathic PD assessed by means of a battery of tests that encompass measures of attention, memory, executive functions, social cognition, language, and visuospatial abilities. RESULTS: A three-cluster model produced the best solution: Cluster A (21.54%) included patients with intact cognition or with a relatively slight cognitive impairment in memory and executive functioning; Cluster B (53.85%) included patients with an intermediate level of cognitive impairment; and Cluster C (24.61%) included patients with the most severe cognitive impairment, with greater deficit compared to Cluster B in executive functioning, and, notably, in tasks with a predominantly posterior cortical basis (naming and visuospatial abilities). The three subgroups did not differ in terms of age, gender, disease duration, motor symptom severity or side of onset, levodopa equivalent daily dose, level of anxiety, or depression; however, patients from Cluster C showed greater impairment than patients from Cluster A in measures of everyday functioning. CONCLUSIONS: We presented a qualitative description of three distinct cognitive phenotypes emerging from a sample of 65 PD patients. The three clusters seem to be related to daily functioning but are independent from the stage of disease, motor functioning, anxiety, and depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Cognição , Doença de Parkinson/psicologia , Idoso , Idoso de 80 Anos ou mais , Ansiedade/etiologia , Ansiedade/psicologia , Atenção , Análise por Conglomerados , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/psicologia , Depressão/etiologia , Depressão/psicologia , Função Executiva , Feminino , Humanos , Idioma , Masculino , Memória , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/psicologia , Testes Neuropsicológicos , Doença de Parkinson/complicações , Fenótipo , Percepção Espacial
5.
Arch Dis Child ; 106(1): 62-67, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32709686

RESUMO

OBJECTIVE: To determine rates of psychiatric comorbidity in a clinical sample of childhood movement disorders (MDs). DESIGN: Cohort study. SETTING: Tertiary children's hospital MD clinics in Sydney, Australia and London, UK. PATIENTS: Cases were children with tic MDs (n=158) and non-tic MDs (n=102), including 66 children with dystonia. Comparison was made with emergency department controls (n=100), neurology controls with peripheral neuropathy or epilepsy (n=37), and community controls (n=10 438). INTERVENTIONS: On-line development and well-being assessment which was additionally clinically rated by experienced child psychiatrists. MAIN OUTCOME MEASURES: Diagnostic schedule and manual of mental disorders-5 criteria for psychiatric diagnoses. RESULTS: Psychiatric comorbidity in the non-tic MD cohort (39.2%) was comparable to the tic cohort (41.8%) (not significant). Psychiatric comorbidity in the non-tic MD cohort was greater than the emergency control group (18%, p<0.0001) and the community cohort (9.5%, p<0.00001), but not the neurology controls (29.7%, p=0.31). Almost half of the patients within the tic cohort with psychiatric comorbidity were receiving medical psychiatric treatment (45.5%) or psychology interventions (43.9%), compared with only 22.5% and 15.0%, respectively, of the non-tic MD cohort with psychiatric comorbidity. CONCLUSIONS: Psychiatric comorbidity is common in non-tic MDs such as dystonia. These psychiatric comorbidities appear to be under-recognised and undertreated.


Assuntos
Transtorno Depressivo/diagnóstico , Distonia/psicologia , Transtornos dos Movimentos/psicologia , Austrália , Estudos de Casos e Controles , Criança , Estudos de Coortes , Comorbidade , Transtorno Depressivo/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Serviço Hospitalar de Emergência , Inglaterra , Feminino , Humanos , Masculino , Psicometria
6.
J Neurosci ; 41(2): 376-389, 2021 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-33219005

