Neurologia最新文献_第2页

Analysis of the prognostic value of emergency blood tests in ischaemic stroke 缺血性脑卒中急诊血液化验的预后价值分析。

Neurologia

Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.03.007

Objectives

This study aims to evaluate the prognostic value of emergency blood test results in patients with acute ischaemic stroke.

Methods

We evaluated 592 prospectively patients with neuroimaging-confirmed ischaemic stroke admitted to our stroke unit between 2015 and 2018. We gathered emergency blood test results and calculated the neutrophil-to-lymphocyte ratio and the neutrophil-to-platelet ratio (neutrophils × 1.000/platelets). The association between blood test results and functional prognosis (as measured with the modified Rankin Scale) and such complications as haemorrhagic transformation was evaluated by logistic regression analysis. The additional predictive value of blood test parameters was assessed with receiver operating characteristic curves and the net reclassification index.

Results

An neutrophil-to-lymphocyte ratio ≥ 3 at admission was associated with a two-fold increase in the risk of functional dependence at 3 months (OR: 2.24; 95% CI: 1.35-3.71) and haemorrhagic transformation (OR: 2.11; 95% CI: 1.09-4.05), while an neutrophil-to-lymphocyte ratio ≥ 3.86 resulted in an increase of 2.4 times in the risk of mortality at 3 months (OR: 2.41; 95% CI: 1.37-4.26) after adjusting for the traditional predictors of poor outcomes. Patients with neutrophil-to-platelet ratio ≥ 32 presented 3 times more risk of haemorrhagic transformation (OR: 3.17; 95% CI: 1.70-5.92) and mortality at 3 months (OR: 3.07; 95% CI: 1.69-5.57). Adding these laboratory parameters to standard clinical-radiological models significantly improved discrimination and prognostic accuracy.

Conclusions

Basic blood test parameters provide important prognostic information for stroke patients and should therefore be analysed in combination with standard clinical and radiological parameters to optimise ischaemic stroke management.

研究目的本研究旨在评估急性缺血性脑卒中患者急诊血液检测结果的预后价值：我们对 2015 年至 2018 年期间本院卒中科收治的 592 例神经影像学确诊缺血性卒中患者进行了前瞻性评估。我们收集了急诊血液检验结果，并计算了中性粒细胞与淋巴细胞比率和中性粒细胞与血小板比率（中性粒细胞 × 1.000/血小板）。我们通过逻辑回归分析评估了血液检测结果与功能性预后（用改良兰金量表衡量）和出血转化等并发症之间的关系。利用接收者操作特征曲线和净重分类指数评估了血液检测参数的额外预测价值：结果：入院时中性粒细胞与淋巴细胞比值≥3 与 3 个月后功能依赖（OR：2.24；95% CI：1.35-3.71）和出血转化（OR：2.11；95% CI：1.09-4.05），而中性粒细胞与淋巴细胞比值≥ 3.86 会导致 3 个月后的死亡风险增加 2.4 倍（OR：2.41；95% CI：1.37-4.26）。中性粒细胞与血小板比值≥32的患者发生出血转化（OR：3.17；95% CI：1.70-5.92）和3个月后死亡（OR：3.07；95% CI：1.69-5.57）的风险增加了3倍。将这些实验室参数添加到标准临床放射学模型中，可显著提高辨别能力和预后准确性：基本血液检验参数可为卒中患者提供重要的预后信息，因此应结合标准临床和放射学参数进行分析，以优化缺血性卒中的治疗。

{"title":"Analysis of the prognostic value of emergency blood tests in ischaemic stroke","authors":"","doi":"10.1016/j.nrleng.2022.03.007","DOIUrl":"10.1016/j.nrleng.2022.03.007","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to evaluate the prognostic value of emergency blood test results in patients with acute ischaemic stroke.</div></div><div><h3>Methods</h3><div>We evaluated 592 prospectively patients with neuroimaging-confirmed ischaemic stroke admitted to our stroke unit between 2015 and 2018. We gathered emergency blood test results and calculated the neutrophil-to-lymphocyte ratio and the neutrophil-to-platelet ratio (neutrophils × 1.000/platelets). The association between blood test results and functional prognosis (as measured with the modified Rankin Scale) and such complications as haemorrhagic transformation was evaluated by logistic regression analysis. The additional predictive value of blood test parameters was assessed with receiver operating characteristic curves and the net reclassification index.</div></div><div><h3>Results</h3><div>An neutrophil-to-lymphocyte ratio ≥ 3 at admission was associated with a two-fold increase in the risk of functional dependence at 3 months (OR: 2.24; 95% CI: 1.35-3.71) and haemorrhagic transformation (OR: 2.11; 95% CI: 1.09-4.05), while an neutrophil-to-lymphocyte ratio ≥ 3.86 resulted in an increase of 2.4 times in the risk of mortality at 3 months (OR: 2.41; 95% CI: 1.37-4.26) after adjusting for the traditional predictors of poor outcomes. Patients with neutrophil-to-platelet ratio ≥ 32 presented 3 times more risk of haemorrhagic transformation (OR: 3.17; 95% CI: 1.70-5.92) and mortality at 3 months (OR: 3.07; 95% CI: 1.69-5.57). Adding these laboratory parameters to standard clinical-radiological models significantly improved discrimination and prognostic accuracy.</div></div><div><h3>Conclusions</h3><div>Basic blood test parameters provide important prognostic information for stroke patients and should therefore be analysed in combination with standard clinical and radiological parameters to optimise ischaemic stroke management.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 617-628"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40696646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intrathecal baclofen therapy as treatment for spasticity and dystonia: Review of cases in a pediatric palliative care unit 鞘内巴氯芬治疗痉挛和肌张力障碍：儿科姑息治疗病房病例回顾

Neurologia

Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.04.008

V. Puertas M , I. de Noriega Echevarria , I. Errasti V , M.A. Perez M , R.M. Alba

Introduction

Patients managed in the Pediatric Palliative Care Integral Unit (PPCIU) have serious neurological conditions that involve significant damage at central nervous system level. The movement disorder is a very common clinical problem and for the patients where an adequate control of muscle tone is not achieved with usual techniques or drugs, intrathecal baclofen therapy (IBT) should be considered.

