Revista de neurologia最新文献

Introduction: Landau-Kleffner Syndrome (LKS) is a subtype of epileptic encephalopathy with spike-wave activation during sleep (EESWAS), characterized by acquired aphasia associated with the emergence of epileptiform abnormalities.

Patients and methods: A cross-sectional descriptive study was conducted in a tertiary hospital, involving one group of children with LKS and another with EESWAS. The aim was to compare the clinical, neurophysiological, and neuropsychological aspects of both groups.

Results: Seven patients with LKS and seven patients with EE-SWAS were analyzed; the samples were homogeneous in terms of sex, etiology, and type of electroencephalographic pattern. The mean ages of onset were 3.6 years in the LKS group, debuting with language and behavioral regression in 100% (five patients with expressive language impairment only), and 4 years in the EE-SWAS group, debuting with epilepsy in 100%, followed by behavioral regression. In 57% of the LKS group, evolving epilepsy was observed with predominantly posterior epileptic abnormalities during wakefulness. The mean duration of continuous spike-and-wave activity during sleep (SWAS) was longer in the LKS group (3.7 vs 1.8 years). Corticosteroids was the most effective treatment, with 86% of patients in both groups showing improvement. On a neuropsychological level, cognitive impairment was observed in 71% of the LKS group versus 43% in the EE-SWAS group; attention difficulties were present in all EE-SWAS patients and 85% of LKS patients.

Conclusions: EE-SWAS is characterized by cognitive-behavioral regression, with corticosteroids being the treatment of choice. LKS is a subtype of epilepsy within this group, with distinct features such as initial language impairment, posterior electroencephalogram (EEG) activity, and a longer duration of SWAS.

Background: Functional magnetic resonance imaging (fMRI) studies examining emotional memory encoding often use event-related designs with stimuli in the form of words or pictures. Prior research has suggested differential hemispheric specialization for these stimulus types, yet no meta-analysis has directly compared the neural systems involved in each.

Methods: A meta-analysis was conducted using peer-reviewed, event-related fMRI studies. The Activation Likelihood Estimation (ALE) method was applied via GingerALE software to compare brain activations associated with the encoding of affective visual stimuli presented as either words or photographs. Three contrasts were assessed: pictures > neutral + control, words > neutral + control, and overlap between both.

Results: Picture stimuli elicited bilateral activation in the medial parahippocampus, while word stimuli produced left-lateralized activation in the lateral parahippocampus. The overlap analysis identified a shared region in the parahippocampal amygdala. All three contrasts revealed significant activations in key medial temporal lobe (MTL) regions involved in emotional memory, including the hippocampus and amygdala.

Conclusions: Both stimulus types engaged medial temporal networks specialized in emotional memory encoding. Word stimuli selectively activated regions lateralized to the left hemisphere, whereas picture stimuli produced bilateral activation with a leftward bias. This study provides the first meta-analytic evidence of a medial-lateral differentiation in the parahippocampal gyrus based on emotional stimulus type.

Introduction: Dementia is a major global health challenge, with Alzheimer's disease (AD) being the most common cause.In China, due to its large and aging population, AD poses a significant threat. Although systematic reviews on the prevalence of dementia in the Chinese population exist, relatively few have specifically targeted AD. This study aimed to analyze the prevalence of AD among the population aged 60 years and older in China from 2014 to 2024.

Methods: A literature search on the prevalence of AD in China was conducted. A meta-analysis was performed using Stata version 16.0. The I² was used to assess heterogeneity. The random-effects model was used to calculate the pooled effect size. Subgroup analyses were conducted based on different characteristics. Meta-regression was used to explore the sources of heterogeneity and identify the factors that significantly affect the effect size. Funnel plots and Egger's test were utilized to evaluate publication bias.

Results: A total of 23 studies were included, with a total sample size of 307,415, including 13,662 patients with AD. The results of the meta-analysis showed that the prevalence of AD among the elderly Chinese population was 5.4% (95% CI: 4.7%-6.2%). The results of the meta-regression indicated that factors such as female sex, advanced age, low educational level, rural residence, and geographical region are the main factors influencing the prevalence of AD.

