41 results on '"L. Mordillo Mateos"'
Search Results
2. Dopamine-dependent changes of cortical excitability induced by transcranial static magnetic field stimulation in Parkinson’s disease
- Author
-
M. Dileone, M. C. Carrasco-López, J. C. Segundo-Rodriguez, L. Mordillo-Mateos, N. López-Ariztegui, F. Alonso-Frech, M. J. Catalan-Alonso, J. A. Obeso, A. Oliviero, and G. Foffani
- Subjects
Medicine ,Science - Abstract
Abstract Transcranial static magnetic field stimulation (tSMS) is a recent low-cost non-invasive brain stimulation technique that decreases cortical excitability in healthy subjects. The objective of the present study was to test the ability of tSMS to modulate cortical excitability in patients with Parkinson’s disease. We performed a randomized double-blind sham-controlled cross-over study to assess cortical excitability before and immediately after tSMS (or sham) applied for 10 min to the more affected motor cortex of patients with Parkinson’s disease. Cortical excitability was quantified by the amplitude of motor evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS). tSMS significantly decreased MEP amplitudes in patients OFF medication (after overnight withdrawal of dopaminergic drugs), but not ON medication (after an acute dose of levodopa). The between-patients variability of tSMS-induced changes was significantly greater ON medication. The variability ON medication could be partly explained by disease progression, i.e. the more advanced the patient, the more likely it was to observe a switch from inhibitory tSMS plasticity OFF medication to paradoxical facilitatory plasticity ON medication. These results suggest that tSMS induces dopamine-dependent changes of cortical excitability in patients with Parkinson’s disease. more...
- Published
- 2017
- Full Text
- View/download PDF
Catalog
3. Prefrontal hemodynamic changes produced by anodal direct current stimulation.
- Author
-
Anna Caterina Merzagora, Guglielmo Foffani, I. Panyavin, L. Mordillo-Mateos, Juan Aguilar, Banu Onaral, and A. Oliviero
- Published
- 2010
- Full Text
- View/download PDF
4. Protocolo terapéutico del dolor con técnicas de estimulación no invasiva
- Author
-
Antonio Oliviero, M.J. Rodríguez Matas, Y.A. Pérez Borrego, V. Soto León, L. Mordillo Mateos, and A. Brocalero Camacho
- Subjects
Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Medicine ,030212 general & internal medicine ,General Medicine ,business - Abstract
espanolResumen El dolor es la causa mas frecuente de consulta y el dolor cronico constituye uno de los problemas de salud mas importantes en la poblacion. El dolor neuropatico tiene gran prevalencia en el dolor cronico. El dolor cronico y el de origen neuropatico son los de abordaje mas complejo. Aunque el tratamiento farmacologico e intervencionista ha evolucionado, los beneficios aun son pobres. La estimulacion cerebral no invasiva incluye una familia de tecnicas basadas en la aplicacion de campos magneticos o electricos, a traves del cuero cabelludo, para obtener efectos en la corteza cerebral. Estas tecnicas incluyen: la estimulacion magnetica transcraneal, la estimulacion con corriente directa, la estimulacion con ultrasonidos y la estimulacion con campos magneticos estaticos. La EMTr del cortex motor tiene un efecto analgesico con un nivel de evidencia A (eficacia demostrada). El optimo perfil de seguridad de la tecnica, la colocan en una posicion excelente para ser utilizada en el tratamiento del dolor de tipo neuropatico en pacientes con dolor cronico farmacorresistente. EnglishPain is the most common reason for physician consultation and chronic pain is the most important health problem. Chronic idiopathic pain is the most prevalent. Both chronic and neuropathic pains have the most complex approach. Several techniques have been used to try to reduce pain, however results are scarce. Non-invasive brain stimulation techniques induce a magnetic or electrical stimulation of the brain, through the scalp, attempting to achieve effects on cerebral cortex. They include: repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial ultrasound stimulation and transcranial static magnetic field stimulation. rTMS has a level A (definite efficacy) of analgesic effect of the primary motor cortex and is widely indicated to treat drug-resistant neuropathic pain. more...
