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Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study aims to assess the effect of electroacupuncture (EA) on non-motor symptoms in Parkinson's disease (PD) patients as a primary goal and motor symptomatology as a secondary outcome. Methods: Twenty-five patients were enrolled in a non-controlled pilot study that involved a 10-session EA intervention in 16 acupoints, applied 3 times a week for 4 weeks. Motor, non-motor, cognitive, and quality of life evaluation were conducted before intervention and 7 days after concluding the last EA session through MDS-Unified PD rating scale (MDS-UPDRS), Non-motor Symptom Scale (NMSS), montreal cognitive assessment (MoCA), and PD questionnaire (PDQ-8), respectively. Results: Patients showed significantly lower scores in the MDS-UPDRS Part II (7.0 ± 5.7 vs. 10.5 ± 7.6, p = 0.046) and Part III (14.0 ± 8.6 vs. 23.1 ± 13.9, p = 0.002), and NMSS total score (35.2 ± 26.6 vs. 54.6 ± 32.5, p = 0.004) in the post-intervention evaluation, with mood/cognition domain of the NMSS being the only significantly affected by treatment. MoCA total score increased after the intervention (24.2 ± 4.5 vs. 21.6 ± 4.3, p = 0.020), while PDQ-8 scores were not significantly affected by the intervention. Conclusions: Non-motor and motor symptomatology were significantly improved after concluding a 10-session EA therapy. Mood and cognitive disorders were the most positively affected by the intervention. Evaluation of the long-term effects of EA in PD is further needed. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Iberoamericana de Ciencias de la Actividad Física y el Deporte is the property of Revista Iberoamericana de Ciencias de la Actividad Física y el Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parkinson's disease (PD) is a neurodegenerative disorder characterized by clinical heterogeneity and multifactorial etiopathogenesis. Although the conventional approach to patient care primarily emphasizes managing symptoms using dopaminergic drugs, newer strategies propose methods to protect dopaminergic neurons by targeting molecular pathways. These experimental medications are here as (1) precisionor broad-targeted therapies according to their mechanism of action, (2) new antiparkinsonian formulations, and (3) repurposed drugs. This narrative review will summarize the most relevant aspects of up-to-date precisionor broad-targeted therapies. A comprehensive literature search of PubMed was performed, to summarize the current evidence regarding experimental medications in PD, between 2013 and 2023. In addition, ClinicalTrials.gov was revised. Several potential neuroprotective strategies are under investigation, including drugs targeting specific molecular pathways implicated in PD pathogenesis. Research is focused on inhibiting the aggregation of misfolded alpha-synuclein, a key protein associated with PD. In addition, therapies targeting mitochondria, lysosomes, and oxidative stress are being explored due to their involvement in neuronal health and survival. Precision targets, including proteins are explored through gene therapies, monoclonal antibodies, kinase inhibitors, and small molecules. Many experimental drugs are still in the early phases of development, and their long-term safety and efficacy are yet to be established. The evolving landscape of experimental therapeutics instills optimism for improved outcomes and enhanced quality of life for individuals grappling with PD. [ABSTRACT FROM AUTHOR]

Background: Patients with Parkinson's disease (PD) usually present neuropsychiatric disorders, which are non-motor symptoms that diminish their quality of life such as depression and anxiety. Objective: To analyze the effect of the administration of melatonin (MEL) on the levels of depression and anxiety in patients with PD. Methods: A pilot study as a cross-controlled, randomized, double-blind, clinical trial was conducted in 26 patients with PD in stages 1-3 from Hoen and Yahr, who received 25 mg of MEL or placebo at noon and 30 min before bedtime for 3 months. Depression and anxiety were measured with Beck's Depression Questionnaire and Beck's Anxiety Questionnaire, respectively. Results: Seventy-three percent of the PD patients presented with depression, and 96% presented with anxiety, and after the intervention these percentages remained. Conclusion: At this dosage, MEL was found to lack effect on levels of depression and anxiety in PD patients. Further studies with longer administration periods and the use of different dosages are needed to evaluate the effects of MEL in PD. [ABSTRACT FROM AUTHOR]

Copyright of Neutrosophic Computing & Machine Learning is the property of Multimedia Larga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

La enfermedad de Parkinson (EP) es una patología neurodegenerativa que afecta el sistema nervioso central, caracterizada por manifestaciones clínicas motoras y no motoras. Dentro de las dificultades motoras se encuentra la disartria hipocinética la cual afecta la voz de quienes padecen la enfermedad. El propósito del presente trabajo es describir desde una mirada multidimensional de la voz aspectos tales como: medidas acústicas, aerodinámicas y laringoscópicas, en un grupo de sujetos con EP. Para tal propósito, se realizó un estudio descriptivo de corte transversal, en el que se evaluaron 10 sujetos con EP en diferentes estadios de evolución de la enfermedad. Se evaluaron parámetros acústicos mediante programa Praat, tiempo máximo de fonación y configuración glótica a través de una nasofibrolaringoscopía. En la evaluación acústica se halló una variación de la frecuencia fundamental encontrándose levemente aumentada en hombres y disminuida en mujeres. El Jitter se encontraba normal. Cuatro sujetos arrojaron un valor de shimmer aumentado y dos presentaron un aumento del nivel de ruido. La relación alpha ratio se encontraba con valores negativos en todos los participantes. En el tiempo máximo de fonación, 60% de la muestra presentó valores descendidos. A nivel visual en el cierre glótico se evidenciaron 6 sujetos con un cierre deficiente y en actividad supraglótica 5 participantes presentaron contracción de bandas. Los sujetos con Parkinson participantes presentan alteraciones en los parámetros acústicos de la voz, tiempo máximo de fonación y configuración glótica. Estas dificultades se hacen más notorias a medida que avanza la enfermedad y las dificultades motoras son más evidentes.