RESUMO

Dysfunction of neuronal circuits is an important determinant of neurodegenerative diseases. Synaptic dysfunction, death, and intrinsic activity of neurons are thought to contribute to the demise of normal behavior in the disease state. However, the interplay between these major pathogenic events during disease progression is poorly understood. Spinal muscular atrophy (SMA) is a neurodegenerative disease caused by a deficiency in the ubiquitously expressed protein SMN and is characterized by motor neuron death, skeletal muscle atrophy, as well as dysfunction and loss of both central and peripheral excitatory synapses. These disease hallmarks result in an overall reduction of neuronal activity in the spinal sensory-motor circuit. Here, we show that increasing neuronal activity by chronic treatment with the FDA-approved potassium channel blocker 4-aminopyridine (4-AP) improves motor behavior in both sexes of a severe mouse model of SMA. 4-AP restores neurotransmission and number of proprioceptive synapses and neuromuscular junctions (NMJs), while having no effects on motor neuron death. In addition, 4-AP treatment with pharmacological inhibition of p53-dependent motor neuron death results in additive effects, leading to full correction of sensory-motor circuit pathology and enhanced phenotypic benefit in SMA mice. Our in vivo study reveals that 4-AP-induced increase of neuronal activity restores synaptic connectivity and function in the sensory-motor circuit to improve the SMA motor phenotype.SIGNIFICANCE STATEMENT Spinal muscular atrophy (SMA) is a neurodegenerative disease, characterized by synaptic loss, motor neuron death, and reduced neuronal activity in spinal sensory-motor circuits. However, whether these are parallel or dependent events is unclear. We show here that long-term increase of neuronal activity by the FDA-approved drug 4-aminopyridine (4-AP) rescues the number and function of central and peripheral synapses in a SMA mouse model, resulting in an improvement of the sensory-motor circuit and motor behavior. Combinatorial treatment of pharmacological inhibition of p53, which is responsible for motor neuron death and 4-AP, results in additive beneficial effects on the sensory-motor circuit in SMA. Thus, neuronal activity restores synaptic connections and improves significantly the severe SMA phenotype.


Assuntos
Transtornos dos Movimentos/tratamento farmacológico , Atrofia Muscular Espinal/tratamento farmacológico , Desempenho Psicomotor/efeitos dos fármacos , Transtornos das Sensações/tratamento farmacológico , 4-Aminopiridina/uso terapêutico , Animais , Morte Celular/efeitos dos fármacos , Camundongos , Camundongos Knockout , Neurônios Motores/efeitos dos fármacos , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/psicologia , Atrofia Muscular Espinal/complicações , Atrofia Muscular Espinal/psicologia , Junção Neuromuscular/efeitos dos fármacos , Bloqueadores dos Canais de Potássio/uso terapêutico , Propriocepção/efeitos dos fármacos , Transtornos das Sensações/etiologia , Transtornos das Sensações/psicologia , Proteína 1 de Sobrevivência do Neurônio Motor/genética , Sinapses/efeitos dos fármacos , Transmissão Sináptica/efeitos dos fármacos , Proteína Supressora de Tumor p53/antagonistas & inibidores
7.
Brain ; 143(12): 3564-3573, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-33242881

RESUMO

KCNN2 encodes the small conductance calcium-activated potassium channel 2 (SK2). Rodent models with spontaneous Kcnn2 mutations show abnormal gait and locomotor activity, tremor and memory deficits, but human disorders related to KCNN2 variants are largely unknown. Using exome sequencing, we identified a de novo KCNN2 frameshift deletion in a patient with learning disabilities, cerebellar ataxia and white matter abnormalities on brain MRI. This discovery prompted us to collect data from nine additional patients with de novo KCNN2 variants (one nonsense, one splice site, six missense variants and one in-frame deletion) and one family with a missense variant inherited from the affected mother. We investigated the functional impact of six selected variants on SK2 channel function using the patch-clamp technique. All variants tested but one, which was reclassified to uncertain significance, led to a loss-of-function of SK2 channels. Patients with KCNN2 variants had motor and language developmental delay, intellectual disability often associated with early-onset movement disorders comprising cerebellar ataxia and/or extrapyramidal symptoms. Altogether, our findings provide evidence that heterozygous variants, likely causing a haploinsufficiency of the KCNN2 gene, lead to novel autosomal dominant neurodevelopmental movement disorders mirroring phenotypes previously described in rodents.