Materials and methods

Descriptive retrospective study based on the review of clinical records of patients who received IBT being followed by the PPCIU of Madrid Autonomous Region in the timeframe between September 2012 and February 2021.

Results

IBT was implanted in 8 patients affected by infantile cerebral palsy (ICP) with a Gross Motor Function Scale (GMFCS) IV–V, 3 patients was a Pantothenate kinase deficit-associated neurodegeneration (PKAN), 2 had Acquired Brain Damage, and the remaining 3 had, respectively, 2 glutaric aciduria type I (GA-1), and poly-malformative syndrome. In all patients we observed a period of clinical stability after IBT, we call this period “honeymoon”. Two patients died while in the honeymoon period, at 24.9 and 19.6 months from implantation of the pump; the median of duration of the honeymoon period in the remaining 14 was 14.4 months (IQ: 8.3–25.8).

Conclusions

IBT was not only used in patients with non-progressive diseases, but also in the group of patients with neurodegenerative or progressive diseases. In all of them, after implantation of the device, we have objectified a period of clinical stability and a better control of muscle tone disorders.

简介：在儿科姑息治疗综合病房（PPCIU）接受治疗的患者都患有严重的神经系统疾病，中枢神经系统受到严重损害。运动障碍是一种非常常见的临床问题，如果使用常规技术或药物无法充分控制患者的肌张力，则应考虑使用鞘内巴氯芬疗法（IBT）。材料和方法根据对马德里自治区姑息治疗综合病房在 2012 年 9 月至 2021 年 2 月期间接受 IBT 治疗的患者临床记录的回顾性研究。结果 8 名小儿脑瘫（ICP）患者接受了 IBT 植入术，其粗大运动功能量表（GMFCS）为 IV-V，3 名患者为泛酸激酶缺乏相关神经变性（PKAN），2 名患者为后天性脑损伤，其余 3 名患者分别为戊二酸尿症 I 型（GA-1）和多畸形综合征。我们观察到所有患者在 IBT 后都有一段临床稳定期，我们称之为 "蜜月期"。两名患者分别在植入泵 24.9 个月和 19.6 个月后在蜜月期死亡；其余 14 名患者蜜月期的中位数为 14.4 个月（IQ：8.3-25.8）。在所有这些患者中，我们都发现在植入该装置后，他们的临床症状在一段时间内趋于稳定，肌张力障碍也得到了更好的控制。

{"title":"Intrathecal baclofen therapy as treatment for spasticity and dystonia: Review of cases in a pediatric palliative care unit","authors":"V. Puertas M , I. de Noriega Echevarria , I. Errasti V , M.A. Perez M , R.M. Alba","doi":"10.1016/j.nrleng.2022.04.008","DOIUrl":"10.1016/j.nrleng.2022.04.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients managed in the Pediatric Palliative Care Integral Unit (PPCIU) have serious neurological conditions that involve significant damage at central nervous system level. The movement disorder is a very common clinical problem and for the patients where an adequate control of muscle tone is not achieved with usual techniques or drugs, intrathecal baclofen therapy (IBT) should be considered.</div></div><div><h3>Materials and methods</h3><div>Descriptive retrospective study based on the review of clinical records of patients who received IBT being followed by the PPCIU of Madrid Autonomous Region in the timeframe between September 2012 and February 2021.</div></div><div><h3>Results</h3><div>IBT was implanted in 8 patients affected by infantile cerebral palsy (ICP) with a Gross Motor Function Scale (GMFCS) IV–V, 3 patients was a Pantothenate kinase deficit-associated neurodegeneration (PKAN), 2 had Acquired Brain Damage, and the remaining 3 had, respectively, 2 glutaric aciduria type I (GA-1), and poly-malformative syndrome. In all patients we observed a period of clinical stability after IBT, we call this period “honeymoon”. Two patients died while in the honeymoon period, at 24.9 and 19.6 months from implantation of the pump; the median of duration of the honeymoon period in the remaining 14 was 14.4 months (IQ: 8.3–25.8).</div></div><div><h3>Conclusions</h3><div>IBT was not only used in patients with non-progressive diseases, but also in the group of patients with neurodegenerative or progressive diseases. In all of them, after implantation of the device, we have objectified a period of clinical stability and a better control of muscle tone disorders.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 675-682"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence and prevalence of multiple sclerosis in Spain: a systematic review 西班牙多发性硬化症的发病率和流行率：系统综述。

Neurologia

Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.02.004

Introduction

Greater understanding of the prevalence and incidence of multiple sclerosis in Spain and their temporal trends is necessary to improve the allocation of healthcare resources and to study aetiological factors.

Methods

We performed a systematic search of the MedLine database and reviewed the reference lists of the articles gathered. We collected studies reporting prevalence or incidence rates of multiple sclerosis in any geographical location in Spain, with no time limits. In 70% of cases, data were extracted by 2 researchers (FGL and EAC); any discrepancies were resolved by consensus.

Results

We identified 51 prevalence and 33 incidence studies published between 1968 and 2018. In the adjusted analysis, the number of prevalent cases per 100 000 population increased by 26.6 (95% confidence interval [CI], 21.5–31.8) every 10 years. After adjusting for year and latitude, the number of incident cases per 100 000 population increased by 1.34 (95% CI, 0.98–1.69) every 10 years. We observed a trend toward higher prevalence and incidence rates at higher latitudes.