Objective: Recent evidence has underscored the detrimental effects of chronic stress on health, particularly its impact on neurodegenerative disorders such as Parkinson's disease (PD). Our study seeks to investigate the complex relationship between autonomic dysfunction and stress-related disorders in PD, aiming to enhance our understanding of these conditions. Methods: We conducted an observational cross-sectional study of PD patients from a movement disorders clinic in Monterrey, Mexico. Sociodemographic and clinical data were collected. Autonomic symptoms were assessed using the Scale for Outcomes in PD-Autonomic (SCOPA-AUT), with patients stratified into two groups based on scores (≥ 10 or < 10). Post-traumatic stress disorder (PTSD) assessment included traumatic experiences and structured interviews using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), Checklist for DSM-5 PTSD (PCL-5), acute stress disorder scale, DSM-5 criteria for adaptive disorder, and the Adverse Childhood Experiences Questionnaire. Results: The study included 32 PD patients and revealed a significant association between post-traumatic stress symptoms and autonomic dysfunction. Those with higher post-traumatic stress symptoms, as measured by the PCL-5 scale, exhibited more pronounced autonomic dysfunction, as indicated by higher SCOPA-AUT scores. Traumatic events were also more prevalent in the group with severe autonomic dysfunction, suggesting a link between trauma and autonomic symptoms in PD patients. Conclusions: Our study suggests that post-traumatic stress symptoms may exacerbate autonomic dysfunction in PD patients. This underscores the need for further research to explore mechanisms and therapeutic implications and emphasizes the importance of considering stress-related disorders in the management of PD. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to investigate the relationship between autonomic dysfunction, specifically orthostatic hypotension, and the presence of psychosis in Parkinson's disease (PD) patients. In addition, we aimed to identify other non-motor factors influencing the development of psychosis. Methods: We conducted a multicentric observational cross-sectional study to investigate the potential association between autonomic dysfunction and psychosis in PD patients. Approval was obtained from the institutional review board. Participants (n = 306) were recruited through non-probabilistic convenience sampling from the Mexican Parkinson Study Group cohort. Data collection occurred between July 2017 and June 2018. Demographic and clinical data were collected, including age, gender, disease duration, medication, and movement disorders society-unified Parkinson's disease rating scale (MDS-UPDRS) scores. Psychosis symptoms were assessed using MDS-UPDRS item 1.2, whereas autonomic dysfunction was assessed using items 1.10, 1.11, and 1.12. Descriptive statistics, Chi-square tests, Mann--Whitney U tests, and logistic regression were employed for analysis using IBM SPSS version 25. Results: In our multicenter cohort of 306 Mexican PD patients, 18% reported symptoms of psychosis. Among these patients, orthostatic hypotension on standing was significantly associated with symptoms of psychosis (p = 0.001, OR 2.82). Regression analysis identified apathy (p = 0.003), cognitive impairment (p = 0.012), and longer disease duration (p = 0.001) as predictors of symptoms of psychosis. Conclusions: While orthostatic hypotension is associated with symptoms of psychosis, cognitive impairment, apathy, and disease duration significantly contribute to its presence in our cohort. These findings underscore the complexity of factors contributing to psychosis in PD. Recognizing these non-motor factors is crucial for the comprehensive care and management of PD patients, especially those at risk of developing psychosis. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parkinson's disease (PD) is a common neurodegenerative disorder worldwide, with over 6.2 million registered cases. Gait analysis plays a fundamental role in evaluating motor abnormalities associated with this disease. However, current methods, such as marker-based systems, are intrusive and expert-dependent. Markerless alternatives, like video sequence analysis, have been proposed, but they tend to provide overall classification scores and lack the ability to interpret joint kinematics in detail. An innovative technique is presented using volumetric convolutional networks that can learn intermediate postural patterns and distinguish between Parkinson's patients and control subjects. This approach utilizes OpenPose activations and then applies hierarchical convolution to minimize classification. In tests conducted with 14 Parkinson's patients and 16 control subjects, this method achieved a classification accuracy of 98%. [ABSTRACT FROM AUTHOR]

Background: Impulse control disorders (ICDs) are behaviors that are performed repeatedly to the point of interfering with the patient's functionality and daily life, without regard for their consequences and with the sole purpose of obtaining immediate gratification. ICDs have been related to dopaminergic treatment. objective: To analyze the association of different risk factors for the development of ICD in the Mexican population. Methods: A cross-sectional study was carried out. The data collected affects the years 2021 to 2023. Data were collected through structured interviews including age, gender, year of symptom onset, year of diagnosis, levodopa equivalent dose, and antiparkinsonian treatment, and history of smoking and alcohol use was evaluated. results: A total of 244 patients diagnosed with Parkinson's disease (PD) were included, of whom 146 (59.8%) were men and 98 (40.2%) were women. The mean age was 63 ± 12.10 years. A total of 35 (14.3%) patients with ICD (ICD-PD) were found; the non-ICD group included 209 subjects (85.7%). When analyzing antiparkinsonian drugs, a higher use of dopamine agonists was found in the ICD group but did not reach statistical significance (p = 0.078). Only the variable alcoholism was identified as a risk factor in the logistic regression, as can be seen in its p = 0.034, the odds ratio value IS 2.55, indicating that patients with alcoholism have a 2.5 times higher risk of developing ICD. The rest of the variables did not show statistically significant p-values. conclusion: History of alcohol use was the main associated risk factor with the development of ICD. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parkinson's disease remains the second most common degenerative disorder of the central nervous system after Alzheimer's. Although it was initially described as a condition with an exclusive motor disorder, it has been shown that non-motor disorders of Parkinson's are an important part of the clinical picture. These include all those disorders that are not motor symptoms: behavioral neuropsychiatric disorders (dementia, depression, anxiety, psychosis); autonomic alteration (postural hypotension, gastrointestinal and genitourinary disorders, diaphoresis); sleep disorders; sensory-motor symptoms (fatigue, restless legs syndrome). Degeneration of non-dopaminergic cellular systems (noradrenergic, serotonergic, and cholinergic) is believed to underlie the development of most non-motor disorders. New studies are necessary to clarify the pathophysiological bases of Parkinson's disease that allow establishing future therapeutic strategies for the follow-up of patients with these disorders.

La Enfermedad de Parkinson (EP) es una enfermedad neurodegenerativa que en función de su progresión produce alteración en las funciones motoras y cognitivas e impacta directamente sobre la independencia y calidad de vida de las personas. Existen diferentes tratamientos que varían en función de los síntomas que se pretenden impactar. Dentro de las múltiples opciones no farmacológicas actualmente se proyecta la Realidad Virtual (RV) como una estrategia eficaz que favorece tanto las funciones motoras como cognitivas y genera beneficios en la funcionalidad y el funcionamiento de la persona. Objetivo: Proponer recomendaciones basadas en evidencia a partir de una revisión de la literatura científica que permita a los Fisioterapeutas respaldar el uso de la Realidad Virtual como intervención clínica terapéutica en Colombia. Método: Para la revisión sistemática se identificaron estudios a partir de terminología MeSH. Se seleccionaron de manera primaria ensayos clínicos aleatorizados y se incluyeron además artículos de igual o superior nivel de evidencia. Resultados: Se incluyeron 23 estudios en total, los cuales cumplieron con los criterios de inclusión relacionados con el componente motor. Las investigaciones consultadas reportaron abordajes de marcha, equilibrio y postura. Los diferentes estudios combinaron realidad virtual con entrenamiento convencional, generando además mejoría en la función motora, y la calidad de vida de la persona con Parkinson. Conclusión: Emplear Realidad Virtual optimiza el tiempo de recuperación, generando motivación y estimulando el aprendizaje visual, auditivo, táctil y motor, siendo una intervención precisa que brinda efectos positivos en el paciente.

