Pub Date : 2023-10-01DOI: 10.1016/j.nrl.2020.10.017
M. Vázquez-Marrufo , E. Sarrias-Arrabal , M. García-Torres , R. Martín-Clemente , G. Izquierdo
Introduction
The applications of artificial intelligence, and in particular automatic learning or “machine learning” (ML), constitute both a challenge and a great opportunity in numerous scientific, technical, and clinical disciplines. Specific applications in the study of multiple sclerosis (MS) have been no exception, and constitute an area of increasing interest in recent years.
Objective
We present a systematic review of the application of ML algorithms in MS.
Materials and methods
We used the PubMed search engine, which allows free access to the MEDLINE medical database, to identify studies including the keywords “machine learning” and “multiple sclerosis.” We excluded review articles, studies written in languages other than English or Spanish, and studies that were mainly technical and did not specifically apply to MS. The final selection included 76 articles, and 38 were rejected.
Conclusions
After the review process, we established 4 main applications of ML in MS: 1) classifying MS subtypes; 2) distinguishing patients with MS from healthy controls and individuals with other diseases; 3) predicting progression and response to therapeutic interventions; and 4) other applications. Results found to date have shown that ML algorithms may offer great support for health professionals both in clinical settings and in research into MS.
{"title":"Revisión sistemática de la aplicación de algoritmos de «machine learning» en la esclerosis múltiple","authors":"M. Vázquez-Marrufo , E. Sarrias-Arrabal , M. García-Torres , R. Martín-Clemente , G. Izquierdo","doi":"10.1016/j.nrl.2020.10.017","DOIUrl":"https://doi.org/10.1016/j.nrl.2020.10.017","url":null,"abstract":"<div><h3>Introduction</h3><p>The applications of artificial intelligence, and in particular automatic learning or “machine learning” (ML), constitute both a challenge and a great opportunity in numerous scientific, technical, and clinical disciplines. Specific applications in the study of multiple sclerosis (MS) have been no exception, and constitute an area of increasing interest in recent years.</p></div><div><h3>Objective</h3><p>We present a systematic review of the application of ML algorithms in MS.</p></div><div><h3>Materials and methods</h3><p>We used the PubMed search engine, which allows free access to the MEDLINE medical database, to identify studies including the keywords “machine learning” and “multiple sclerosis.” We excluded review articles, studies written in languages other than English or Spanish, and studies that were mainly technical and did not specifically apply to MS. The final selection included 76 articles, and 38 were rejected.</p></div><div><h3>Conclusions</h3><p>After the review process, we established 4 main applications of ML in MS: 1) classifying MS subtypes; 2) distinguishing patients with MS from healthy controls and individuals with other diseases; 3) predicting progression and response to therapeutic interventions; and 4) other applications. Results found to date have shown that ML algorithms may offer great support for health professionals both in clinical settings and in research into MS.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 8","pages":"Pages 577-590"},"PeriodicalIF":3.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2020.10.017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50190507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.nrl.2021.02.006
M. Torres-Ferrus , A.C. López-Veloso , V. Gonzalez-Quintanilla , N. González-García , J. Díaz de Teran , A. Gago-Veiga , J. Camiña , M. Ruiz , N. Mas-Sala , S. Bohórquez , V.J. Gallardo , P. Pozo-Rosich
Background
Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning.
Objective
To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities.
Method
This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction.
Results
We included 306 patients (85.6% women, mean age 42.3 ±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17–5.00]; p < 0.001), being older than 46.5 years (4.04 [2.48–6.59]; p < 0.001), having chronic migraine (2.31 [1.41–3.77]; p = 0.001), using preventive medication (2.45 [1.35–4.45]; p = 0.004), analgesic overusing (3.51 [2.03–6.07]; p < 0.001), menopause (4.18 [2.43–7.17]; p < 0.001) and anxiety (2.90 [1.80–4.67]; p < 0.001) and depression (6.14 [3.18–11.83]; p < 0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62–0.85), Kappa: 0.48, p = 0.005).
Conclusions
Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.