Conclusion: In the past decade, the prevalence of AD among people over 60 years of age in China was approximately 5.4%, which is a major public health problem for China.

Background: Individuals with Autism Spectrum Disorder (ASD), may present with behavioral disturbances, difficulties dealing with change, restricted interests and/or sensory disturbances. Among their characteristic behaviors are self-injurious behaviors that tend to be compulsive, unplanned, rhythmic and repetitive. The aim of this study was to investigate the relationship between self-injurious behaviors in hospitalized adolescents with ASD, depression and anxiety.

Methods: The sample included 50 patients with ASD, aged between 14 and 27 years. These patients were assessed using the Autism Diagnostic Observation Scale (ADOS-2), the Autism Diagnostic Interview-Revised (ADI-R), the Trait-State Anxiety Questionnaire, the Beck Depression Inventory (BDI), the Adolescent/Adult Sensory Profile (AASP) and the Inventory of Statements About Self-injury (ISAS).

Results: The results revealed significant and positive correlations between the level of self-injury and its dimensions: self-regulation (ρ = 0.861), sensation seeking and strength (ρ = 0.767), suicide avoidance (ρ = 0.732), revenge (ρ = 0.643), self-control (ρ = 0.700), manifestation of distress (ρ = 0.828) and blunting (ρ = 0.702).

Conclusions: There is evidence of a positive relationship between levels of self-harm and sensory defensiveness, specifically in the emotion avoidance profile.

Introduction: As Parkinson's disease progresses, symptoms develop that make it more difficult to control, either because of the presence of fluctuations despite adequate oral treatment, or because of the adverse effects caused by the continued use of levodopa, considered the gold standard. At this point in the course of the disease, there are different therapeutic alternatives that provide more continuous dopaminergic stimulation and help to improve this symptomatology: deep brain stimulation (Medtronic®: Percept™ Primary Cell (PC), Percept™ ReChargable (RC)), intestinal gel Levodopa/Carbidopa (Duodopa®) o Levodopa/Carbidopa/Entacapona (Lecigon®), as well as subcutaneous infusion of foslevodopa/foscarbidopa (Foslevodopa®) and continuous infusion of apomorphine (Dacepton®, Apo-Go®).

Objective: Pharmacoeconomic study of the different therapies for treating advanced Parkinson's disease in Spain.

Patients and methods: Based on a Markov model, the efficacy and costs of these therapies were compared, measuring life years gained (LYG) and quality-adjusted life years (QALY).

Results: Dacepton® (apomorphine) is the most cost-effective option with a cost of 20,782€/QALY (1€ = 1.0815 USD, 2025), compared to three times or more for the other therapies with Lecigon® (levodopa/carbidopa/entacapone) being the least cost-effective with a cost of 104,000€/QALY. Deep brain stimulation (DBS) and Duodopa® also proved to be effective options, but more costly than Dacepton®.

Conclusions: These results provide additional information on the efficiency of treatments that should inform decision-making in the management of advanced Parkinson's disease, thus enabling better resource management.

Introduction: Post-traumatic stress disorder (PTSD) develops in response to a traumatic experience, whether real or threatening, which produces emotions of intense fear and memory problems, significantly damaging the quality of life of those who manifest it. In recent years, anatomical-functional changes in the amygdala-hippocampus-prefrontal cortex circuit have begun to be studied as a key factor in the prevention, vulnerability, and treatment of PTSD, with neuroplasticity being one of the factors of greatest interest. Therefore, this review will address the latest published data regarding PTSD and neuroplasticity.

Development: Data from preclinical and clinical models support that a traumatic experience modifies both synaptic plasticity through electrophysiological and chemical variables, as well as myelin plasticity which enables short and long-distance connections. This remodelling of circuitry is crucial for the development of PTSD. However, it is also closely associated with prevention and positive treatment outcomes. Variables such as social support or the use of psychotherapy following a traumatic experience are linked to a good prognosis.

Conclusions: Therefore, there is an interesting connection between neuroplasticity and PTSD, although many questions remain open today, along with promising lines of prevention and intervention, including psychedelic substances.