Neurologia最新文献

英文中文

Association between psoriasis and dementia: A systematic review 银屑病与痴呆症之间的关系：系统回顾

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2020.12.007

J. Zhao , T. Li , J. Wang

Introduction

Risk factors for dementia include genetic factors, aging, environmental factors, certain diseases, and unhealthy lifestyle; most types of dementia share a common chronic systemic inflammatory phenotype. Psoriasis is also considered to be a chronic systemic inflammatory disease. It has been suggested that psoriasis may also contribute to the risk of dementia. The aim of this study was to systematically review the literature on the association between psoriasis and dementia.

Development

Articles were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched the PubMed and Web of Science databases to identify articles published in peer-reviewed journals and studying the association between psoriasis and dementia. Studies meeting the inclusion criteria were reviewed. We used the Newcastle–Ottawa Scale to assess the quality of each study. After applying the inclusion and exclusion criteria, we included 8 studies for review, 3 of which were found to present a higher risk of bias. Six of the 8 studies supported the hypothesis that prior diagnosis of psoriasis increases the risk of dementia; one study including only a few cases reported that psoriasis decreased the risk of dementia, and one study including relatively young patients found no significant association between psoriasis and the risk of dementia.

Conclusion

Most studies included in this review supported the hypothesis that psoriasis constitutes a risk factor for dementia. However, well-designed stratified cohort studies assessing both psoriasis severity and treatment status are still required to determine the real effect of psoriasis on the risk of dementia and its subtypes.

导言：痴呆症的风险因素包括遗传因素、衰老、环境因素、某些疾病和不健康的生活方式；大多数类型的痴呆症都有共同的慢性全身炎症表型。银屑病也被认为是一种慢性全身性炎症性疾病。有人认为，银屑病也可能导致痴呆症的风险。本研究旨在系统回顾有关银屑病与痴呆症之间关系的文献。文章的筛选根据系统综述和荟萃分析首选报告项目（PRISMA）指南进行。我们搜索了 PubMed 和 Web of Science 数据库，以确定发表在同行评审期刊上、研究银屑病与痴呆症关系的文章。我们对符合纳入标准的研究进行了审查。我们使用纽卡斯尔-渥太华量表来评估每项研究的质量。应用纳入和排除标准后，我们纳入了 8 项研究进行审查，发现其中 3 项研究存在较高的偏倚风险。在这 8 项研究中，有 6 项研究支持 "银屑病会增加痴呆症风险 "的假设；1 项仅纳入少数病例的研究报告称银屑病会降低痴呆症风险；1 项纳入相对年轻患者的研究发现银屑病与痴呆症风险之间没有显著关联。然而，要确定银屑病对痴呆症及其亚型风险的真正影响，还需要进行精心设计的分层队列研究，评估银屑病的严重程度和治疗状况。

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引用次数: 5

Bilingüismo y lenguaje en niños con trastorno del espectro autista: una revisión sistemática 自闭症谱系障碍儿童的双语能力和语言：系统综述

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2021.04.010

D. Garrido , B. López , G. Carballo

Introduction

Communication and language skills are among the most severely affected domains in individuals with autistic spectrum disorder (ASD). When a child diagnosed with ASD lives in a bilingual environment, the parents often express concerns about whether their child should learn both languages simultaneously, turning to specialists for advice. Despite the lack of evidence of any negative effect, some professionals disagree on this subject. In this systematic review we study whether bilingualism affects language development in children with ASD.

Methods

We reviewed the literature published in 4 different databases. After applying a series of selection criteria, we selected 12 scientific articles, including a total of 328 children diagnosed with ASD (169 bilingual and 159 monolingual), with ages ranging from 3 to 12 years. These patients were evaluated with different receptive and expressive language assessment instruments covering several areas. The assessments were performed directly on the children, although indirect assessment of parents was also performed in some studies.

Conclusions

There seems to be consensus regarding the assertion that bilingualism does not entail any additional difficulty for language development in children with ASD from the age of 3.

导言沟通和语言技能是自闭症谱系障碍（ASD）患者受影响最严重的领域之一。当被诊断为自闭症谱系障碍的儿童生活在双语环境中时，他们的父母往往会对孩子是否应该同时学习两种语言表示担忧，并向专家寻求建议。尽管没有证据表明这对孩子有任何负面影响，但一些专业人士对此持不同意见。在这篇系统性综述中，我们研究了双语是否会影响 ASD 儿童的语言发展。在应用了一系列筛选标准后，我们选出了 12 篇科学论文，共包括 328 名被诊断为 ASD 的儿童（169 名双语儿童和 159 名单语儿童），年龄从 3 岁到 12 岁不等。我们使用不同的接受性和表达性语言评估工具对这些患者进行了评估，涉及多个领域。尽管有些研究也对家长进行了间接评估，但这些评估都是直接对儿童进行的。结论双语并不会给 3 岁以上的 ASD 儿童的语言发展带来额外的困难，这一观点似乎已达成共识。