{"title":"The MIGREX study: Prevalence and risk factors of sexual dysfunction among migraine patients","authors":"M. Torres-Ferrus , A.C. López-Veloso , V. Gonzalez-Quintanilla , N. González-García , J. Díaz de Teran , A. Gago-Veiga , J. Camiña , M. Ruiz , N. Mas-Sala , S. Bohórquez , V.J. Gallardo , P. Pozo-Rosich","doi":"10.1016/j.nrl.2021.02.006","DOIUrl":"10.1016/j.nrl.2021.02.006","url":null,"abstract":"<div><h3>Background</h3><p>Migraine attacks have a high impact on daily activities. There is limited research on the burden of migraine on sexual functioning.</p></div><div><h3>Objective</h3><p>To determine the prevalence of sexual dysfunction in patients with migraine and its relationship with migraine features and comorbidities.</p></div><div><h3>Method</h3><p>This is a cross-sectional study. We included migraine patients between 18 and 60 years-old from 8 Headache Clinics in Spain. We recorded demographic data and migraine features. Patients fulfilled a survey including comorbidities, Arizona Sexual Experiences Scale, Hospital Anxiety and Depression Scale and a questionnaire about migraine impact on sexual activity. A K-nearest neighbor supervised learning algorithm was used to identify differences between migraine patients with and without sexual dysfunction.</p></div><div><h3>Results</h3><p>We included 306 patients (85.6% women, mean age 42.3<!--> <!-->±11.1 years). A 41.8% of participants had sexual dysfunction. Sexual dysfunction was associated with being female (OR [95% CI]: 2.42 [1.17–5.00]; <em>p</em> <!--><<!--> <!-->0.001), being older than 46.5 years (4.04 [2.48–6.59]; <em>p</em> <!--><<!--> <!-->0.001), having chronic migraine (2.31 [1.41–3.77]; <em>p</em> <!-->=<!--> <!-->0.001), using preventive medication (2.45 [1.35–4.45]; <em>p</em> <!-->=<!--> <!-->0.004), analgesic overusing (3.51 [2.03–6.07]; <em>p</em> <!--><<!--> <!-->0.001), menopause (4.18 [2.43–7.17]; <em>p</em> <!--><<!--> <!-->0.001) and anxiety (2.90 [1.80–4.67]; <em>p</em> <!--><<!--> <!-->0.001) and depression (6.14 [3.18–11.83]; <em>p</em> <!--><<!--> <!-->0.001). However, only female gender, age, menopause and depression were the statistically significant variables selected in the model to classify migraine patients with or without sexual dysfunction (Accuracy [95% CI]: 0.75 (0.62–0.85), Kappa: 0.48, <em>p</em> <!-->=<!--> <!-->0.005).</p></div><div><h3>Conclusions</h3><p>Sexual dysfunction is frequent in migraine patients visited in a headache clinic. However, migraine characteristics or use of preventive medication are not directly associated with sexual dysfunction. Instead, risk factors for sexual dysfunction were female gender, higher age, menopause and depression.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 8","pages":"Pages 541-549"},"PeriodicalIF":3.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25518477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.nrl.2022.09.006
M. Viscasillas Sancho, C. Moreno Loscertales, S. García Rubio, D. Sagarra Mur
{"title":"Encefalopatía de Hashimoto posvacuna frente a coronavirus 2 del síndrome respiratorio agudo grave","authors":"M. Viscasillas Sancho, C. Moreno Loscertales, S. García Rubio, D. Sagarra Mur","doi":"10.1016/j.nrl.2022.09.006","DOIUrl":"https://doi.org/10.1016/j.nrl.2022.09.006","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 8","pages":"Pages 601-602"},"PeriodicalIF":3.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50169050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.1016/j.nrl.2020.10.015
R. López-Blanco , A. Sorrentino Rodriguez , E. Cubo , Í. Gabilondo , D. Ezpeleta , M.A. Labrador-Espinosa , Á. Sánchez-Ferro , C. Tejero , M. Matarazzo , por el Comité Ad-Hoc de Nuevas Tecnologías de la SEN
Introduction
New technologies (NT) are increasingly widespread in biomedicine. Using the consensus definition of NT established by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology (SEN), we evaluated the impact of these technologies on Spanish neurology, based on communications presented at Annual Meetings of the SEN.