- Published
- 2019
- Full Text
- View/download PDF
5. P037 Transcranial static magnetic field stimulation-induced modulation of motor cortex excitability in Parkinson’s disease
- Author
-
Fernando Alonso-Frech, M. J. Catalan-Alonso, J. C. Segundo-Rodriguez, Antonio Oliviero, Guglielmo Foffani, Jose A. Obeso, N. López-Aristegu, M.C. Carrasco-Lopez, Michele Dileone, and L. Mordillo Mateos more...
- Subjects
Levodopa ,Parkinson's disease ,medicine.medical_treatment ,Dopaminergic ,Stimulation ,medicine.disease ,Sensory Systems ,Transcranial magnetic stimulation ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Neurology ,Dopamine ,030220 oncology & carcinogenesis ,Physiology (medical) ,Brain stimulation ,medicine ,Neurology (clinical) ,Psychology ,Neuroscience ,030217 neurology & neurosurgery ,Motor cortex ,medicine.drug - Abstract
Question tSMS is a new non-pharmacological, low-cost, non-invasive brain stimulation (NIBS) technique that decreases cortical excitability in healthy subjects. The effects of tSMS in Parkinson’s disease remain unknown. We designed this study to test the ability of transcranial static magnetic field stimulation (tSMS) to modulate motor cortex excitability in patients with Parkinson’s disease. Methods We performed a randomized double-blind sham-controlled cross-over study to assess cortical excitability before and immediately after tSMS (or sham) applied for 10 min to the motor cortex of patients with Parkinson’s disease. Motor cortex excitability was quantified by the amplitude of motor evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS). In a separated single-blind experimental session we evaluated the effects of tSMS on SICI and SICF. Patients were studied both after overnight withdrawal of dopaminergic therapy (OFF) medication and after an acute dose of levodopa (ON). Results tSMS significantly decreased MEP amplitudes compared to sham in patients OFF medication, but not ON medication. Furthermore, tSMS induced an increase in SICI and a reduction in SICF only in OFF condition. Conclusions These results suggest a dopamine dependency of tSMS-induced cortical changes and encourage the application of tSMS for future clinical trials in patients with Parkinson’s disease. more...
- Published
- 2017
- Full Text
- View/download PDF
6. P148 Dose–effect of transcranial static magnetic field stimulation on excitatory and inhibitory intracortical circuits
- Author
-
Guglielmo Foffani, Michele Dileone, Antonio Oliviero, and L. Mordillo Mateos
- Subjects
Transcranial direct-current stimulation ,Chemistry ,medicine.medical_treatment ,CTBS ,Stimulation ,Inhibitory postsynaptic potential ,Magnetostatics ,Sensory Systems ,medicine.anatomical_structure ,Neurology ,Physiology (medical) ,Brain stimulation ,medicine ,Excitatory postsynaptic potential ,Neurology (clinical) ,Neuroscience ,Motor cortex - Abstract
Question Transcranial static magnetic field stimulation (tSMS) is a new low-cost, non-invasive brain stimulation (NIBS) technique. When tSMS is applied for 10–15 min over the motor cortex, it leads to a short-lasting decrease of cortical excitability in healthy subjects, as measured by a decreased amplitude of motor-evoked potentials (MEPs), associated with an increase of short-latency intracortical inhibition (SICI). Here we aimed to test the effects of a longer application of tSMS (30 min) on excitatory and inhibitory intracortical circuits. Methods We performed 3 randomized double-blind sham-controlled experiments in a total of 31 right-handed healthy subjects. In experiment 1 we assessed MEP amplitudes before and after tSMS (or sham) applied for 30 min to the non-dominant motor cortex. In experiment 2 we tested the effects of 30 min of tSMS on SICI and I wave interaction. In experiment 3 we evaluated the effects of 10 min of tSMS on SICI and on the first peak of I wave interaction (short-latency intracortical facilitation, SICF). Results Prolonged application of tSMS (30 min) significantly decreased MEP amplitudes compared to sham till 30 min after the end of tSMS and, surprisingly, reduced SICI while increasing SICF. By applying tSMS for only 10 min, we found a significant and short-lasting increase of SICI with reduction of SICF. Conclusions We found that a prolonged application of tSMS leads to a long-lasting reduction in motor cortex excitability, similar to those typically induced by continuous theta-burst stimulation (cTBS) and cathodal transcranial direct current stimulation (tDCS). Moreover, SICI and SICF could be modulated in a bidirectional way by tSMS, depending on the application time, revealing a dose–effect of tSMS on excitatory and inhibitory intracortical circuits. more...