Assuntos
Transtornos dos Movimentos/genética , Transtornos do Neurodesenvolvimento/genética , Canais de Potássio Ativados por Cálcio de Condutância Baixa/genética , Adolescente , Adulto , Ataxia Cerebelar/genética , Ataxia Cerebelar/psicologia , Criança , Pré-Escolar , Fenômenos Eletrofisiológicos , Exoma , Mutação da Fase de Leitura , Variação Genética , Haploinsuficiência , Humanos , Deficiência Intelectual/genética , Deficiência Intelectual/psicologia , Deficiências da Aprendizagem/genética , Deficiências da Aprendizagem/psicologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/psicologia , Mutação de Sentido Incorreto/genética , Transtornos do Neurodesenvolvimento/psicologia , Técnicas de Patch-Clamp , Substância Branca/anormalidades , Substância Branca/diagnóstico por imagem , Adulto Jovem
8.
Ideggyogy Sz ; 73(7-08): 261-268, 2020 Jul 30.
Artigo em Húngaro | MEDLINE | ID: mdl-32750243

RESUMO

Background and purpose: The majority of patients with advanced Parkinson's disease are treated at specialized movement disorder centers. Currently, there is no clear consensus on how to define the stages of Parkinson's disease; the proportion of Parkinson's patients with advanced Parkinson's disease, the referral process, and the clinical features used to characterize advanced Parkinson's disease are not well delineated. The primary objective of this observational study was to evaluate the proportion of Parkinson's patients identified as advanced patients according to physician's judgment in all participating movement disorder centers across the study. Here we evaluate the Hungarian subset of the participating patients. Methods: The study was conducted in a cross-sectional, non-interventional, multi-country, multi-center format in 18 countries. Data were collected during a single patient visit. Current Parkinson's disease status was assessed with Unified Parkinson's Disease Rating Scale (UPDRS) parts II, III, IV, and V (modified Hoehn and Yahr staging). Non-motor symptoms were assessed using the PD Non-motor Symptoms Scale (NMSS); quality of life was assessed with the PD 8-item Quality-of-Life Questionnaire (PDQ-8). Parkinson's disease was classified as advanced versus non-advanced based on physician assessment and on questions developed by the Delphi method. Results: Overall, 2627 patients with Parkinson's disease from 126 sites were documented. In Hungary, 100 patients with Parkinson's disease were documented in four movement disorder centers, and, according to the physician assessment, 50% of these patients had advanced Parkinson's disease. Their mean scores showed significantly higher impairment in those with, versus without advanced Parkinson's disease: UPDRS II (14.1 vs. 9.2), UPDRS IV Q32 (1.1 vs. 0.0) and Q39 (1.1 vs. 0.5), UPDRS V (2.8 vs. 2.0) and PDQ-8 (29.1 vs. 18.9). Conclusion: Physicians in Hungarian movement disorder centers assessed that half of the Parkinson's patients had advanced disease, with worse motor and non-motor symptom severity and worse QoL than those without advanced Parkinson's disease. Despite being classified as eligible for invasive/device-aided treatment, that treatment had not been initiated in 25% of these patients.


Assuntos
Transtornos dos Movimentos/psicologia , Doença de Parkinson/classificação , Doença de Parkinson/diagnóstico , Qualidade de Vida/psicologia , Estudos Transversais , Humanos , Hungria/epidemiologia , Transtornos dos Movimentos/diagnóstico , Transtornos dos Movimentos/epidemiologia , Doença de Parkinson/epidemiologia , Doença de Parkinson/psicologia , Índice de Gravidade de Doença , Inquéritos e Questionários
9.
Eur J Paediatr Neurol ; 28: 101-109, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32800685