La vida de Francisco Javier Lopera Restrepo, Pacho, podría ser resumida en la letra de una canción francesa, en los versos de un poeta coterráneo, o en unos pocos aforismos inventados. Aquel frío domingo 10 de junio de 1951, en el corregimiento de Aragón, municipio de Santa Rosa de Osos, hacia el norte de Antioquia, a orillas del primer tramo del cauce del Río Grande, nació Francisco Javier, hijo de Blanca Elena y Luis Emilio. Fue el 4º hijo que alumbró Blanca Elena. Era el mayor de los varones. Los Lopera-Restrepo, una típica familia campesina antioqueña de 13 hermanos. Aragón, tierra helada, con escasos 700 habitantes en esa época. Entre montañas boscosas y los silbos de las mirlas, a más de 2600 metros sobre el nivel del mar, la neblina y el frío eran persistentes. A pesar de las temperaturas tan bajas, no caía nieve, sólo heladas que tapizaban con granizo las huertas y acababan con los cultivos de papa, en la época de clima seco. De un día para otro llegaba la ruina.

Background and purpose: The aim of this study was to assess the possible pharmacological interactions between safinamide and antidepressants, and in particular the appearance of serotonin syndrome with data from real life. Methods: We conducted a retrospective observational study of patients with Parkinson's disease from our Movement Disorders Unit, who were under treatment with any antidepressant drug and safinamide. Specifically, symptoms suggestive of serotonin syndrome were screened for. Also, we collected time of simultaneous use, doses of levodopa and other antiparkinsonian drugs. Results: Clinical records were reviewed for the study period of September 2018 to September 2019. Seventy-eight PD patients who were treated with safinamide of which 25 (32.05%) had a concomitant treatment with an antidepressant drug, being sertraline and escitalopram the most frequent. Mean age was 80 years ± 8.43 and H&Y stage was 3 [2–4]. Mean dose of levodopa used was 703.75 mg ± 233.15. Median duration of concomitant treatment with safinamide and antidepressant drug was 6 months (IQR 20.5), and over eighteen months in 5 cases. No case of serotonin syndrome was recorded, neither was any of its typical manifestations combined or in isolation. Conclusions: Our real clinical practice study suggests that concomitant use of safinamide with antidepressant drugs in PD patients seemed to be safe and well tolerated, even in the long term. However, caution is warranted, individualizing treatment regimens and monitoring the potential appearance of adverse effects. Resumen: Objetivos: El objetivo de este estudio ha sido evaluar las posibles interacciones farmacológicas entre safinamida y antidepresivos; en particular la aparición del síndrome serotoninérgico mediante datos obtenidos en la vida real. Material y métodos: Realizamos un estudio observacional retrospectivo de pacientes con enfermedad de Parkinson (EP) de nuestra unidad de trastornos del movimiento, que estaban en tratamiento con algún fármaco antidepresivo y safinamida. Específicamente, se examinaron los síntomas sugestivos de síndrome serotoninérgico. Además, se recogieron tiempos de uso simultáneo, dosis de levodopa y otros fármacos antiparkinsonianos concomitantes. Resultados: Se revisaron las historias clínicas correspondientes al período de estudio de septiembre de 2018 a septiembre de 2019. Setenta y ocho pacientes con EP se encontraban en tratamiento con safinamida, de los cuales 25 (32,05%) se encontraban recibiendo además un fármaco antidepresivo, siendo sertralina y escitalopram los más frecuentes. La edad media fue de 80 años ± 8,43 y el estadio H&Y fue de 3 [2-4]. La dosis media de levodopa utilizada fue de 703,75 mg ± 233,15. La mediana de duración del tratamiento concomitante con safinamida y un fármaco antidepresivo fue de 6 meses (IQR: 20,5), y más de 18 meses en 5 casos. No se registró ningún caso de síndrome serotoninérgico, ni tampoco ninguno de sus síntomas de forma aislada. Conclusión: Nuestro estudio de práctica clínica real sugiere que el uso concomitante de safinamida con fármacos antidepresivos en pacientes con EP parece ser seguro y bien tolerado, incluso a largo plazo. Sin embargo, es necesaria precaución, individualizando los regímenes de tratamiento, y controlando la posible aparición de efectos adversos.