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引用次数: 1

Encefalopatía epiléptica y del desarrollo asociada a mutación del SYNGAP1: descripción de un caso y respuesta al tratamiento con cannabidiol 与SYNGAP1突变相关的癫痫和发育性脑病:一个病例的描述和对大麻二酚治疗的反应

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2023.01.002

Y. López-Moreno , P. Cabezudo-García , N.L. Ciano-Petersen , G. García-Martín , P.J. Serrano-Castro

引用次数: 0

Ludificación y neurorrehabilitación motora en niños y adolescentes: revisión sistemática 儿童和青少年的跛行和运动神经康复：系统综述

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2021.02.011

M. Pimentel-Ponce , R.P. Romero-Galisteo , R. Palomo-Carrión , E. Pinero-Pinto , J.A. Merchán-Baeza , M. Ruiz-Muñoz , J. Oliver-Pece , M. González-Sánchez

Introduction

Gamification consists of the use of games in non-playful contexts. It is widely employed in the motor rehabilitation of neurological diseases, but mainly in adult patients. The objective of this review was to describe the use of gamification in the rehabilitation of children and adolescents with neuromotor impairment.

Methods

We performed a systematic review of clinical trials published to date on the MEDLINE (PubMed), Scielo, SCOPUS, Dialnet, CINAHL, and PEDro databases, following the PRISMA protocol. The methodological quality of the studies identified was assessed using the PEDro scale.

Results

From a total of 469 studies, 10 clinical trials met the inclusion criteria. We analysed the gamification systems used as part of the rehabilitation treatment of different neuromotor conditions in children and adolescents. Cerebral palsy was the most frequently studied condition (6 studies), followed by developmental coordination disorder (3), and neurological impairment of balance and coordination (1).

Conclusion

The use of gamification in rehabilitation is helpful in the conventional treatment of neuromotor disorders in children and adolescents, with increased motivation and therapeutic adherence being the benefits with the greatest consensus among authors. While strength, balance, functional status, and coordination also appear to improve, future research should aim to determine an optimal dosage.

导言游戏化包括在非游戏环境中使用游戏。游戏化广泛应用于神经系统疾病的运动康复，但主要针对成年患者。我们按照PRISMA协议，对MEDLINE（PubMed）、Scielo、SCOPUS、Dialnet、CINAHL和PEDro数据库中迄今为止发表的临床试验进行了系统回顾。结果在总共 469 项研究中，有 10 项临床试验符合纳入标准。我们分析了作为儿童和青少年不同神经运动症状康复治疗一部分的游戏化系统。脑瘫是最常被研究的病症（6 项研究），其次是发育协调障碍（3 项）和平衡与协调神经损伤（1 项）。虽然力量、平衡、功能状态和协调性似乎也有所改善，但未来的研究应以确定最佳剂量为目标。

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引用次数: 0

Miopatía nemalínica esporádica de inicio tardío manifestándose como una insuficiencia respiratoria hipercápnica 迟发性散发性线粒体肌病表现为高呼吸衰竭

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2023.01.001

D.A. García Estévez , A. Juanatey-García , B. San Millán Tejado , F. Barros Angueira

引用次数: 0

“Flail arm syndrome” with anti-Hu antibodies 带有抗胡抗体的“连枷臂综合征”

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2022.11.002

M.M. Rosselló Vadell, F. Miralles

引用次数: 0

Evaluation of the anticonvulsant and neuroprotective effect of intracerebral administration of growth hormone in rats 评估大鼠脑内注射生长激素的抗惊厥和神经保护作用

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2021.03.010

I. Zamora-Bello , A. Martínez , L. Beltrán-Parrazal , I. Santiago-Roque , E. Juárez-Aguilar , M.L. López-Meraz

Introduction

The growth hormone (GH) has been reported as a crucial neuronal survival factor in the hippocampus against insults of diverse nature. Status epilepticus (SE) is a prolonged seizure that produces extensive neuronal cell death. The goal of this study was to evaluate the effect of intracerebroventricular administration of GH on seizure severity and SE-induced hippocampal neurodegeneration.

Methodology

Adult male rats were implanted with a guide cannula in the left ventricle and different amounts of GH (70, 120 or 220 ng/3 μl) were microinjected for 5 days; artificial cerebrospinal fluid was used as the vehicle. Seizures were induced by the lithium–pilocarpine model (3 mEq/kg LiCl and 30 mg/kg pilocarpine hydrochloride) one day after the last GH administration. Neuronal injury was assessed by Fluoro-Jade B (F-JB) staining.