Material and methods
We defined the concept of NT in neurology as a novel technology or novel application of an existing technology, characterised by a certain degree of coherence persisting over time, with the potential to have an impact on the present and/or future of neurology. We conducted a descriptive study of scientific communications presented at the SEN's annual meetings from 2012 to 2018, analysing the type of NT, the field of neurology, and the geographical provenance of the studies.
Results
We identified 299 communications related with NT from a total of 8,139 (3.7%), including 120 posters and 179 oral communications, ranging from 1.6% of all communications in 2012 to 6.8% in 2018. The technologies most commonly addressed were advanced neuroimaging (24.7%), biosensors (17.1%), electrophysiology and neurostimulation (14.7%), and telemedicine (13.7%). The neurological fields where NT were most widely employed were movement disorders (18.4%), cerebrovascular diseases (15.7%), and dementia (13.4%). Madrid was the region presenting the highest number of communications related to NT (32.8%), followed by Catalonia (26.8%) and Andalusia (9.0%).
Conclusions
The number of communications addressing NT follows an upward trend. The number of NT used in neurology has increased in parallel with their availability. We found scientific communications in all neurological subspecialties, with a heterogeneous geographical distribution.
{"title":"Impacto de las nuevas tecnologías en la neurología en España. Revisión del Comité Ad-Hoc de Nuevas Tecnologías de la Sociedad Española de Neurología","authors":"R. López-Blanco , A. Sorrentino Rodriguez , E. Cubo , Í. Gabilondo , D. Ezpeleta , M.A. Labrador-Espinosa , Á. Sánchez-Ferro , C. Tejero , M. Matarazzo , por el Comité Ad-Hoc de Nuevas Tecnologías de la SEN","doi":"10.1016/j.nrl.2020.10.015","DOIUrl":"https://doi.org/10.1016/j.nrl.2020.10.015","url":null,"abstract":"<div><h3>Introduction</h3><p>New technologies (NT) are increasingly widespread in biomedicine. Using the consensus definition of NT established by the New Technologies Ad-Hoc Committee of the Spanish Society of Neurology (SEN), we evaluated the impact of these technologies on Spanish neurology, based on communications presented at Annual Meetings of the SEN.</p></div><div><h3>Material and methods</h3><p>We defined the concept of NT in neurology as a novel technology or novel application of an existing technology, characterised by a certain degree of coherence persisting over time, with the potential to have an impact on the present and/or future of neurology. We conducted a descriptive study of scientific communications presented at the SEN's annual meetings from 2012 to 2018, analysing the type of NT, the field of neurology, and the geographical provenance of the studies.</p></div><div><h3>Results</h3><p>We identified 299 communications related with NT from a total of 8,139 (3.7%), including 120 posters and 179 oral communications, ranging from 1.6% of all communications in 2012 to 6.8% in 2018. The technologies most commonly addressed were advanced neuroimaging (24.7%), biosensors (17.1%), electrophysiology and neurostimulation (14.7%), and telemedicine (13.7%). The neurological fields where NT were most widely employed were movement disorders (18.4%), cerebrovascular diseases (15.7%), and dementia (13.4%). Madrid was the region presenting the highest number of communications related to NT (32.8%), followed by Catalonia (26.8%) and Andalusia (9.0%).</p></div><div><h3>Conclusions</h3><p>The number of communications addressing NT follows an upward trend. The number of NT used in neurology has increased in parallel with their availability. We found scientific communications in all neurological subspecialties, with a heterogeneous geographical distribution.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 8","pages":"Pages 591-598"},"PeriodicalIF":3.9,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2020.10.015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50190508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.nrl.2021.01.009
A.R. Bentivoglio , M.R. Lo Monaco , R. Liperoti , D. Fusco , E. Di Stasio , A. Tondinelli , D. Marzullo , A. Maino , M.C. Cipriani , M.C. Silveri
Background
and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease.