Introduction: Reliable assessment of individuals with Parkinson's disease (PD) is essential for providing adequate treatment. Clinical assessment is a complex and time-consuming task, especially for bradykinesia, since its evaluation can be influenced by the degree of experience of the examiner, patient collaboration and individual bias. Improvement of the clinical evaluation can be obtained by considering assessments from several professionals. However, this is only true when inter and intra-rater agreement are high. Recently, the Movement Disorder Society highlighted, during the COVID-19 pandemic, the need to develop and validate technologies for remote assessment of the motor status of people with PD. Thus, this study introduces an objective strategy for the remote evaluation of bradykinesia using multi-specialist analysis. Methods: Twelve volunteers with PD participated and these were asked to execute finger tapping, hand opening/closing and pronation/supination movements. Each task was recorded and rated by fourteen PD health experts for each patient. The scores were assessed on an individual basis. Intra and inter-rater agreement and correlation were estimated. Results: The results showed that agreements and correlations between experienced examiners were high with low variability. In addition, group analysis was noted as possessing the potential to solve individual inconsistency bias. Conclusion: Furthermore, this study demonstrated the need for a group with prior training and experience, along with indicating the importance for the development of a clinical protocol that can use telemedicine for the evaluation of individuals with PD, as well as the inclusion of a specialized mediating group. In Addition, this research helps to the development of a valid remote assessment of bradykinesia. Resumen: Introducción: La evaluación confiable de las personas con la enfermedad de Parkinson (EP) es esencial para lograr con un tratamiento adecuado. La evaluación clínica es una tarea compleja y que requiere mucho tiempo, especialmente para la bradicinesia, ya que su evaluación puede verse influenciada por el grado de experiencia del examinador, la colaboración del paciente y el sesgo individual. La mejora de la evaluación clínica se puede obtener considerando las evaluaciones de varios profesionales. Sin embargo, esto solo es más preciso cuando el convenio intra e inter evaluadores es alto. Recientemente, la Sociedad de Trastornos del Movimiento destacó, durante la pandemia COVID-19, la necesidad de desarrollar y validar tecnologías para la evaluación remota del estado motor de las personas con EP. Por lo tanto, este estudio presenta una estrategia objetiva para la evaluación remota de la bradicinesia mediante un análisis multi evaluadores. Métodos: Participaron 12 voluntarios con EP y se les pidió que ejecutaran movimientos de golpeteo de dedos de las manos, movimientos con las manos y pronación-supinación de las manos. Cada ejecución del movimiento fue registrado y calificado por 14 expertos en salud. Las puntuaciones se evaluaron de forma individual. Se estimó el convenio y la correlación intra e inter evaluadores. Resultados: Los resultados mostraron que los convenios y las correlaciones inter evaluadores experimentados son altos con baja variabilidad. Además, se observó que el análisis de grupo posee el potencial de resolver el sesgo de inconsistencia individual. Conclusiones: De esta forma, este estudio demostró la necesidad de un grupo con formación y experiencia previa, señalando la importancia para el desarrollo de un protocolo clínico que utiliza la telemedicina para la evaluación de personas con EP y como la inclusión de un grupo mediador especializado. En realidad, esta investigación propone una evaluación remota eficaz de la bradicinesia.

Purpose: Covid-19 has affected all people, especially those with chronic diseases, including Parkinson's Disease (PD). Covid-19 may affect both motor and neuropsychiatric symptoms of PD patients. We intend to evaluate different aspects of Covid-19 impact on PD patients. Methods: 647 PD patients were evaluated in terms of PD-related and Covid-19-related clinical presentations in addition to past medical history during the pandemic through an online questioner. They were compared with an age-matched control group consist of 673 individuals and a sample of the normal population consist of 1215 individuals. Results: The prevalence of Covid-19 in PD patients was 11.28%. The mortality was 1.23% among PD patients. The prevalence of Covid-19 in PD patients who undergone Deep Brain Stimulation (DBS) was 18.18%. No significant association was found between the duration of disease and the prevalence of Covid-19. A statistically significant higher prevalence of Covid-19 in PD patients who had direct contact with SARS-CoV-19 infected individuals was found. No statistically significant association has been found between the worsening of motor symptoms and Covid-19. PD patients and the normal population may differ in the prevalence of some psychological disorders, including anxiety and sleeping disorders, and Covid-19 may affect the psychological status. Conclusion: PD patients possibly follow tighter preventive protocols, which lead to lower prevalence and severity of Covid-19 and its consequences in these patients. Although it seems Covid-19 does not affect motor and psychological aspects of PD as much as it was expected, more accurate evaluations are suggested in order to clarify such effects. Resumen: Objetivo: La COVID-19 ha afectado a toda la población, especialmente a aquellos con enfermedades crónicas, incluyendo a los pacientes con enfermedad de Parkinson (EP). La COVID-19 puede empeorar tanto los signos motores como los síntomas neuropsiquiátricos de los pacientes con EP. El objetivo de este estudio es evaluar diferentes aspectos del impacto de la COVID-19 en los pacientes con EP. Métodos: A través de un cuestionario virtual se evaluó a 647 pacientes con EP de acuerdo con sus presentaciones clínicas relacionadas con la EP y con la COVID-19, además de la historia médica previa durante la pandemia. Se compararon con un grupo de controles sanos de la misma edad que constaba de 673 individuos y una muestra de la población general de 1.215 individuos. Resultados: La prevalencia de la COVID-19 en pacientes con EP fue del 11,28%. La mortalidad fue del 1,23% entre los pacientes con EP. La prevalencia de COVID-19 en pacientes con EP con estimulación cerebral profunda fue del 18,18%. No se encontró una asociación significativa entre la duración de la enfermedad y la prevalencia de COVID-19. Se halló una prevalencia mayor de COVID-19 que fue estadísticamente significativa en pacientes con EP que tuvieron contacto directo con personas infectadas con SARS-CoV-2. No se encontró una asociación estadísticamente significativa entre el empeoramiento de los signos motores y la COVID-19. Los pacientes con EP y la población general podrían diferir en la prevalencia de algunos trastornos psicológicos, incluidos los trastornos de ansiedad y del sueño, y la COVID-19 podría afectar al estado psicológico. Conclusión: Los pacientes con EP posiblemente sigan protocolos preventivos más estrictos, lo que conduce a una menor prevalencia y gravedad de COVID-19 y de sus consecuencias en estos pacientes. Aunque parece que la COVID-19 no afecta los aspectos motores y psicológicos de la EP tanto como se esperaba, se recomienda la realización de evaluaciones más precisas para aclarar tales efectos.

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Parkinson's disease (PD) accounts for a significant burden on modern society, with an increasingly rapid growth in cases. Variants of several genes have been linked to the risk of developing the disease (e.g., the GBA gene). Other genes have been associated with autosomal dominant (e.g., SNCA, LRRK2, VPS35) and autosomal recessive PD (e.g., PRKN, PINK1, DJ-1). Such genes as 13A2, FBXO7, PLA2G6, SYNJ1, and DNAJC6 are associated with recessive forms displaying early onset, greater severity, and atypical characteristics. The genetic study of PD has clinical implications, shedding light on the underlying molecular mechanisms and potential therapeutic targets. This article presents a brief review of the molecular and genetic mechanisms and the phenotype–genotype relationship of GBA and other genes associated with autosomal dominant monogenic PD. Resumen: The prevalence of Parkinson disease (PD) has increased, representing a significant burden for modern society. Pathogenic variants in diverse genes have been related to the risk of PD (e.g., GBA). Specific pathogenic variants in several genes are causative of autosomal dominant PD (i.e., SNCA, LRRK2, VPS35) or autosomal recessive PD (i.e., PRKN, PINK1, DJ-1). Besides, genes like ATP13A2, FBXO7, PLA2G6, SYNJ1, and DNAJC6, are related to early-onset recessive parkinsonism, usually with a more severe progression and atypical features. PD genetics help in the understanding of the underlying molecular mechanism and the identification of potential therapeutic targets.This article presents a brief overview of molecular mechanisms and genotypephenotype relation of autosomal-dominant and GBA-related PD.