- Published
- 2017
- Full Text
- View/download PDF
7. W15.2 Effects of bilateral simultaneous transcranial direct current stimulation (tDCS) of human motor cortex
- Author
-
Antonio Oliviero, J. Millán Pascual, L. Mordillo Mateos, and L. Turpin Fenoll
- Subjects
medicine.anatomical_structure ,Neurology ,Transcranial direct-current stimulation ,business.industry ,Physiology (medical) ,medicine.medical_treatment ,medicine ,Neurology (clinical) ,business ,Neuroscience ,Sensory Systems ,Motor cortex ,Transcranial alternating current stimulation - Published
- 2011
- Full Text
- View/download PDF
8. Combining Transcranial Direct Current Stimulation With Hand Robotic Rehabilitation in Chronic Stroke Patients: A Double-Blind Randomized Clinical Trial.
- Author
-
Bernal-Jiménez JJ, Dileone M, Mordillo-Mateos L, Martín-Conty JL, Durantez-Fernández C, Viñuela A, Martín-Rodríguez F, Lerin-Calvo A, Alcántara-Porcuna V, and Polonio-López B
- Subjects
- Humans, Double-Blind Method, Male, Female, Middle Aged, Prospective Studies, Aged, Stroke physiopathology, Stroke complications, Combined Modality Therapy, Chronic Disease, Recovery of Function, Treatment Outcome, Muscle Spasticity rehabilitation, Adult, Stroke Rehabilitation methods, Transcranial Direct Current Stimulation methods, Robotics, Hand physiopathology
- Abstract
Objective: This study aimed to assess the impact of combining transcranial direct current stimulation with end-effector robot-assisted treatment on upper limb function, spasticity, and hand dexterity in chronic stroke patients., Design: This was a prospective, double-blind randomized trial with 20 equally allocated stroke patients. The experimental group received dual transcranial direct current stimulation (anode over affected M1, cathode over contralateral M1) alongside robot-assisted treatment, while the control group received sham transcranial direct current stimulation with the same electrode placement + robot-assisted treatment. Each patient underwent 20 combined transcranial direct current stimulation and robot-assisted treatment sessions. The primary outcome measure was the Fugl-Meyer Upper Limb motor score, with secondary outcomes including AMADEO kinematic measures, Action Research Arm Test, and Functional Independence Measure. Assessments were conducted at baseline, after rehabilitation, and 3 mos later., Results: Combining bilateral transcranial direct current stimulation with robot-assisted treatment did not yield additional improvements in Fugl-Meyer Upper Limb motor score, Functional Independence Measure, or Action Research Arm Test scores among stroke patients. However, the real transcranial direct current stimulation group showed enhanced finger flexion in the affected hand based on AMADEO kinematic measures., Conclusions: The addition of transcranial direct current stimulation to robot-assisted treatment did not result in significant overall functional improvements in chronic stroke patients. However, a benefit was observed in finger flexion of the affected hand., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) more...
- Published
- 2024
- Full Text
- View/download PDF
9. A Prospective Observational Study of Frailty in Geriatric Revitalization Aimed at Community-Dwelling Elderly.
- Author
-
Morales-Sánchez A, Calvo Arenillas JI, Gutiérrez Palmero MJ, Martín-Conty JL, Polonio-López B, Dzul López LA, Mordillo-Mateos L, Bernal-Jiménez JJ, Conty-Serrano R, Torres-Falguera F, Martínez Cano A, and Durantez-Fernández C more...