Results

Rats injected with 120 ng of GH did not had SE after 30 mg/kg pilocarpine, they required a higher number of pilocarpine injections to develop SE than the rats pretreated with the vehicle, 70 ng or 220 ng GH. Prefrontal and parietal cortex EEG recordings confirmed that latency to generalized seizures and SE was also significantly higher in the 120 ng group when compared with all the experimental groups. FJ-B positive cells were detected in the hippocampus after SE in all rats, and no significant differences in the number of F-JB cells in the CA1 area and the hilus was observed between experimental groups.

Conclusion

Our results indicate that, although GH has an anticonvulsive effect in the lithium–pilocarpine model of SE, it does not exert hippocampal neuroprotection after SE.

导言据报道，生长激素（GH）是海马中一种关键的神经元存活因子，可抵御各种性质的损伤。癫痫状态（SE）是一种长时间的癫痫发作，会导致大量神经细胞死亡。本研究的目的是评估脑室内注射 GH 对癫痫发作严重程度和 SE 诱导的海马神经变性的影响。方法将导管植入成年雄性大鼠左心室，微量注射不同剂量的 GH（70、120 或 220 ng/3 μl），持续 5 天；人工脑脊液作为载体。在最后一次注射 GH 一天后，通过锂-匹洛卡品模型（3 mEq/kg 氯化锂和 30 mg/kg 盐酸匹洛卡品）诱发癫痫发作。结果注射120 ng GH的大鼠在注射30 mg/kg盐酸匹罗卡品后没有出现SE，但它们需要注射更多的盐酸匹罗卡品才能出现SE，这要高于用载体、70 ng或220 ng GH预处理的大鼠。前额叶和顶叶皮层脑电图记录证实，与所有实验组相比，120 ng 组大鼠全身性癫痫发作和 SE 的潜伏期也明显较长。结论我们的研究结果表明，虽然 GH 在锂-匹罗卡品 SE 模型中具有抗惊厥作用，但它并不能在 SE 后发挥海马神经保护作用。

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引用次数: 0

Modelo de riesgo de crisis en acúmulos o estado epiléptico e intervención en servicios de urgencias 群集性或状态性癫痫发作风险模型及急诊科干预措施

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2024-01-01 DOI: 10.1016/j.nrl.2021.02.015

C. Fernández Alonso , F. González Martínez , R. Alonso Avilés , M. Liñán López , M.E. Fuentes Ferrer , B. Gros Bañeres , en representación de grupo ACESUR

Objectives

To identify possible predictors of seizure cluster or status epilepticus (SE) and to evaluate whether these patients receive greater interventions in emergency departments.

Methodology

We conducted a secondary analysis of the ACESUR Registry, a multipurpose, observational, prospective, multicentre registry of adult patients with seizures from 18 emergency departments. Clinical and care-related variables were collected. We identified risk factors and risk models for seizure cluster or SE and assessed the effect of interventions by prehospital emergency services and the hospital emergency department.

Results

We identified a total of 186 (28%) patients from the ACESUR registry with seizure cluster (126 [19%]) or SE (60 [9%]); the remaining 478 patients (72%) had isolated seizures. The risk model for seizure cluster or SE in the emergency department included Charlson Comorbidity Index scores ≥ 3 (OR: 1.60; 95% CI, 1.05-2.46; P = .030), ≥ 2 habitual antiepileptic drugs (OR: 2.29; 95% CI, 1.49-3.51; P < .001), and focal seizures (OR: 1.56; 95% CI, 1.05-2.32; P = .027). The area under the curve of the model was 0.735 (95% CI, 0.693-0.777; P = .021). Patients with seizure cluster and SE received more aggressive interventions both by prehospital emergency services (OR: 2.89; 95% CI, 1.91-4.36; P < .001) and at the emergency department (OR: 4.41; 95% CI, 2.69-7.22; P < .001).

Conclusions

This risk model may be of prognostic value in identifying adult patients at risk of presenting seizure cluster or SE in the emergency department. In our sample, these patients received more aggressive treatment than adult patients with isolated seizures before arriving at hospital, and even more so in the emergency department.

方法我们对 ACESUR 登记进行了二次分析，这是一项多用途、观察性、前瞻性、多中心登记，登记对象为 18 个急诊科的成年癫痫发作患者。我们收集了临床和护理相关变量。我们确定了癫痫群发或SE的风险因素和风险模型，并评估了院前急救服务和医院急诊科干预措施的效果。结果我们从ACESUR登记处共发现186例（28%）患者有癫痫群发（126例[19%]）或SE（60例[9%]）；其余478例患者（72%）有孤立癫痫发作。急诊科癫痫群发或SE的风险模型包括Charlson合并症指数评分≥3（OR：1.60；95% CI，1.05-2.46；P = .030）、习惯性抗癫痫药物≥2（OR：2.29；95% CI，1.49-3.51；P <；.001）和局灶性癫痫发作（OR：1.56；95% CI，1.05-2.32；P = .027）。模型的曲线下面积为 0.735 (95% CI, 0.693-0.777; P = .021)。院前急救服务（OR：2.89；95% CI，1.91-4.36；P <；.001）和急诊科（OR：4.41；95% CI，2.69-7.22；P <；.001）均对癫痫发作群集和 SE 患者采取了更积极的干预措施。在我们的样本中，这些患者在入院前接受的治疗比单独发作的成年患者更积极，在急诊科接受的治疗甚至更积极。