RESUMO

AIM: To develop a cognitive behavioural treatment (CBT) approach that included novel attention training components to support symptom management in children with a primary diagnosis of Functional Movement Disorder (FMD). METHOD: Eighteen children (9 male and 9 female) with a mean age of 13 years (sd = 2.46, range 10-18 years) were assessed and completed CBT with novel attention training components. Treatment outcomes were measured using the Child Global Assessment Scale (CGAS) which was administered at baseline and post-treatment. RESULTS: Scores on the CGAS improved significantly post-treatment (p < 0.001) with all participants showing significant change in functioning on the basis of the Reliable Change Index (RCI), with clinically significant change across classification boundaries. INTERPRETATION: This case series provides support for the use of CBT with attention training components for the management of FMD. Larger trials are necessary to identify which individual treatment components are most effective and to better understand and quantify response to treatment. Future clinical treatment studies would benefit from the inclusion of objective measures of interoception and attentional focus.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtornos dos Movimentos/psicologia , Transtornos dos Movimentos/terapia , Transtornos Psicofisiológicos/psicologia , Transtornos Psicofisiológicos/terapia , Adolescente , Criança , Feminino , Humanos , Masculino , Resultado do Tratamento
12.
J Psychosom Res ; 133: 110100, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32224346

RESUMO

OBJECTIVE: Emotional difficulties are common in functional movement disorders (FMD), yet their contribution to the disease remains unclear. We explored the potential role of emotional difficulties as risk and maintaining factors of FMD by looking at the effect of emotions on attention. METHOD: The dot-probe task was used to investigate attentional biases induced by emotional faces in 25 patients with FMD and 25 healthy controls (HC). A pair of faces, one emotional (happy, angry, sad) and the other neutral, was displayed on a monitor to either the left or the right side of a central fixation cross. The face disappeared and a dot was flashed in place of one of the faces. Participants had to indicate the location of the dot. All participants completed the Toronto Alexithymia Scale. Psychological assessment of 23 patients also involved the Short Form Health Survey, the Hamilton Anxiety and the Hamilton Depression Rating Scales. RESULTS: A general attentional bias away from emotional faces was noted for the FMD group compared to the HC. A more fine-tuned analysis revealed an attentional bias specifically away from sad faces for the FMD. CONCLUSION: Our findings suggest a specific effect of emotions on attention in FMD that likely involves avoidance of sadness. Since this was not related to alexithymia or mood, we excluded these factors in explaining the results. Attentional bias away from sad faces correlated with general health, suggesting that avoidance of sadness might contribute to the perception of a better general health status in FMD.


Assuntos
Aprendizagem da Esquiva/fisiologia , Emoções , Transtornos dos Movimentos/psicologia , Adulto , Afeto , Sintomas Afetivos/complicações , Atenção , Expressão Facial , Feminino , Humanos , Masculino , Transtornos dos Movimentos/complicações , Adulto Jovem
13.
Disabil Health J ; 13(4): 100923, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32317244

RESUMO

BACKGROUND: Self-efficacy and health locus of control are widely recognized as psychological factors related to life satisfaction. However, little is known about the mechanisms of the decrease in life satisfaction in disabled people. OBJECTIVE/HYPOTHESIS: The aim of the present study was to clarify the relationship between health locus of control (HLOC) and life satisfaction in people with acquired mobility impairment in comparison to a non-disabled sample, and to specify how self-efficacy interacts with these components. We hypothesized that self-efficacy is a mediator between HLOC and life satisfaction, and that disability moderates this relationship. METHODS: The cross-sectional study included a total of 120 participants (including 50% women) aged between 18 and 63 years (M = 33.33, SD = 9.55), and consisting equally of disabled and non-disabled persons. Data were collected using the Satisfaction With Life Scale (SWLS), the Multidimensional Health Locus of Control (MHLC), and the General Self-Efficacy Scale (GSES). RESULTS: Consistent with most previous research, the results of this study indicate that life satisfaction decreased in persons with an acquired mobility impairment when compared to non-disabled participants. The study indicates that the GSES fully mediates the relationship between SWLS and all three scales of the MHLC: internal (IHLC), powerful others (PHLC), and chance (CHLC). In addition, Movement disability moderates the PHLC-GSES and CHLC-GSES relationships. CONCLUSIONS: The findings suggest that people with movement disability may construct life satisfaction differently than persons without disability. Self-efficacy should be a target in therapy to improve life satisfaction in people with mobility impairment.