La enfermedad de Parkinson constituye la segunda enfermedad neurodegenerativa más frecuente (América del Sur 394 por 100 000) la cual afecta el control del movimiento, equilibrio y funciones cognitivas, entre otras. Se caracteriza por presentar síntomas motores y no motores, estos últimos han ganado relevancia, debido a que preceden a los síntomas motores e interfieren negativamente en la calidad de vida de los pacientes. El objetivo del estudio es revisar en la literatura los datos más actualizados, con el tipo y frecuencia de los trastornos no motores diagnosticados en pacientes con enfermedad de Parkinson. Se realizó una búsqueda bibliográfica de los últimos 5 años, en los motores de búsqueda de PubMed y la Biblioteca Virtual de Salud de la OPS, en cada una de ellas se utilizaron ecuaciones de búsqueda a través de términos MeSh/DeCS: Trastornos no motores, Síntomas no motores, Manifestaciones clínicas no motoras y enfermedad de Parkinson. De acuerdo a los resultados obtenidos, se evidenció que los síntomas no motores más frecuentes son los trastornos del ánimo y del sueño, existiendo diferencias entre hombres y mujeres. En conclusión, los síntomas no motores deben ser identificados de manera temprana o de forma retrospectiva, con la finalidad de realizar un manejo terapéutico integral del paciente.

Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease among adults worldwide. It is characterised by the death of dopaminergic neurons in the substantia nigra pars compacta and, in some cases, presence of intracytoplasmic inclusions of α-synuclein, called Lewy bodies, a pathognomonic sign of the disease. Clinical diagnosis of PD is based on the presence of motor alterations. The treatments currently available have no neuroprotective effect. The exact causes of PD are poorly understood. Therefore, more precise preclinical models have been developed in recent years that use induced pluripotent stem cells (iPSC). In vitro studies can provide new information on PD pathogenesis and may help to identify new therapeutic targets or to develop new drugs. Resumen: La enfermedad de Parkinson (EP) es la segunda enfermedad neurodegenerativa más común a nivel mundial en adultos mayores. Se caracteriza por la pérdida de neuronas dopaminérgicas (nDAs) en la sustancia nigra pars compacta del mesencéfalo y en algunos casos acompañada de la aparición de cuerpos intracitoplásmaticos de Lewy de α-sinucleína, signo patognomónico de la enfermedad. La EP se diagnostica clínicamente por la presencia de alteraciones motoras principalmente y en la actualidad los tratamientos presentan nula actividad neuroprotectora. Aún no se han establecido las causas exactas de la EP, por lo que, en los últimos años se ha buscado el desarrollo de modelos preclínicos más precisos, utilizando células troncales pluripotentes inducidas (iPSCs). Permitiendo el estudio de la enfermedad de manera in vitro para generar conocimiento novedoso sobre su patogénesis y el descubrimiento de nuevos posibles blancos terapéuticos o el desarrollo de nuevos fármacos.

Foundation: parkinson's disease is a chronic progressive disorder of the nervous system that mainly affects motor coordination and movement control. Quality of life in patients with Parkinson's disease can vary widely depending on the severity of symptoms and the effectiveness of treatment. Objective: to analyze the quality of life of patients with Parkinson's disease in terms of factors: depression, cognitive functioning, age, sex, duration of the disease and education. Methods: descriptive and correlational, cross-sectional study. 40 people diagnosed with idiopathic Parkinson's disease and members of the Association of People with Disabilities were surveyed. The Mini Mental State Examination was used to assess cognitive functioning, the Parkinson's Disease Quality of Life Questionnaire to assess quality of life, and the Beck Depression Scale to assess emotional status. A non-parametric analysis was used to analyze the correlation, by performing several significance tests in correspondence with the distribution of the variables. The results were presented in quantities and percentages. Results: somatic problems, motor capacity, daily living activity, cognitive functioning and emotional state are among the most affected areas of life. Support from family members and communication with the social environment were the least impaired. A significant correlation was observed between depression and quality of life. Conclusions: the results suggest that early recognition and adequate treatment of depression can improve quality of life and reduce some of the somatic alterations of patients with Parkinson's disease.

Introducción: La enfermedad de Parkinson (EP) es un trastorno neurodegenerativo asociado a muerte de las células productoras de dopamina del núcleo estriado, afecta al control motor, causando síntomas como rigidez muscular y temblores, así como alteraciones específicas en la marcha, como pasos arrastrados y reducción de la amplitud del balanceo de los brazos. Estas dificultades en la locomoción se agravan con la progresión de la enfermedad y aumentan el riesgo de caídas. Objetivo: Realizar una revisión de literatura relacionada con las alteraciones del control motor y la marcha en personas mayores de 65 años con EP y las distintas alternativas de tratamiento. Metodología: Revisión de la literatura basada en las recomendaciones de guías de revisiones sistemáticas para las revisiones de alcance. La búsqueda se realizó en bases de datos como Medline/pubmed y Physiotherapy Evidence Database PEDro, limitando la búsqueda a artículos en inglés publicados en los últimos cinco años. Resultados: Se identificación 934 registros de los cuales se incluyeron 21 que cumplían con los criterios de elegibilidad que presentaban las principales alteraciones del control motor y la marcha agrupados en cambios en la postura, bradicinesia, debilidad muscular y una zancada más corta. Conclusiones: La EP produce alteraciones notables en el control motor y en la marcha de los pacientes. Estas alteraciones se caracterizan por dificultades en la iniciación y mantenimiento de movimientos, así como en la coordinación de la marcha, lo que resulta en pasos arrastrados, disminución en la amplitud del balanceo de los brazos y problemas con la postura. Estos cambios no solo limitan la movilidad y la independencia funcional, sino que también aumentan el riesgo de caídas y lesiones, impactando significativamente en la calidad de vida de los pacientes con esta enfermedad. Es crucial implementar intervenciones terapéuticas específicas y adaptadas en donde se involucren ambientes enriquecidos para abordar estas alteraciones y mejorar su calidad de vida. Resultados: Se identificación 934 registros de los cuales se incluyeron 21 que cumplían con los criterios de elegibilidad que presentaban las principales alteraciones del control motor y la marcha agrupados en cambios en la postura, bradicinesia, debilidad muscular y una zancada más corta. Conclusiones: La marcha en EP está caracterizada por la alteración en el equilibrio y control postural, presentando signos comunes como reducción de la amplitud del balanceo de los brazos, longitud de la zancada y pasos arrastrados. Se identificó que al realizar un entrenamiento cognitivo con tareas duales disminuyó el tiempo de apoyo doble, mejora la velocidad y la longitud de la zancada. Las señales o claves auditivas y visuales, además de los ambientes enriquecidos son efectivos en el tratamiento enfocado en el aprendizaje motor de la marcha.