Conclusions

The prevalence of multiple sclerosis in Spain has increased in recent decades, although case ascertainment appears to be incomplete in many studies. Incidence rates have also increased, but this may be due to recent improvements in the detection of new cases.

导言：有必要进一步了解多发性硬化症在西班牙的患病率和发病率及其时间趋势，以改善医疗资源的分配并研究病因：我们在 MedLine 数据库中进行了系统搜索，并查阅了所收集文章的参考文献目录。我们收集了报告西班牙任何地区多发性硬化症流行率或发病率的研究，没有时间限制。在 70% 的案例中，数据由两名研究人员（FGL 和 EAC）提取；任何差异均通过协商一致的方式解决：我们确定了 1968 年至 2018 年间发表的 51 项患病率研究和 33 项发病率研究。在调整后的分析中，每 10 万人中的流行病例数每 10 年增加 26.6 例（95% 置信区间 [CI]，21.5-31.8）。根据年份和纬度进行调整后，每 10 万人中的发病人数每 10 年增加 1.34 例（95% 置信区间 [CI]，0.98-1.69）。我们观察到纬度越高，患病率和发病率越高的趋势：结论：近几十年来，西班牙多发性硬化症的患病率有所上升，但许多研究的病例确定似乎并不完整。发病率也有所上升，但这可能是由于最近在发现新病例方面有所改进。

{"title":"Incidence and prevalence of multiple sclerosis in Spain: a systematic review","authors":"","doi":"10.1016/j.nrleng.2022.02.004","DOIUrl":"10.1016/j.nrleng.2022.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Greater understanding of the prevalence and incidence of multiple sclerosis in Spain and their temporal trends is necessary to improve the allocation of healthcare resources and to study aetiological factors.</div></div><div><h3>Methods</h3><div>We performed a systematic search of the MedLine database and reviewed the reference lists of the articles gathered. We collected studies reporting prevalence or incidence rates of multiple sclerosis in any geographical location in Spain, with no time limits. In 70% of cases, data were extracted by 2 researchers (FGL and EAC); any discrepancies were resolved by consensus.</div></div><div><h3>Results</h3><div>We identified 51 prevalence and 33 incidence studies published between 1968 and 2018. In the adjusted analysis, the number of prevalent cases per 100 000 population increased by 26.6 (95% confidence interval [CI], 21.5–31.8) every 10 years. After adjusting for year and latitude, the number of incident cases per 100 000 population increased by 1.34 (95% CI, 0.98–1.69) every 10 years. We observed a trend toward higher prevalence and incidence rates at higher latitudes.</div></div><div><h3>Conclusions</h3><div>The prevalence of multiple sclerosis in Spain has increased in recent decades, although case ascertainment appears to be incomplete in many studies. Incidence rates have also increased, but this may be due to recent improvements in the detection of new cases.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 639-650"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10726866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional outcomes of patients with NORSE and FIRES treated with immunotherapy: A systematic review 接受免疫疗法治疗的 NORSE 和 FIRES 患者的功能疗效：系统综述。

Neurologia

Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2022.03.004

Objective

To determine the frequency of good functional outcomes in patients with NORSE and FIRES treated with immunotherapy.

Methods

We performed a systematic search of the MedLine and EMBASE databases to gather studies including at least 5 patients with NORSE or FIRES and at least one patient treated with immunotherapy, and reporting functional outcomes. Good functional outcome was defined as a modified Rankin Scale (mRS) score ≤ 2 (or an equivalent measure) at the last available follow-up assessment. Only patients with known functional outcomes were included in the analysis.

Results

We analyzed 16 studies including a total of 161 patients with NORSE. Six studies were carried out only with FIRES patients (n = 64). Of the 161 patients with NORSE, 141 (87.5%) received immunotherapy. Outcome data were available for 135, 56 of whom (41.4%) achieved good functional outcomes. Twenty-four of the 58 patients with FIRES treated with immunotherapy and for whom outcome data were available achieved good functional outcomes (41.3%). Mortality rates in patients with NORSE and FIRES treated with immunotherapy were 20/121 (16.5%) and 6/58 (10.3%), respectively. By type of immunotherapy, good functional outcomes were achieved in 36/89 patients receiving glucocorticoids (40.4%), 27/71 patients receiving IV immunoglobulins (38%), 11/37 patients treated with plasma exchange (29.7%), 5/17 patients receiving rituximab (29.4%), and 2/13 patients receiving cyclophosphamide (15.3%).

Conclusion

Despite the lack of randomised clinical trials, immunotherapy is frequently prescribed to patients with NORSE and FIRES. However, rates of functional dependence and mortality remain high in these patients. Second-line therapies achieved lower rates of good outcomes, probably because they were administered to patients with more severe, refractory disease.