Assuntos
Pessoas com Deficiência/psicologia , Pessoas com Deficiência/estatística & dados numéricos , Voluntários Saudáveis/estatística & dados numéricos , Transtornos dos Movimentos/psicologia , Satisfação Pessoal , Qualidade de Vida/psicologia , Autoeficácia , Adolescente , Adulto , Atitude Frente a Saúde , Estudos Transversais , Feminino , Voluntários Saudáveis/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Epilepsy Behav ; 106: 107028, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32203928

RESUMO

Nonepileptic attack disorder (NEAD) and functional movement disorder (FMD) are functional neurological disorders commonly seen in neuropsychiatry services. Although their initial referral pathways involve epileptologists (NEAD) and specialists in movement disorders (FMD), these conditions are currently classified as two possible manifestations of a single underlying conversion disorder. We set out to compare the characteristics of patients with NEAD and patients with FMD in order to quantify the degree of overlap between these patient groups. We retrospectively reviewed comprehensive clinical data from 146 consecutive patients with functional neurological disorders (NEAD: n = 117; FMD: n = 29) attending a specialist Neuropsychiatry Clinic run by a single Consultant in Behavioral Neurology. The two clinical groups were directly compared with regard to demographic and clinical characteristics, as well as somatic and psychiatric presentations. The results showed that in most features, there were no significant differences between patients with NEAD and patients with FMD. However, patients with NEAD reported an earlier age at onset (p = 0.033) and a higher proportion of acute onset (p = 0.037), alterations of consciousness (p = 0.001), and headache (p = 0.042), whereas patients with FMD reported a higher prevalence of childhood abuse (p = 0.008), as well as mobility problems (p = 0.007) and comorbid functional symptoms (dysarthria, p = 0.004; dizziness, p = 0.035; weakness, p = 0.049). Despite different phenotypic presentations, NEAD and FMD might represent a clinical continuum, with relevant implications in terms of both diagnostic strategies and treatment approaches.


Assuntos
Transtornos dos Movimentos/fisiopatologia , Transtornos dos Movimentos/psicologia , Convulsões/fisiopatologia , Convulsões/psicologia , Adulto , Transtorno Conversivo/diagnóstico , Transtorno Conversivo/fisiopatologia , Transtorno Conversivo/psicologia , Progressão da Doença , Transtornos Dissociativos/diagnóstico , Transtornos Dissociativos/fisiopatologia , Transtornos Dissociativos/psicologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/diagnóstico , Transtornos Psicofisiológicos/diagnóstico , Transtornos Psicofisiológicos/fisiopatologia , Transtornos Psicofisiológicos/psicologia , Estudos Retrospectivos , Convulsões/diagnóstico
15.
Inf. psiquiátr ; (239): 27-35, ene.-mar. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192461

RESUMO

La depresión es un proceso que se observa más frecuentemente en personas con enfermedades neurológicas que en la población general. Las manifestaciones clínicas de la depresión en los pacientes neurológicos pueden ser algo diferentes de las habituales. Por otra parte, supone un factor de riesgo para sufrir enfermedades neurodegenerativas y, a su vez, empeora el pronóstico de la patología neurológica. Aunque la depresión es frecuente en diversas enfermedades neurológicas, nos centraremos en las patologías vascular y neurodegenerativa, mucho más frecuentes en población geriátrica. La depresión postictus ocurre en uno de cada tres pacientes que han sufrido un ictus y es uno de los principales factores que dificultan la recuperación. La depresión es el segundo síndrome neuropsiquiátrico más frecuente en la enfermedad de Alzheimer tras la apatía. En la enfermedad de Parkinson la depresión es la manifestación psiquiátrica más frecuente. Las técnicas de neuroimagen están haciendo avanzar nuestros conocimientos sobre la neurobiología de la depresión y podrían ayudarnos, en un futuro, en el diagnóstico y en el control del tratamiento. El diagnóstico de la depresión en el paciente geriátrico con enfermedad neurológica con comitante adolece de la falta de escalas de evaluación específicas por lo que se siguen los criterios diagnósticos generales. En cuanto al tratamiento, tampoco existen protocolos tera-péuticos específicos para el paciente neurogeriátrico con depresión