- Abstract
(1) Background: The increasing life expectancy brings an increase in geriatric syndromes, specifically frailty. The literature shows that exercise is a key to preventing, or even reversing, frailty in community-dwelling populations. The main objective is to demonstrate how an intervention based on multicomponent exercise produces an improvement in frailty and pre-frailty in a community-dwelling population. (2) Methods: a prospective observational study of a multicomponent exercise program for geriatric revitalization with people aged over 65 holding Barthel Index scores equal to, or beyond, 90. The program was developed over 30 weeks, three times a week, in sessions lasting 45-50 min each. Frailty levels were registered by the Short Physical Performance Battery, FRAIL Questionnaire Screening Tool, and Timed "Up & Go" at the beginning of the program, 30 weeks later (at the end of the program), and following 13 weeks without training; (3) Results: 360 participants completed the program; a greater risk of frailty was found before the program started among older women living in urban areas, with a more elevated fat percentage, more baseline pathologies, and wider baseline medication use. Furthermore, heterogeneous results were observed both in training periods and in periods without physical activity. However, they are consistent over time and show improvement after training. They show a good correlation between TUG and SPPB; (4) Conclusions: A thirty-week multicomponent exercise program improves frailty and pre-frailty status in a community-dwelling population with no functional decline. Nevertheless, a lack of homogeneity is evident among the various tools used for measuring frailty over training periods and inactivity periods. more...
- Published
- 2024
- Full Text
- View/download PDF
10. Is the Combination of Robot-Assisted Therapy and Transcranial Direct Current Stimulation Useful for Upper Limb Motor Recovery? A Systematic Review with Meta-Analysis.
- Author
-
Bernal-Jiménez JJ, Polonio-López B, Sanz-García A, Martín-Conty JL, Lerín-Calvo A, Segura-Fragoso A, Martín-Rodríguez F, Cantero-Garlito PA, Corregidor-Sánchez AI, and Mordillo-Mateos L
- Abstract
Stroke is the third leading cause of disability in the world, and effective rehabilitation is needed to improve lost functionality post-stroke. In this regard, robot-assisted therapy (RAT) and transcranial direct current stimulation (tDCS) are promising rehabilitative approaches that have been shown to be effective in motor recovery. In the past decade, they have been combined to study whether their combination produces adjuvant and greater effects on stroke recovery. The aim of this study was to estimate the effectiveness of the combined use of RATs and tDCS in the motor recovery of the upper extremities after stroke. After reviewing 227 studies, we included nine randomised clinical trials (RCTs) in this study. We analysed the methodological quality of all nine RCTs in the meta-analysis. The analysed outcomes were deficit severity, hand dexterity, spasticity, and activity. The addition of tDCS to RAT produced a negligible additional benefit on the effects of upper limb function (SMD -0.09, 95% CI -0.31 to 0.12), hand dexterity (SMD 0.12, 95% CI -0.22 to 0.46), spasticity (SMD 0.04, 95% CI -0.24 to 0.32), and activity (SMD 0.66, 95% CI -1.82 to 3.14). There is no evidence of an additional effect when adding tDCS to RAT for upper limb recovery after stroke. Combining tDCS with RAT does not improve upper limb motor function, spasticity, and/or hand dexterity. Future research should focus on the use of RAT protocols in which the patient is given an active role, focusing on the intensity and dosage, and determining how certain variables influence the success of RAT. more...
- Published
- 2024
- Full Text
- View/download PDF
11. Clinical outcome prediction of acute neurological patients admitted to the emergency department: Sequential Organ Failure Assessment score and modified SOFA score.
- Author
-
Donoso-Calero MI, Sanz-García A, Polonio-López B, Maestre Miquel C, Durantez Fernández C, Mordillo-Mateos L, Mohedano-Moriano A, Conty-Serrano R, Otero-Agra M, Jorge-Soto C, Martín-Conty JL, and Martín-Rodríguez F more...