目的：确定接受免疫疗法治疗的 NORSE 和 FIRES 患者获得良好功能预后的频率：确定接受免疫疗法治疗的 NORSE 和 FIRES 患者获得良好功能预后的频率：我们对 MedLine 和 EMBASE 数据库进行了系统性检索，收集了至少包括 5 名 NORSE 或 FIRES 患者和至少一名接受免疫疗法治疗的患者，并报告了功能结果的研究。良好功能结果的定义是：在最后一次随访评估时，改良Rankin量表（mRS）评分≤2（或同等指标）。只有已知功能结果的患者才被纳入分析：我们分析了 16 项研究，共纳入 161 名 NORSE 患者。其中六项研究仅针对 FIRES 患者（n = 64）。在 161 名 NORSE 患者中，141 人（87.5%）接受了免疫疗法。135名患者获得了疗效数据，其中56人（41.4%）获得了良好的功能性疗效。在 58 名接受免疫疗法且有结果数据的 FIRES 患者中，24 人（41.3%）获得了良好的功能性结果。接受免疫疗法治疗的 NORSE 和 FIRES 患者的死亡率分别为 20/121 例（16.5%）和 6/58 例（10.3%）。根据免疫疗法的类型，接受糖皮质激素治疗的患者中有36/89例（40.4%）、接受静脉注射免疫球蛋白治疗的患者中有27/71例（38%）、接受血浆置换治疗的患者中有11/37例（29.7%）、接受利妥昔单抗治疗的患者中有5/17例（29.4%）、接受环磷酰胺治疗的患者中有2/13例（15.3%）获得了良好的功能预后：结论：尽管缺乏随机临床试验，但免疫疗法经常被用于 NORSE 和 FIRES 患者。结论：尽管缺乏随机临床试验，但免疫疗法经常被用于 NORSE 和 FIRES 患者，但这些患者的功能依赖率和死亡率仍然很高。二线疗法取得良好疗效的比例较低，这可能是因为这些疗法用于治疗病情更严重的难治性患者。

{"title":"Functional outcomes of patients with NORSE and FIRES treated with immunotherapy: A systematic review","authors":"","doi":"10.1016/j.nrleng.2022.03.004","DOIUrl":"10.1016/j.nrleng.2022.03.004","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the frequency of good functional outcomes in patients with NORSE and FIRES treated with immunotherapy.</div></div><div><h3>Methods</h3><div>We performed a systematic search of the MedLine and EMBASE databases to gather studies including at least 5 patients with NORSE or FIRES and at least one patient treated with immunotherapy, and reporting functional outcomes. Good functional outcome was defined as a modified Rankin Scale (mRS) score ≤ 2 (or an equivalent measure) at the last available follow-up assessment. Only patients with known functional outcomes were included in the analysis.</div></div><div><h3>Results</h3><div>We analyzed 16 studies including a total of 161 patients with NORSE. Six studies were carried out only with FIRES patients (n = 64). Of the 161 patients with NORSE, 141 (87.5%) received immunotherapy. Outcome data were available for 135, 56 of whom (41.4%) achieved good functional outcomes. Twenty-four of the 58 patients with FIRES treated with immunotherapy and for whom outcome data were available achieved good functional outcomes (41.3%). Mortality rates in patients with NORSE and FIRES treated with immunotherapy were 20/121 (16.5%) and 6/58 (10.3%), respectively. By type of immunotherapy, good functional outcomes were achieved in 36/89 patients receiving glucocorticoids (40.4%), 27/71 patients receiving IV immunoglobulins (38%), 11/37 patients treated with plasma exchange (29.7%), 5/17 patients receiving rituximab (29.4%), and 2/13 patients receiving cyclophosphamide (15.3%).</div></div><div><h3>Conclusion</h3><div>Despite the lack of randomised clinical trials, immunotherapy is frequently prescribed to patients with NORSE and FIRES. However, rates of functional dependence and mortality remain high in these patients. Second-line therapies achieved lower rates of good outcomes, probably because they were administered to patients with more severe, refractory disease.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 629-638"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33482198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Post-COVID-19 memory complaints: Prevalence and associated factors COVID-19 后的记忆投诉：发病率和相关因素

Neurologia

Pub Date : 2024-10-01 DOI: 10.1016/j.nrleng.2024.09.001

M. Ahmed , S. Roy , M.A. Iktidar , S. Chowdhury , S. Akter , A.M.K. Islam , M.D.H. Hawlader

Introduction

Memory complaints resulting from COVID-19 may have a significant impact on the survivors’ quality of life. Unfortunately, there is insufficient information available on memory loss and its relationship to COVID-19. Therefore, the purpose of this research was to determine the prevalence of memory complaints in post-COVID-19 patients and to find potential contributing factors.

Method

A cross-sectional survey was conducted on 401 individuals who had previously been diagnosed with COVID-19 at four COVID testing centers situated across Bangladesh. The MAC-Q questionnaire was used to evaluate memory. A binary logistic regression model was fit to study the variables related to memory complaints, with a p-value of <0.05 deemed statistically significant.

Result

Memory complaints was prevalent in 19.2% of the post-COVID patients. Individual predictor analysis revealed that among the treatment modalities, steroids and antibiotics were associated with impaired memory. Multiple logistic regression showed that individuals who recovered from COVID-19 within six to twelve months were more likely to have memory deficits. Even though age, sex, oxygen demand, and hospitalization were not linked with memory complaints, rural residents exhibited more significant memory complaints than urban residents.

Conclusion

Nearly one-fifth of the COVID-19 patients suffer from various degrees of memory complaints within one year. However, no association was found between COVID-19 severity to memory complaints.

导言：COVID-19 引起的记忆障碍可能会对幸存者的生活质量产生重大影响。遗憾的是，有关记忆力衰退及其与 COVID-19 关系的信息尚不充分。因此，本研究的目的是确定 COVID-19 后患者记忆力衰退的普遍程度，并找出潜在的诱发因素。采用 MAC-Q 问卷评估记忆力。结果19.2%的 COVID 后患者有记忆障碍。个体预测分析显示，在治疗方式中，类固醇和抗生素与记忆力受损有关。多元逻辑回归显示，在 6 至 12 个月内从 COVID-19 康复的患者更有可能出现记忆障碍。结论近五分之一的 COVID-19 患者在一年内出现不同程度的记忆障碍。结论近五分之一的 COVID-19 患者在一年内出现不同程度的记忆障碍，但 COVID-19 的严重程度与记忆障碍之间并无关联。