Depression is a process that is observed more frequently in people with neurological diseases than in the general population. The clinical manifestations of depression in neurological patients may be somewhat different than usual. On the other hand, it represents a risk factor for neurodegenerative diseases and, in turn, worsens the prognosis of neurological pathology. Although depression is common in va-rious neurological diseases, we will focus on vascular and neurodegenerative pathologies, much more frequent in geriatric population. Post-stroke depression occurs in one in three patients who have suffered a stroke and is one of the main factors that make recovery difficult. Depression is the second most common neuropsychiatric syndrome in Alzheimer's disease after apathy. In Parkinson's disease, depression is the most frequent psychiatric manifestation.Neuroimaging techniques are advancing our knowledge about the neurobiology of depression and could help us, in the future, in the diagnosis and control of treatment. The diagnosis of depression in the geriatric patient with concomitant neurological disease suffers from the lack of specific evaluation scales, so the general diagnostic criteria are followed. Regarding treatment, there are no specific therapeutic protocols for the neurogeriatric patient with depression


Assuntos
Humanos , Idoso , Idoso de 80 Anos ou mais , Depressão/diagnóstico , Doenças do Sistema Nervoso/complicações , Idoso Fragilizado , Doenças Neurodegenerativas/psicologia , Doenças do Sistema Nervoso/psicologia , Acidente Vascular Cerebral , Neuroimagem/métodos , Transtornos dos Movimentos/psicologia
16.
Toxicol Lett ; 325: 1-13, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32088201

RESUMO

Olfaction is often affected in parkinsonian patients and its disturbances precede the classical cognitive and locomotor dysfunction. The olfactory bulb might be the region of onset in Parkinson's disease (PD) pathogenesis, evidenced by the presence of disease-related protein aggregates and disturbed olfactory information processing. However, the underlying molecular mechanism that governs the olfactory bulb impairments remains unclear. This study was designed to investigate the relationship between olfactory bulb and inflammatory pathological alterations and the potential mechanisms. Here we found that rotenone led to typical parkinsonian symptoms and decreased tyrosine hydroxylase (TH)-positive neurons in the olfactory bulb. Additionally, increased NF-κB nuclear translocation and NLRP3 inflammasome components expressions caused by rotenone injection were observed accompanied by the activation of microglia and astrocytes in the olfactory bulb. Rotenone also triggered Drp1-mediated mitochondrial fission and this in turn caused mitochondrial damage. Furthermore, Mdivi-1(a selective Drp1 inhibitor) markedly ameliorated the morphologic disruptions of mitochondria and Drp1 translocation, inhibited the nuclear translocation of NF-κB, eventually blocked the downstream pathway of the NLRP3/caspase-1/IL-1ß axis and expression of iNOS. Overall, these findings suggest that Drp1-dependent mitochondrial fission induces NF-κB nuclear translocation and NLRP3 inflammasome activation that may further contribute to olfactory bulb disturbances.


Assuntos
Dinaminas/genética , Bulbo Olfatório/patologia , Doença de Parkinson Secundária/genética , Doença de Parkinson Secundária/patologia , Rotenona/toxicidade , Desacopladores/toxicidade , Animais , Dinaminas/efeitos dos fármacos , Inflamassomos/genética , Masculino , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/patologia , Transtornos dos Movimentos/patologia , Transtornos dos Movimentos/psicologia , NF-kappa B/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Neurônios/patologia , Óxido Nítrico Sintase Tipo II/biossíntese , Óxido Nítrico Sintase Tipo II/genética , Doença de Parkinson Secundária/induzido quimicamente , Ratos , Ratos Sprague-Dawley , Olfato/genética , Tirosina 3-Mono-Oxigenase/metabolismo
17.
J Alzheimers Dis ; 74(1): 331-343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32039846

