RESUMO
OBJECTIVE: Chronic renal failure frequently causes uremic encephalopathy with impairment of various cognitive functions, but the pathophysiology of uremic syndrome is complex and poorly understood. In this study, we wished to establish a reliable tool and monitor system to evaluate the central nervous system dysfunction of patients with uremic encephalopathy. METHODS: A group of 31 patients with chronic renal failure was assessed with online real time brain mapping using the CATEEM technology to detect deviations and abnormal EEG patterns. Quantitative EEG data were compared with those of an age-matched healthy control group and correlated to laboratory markers and various dosages of erythropoietin. RESULTS: Electrical power was most prominent in delta, theta and alpha frequencies in the temporal and central brain areas (electrode positions T5, T6, C3 and C4). Explorative statistical comparison of the two data sets with respect to these brain areas revealed that the increases in electrical power in delta, theta and alpha frequency bands were different from healthy people with p-values of p<0.003 (delta), p<0.0003 (theta), p<0.01 (alpha 1) and p<0.01 (alpha 2). In addition, high levels of hemoglobin were significantly correlated with higher theta activity. CONCLUSION: We detected distinct EEG deviations from normality in patients with chronic renal failure. Online real time brain mapping using the CATEEM technology provides a unique possibility to monitor mental impairment and serves as a control for therapeutical intervention.
Assuntos
Eletroencefalografia , Falência Renal Crônica/fisiopatologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Mapeamento Encefálico , Estudos de Casos e Controles , Eritropoetina/administração & dosagem , Feminino , Humanos , Falência Renal Crônica/tratamento farmacológico , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Proteínas Recombinantes , Diálise RenalRESUMO
Although inflammatory demyelination is considered to be the key feature in multiple sclerosis (MS) pathogenesis, histopathological investigations and MRI studies recently highlighted the extent of neuronal damage that occurs even in the early stages of the disease. We report the unusual case of a patient with Machado-Joseph disease (MJD; spinocerebellar ataxia (SCA) III) and discuss this coincidence in light current pathogenetic paradigms of CNS autoimmunity.