{"title":"Post-COVID-19 memory complaints: Prevalence and associated factors","authors":"M. Ahmed , S. Roy , M.A. Iktidar , S. Chowdhury , S. Akter , A.M.K. Islam , M.D.H. Hawlader","doi":"10.1016/j.nrleng.2024.09.001","DOIUrl":"10.1016/j.nrleng.2024.09.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Memory complaints resulting from COVID-19 may have a significant impact on the survivors’ quality of life. Unfortunately, there is insufficient information available on memory loss and its relationship to COVID-19. Therefore, the purpose of this research was to determine the prevalence of memory complaints in post-COVID-19 patients and to find potential contributing factors.</div></div><div><h3>Method</h3><div>A cross-sectional survey was conducted on 401 individuals who had previously been diagnosed with COVID-19 at four COVID testing centers situated across Bangladesh. The MAC-Q questionnaire was used to evaluate memory. A binary logistic regression model was fit to study the variables related to memory complaints, with a <em>p</em>-value of <0.05 deemed statistically significant.</div></div><div><h3>Result</h3><div>Memory complaints was prevalent in 19.2% of the post-COVID patients. Individual predictor analysis revealed that among the treatment modalities, steroids and antibiotics were associated with impaired memory. Multiple logistic regression showed that individuals who recovered from COVID-19 within six to twelve months were more likely to have memory deficits. Even though age, sex, oxygen demand, and hospitalization were not linked with memory complaints, rural residents exhibited more significant memory complaints than urban residents.</div></div><div><h3>Conclusion</h3><div>Nearly one-fifth of the COVID-19 patients suffer from various degrees of memory complaints within one year. However, no association was found between COVID-19 severity to memory complaints.</div></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 8","pages":"Pages 651-657"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Strength of association of classical vascular risk factors in young patients with ischaemic stroke: a case-control study 缺血性脑卒中年轻患者中经典血管风险因素的关联强度：病例对照研究。

Neurologia

Pub Date : 2024-09-01 DOI: 10.1016/j.nrleng.2022.07.006

Introduction

Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.

Methods

We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.

Results

Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.

Conclusions

Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.

导言最近的研究报告显示，年轻人缺血性中风的发病率越来越高。然而，传统血管风险因素之间的关联性尚未完全确定：我们将 120 名在 55 岁前首次发生缺血性中风并在本中心中风科住院的患者与来自一项基于人群的队列研究（HERMEX）的 600 名健康非中风对照者进行了性别匹配比较。评估的风险因素包括：高血压、肥胖、耳鸣、目前吸烟、估计肾小球滤过率（eGFR）、总胆固醇、低密度脂蛋白胆固醇（LDL-C）、甘油三酯、高密度脂蛋白胆固醇（HDL-C）和糖尿病。我们采用了逻辑回归分析法，并计算了人群归因风险。我们按性别和病因亚组进行了总体分析：通过逻辑回归分析，我们发现总体而言，重要的风险因素包括：高血压（OR：1.58；95%CI：1.01-2.50）、心房颤动（OR：4.77；95%CI：1.20-19.00）、低 eGFR（OR：4.74；95%CI：1.3-21.94）和低 HDL-C（OR：5.20；95%CI：3.29-8.21），以及男性吸烟（OR：1.86；95%CI：1.14-3.03）。低密度脂蛋白胆固醇与中风呈反向关系。高密度脂蛋白胆固醇的人群归因风险为 37.8%，高血压的人群归因风险为 21.1%。就病因亚组而言，只有低 HDL-C 与病因不明的中风有关：结论：高血压、心房颤动、低肾小球滤过率、低 HDL-C 以及男性吸烟是 55 岁以下首次缺血性脑卒中患者的主要风险因素。我们认为，进一步探讨如何管理低 HDL-C 水平，将其作为年轻中风患者预防策略的一部分，将特别有意义。

{"title":"Strength of association of classical vascular risk factors in young patients with ischaemic stroke: a case-control study","authors":"","doi":"10.1016/j.nrleng.2022.07.006","DOIUrl":"10.1016/j.nrleng.2022.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent studies have reported an increasing incidence of ischaemic stroke among young adults. However, the strength of the association between traditional vascular risk factors has not been fully established.</p></div><div><h3>Methods</h3><p>We compared 120 patients with a first ischaemic stroke before the age of 55 years admitted to the stroke unit of our centre with 600 healthy non-stroke controls from a population-based cohort study (HERMEX), matched for sex. Risk factors assessed included: hypertension, obesity, auricular fibrillation, current smoking, estimated glomerular filtration rate (eGFR), total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C) and diabetes mellitus. We used logistic regression analysis and calculated population attributable risk. We performed an overall analysis, by sex and aetiological subgroup.</p></div><div><h3>Results</h3><p>Using logistic regression analysis, we found that overall, the significant risk factors were: hypertension (OR: 1.58; 95%CI: 1.01-2.50), atrial fibrillation (OR: 4.77; 95%CI: 1.20-19.00), low eGFR (OR: 4.74; 95%CI: 1.3-21.94) and low HDL-C (OR: 5.20; 95%CI: 3.29-8.21), as well as smoking for males (OR: 1.86; 95%CI: 1.14-3.03). LDL-C showed an inverse association with stroke. The population attributable risk for HDL-C was 37.8% and for hypertension 21.1%. In terms of aetiological subgroups, only low HDL-C was associated with stroke of undetermined aetiology.</p></div><div><h3>Conclusions</h3><p>Hypertension, auricular fibrillation, low eGFR, and low HDL-C, plus tobacco use in men, are the main risk factors among patients under 55 years of age with a first ischaemic stroke. We believe that it would be of particular interest to further explore the management of low HDL-C levels as part of preventive strategies in young stroke patients.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 604-613"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580822001420/pdfft?md5=4c95ffad50c9af71107613f15bfeeaa7&pid=1-s2.0-S2173580822001420-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40456578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Botulinum toxin type A infiltration in spasticity and cervical dystonia. Muscle morphology: an overlooked factor 痉挛和颈肌张力障碍中的 A 型肉毒毒素浸润。肌肉形态：一个被忽视的因素

Neurologia

Pub Date : 2024-09-01 DOI: 10.1016/j.nrleng.2021.09.012

Introduction

Botulinum toxin type A is used to treat spasticity and dystonia. However, its relationship with muscle morphology has not been studied. The action mechanism of botulinum toxin is based on the inhibition of acetylcholine release. Therefore, larger doses of toxin would be needed to treat larger muscles. This study aims to establish whether there is a discrepancy between muscle morphology and the botulinum toxin doses administered.