El incremento de la incidencia y prevalencia de las patologías Parkinson y Alzheimer generan una alarma en los sistemas de salud debido a sus consecuencias en los individuos, familia y sociedad. El desarrollo de tratamientos no farmacológicos dirigidos a la rehabilitación cognitiva abre nuevas posibilidades para el incremento de la calidad de vida de estos pacientes

The genes associated with autosomal recessive Parkinson's disease (PD) include the PRKN, PINK1, and DJ-1 genes. Homozygous and compound heterozygous carriers of pathogenic variants of these genes tend to display typical characteristics of PD at early ages.On the other hand, the ATP13A2, FBXO7, PLA2G6, SYNJ1, and DNAJC6 genes are associated with early-onset recessive forms that frequently present with pyramidal signs, ataxia, and oculomotor alterations, with early appearance of levodopa-induced motor fluctuations and dyskinesia. Such non-motor symptoms as depression, psychiatric disorders, hallucinations, and epilepsy are also more frequent in this group.Among multiple molecular mechanisms involved in these cases, key examples are the dysfunction of mitochondrial and lysosomal processes.This article presents a brief review intended to inform clinicians about the basic molecular mechanisms and phenotype–genotype relationship of these monogenic forms of PD. Resumen: Los genes asociados a enfermedad de Parkinson (EP) de herencia mendeliana autosómica recesiva incluyen PRKN, PINK1 y DJ-1. Los individuos portadores homocigotos o heterocigotos compuestos de variantes patogénicas en estos genes tienden a manifestar características típicas de la enfermedad de EP a edad temprana.Por otro lado, los genes ATP13A2, FBXO7, PLA2G6, SYNJ1, y DNAJC6, se asocian a formas recesivas de manifestación precoz, presentan con frecuencia signos piramidales, ataxia y alteraciones oculomotoras, y desarrollan tempranamente, fluctuaciones motoras y disquinesias inducidas por levodopa. Alteraciones no motoras como depresión, alteraciones psiquiátricas, alucinaciones y epilepsia son también más frecuentes en este grupo.Entre los múltiples aspectos moleculares comprometidos en estos casos, destacan la disfunción de procesos mitocondriales y lisosomales.En este artículo presentamos una breve revisión orientada al clínico sobre los aspectos moleculares básicos y relación fenotipo-genotipo de estas formas monogénicas de la EP.

En los estudios de carga global de mortalidad de las enfermedades se establece que las enfermedades neurológicas son la segunda causa de muerte a nivel mundial y la primera causa de discapacidad, de años de vida ajustados por discapacidad (AVAD), así como de pérdida de años de vida ajustados por calidad (AVAC). En general, las enfermedades neurológicas son crónicas y dependen de un régimen continuo de tratamiento con el fin de evitar recaídas, por lo que, el desabastecimiento de medicamentos en Colombia, aunque no es un fenómeno reciente, sí se ha acentuado notablemente desde la pandemia de COVID-19, con repercusión directa en los pacientes y en los costos directos para el sistema de salud. Entre agosto y septiembre del 2022, se organizaron mesas de trabajo con múltiples asociaciones médico científicas, la Superintendencia Nacional de Salud y el Instituto Nacional de Vigilancia de Medicamentos y Alimentos (Invima), en las cuales se revelaron que las posibles causas del desabastecimiento serían: el incremento en la demanda; las restricciones por los fabricantes en los contratos con las entidades promotoras de salud (EPS) y los gestores de salud; los retrasos en las entregas de pedidos; los procedimientos pendientes en el Invima; los problemas en la adquisición de materias primas y la disminución del interés de la industria en comercializar productos de baja rentabilidad.

Objective: Parkinson's disease (PD) presents as a chronic condition with symptoms that worsen over time. Many PD patients experience pain at some point during their illness. This complaint is often overlooked because PD is primarily a motor disorder. The main objective is to assess the prevalence and the most frequent type of pain in this population, as well as its relation to common neuropsychiatric factors. Methods: A cross-sectional study was conducted including 196 patients diagnosed with PD. The variables analyzed included age, gender, smoking, alcohol consumption, anxiety, depression, antiparkinsonian treatment (levodopa, dopaminergic agonists, monoamine oxidase inhibitors, and amantadine), intake of antidepressants or antipsychotics, age of symptom onset, age of diagnosis, years of progression, total MDS-UPDRS 3.3 score, total MDS-UPDRS score, MDS-non-motor symptom scores, Hamilton depression and anxiety scales, and montreal Cognitive Assessment. Results: Our patient cohort consisted of 115 males (58.7%) and 81 females (41.3%), with a mean age of 63.56 ± 11.88. The mean disease duration was 7.18 ± 4.9 years. The most common type of pain was musculoskeletal pain, present in 66.7%, followed by radicular pain (24.2%), pain related to fluctuations (22.7%), chronic pain (20.7%), nocturnal pain (17.2%), discoloration, edema, or swollen pain (14.6%), and orofacial pain (5.6%). Conclusions: From the study carried out, it can be observed that the most common type of pain was musculoskeletal pain, followed by radicular pain. Pain patients had a significant association with depression and anxiety due to the intensity of pain. [ABSTRACT FROM AUTHOR]