RESUMO

Corticobasal syndrome (CBS) is a neuropathologically heterogeneous entity. The use of cerebrospinal fluid and amyloid biomarkers enables detection of underlying Alzheimer's disease (AD) pathology. We thus compared clinical, eye movement, and 18FDG-PET imaging characteristics in CBS in two groups of patients divided according to their amyloid biomarkers profile. Fourteen patients presenting with CBS and amyloidosis (CBS-A+) were compared with 16 CBS patients without amyloidosis (CBS-A-). The two groups showed similar motor abnormalities (parkinsonism, dystonia) and global cognitive functions. Unlike CBS-A+ patients who displayed more posterior cortical abnormalities, CBS-A- patients demonstrated more anterior cortical and brain stem dysfunctions on the basis of neuropsychological testing, study of saccade velocities and brain hypometabolism areas on 18FDG-PET. Interestingly, Dopamine Transporter SPECT imaging showed similar levels of dopaminergic degeneration in both groups. These findings confirm common and distinct brain abnormalities between the different neurodegenerative diseases that result in CBS. We demonstrate the importance of a multidisciplinary approach to improve diagnosis in vivo in particular on oculomotor examination.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Amiloidose/diagnóstico por imagem , Idoso , Doença de Alzheimer/complicações , Amiloidose/complicações , Biomarcadores/líquido cefalorraquidiano , Tronco Encefálico/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Cognição , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Movimentos Oculares , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Transtornos dos Movimentos/complicações , Transtornos dos Movimentos/psicologia , Tomografia por Emissão de Pósitrons , Desempenho Psicomotor , Movimentos Sacádicos , Síndrome , Tomografia Computadorizada de Emissão de Fóton Único
18.
Int J Dev Neurosci ; 80(2): 106-122, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31990423

RESUMO

Many neuropsychiatric disorders are associated with both dopaminergic (DAergic) and developmental hypotheses. Since DAergic receptors are expressed in the developing brain, it is possible that alterations in dopamine (DA) signaling may impair brain development and consequent behavior. In our previous study, using a zebrafish model, we showed that an increase of DA during the 3 to 5 days postfertilization (dpf) developmental window (an important window for GABAergic neuronal differentiation) affects the motor behavior of 5 dpf larvae. In this study, we set out to determine whether these behavioral alterations were sustained in larvae at older stages (7 and 14 dpf). To test this hypothesis, we chronically treated zebrafish larvae from 3 to 5 dpf with DA. After washing the drug, we recorded and analyzed the first 5 and 30 min of the motor behavior of 5, 7, and 14 dpf subjects. We analyzed mobile episodes, distance traveled, time mobile, distance traveled per mobile episode, time in movement per mobile episode, and distance traveled per time mobile. We showed, once again, that an increase of DA during the 3 to 5 dpf developmental window reduces the number of movement episodes initiated by 5 dpf larvae. We also detected a decrease of other motor behavior parameters in 5 dpf DA-treated larvae. We observed that these alterations are sustained in the 7 dpf larvae. However, we did not see these general locomotor alterations in the 14 dpf larvae. Moreover, we detected a decrease of distance traveled and an increase of time of locomotion per episode in the first 5 min of behavioral analyses in 14 dpf DA-treated larvae. To test if the alterations in the first 5 min were due to anxiety-like behavior, we used a light/dark preference paradigm. We recorded 5dpf, 7dpf, and 14dpf larvae for 5 min and analyzed time of freezing, preference for light or dark, number of entries to the dark, percentage of time in the light. We observed that 5dpf larvae treated with DA showed more freezing, less passages to the dark, and more time spent in the light as compared to their control counterparts. But 7dpf and 14dpf larvae did not show these alterations. Taken overall, therefore, our results suggest that DA does play a role in the development of zebrafish motor behavior, and, furthermore, that some behaviors are more sensitive than others to the effects of DAergic imbalances during development.


Assuntos
Ansiedade/psicologia , Dopamina/farmacologia , Larva/crescimento & desenvolvimento , Transtornos dos Movimentos/psicologia , Peixe-Zebra/crescimento & desenvolvimento , Envelhecimento , Animais , Ansiedade/induzido quimicamente , Luz , Locomoção/efeitos dos fármacos , Atividade Motora/efeitos dos fármacos
19.
J Neurol Surg A Cent Eur Neurosurg ; 81(2): 105-110, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935786