Methods

We dissected, and subsequently measured and weighed, muscles from the upper and lower limbs and the head of a fresh cadaver. We consulted the summary of product characteristics for botulinum toxin type A to establish the recommended doses for each muscle and calculated the number of units infiltrated per gramme of muscle.

Results

Different muscles present considerable morphological variability, and the doses of botulinum toxin administered to each muscle are very similar. We observed great variability in the amount of botulinum toxin administered per gramme of muscle, ranging from 0.3 U/g in the biceps femoris to 14.6 U/g in the scalene muscles. The mean dose was 2.55 U/g. The doses administered for nearly all lower limb muscles were below this value.

Conclusions

There are significant differences in morphology between the muscles of the lower limbs, upper limbs, and head, but similar doses of botulinum toxin are administered to each muscle. These differences result in great variability in the number of units of botulinum toxin administered per gramme of muscle.

导言 A 型肉毒毒素用于治疗痉挛和肌张力障碍。然而，它与肌肉形态的关系尚未得到研究。肉毒杆菌毒素的作用机制基于抑制乙酰胆碱的释放。因此，治疗较大的肌肉需要较大剂量的毒素。本研究旨在确定肌肉形态与肉毒毒素给药剂量之间是否存在差异。方法我们解剖了一具新鲜尸体的上肢、下肢和头部肌肉，随后进行了测量和称重。我们参考了 A 型肉毒毒素的产品特性概要，确定了每块肌肉的推荐剂量，并计算了每克肌肉浸润的单位数。我们观察到，每克肌肉的肉毒杆菌毒素用量差异很大，从股二头肌的 0.3 U/g 到头皮肌的 14.6 U/g 不等。平均剂量为 2.55 U/g。结论下肢肌肉、上肢肌肉和头部肌肉在形态上存在显著差异，但每块肌肉的肉毒毒素剂量相似。这些差异导致每克肌肉所注射的肉毒杆菌毒素单位数量差异很大。

{"title":"Botulinum toxin type A infiltration in spasticity and cervical dystonia. Muscle morphology: an overlooked factor","authors":"","doi":"10.1016/j.nrleng.2021.09.012","DOIUrl":"10.1016/j.nrleng.2021.09.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Botulinum toxin type A is used to treat spasticity and dystonia. However, its relationship with muscle morphology has not been studied. The action mechanism of botulinum toxin is based on the inhibition of acetylcholine release. Therefore, larger doses of toxin would be needed to treat larger muscles. This study aims to establish whether there is a discrepancy between muscle morphology and the botulinum toxin doses administered.</p></div><div><h3>Methods</h3><p>We dissected, and subsequently measured and weighed, muscles from the upper and lower limbs and the head of a fresh cadaver. We consulted the summary of product characteristics for botulinum toxin type A to establish the recommended doses for each muscle and calculated the number of units infiltrated per gramme of muscle.</p></div><div><h3>Results</h3><p>Different muscles present considerable morphological variability, and the doses of botulinum toxin administered to each muscle are very similar. We observed great variability in the amount of botulinum toxin administered per gramme of muscle, ranging from 0.3 U/g in the biceps femoris to 14.6 U/g in the scalene muscles. The mean dose was 2.55 U/g. The doses administered for nearly all lower limb muscles were below this value.</p></div><div><h3>Conclusions</h3><p>There are significant differences in morphology between the muscles of the lower limbs, upper limbs, and head, but similar doses of botulinum toxin are administered to each muscle. These differences result in great variability in the number of units of botulinum toxin administered per gramme of muscle.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 523-529"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580823000287/pdfft?md5=ba59c6ad5a3cb0124100df065b292d4b&pid=1-s2.0-S2173580823000287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9445188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional correlation between cerebellum and basal ganglia: A parkinsonism model 小脑和基底神经节之间的功能相关性：帕金森病模型

Neurologia

Pub Date : 2024-09-01 DOI: 10.1016/j.nrleng.2024.07.002

L. Vásquez-Celaya , G. Marín , M.E. Hernández , P. Carrillo , C.A. Pérez , G.A. Coria-Avila , J. Manzo , M. Miquel , L.I. García

Introduction

The cerebellar response has been studied for years with different models of alteration of other brain structures to understand its complex functioning and its relationship with the rest of the body. Studies in patients with Parkinson's disease (PD) showed that the cerebellar function is modified by deficit of the basal ganglia; which supports the hypothesis that both structures are related anatomically and functionally.

Methods

In our study, the ventrolateral striatum (VLS) of the basal ganglia was altered by an electrolytic lesion, in order to produce a similar jaw frequency of jaw tremor movements presented in parkinsonism, thereafter we analyzed the effect of the lesion on the expression of multiunit activity (MUA) of the cerebellum.

Results

We found cerebellar activation during mandibular movements and increment during oral jaw tremor movements. In addition, the amplitude of baseline MUA registered in animals with alteration of the VLS decreased with respect to the intact group.