The diagnosis of Parkinson's disease (PD) is based on the main motor manifestations: bradykinesia in combination with tremor at rest, rigidity, or both. When the diagnosis is made based on typical clinical motor symptoms, up to 60 % of the dopaminergic neurons of the mesencephalic substantia nigra pars compacta have already been lost. The identification of premotor symptoms is an early marker to suspect the future appearance of the disease, as well as its progression and severity. The hypothesis about the pathogenesis that best exposes the progression of the disease is Braak's theory. It is based on the appearance and presence of Lewy bodies in different anatomical structures, which are represented in each of its six stages and could be the biological explanation biological of premotor, motor, and non-motor symptoms. Early detection of premotor symptoms can have positive repercussions in the approach, follow-up, diagnosis and treatment of PD. The purpose of this article is to identify the neurological approaches described by Braak's theory for the premotor symptoms of Parkinson's disease according to the literature published in the last 20 years. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Pesquisa: Cuidado é Fundamental is the property of Revista de Pesquisa: Cuidado e Fundamental Online and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Alerta (San Salvador) - Revista Cientifica del Instituto Nacional de Salud is the property of Instituto Nacional de Salud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Andaluza de Medicina del Deporte is the property of Centro Andaluza de Medicina del Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Investiga: Investigaciin, Vinculación, Docencia y Gestiin is the property of Revista Enfermeria Investiga and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: depression is the most common neuropsychiatric disorder among people with Parkinson's disease and its prevalence ranges from 2.7% to 90%. Objective: to establish the relationship between the intensity of depressive symptoms, severity of motor signs and decreased ability to perform activities of daily living. Methods: a cross-sectional descriptive study was conducted in the Neurology Consultation in patients with idiopathic Parkinson's disease residing in the Municipalities of Santo Domingo and Santa Clara, Villa Clara Province, from January 2017 to January 2019; the sample consisted of 35 patients. The program Statistical Package for the Social Sciences version 21.0 was used in the data analysis. Descriptive statistical methods were used. Results: there was a significant relationship between the duration of the disease and the intensity of depression. It was determined that the greater the intensity of depression, the worse the motor and functional performance, which coincides with stage III of the Hoehn and Yahr scale. Conclusions: the greater intensity of depressive symptoms contributed to worse motor and functional performance in these patients. [ABSTRACT FROM AUTHOR]

Background: STAT-ON™ is an objective tool that registers ON-OFF fluctuations making possible to know the state of the patient at every moment of the day in normal life. Our aim was to analyze the opinion of different Parkinson's disease experts about the STAT-ON™ tool after using the device in a real clinical practice setting (RCPS). Methods: STAT-ON™ was provided by the Company Sense4Care to Spanish neurologists for using it in a RCPS. Each neurologist had the device for at least three months and could use it in PD patients at his/her own discretion. In February 2020, a survey with 30 questions was sent to all participants. Results: Two thirds of neurologists (53.8% females; mean age 44.9 ± 9 years old) worked in a Movement Disorders Unit, the average experience in PD was 16 ± 6.9 years, and 40.7% of them had previously used other devices. A total of 119 evaluations were performed in 114 patients (range 2–9 by neurologist; mean 4.5 ± 2.3). STAT-ON™ was considered “quite” to “very useful” by 74% of the neurologists with an overall opinion of 6.9 ± 1.7 (0, worst; 10, best). STAT-ON™ was considered better than diaries by 70.3% of neurologists and a useful tool for the identification of patients with advanced PD by 81.5%. Proper identification of freezing of gait episodes and falls were frequent limitations reported. Conclusion: STAT-ON™ could be a useful device for using in PD patients in clinical practice. Resumen: Introducción: STAT-ON es un dispositivo que registra las fluctuaciones on-off que permite conocer el estado del paciente con enfermedad de Parkinson (EP) en cada momento del día.Nuestro objetivo fue analizar la opinión de diferentes expertos en EP sobre STAT-ON, después de usar el dispositivo en un entorno de práctica clínica real (PCR). Métodos: STAT-ON fue proporcionado por la compañía Sense4Care a neurólogos españoles para usarlo en PCR. Cada neurólogo dispuso del dispositivo durante al menos tres meses y podía usarlo en pacientes con EP, según su criterio. En febrero de 2020, se envió una encuesta con 30 preguntas a todos los participantes. Resultados: Dos tercios de los neurólogos (53,8% mujeres; edad promedio 44,9 ± 9 años) trabajaban en una Unidad de Trastornos del Movimiento, con una experiencia en EP de 16 ± 6,9 años, habiendo el 40,7% usado otros dispositivos previamente. Se realizaron un total de 119 evaluaciones en 114 pacientes (rango dos a nueve por neurólogo; media 4,5 ± 2,3). STAT-ON fue considerado «bastante» a «muy útil» por el 74% de los neurólogos, con una opinión general de 6,9 ± 1,7 (0, peor; 10, mejor). STAT-ON fue considerado mejor que los diarios por el 70,3% de los neurólogos y una herramienta útil para la identificación de pacientes con EP avanzada por un 81,5%. La identificación adecuada de los episodios de congelación de la marcha y las caídas fueron las limitaciones más reportadas. Conclusiones: STAT-ON podría ser un dispositivo útil para usar en la PCR.

Introduction: Unilateral Gamma Knife™ stereotactic radiosurgery on the ventral-intermediate nucleus of the thalamus is a minimally invasive neurosurgical option for refractory tremor. We describe the experience of Gamma Knife™ thalamotomy (GKT) in patients with essential tremor (ET) and tremor-dominant Parkinson's disease (PD) at our specialised stereotactic neurosurgery unit. Methods: We reviewed the cases of patients treated with GKT between January 2014 and February 2018 with a minimum of 12 months’ follow-up. We analysed clinical and demographic variables, indication, radiation dose, effectiveness (based on subscales of the Fahn-Tolosa-Marin [FTM] scale and the Movement Disorders Society-Unified Parkinson's Disease Rating Scale [MDS-UPDRS] motor score), and adverse events. Results: Thirteen patients were registered, 6 with a diagnosis of tremor-dominant PD, four with refractory ET, and three with ET and PD. Median age was 78 years (range, 62-83), with seven patients aged over 75 years. Four patients were receiving anticoagulants and two had history of stroke. The maximum radiation dose administered was 130 Gy. Mean (standard deviation) follow-up duration was 30.0 (14.5) months. Significant tremor improvement was observed on the FTM subscales: 63.6% at 12 months and 63.5% at the end of follow-up; MDS-UPDRS tremor items showed improvements of 71.3% at 12 months and 60.3% at the end of follow up. Eleven patients reported significant improvements in quality of life, and 3 reported mild and transient adverse effects. Conclusions: This is the largest series of patients with essential and parkinsonian tremor treated with GKT and followed up in the long term in Spain. GKT can be safe and effective in the long term in patients with refractory tremor, including in elderly patients and those receiving anticoagulants. Resumen: Introducción: La radiocirugía estereotáctica con Gamma Knife® (GK), sobre el núcleo ventral intermedio-medial del tálamo (VIM), unilateral es una opción neuroquirúrgica mínimamente invasiva para el temblor refractario. Se describe la experiencia de talamotomía con GK (TGK) en pacientes con temblor esencial (TE) y enfermedad de Parkinson (EP) de predominio tremórico de una unidad especializada en cirugía estereotáctica. Métodos: Se revisan los pacientes tratados con TGK desde enero de 2014 hasta febrero de 2018. Se analizan variables clínico-demográficas, indicación, dosis empleada, eficacia (mediante subescalas de Fahn-Tolosa-Marin (FTM) y MDS-UPDRS motora) y efectos adversos (EA). Resultados: Se registraron 13 pacientes, seis con diagnóstico de EP de predominio tremórico, cuatro con TE refractario y tres casos de TE + EP. La mediana de edad fue 78 años (62-83), con siete pacientes > 75 años. Cuatro pacientes anticoagulados y dos con antecedentes de ictus previo. La dosis máxima de radiación aplicada fue 130 Gy. La media de seguimiento fue 30,0 (14,5) meses. Se observó una mejoría significativa del temblor en las subescalas de FTM del 63,6% a 12 meses y del 63,5% al final del seguimiento y en items de temblor de MDS-UPDRS del 71,3% a 12 meses y del 60,3% al final del seguimiento. Once pacientes refirieron mejoría significativa en su calidad de vida. Tres pacientes refirieron EA leves y transitorios. Conclusiones: Se presenta la mayor serie de pacientes con TE y parkinsoniano tratados con TGK en España con seguimiento a largo plazo. La TGK puede ser un tratamiento seguro y con eficacia mantenida en temblor refractario, incluso en edad avanzada o en tratamiento anticoagulante.