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引用次数: 1

Midriasis unilateral episódica benigna: reporte de un caso y enfoque clínico-topográfico 良性单侧发作性眼球震颤：病例报告和临床地形学方法

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2023-12-30 DOI: 10.1016/j.nrl.2023.04.003

V. Valencia-Cifuentes , J. Quiñones

引用次数: 0

Systematic review of gender bias in clinical trials of monoclonal antibodies for the treatment of multiple sclerosis 单克隆抗体治疗多发性硬化症临床试验中性别偏倚的系统评价

IF 3.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia

Pub Date : 2023-11-01 DOI: 10.1016/j.nrl.2021.01.003

M. Alonso-Moreno, M. Ladrón-Guevara, P. Ciudad-Gutiérrez

Introduction

This article analyses the presence of gender bias in clinical trials of monoclonal antibodies used to treat multiple sclerosis.

Material and methods

We performed a systematic review of controlled clinical trials of 4 monoclonal antibodies used to treat multiple sclerosis (natalizumab, rituximab, alemtuzumab, and ocrelizumab). We searched the PubMed/MEDLINE database for articles published in English before March 2020. The study was conducted in accordance with the relevant international recommendations.

Results

The search identified 89 articles, 55 of which met the inclusion criteria. Of all patients included in these trials, 64.6% were women. The lead authors of 10 of the studies were women. Fifteen of the 55 studies included a sex-based analysis of the primary endpoint. Only 8 articles discussed the results separately for men and for women.

Conclusions

The clinical trials of these 4 monoclonal antibodies present a significant gender bias. In most cases, the primary and secondary endpoints are not analyzed according to patient sex, despite the fact that international recommendations include this as a minimum requirement for ensuring scientific validity and obtaining appropriate results for extrapolation to the wider population.

本文分析了用于治疗多发性硬化症的单克隆抗体临床试验中存在的性别偏见。材料和方法我们对用于治疗多发性硬化症的4种单克隆抗体(natalizumab, rituximab, alemtuzumab和ocrelizumab)的对照临床试验进行了系统回顾。我们在PubMed/MEDLINE数据库中检索了2020年3月之前发表的英文文章。这项研究是按照有关的国际建议进行的。结果共检索到89篇文献，其中55篇符合纳入标准。在这些试验的所有患者中，64.6%是女性。其中10项研究的主要作者是女性。55项研究中有15项包括基于性别的主要终点分析。只有8篇文章分别讨论了男性和女性的结果。结论4种单克隆抗体在临床试验中存在明显的性别偏倚。在大多数情况下，主要和次要终点没有根据患者的性别进行分析，尽管国际建议将其作为确保科学有效性和获得适当结果以外推到更广泛人群的最低要求。

{"title":"Systematic review of gender bias in clinical trials of monoclonal antibodies for the treatment of multiple sclerosis","authors":"M. Alonso-Moreno, M. Ladrón-Guevara, P. Ciudad-Gutiérrez","doi":"10.1016/j.nrl.2021.01.003","DOIUrl":"10.1016/j.nrl.2021.01.003","url":null,"abstract":"<div><h3>Introduction</h3><p>This article analyses the presence of gender bias in clinical trials of monoclonal antibodies used to treat multiple sclerosis.</p></div><div><h3>Material and methods</h3><p>We performed a systematic review of controlled clinical trials of 4 monoclonal antibodies used to treat multiple sclerosis (natalizumab, rituximab, alemtuzumab, and ocrelizumab). We searched the PubMed/MEDLINE database for articles published in English before March 2020. The study was conducted in accordance with the relevant international recommendations.</p></div><div><h3>Results</h3><p>The search identified 89 articles, 55 of which met the inclusion criteria. Of all patients included in these trials, 64.6% were women. The lead authors of 10 of the studies were women. Fifteen of the 55 studies included a sex-based analysis of the primary endpoint. Only 8 articles discussed the results separately for men and for women.</p></div><div><h3>Conclusions</h3><p>The clinical trials of these 4 monoclonal antibodies present a significant gender bias. In most cases, the primary and secondary endpoints are not analyzed according to patient sex, despite the fact that international recommendations include this as a minimum requirement for ensuring scientific validity and obtaining appropriate results for extrapolation to the wider population.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 9","pages":"Pages 695-706"},"PeriodicalIF":3.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.01.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25523612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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