Introduction
Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains.
Material and methods
We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale.
Results
Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task.
Conclusion
We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.
{"title":"Gender may be related to the side of the motor syndrome and cognition in idiopathic Parkinson's disease","authors":"A.R. Bentivoglio , M.R. Lo Monaco , R. Liperoti , D. Fusco , E. Di Stasio , A. Tondinelli , D. Marzullo , A. Maino , M.C. Cipriani , M.C. Silveri","doi":"10.1016/j.nrl.2021.01.009","DOIUrl":"10.1016/j.nrl.2021.01.009","url":null,"abstract":"<div><h3>Background</h3><p>and Sex and cognitive profile may be related to the laterality of motor symptoms in idiopathic Parkinson's disease.</p></div><div><h3>Introduction</h3><p>Parkinson's disease (PD) is well recognised as an inherently asymmetric disease with unilateral onset of motor symptoms. The laterality of motor symptoms may be linked to sex, clinical and demographic variables, and neuropsychological disorders. However, the available data are inconsistent. This study aimed to explore the potential association between the laterality of motor symptoms and clinical and demographic variables and deficits in specific cognitive domains.</p></div><div><h3>Material and methods</h3><p>We retrospectively recruited 97 participants with idiopathic PD without dementia; 60 presented motor symptoms on the left side and 37 on the right side. Both groups were comparable in terms of age, age at disease onset, disease duration, and severity of the neurological deficits according to the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale.</p></div><div><h3>Results</h3><p>Participants with left-side motor symptoms scored lower on the Schwab and England Activities of Daily Living scale. Our sample included more men than women (67% vs. 33%). Both sexes were not equally represented in the 2 groups: there were significantly more men than women in the group of patients with left-side motor symptoms (77% vs. 23%), whereas the percentages of men and women in the group of patients with right-side motor symptoms were similar (51% vs. 49%). Both groups performed similarly in all neuropsychological tasks, but women, independently of laterality, performed better than men in the naming task.</p></div><div><h3>Conclusion</h3><p>We found a clear prevalence of men in the group of patients with left-side motor symptoms; this group also scored lower on the Schwab and England Scale. Female sex was predictive of better performance in the naming task. Sex should always be considered in disorders that cause asymmetric involvement of the brain, such as PD.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 467-474"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.01.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25494752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.nrl.2022.08.003
M. Mendibe Bilbao , D. Ezpeleta Echávarri , J.M. Láinez Andrés
{"title":"La SEN y el modelo español de recertificación impulsado por FACME y sus sociedades científico-médicas federadas","authors":"M. Mendibe Bilbao , D. Ezpeleta Echávarri , J.M. Láinez Andrés","doi":"10.1016/j.nrl.2022.08.003","DOIUrl":"10.1016/j.nrl.2022.08.003","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 519-520"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42718081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.nrl.2022.08.002
A. Sanchez-Larsen, L. Rojas-Bartolomé, M. Fernández-Valiente, D. Sopelana
{"title":"Encefalitis anti-NMDA-R post-COVID-19: descripción de un caso y propuesta de su mecanismo fisiopatológico","authors":"A. Sanchez-Larsen, L. Rojas-Bartolomé, M. Fernández-Valiente, D. Sopelana","doi":"10.1016/j.nrl.2022.08.002","DOIUrl":"https://doi.org/10.1016/j.nrl.2022.08.002","url":null,"abstract":"","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 513-516"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50180342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.nrl.2021.01.012
S. Llufriu , E. Agüera , L. Costa-Frossard , V. Galán , L. Landete , D. Lourido , J.E. Meca-Lallana , E. Moral , F. Bravo-Rodríguez , L. Koren , A. Labiano , A. León , P. Martín , M.D. Monedero , L. Requeni , I. Zubizarreta , À. Rovira
Introduction
Magnetic resonance imaging (MRI) is widely used for the diagnosis and follow-up of patients with multiple sclerosis (MS). Coordination between Neurology and Neuroradiology departments is crucial for performing and interpreting radiological studies as efficiently and as accurately as possible. However, improvements can be made in the communication between these departments in many Spanish hospitals.