Introduction: Understanding alterations to brain anatomy and cognitive function associated with neurodegenerative diseases remains a challenge for neuroscience today. In experimental neuroscience, several computerised tests have been developed to contribute to our understanding of neural networks involved in cognition. The Attention Network Test (ANT) enables us to measure the activity of 3 attentional networks (alertness, orienting, and executive function). Objectives: The main aim of this review is to describe all the anatomical and functional alterations found in diverse neurological diseases using the ANT. Material and methods: We collected studies published since 2010 in the PubMed database that employed the ANT in different neurological diseases. Thirty-two articles were obtained, addressing multiple sclerosis, epilepsy, and Parkinson’s disease, among other disorders. Conclusions: Some of the anatomical structures proposed in the 3 attentional networks model were confirmed. The most relevant structures in the alertness network are the prefrontal cortex, parietal region, thalamus, and cerebellum. The thalamus is also relevant in the orienting network, together with posterior parietal regions. The executive network does not depend exclusively on the prefrontal cortex and anterior cingulate cortex, but also involves such subcortical structures as the basal ganglia and cerebellum and their projections towards the entire cortex. Resumen: Introducción: Comprender las alteraciones en la anatomía y función del cerebro en los procesos cognitivos para las enfermedades neurodegenerativas es aún un desafío para la neurociencia actual. Desde la neurociencia experimental, algunos tests computarizados han sido desarrollados para mejorar nuestro conocimiento de las redes neurales involucradas en la cognición. El Attention Network Test (ANT) permite medir la activad de las tres redes atencionales (alerta, orientación y función ejecutiva). Objetivos: El principal objetivo de esta revisión fue describir todas las alteraciones anatómicas y funcionales encontradas en diversas enfermedades neurológicas usando el ANT. Material y métodos: Un protocolo de revisión fue aplicado seleccionando estudios desde 2010 en la base de datos PubMed que involucraban al Attention Network Test en diferentes enfermedades neurológicas. Se obtuvieron treinta y dos artículos para esclerosis múltiple, epilepsia o Parkinson entre otras patologías. Conclusiones: Se confirman algunas de las estructuras anatómicas propuestas para el modelo de tres grandes redes atencionales. Las estructuras más relevantes para la red de alerta son la corteza prefrontal, regiones parietales, tálamo y el cerebelo. El tálamo es también relevante para la red de orientación, junto a regiones parietales posteriores. Respecto a la red ejecutiva, no depende exclusivamente de la corteza prefrontal y corteza cingulada anterior, sino también de estructuras subcorticales como los ganglios basales y el cerebelo y sus proyecciones hacia toda la corteza.

Objetivo: Determinar la latencia diagnóstica en la enfermedad de Parkinson (EP), así como su relación con variables clínicas y demográficas. Determinar la percepción de síntomas no motores: disfunción olfatoria, trastorno conductual del sueño MOR, depresión y estreñimiento, previos al diagnóstico de EP. Materiales y métodos: Estudio transversal realizado en Yucatán, México en sujetos con EP. Se analizó la asociación entre la latencia diagnóstica con variables clínicas y demográficas usando las pruebas estadísticas no paramétricas: U de Mann Whitney y Kruskal-Wallis. Resultados: Se incluyeron un total de 60 sujetos con una edad promedio de 66.7 años. El tiempo promedio transcurrido desde el inicio del primer síntoma motor hasta el diagnóstico fue de 20.8 meses. El tener antecedentes familiares de EP se asoció significativamente (p=0.031) con una latencia diagnóstica más prolongada en comparación con aquellos pacientes que no refirieron familiares con EP. En cualquier momento antes del diagnóstico de EP: el 36.6% de los pacientes percibieron estreñimiento, 15% depresión, 13.3% trastorno conductual del sueño MOR y 11.6% disfunción olfatoria, 51.7% no refirió ninguno. Conclusiones: La latencia diagnóstica promedio de un grupo de 60 pacientes con EP diagnosticados en Yucatán fue de 20.8 meses. La latencia diagnóstica no se asoció significativamente con el tipo de servicio médico de neurología que realizó en diagnóstico de EP (público o privado), ni con otras variables clínicas ni demográficas además del antecedente familiar de EP.

Acupuncture is a very effective and safe technique for treating the symptoms of Parkinson's disease. The practice of this technique has among its benefits: reducing signs and symptoms, improving motor functions, reducing the need for medication, minimizing medication side effects, slowing the progression of the disease, increasing dopamine levels, decreasing neuronal damage and death, increase cyclophilin levels, increase the number of stem cells and the number of neurons transformed from them, and enhance antioxidant systems. For years it has been postulated that the insertion of needles causes the release of endorphins and that it promotes local blood flow.

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