Conclusions

Accordingly, we conclude that cerebellar changes in MUA may be due to a decrease in the cerebellar inflectional or as a possible compensatory function between cerebellum and basal ganglia.

导言：多年来，人们通过改变其他大脑结构的不同模型来研究小脑反应，以了解小脑的复杂功能及其与身体其他部分的关系。对帕金森病（PD）患者的研究表明，小脑功能因基底节功能缺失而改变；这支持了这两种结构在解剖学和功能上相关的假设。方法在我们的研究中，基底节的腹外侧纹状体（VLS）被电解病变改变，以产生类似帕金森病患者下颌震颤运动的频率，之后我们分析了病变对小脑多单位活动（MUA）表达的影响。结论我们得出结论，小脑多单位活动的变化可能是由于小脑转折功能的下降或小脑与基底节之间可能存在的代偿功能。

{"title":"Functional correlation between cerebellum and basal ganglia: A parkinsonism model","authors":"L. Vásquez-Celaya , G. Marín , M.E. Hernández , P. Carrillo , C.A. Pérez , G.A. Coria-Avila , J. Manzo , M. Miquel , L.I. García","doi":"10.1016/j.nrleng.2024.07.002","DOIUrl":"10.1016/j.nrleng.2024.07.002","url":null,"abstract":"<div><h3>Introduction</h3><p>The cerebellar response has been studied for years with different models of alteration of other brain structures to understand its complex functioning and its relationship with the rest of the body. Studies in patients with Parkinson's disease (PD) showed that the cerebellar function is modified by deficit of the basal ganglia; which supports the hypothesis that both structures are related anatomically and functionally.</p></div><div><h3>Methods</h3><p>In our study, the ventrolateral striatum (VLS) of the basal ganglia was altered by an electrolytic lesion, in order to produce a similar jaw frequency of jaw tremor movements presented in parkinsonism, thereafter we analyzed the effect of the lesion on the expression of multiunit activity (MUA) of the cerebellum.</p></div><div><h3>Results</h3><p>We found cerebellar activation during mandibular movements and increment during oral jaw tremor movements. In addition, the amplitude of baseline MUA registered in animals with alteration of the VLS decreased with respect to the intact group.</p></div><div><h3>Conclusions</h3><p>Accordingly, we conclude that cerebellar changes in MUA may be due to a decrease in the cerebellar inflectional or as a possible compensatory function between cerebellum and basal ganglia.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 555-563"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2173580824000658/pdfft?md5=5a40fac51f62ce86fe2778197601442e&pid=1-s2.0-S2173580824000658-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The cross-sectional area of the median nerve: An independent prognostic biomarker in amyotrophic lateral sclerosis 正中神经的横截面积：肌萎缩性脊髓侧索硬化症的独立预后生物标志物

Neurologia

Pub Date : 2024-09-01 DOI: 10.1016/j.nrleng.2024.07.003

J.J. Martínez-Payá , J. Ríos-Díaz , M.E. del Baño-Aledo , D. Hervás , J.I. Tembl-Ferrairó , T. Sevilla-Mantecón , J.F. Vázquez-Costa

Introduction

Ultrasound changes in the cross-sectional area of the median nerve (CSAmn) could be of interest as biomarkers in patients with amyotrophic lateral sclerosis (ALS).

Methods

Eighty-four ALS patients (51 men [60.7%]; mean 62.0 [SD 11.46] years old) and forty-six controls (27 men [58.7%]; mean 59.9 [SD 8.08] years old) of two different cohorts were recruited between September 2013 and February 2018. The CSAmn was measured bilaterally in each cohort, by two different examiners with two different ultrasound machines (one in each cohort). Its association with clinical variables (disease duration, muscle strength, disability, progression rate and tracheostomy-free survival) was assessed.

Results

The CSAmn was smaller in patients than in controls, and the study cohort did not influence its values. A mild correlation between the strength of the wrist flexor and the CSAmn was found. In the multivariable analysis, the probability of this association being true was 90%. In the cox regression, both a faster progression rate and a larger CSAmn independently predicted poor survival (HR = 4.29, [Cr.I95%: 2.71–6.80], p < 0.001; and HR = 1.14, [Cr.I95%: 1.03–1.25], p = 0.01), after adjusting by age, body mass index, bulbar onset, and diagnostic delay.

Conclusions

The CSAmn is an easy to assess biomarker that seems reliable and reproducible. Our data also suggest that it could act as a progression and prognostic biomarker in ALS patients. Longitudinal studies with repeated measures are warranted to confirm its usefulness in the clinical practice.

方法在 2013 年 9 月至 2018 年 2 月间招募了两个不同队列的八十四名 ALS 患者（51 名男性 [60.7%]；平均 62.0 [SD 11.46] 岁）和四十六名对照组患者（27 名男性 [58.7%]；平均 59.9 [SD 8.08] 岁）。在每个队列中，由两名不同的检查人员使用两台不同的超声波机（每个队列一台）测量双侧 CSAmn。结果患者的 CSAmn 小于对照组，研究队列对其值没有影响。腕屈肌力量与 CSAmn 之间存在轻微相关性。在多变量分析中，这种关联的真实概率为 90%。在Cox回归中，在根据年龄、体重指数、球部发病和诊断延迟进行调整后，较快的进展速度和较大的CSAmn均可独立预测较差的生存率（HR = 4.29，[Cr.I95%：2.71-6.80]，p < 0.001；HR = 1.14，[Cr.I95%：1.03-1.25]，p = 0.01）。我们的数据还表明，它可以作为 ALS 患者的进展和预后生物标志物。有必要进行重复测量的纵向研究，以确认其在临床实践中的实用性。