Methods
A panel of 17 neurologists and neuroradiologists from 8 Spanish hospitals held in-person and online meetings to draft a series of good practice guidelines for the coordinated management of MS. The drafting process included 4 phases: 1) establishing the scope of the guidelines and the methodology of the study; 2) literature review on good practices or recommendations on the use of MRI in MS; 3) discussion and consensus between experts; and 4) validation of the contents.
Results
The expert panel agreed a total of 9 recommendations for improving coordination between neurology and neuroradiology departments. The recommendations revolve around 4 main pillars: 1) standardising the process for requesting and scheduling MRI studies and reports; 2) designing common protocols for MRI studies; 3) establishing multidisciplinary committees and coordination meetings; and 4) creating formal communication channels between both departments.
Conclusions
These consensus recommendations are intended to optimise coordination between neurologists and neuroradiologists, with the ultimate goal of improving the diagnosis and follow-up of patients with MS.
{"title":"Recomendaciones para la coordinación de los servicios de Neurología y Neurorradiología en la atención a pacientes con esclerosis múltiple","authors":"S. Llufriu , E. Agüera , L. Costa-Frossard , V. Galán , L. Landete , D. Lourido , J.E. Meca-Lallana , E. Moral , F. Bravo-Rodríguez , L. Koren , A. Labiano , A. León , P. Martín , M.D. Monedero , L. Requeni , I. Zubizarreta , À. Rovira","doi":"10.1016/j.nrl.2021.01.012","DOIUrl":"https://doi.org/10.1016/j.nrl.2021.01.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Magnetic resonance imaging (MRI) is widely used for the diagnosis and follow-up of patients with multiple sclerosis (MS). Coordination between Neurology and Neuroradiology departments is crucial for performing and interpreting radiological studies as efficiently and as accurately as possible. However, improvements can be made in the communication between these departments in many Spanish hospitals.</p></div><div><h3>Methods</h3><p>A panel of 17 neurologists and neuroradiologists from 8 Spanish hospitals held in-person and online meetings to draft a series of good practice guidelines for the coordinated management of MS. The drafting process included 4 phases: <em>1)</em> establishing the scope of the guidelines and the methodology of the study; <em>2)</em> literature review on good practices or recommendations on the use of MRI in MS; <em>3)</em> discussion and consensus between experts; and <em>4)</em> validation of the contents.</p></div><div><h3>Results</h3><p>The expert panel agreed a total of 9 recommendations for improving coordination between neurology and neuroradiology departments. The recommendations revolve around 4 main pillars: <em>1)</em> standardising the process for requesting and scheduling MRI studies and reports; <em>2)</em> designing common protocols for MRI studies; <em>3)</em> establishing multidisciplinary committees and coordination meetings; and <em>4)</em> creating formal communication channels between both departments.</p></div><div><h3>Conclusions</h3><p>These consensus recommendations are intended to optimise coordination between neurologists and neuroradiologists, with the ultimate goal of improving the diagnosis and follow-up of patients with MS.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 453-462"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.01.012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50180391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-01DOI: 10.1016/j.nrl.2021.01.007
E. Kim , H. Kang , T.-S. Noh , S.-H. Oh , M.-W. Suh
Introduction
Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness.
Methods
We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas.
Results
Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas.
Conclusions
Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.
{"title":"Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement","authors":"E. Kim , H. Kang , T.-S. Noh , S.-H. Oh , M.-W. Suh","doi":"10.1016/j.nrl.2021.01.007","DOIUrl":"10.1016/j.nrl.2021.01.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness.</p></div><div><h3>Methods</h3><p>We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas.</p></div><div><h3>Results</h3><p>Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas.</p></div><div><h3>Conclusions</h3><p>Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.</p></div>","PeriodicalId":19300,"journal":{"name":"Neurologia","volume":"38 7","pages":"Pages 475-485"},"PeriodicalIF":3.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.nrl.2021.01.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25481194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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