RESUMO

OBJECTIVE: We recently developed a new subcortical mapping technique based on the concept of stimulating the tissue at the site of and synchronously with resection. Our hypothesis was that instead of performing resection and mapping sequentially, a synchronized resection and mapping could potentially improve deficit rates. METHODS: We report our 5-year series of patients who prospectively underwent tumor surgery adjacent to the corticospinal tract (CST) (defined as < 1 cm using diffusion tension imaging and fiber tracking) with simultaneous subcortical short train cathodal monopolar mapping, equipped with a new acoustic motor evoked potential (MEP) alarm. Continuous (temporal coverage) and dynamic (spatial coverage) mapping was realized technically by integrating the mapping probe at the tip of a new suction device. Motor function was assessed using the Medical Research Council scale (from M1 to M5) 1 day after surgery, at discharge, and at 3 months. RESULTS: Technically, the method was successful in all 182 cases. The lowest individual motor thresholds reached during resection were > 10 mA, n = 56; 6-10 mA, n = 31; 4-5 mA, n = 37; and 1-3 mA, n = 58. At 3 months, six patients (3%) had a persisting postoperative motor deficit that was caused by direct mechanical injury in three of these patients (1.7%). CONCLUSIONS: Continuous dynamic mapping was found to be a feasible and ergonomic technique for localizing the exact site of the CST and distance to the motor fibers. This new technique may improve the safety of motor eloquent tumor surgery.


Assuntos
Mapeamento Encefálico/métodos , Neoplasias Encefálicas/diagnóstico por imagem , Tratos Piramidais/diagnóstico por imagem , Adulto , Idoso , Neoplasias Encefálicas/cirurgia , Simulação por Computador , Imagem de Difusão por Ressonância Magnética , Epilepsia Motora Parcial , Feminino , Humanos , Monitorização Neurofisiológica Intraoperatória , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/diagnóstico por imagem , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/psicologia , Procedimentos Neurocirúrgicos , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/psicologia , Estudos Prospectivos , Software , Resultado do Tratamento
20.
J Neuropsychiatry Clin Neurosci ; 32(1): 67-72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31564234

RESUMO

OBJECTIVE: The purpose of this study was to determine whether patients with functional movement disorders (FMDs) differ in their internal versus external locus of control (LOC) and whether LOC in these patients affected disease severity, quality of life, and functional impairment compared with control subjects with degenerative (Parkinson's disease) and nondegenerative (focal dystonia) neurological conditions. METHODS: A total of 156 patients with FMD (N=45), Parkinson's disease (N=64), and focal dystonia (N=47) were recruited between June 2015 and August 2017. The authors administered the general Levenson Multidimensional LOC (LOC-G) and health-specific Multidimensional Health LOC (LOC-H) scales. An internal LOC was represented similarly in both scales: the external LOC included "chance" and "powerful others" in the LOC-G measure and chance, "other people," and "doctors" in the LOC-H measure. Quality of life, functional impairment, and FMD severity were assessed. One-way analysis of variance and adjusted logistic regressions were used, as well as ordinary least-squares between and within groups, respectively. RESULTS: Patients with FMD had lower external chance LOC-G scores compared with patients in the Parkinson's disease group (odds ratio=0.90, p=0.03) and higher internal (odds ratio=1.22, p=0.01) and lower external (odds ratio=0.77, p=0.02) doctors LOC-H scores compared with patients in the focal dystonia group. External powerful others LOC-G score was associated with functional impairment (regression coefficient=-0.04, p=0.02). There were no effects of LOC on quality of life or disease severity. CONCLUSIONS: Patients with FMD exhibited high "within our control" internal general and health-specific frame of reference. LOC had no influence on quality of life or disease severity in this patient population.


Assuntos
Transtorno Conversivo/psicologia , Distúrbios Distônicos/psicologia , Controle Interno-Externo , Transtornos dos Movimentos/psicologia , Doença de Parkinson/psicologia , Transtornos Psicofisiológicos/psicologia , Adulto , Idoso , Transtorno Conversivo/fisiopatologia , Estudos Transversais , Distúrbios Distônicos/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/fisiopatologia , Doença de Parkinson/fisiopatologia , Transtornos Psicofisiológicos/fisiopatologia , Qualidade de Vida , Índice de Gravidade de Doença
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...