{"title":"The cross-sectional area of the median nerve: An independent prognostic biomarker in amyotrophic lateral sclerosis","authors":"J.J. Martínez-Payá , J. Ríos-Díaz , M.E. del Baño-Aledo , D. Hervás , J.I. Tembl-Ferrairó , T. Sevilla-Mantecón , J.F. Vázquez-Costa","doi":"10.1016/j.nrleng.2024.07.003","DOIUrl":"10.1016/j.nrleng.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Ultrasound changes in the cross-sectional area of the median nerve (CSAmn) could be of interest as biomarkers in patients with amyotrophic lateral sclerosis (ALS).</p></div><div><h3>Methods</h3><p>Eighty-four ALS patients (51 men [60.7%]; mean 62.0 [SD 11.46] years old) and forty-six controls (27 men [58.7%]; mean 59.9 [SD 8.08] years old) of two different cohorts were recruited between September 2013 and February 2018. The CSAmn was measured bilaterally in each cohort, by two different examiners with two different ultrasound machines (one in each cohort). Its association with clinical variables (disease duration, muscle strength, disability, progression rate and tracheostomy-free survival) was assessed.</p></div><div><h3>Results</h3><p>The CSAmn was smaller in patients than in controls, and the study cohort did not influence its values. A mild correlation between the strength of the wrist flexor and the CSAmn was found. In the multivariable analysis, the probability of this association being true was 90%. In the cox regression, both a faster progression rate and a larger CSAmn independently predicted poor survival (HR=4.29, [Cr.I95%: 2.71–6.80], <em>p</em>    =0.01), after adjusting by age, body mass index, bulbar onset, and diagnostic delay.</p></div><div><h3>Conclusions</h3><p>The CSAmn is an easy to assess biomarker that seems reliable and reproducible. Our data also suggest that it could act as a progression and prognostic biomarker in ALS patients. Longitudinal studies with repeated measures are warranted to confirm its usefulness in the clinical practice.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 564-572"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S217358082400066X/pdfft?md5=538e3f37fafb0132b313683a428f23c9&pid=1-s2.0-S217358082400066X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neuropsychological rehabilitation for post–COVID-19 syndrome: results of a clinical programme and six-month follow up COVID-19后综合征的神经心理康复治疗：临床计划的结果和六个月的随访。

Neurologia

Pub Date : 2024-09-01 DOI: 10.1016/j.nrleng.2022.06.007

Introduction

Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention programme for post-COVID-19 syndrome.

Method

In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation programme, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the programme, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life).

Results

The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n = 91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n = 32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living.

Conclusions

Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.

简介COVID-19后综合征患者可能会出现认知和情绪症状。本研究旨在分析针对COVID-19后综合征的门诊神经心理学干预项目的结果：2020 年 6 月，古特曼研究所启动了一项门诊后 COVID-19 神经康复计划，包括呼吸疗法、物理疗法和神经心理康复。在项目实施前后，所有参与者的认知-情感状态都将接受评估。治疗 6 个月后，进行后续评估（包括收集日常生活各方面的信息）：分析的样本包括 123 名患者（平均年龄：51 岁，标准差：12.41）。74%（n = 91）的患者存在认知障碍，并接受了认知治疗（实验组）；其余 26%（n = 32）的患者为对照组。干预后，实验组的工作记忆、言语记忆（学习、回忆和识别）、言语流畅性和焦虑抑郁症状均有所改善。对照组则在即时记忆、言语记忆（学习和识别）和抑郁症状方面有所改善，但后两者的影响程度小于实验组。治疗 6 个月后，44.9% 的患者无法从事 COVID-19 前的工作活动，81.2% 的患者在日常生活中遇到困难：结论：神经心理康复是治疗COVID-19后综合征患者认知情感缺陷的有效手段。然而，在治疗结束数月后，并非所有患者都能恢复到 COVID-19 前的功能水平。

{"title":"Neuropsychological rehabilitation for post–COVID-19 syndrome: results of a clinical programme and six-month follow up","authors":"","doi":"10.1016/j.nrleng.2022.06.007","DOIUrl":"10.1016/j.nrleng.2022.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p>Patients with post-COVID-19 syndrome may present cognitive and emotional symptomatology. This study aims to analyse the results of an outpatient neuropsychological intervention programme for post-COVID-19 syndrome.</p></div><div><h3>Method</h3><p>In June 2020 Institut Guttmann started an outpatient post-COVID-19 neurorehabilitation programme, including respiratory therapy, physiotherapy, and neuropsychological rehabilitation. Before and after the programme, the cognitive-emotional state of all participants is assessed. Six months after treatment, a follow-up assessment is administered (which includes a collection of information on various aspects of daily life).</p></div><div><h3>Results</h3><p>The sample analysed consisted of 123 patients (mean age: 51 years, SD: 12.41). Seventy-four per cent (n = 91) had cognitive impairment and underwent cognitive treatment (experimental group); the remaining 26% (n = 32) constituted the control group. After the intervention, the experimental group improved in working memory, verbal memory (learning, recall and recognition), verbal fluency and anxious-depressive symptomatology. The control group showed changes in immediate memory, verbal memory (learning and recognition) and depressive symptomatology, although the effect size in the latter two was smaller than in the experimental group. Six months after treatment, 44.9% of the patients were unable to perform their pre-COVID-19 work activity, and 81.2% reported difficulties in their activities of daily living.</p></div><div><h3>Conclusions</h3><p>Neuropsychological rehabilitation is an effective tool to treat the cognitive-emotional deficits present in post-COVID-19 syndrome. However, months after the end of treatment, not all patients recover their pre-COVID-19 functional level.</p></div>","PeriodicalId":94155,"journal":{"name":"Neurologia","volume":"39 7","pages":"Pages 592-603"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9476330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9548210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0