- Subjects
- Adult, Humans, Prospective Studies, Retrospective Studies, Prognosis, Organ Dysfunction Scores, Emergency Service, Hospital
- Abstract
Background: The aim of this study was to determine the ability of the Sequential Organ Failure Assessment score (SOFA) and modified SOFA score (mSOFA) as predictive tools for 2-day and 28-day mortality and ICU admission in patients with acute neurological pathology treated in hospital emergency departments (EDs)., Methods: An observational, prospective cohort study in adults with acute neurological disease transferred by ambulance to an ED was conducted from 1 January 2019 to 31 August 2022 in five hospitals in Castilla-León (Spain). Score discrimination was assessed by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve of the score., Results: A total of 640 adult patients with neurological disease were included. For the prediction of 2-day mortality (all-cause), mSOFA presented a higher AUC than SOFA (mSOFA = 0.925 vs. SOFA = 0.902). This was not the case for 28-day mortality, for which SOFA was higher than mSOFA (mSOFA = 0.852 vs. SOFA = 0.875). Finally, ICU admission showed that SOFA was higher than mSOFA (mSOFA = 0.834 vs. SOFA = 0.845)., Conclusion: Both mSOFA and SOFA presented similar predictive ability, with mSOFA being the best predictor for short-term mortality and SOFA being the best predictor for medium-term mortality, as well as for ICU admission. These results in a cohort of patients with acute neurological pathology pave the way for the use of both predictive tools in the ED. The inclusion of these tools could improve the clinical assessment and further treatment of neurological patients, who commonly present the worst outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Donoso-Calero, Sanz-García, Polonio-López, Maestre Miquel, Durantez Fernández, Mordillo-Mateos, Mohedano-Moriano, Conty-Serrano, Otero-Agra, Jorge-Soto, Martín-Conty and Martín-Rodríguez.) more...
- Published
- 2023
- Full Text
- View/download PDF
12. "Nurses and health professionals facing female genital mutilation: a qualitative study ".
- Author
-
Ugarte-Gurrutxaga M, Mazoteras-Pardo V, de Corral GM, Molina-Gallego B, Mordillo-Mateos L, and Gómez-Cantarino S
- Abstract
Background: Transnational migratory movements make Spain a country with a very diverse population, including women and girls from countries where Female Genital Mutilation (FGM) is practiced. Given this reality, we set out to carry out a qualitative study to identify the knowledge, attitudes and skills of health professionals regarding FGM., Method: Qualitative study with a content analysis approach. Forty-seven health professionals with the profiles of Nursing, Family Medicine, Pediatrics, Midwifery and Gynecology and Obstetrics were purposively selected. Data were collected through semi-structured in-depth interviews and focus groups. The qualitative content analysis approach was used for data analysis. The study was conducted in the years 2019 and 2022., Results: Although most professionals are aware of the current legislation on FGM in Spain, only a few of them are aware of the existence of the FGM prevention protocol in Castilla-La Mancha. This lack of knowledge together with the perception that FGM belongs to the private sphere of women, contributes to the loss of opportunities to identify and prevent FGM., Conclusion: Health professionals' training, especially midwives and pediatricians, is essential to the identification and action against Female Genital Mutilation., (© 2023. The Author(s).) more...
- Published
- 2023
- Full Text
- View/download PDF
13. Prehospital seizures: Short-term outcomes and risk stratification based in point-of-care testing.
- Author
-
Donoso-Calero MI, Martín Conty JL, López-Izquierdo R, Sanz-García A, Dileone M, Polonio-López B, Mordillo-Mateos L, Delgado Benito JF, Del Pozo Vegas C, Mohedano-Moriano A, and Martín-Rodríguez F
- Subjects
- Adult, Humans, Prospective Studies, Seizures diagnosis, Point-of-Care Testing, Risk Assessment, Retrospective Studies, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic diagnosis, Brain Injuries, Traumatic therapy, Stroke complications, Emergency Medical Services
- Abstract
Background: Information for treatment or hospital derivation of prehospital seizures is limited, impairing patient condition and hindering patients risk assessment by the emergency medical services (EMS). This study aimed to determine the associated factors to clinical impairment, and secondarily, to determine risk factors associated to cumulative in-hospital mortality at 2, 7 and 30 days, in patients presenting prehospital seizures., Methods: Prospective, multicentre, EMS-delivery study involving adult subjects with prehospital seizures, including five advanced life support units, 27 basic life support units and four emergency departments in Spain. All bedside variables: including demographic, standard vital signs, prehospital laboratory tests and presence of intoxication or traumatic brain injury (TBI), were analysed to construct a risk model using binary logistic regression and internal validation methods., Results: A total of 517 patients were considered. Clinical impairment was present in 14.9%, and cumulative in-hospital mortality at 2, 7 and 30-days was 3.4%, 4.6% and 7.7%, respectively. The model for the clinical impairment indicated that respiratory rate, partial pressure of carbon dioxide, blood urea nitrogen, associated TBI or stroke were risk factors; higher Glasgow Coma Scale (GCS) scores mean a lower risk of impairment. Age, potassium, glucose, prehospital use of mechanical ventilation and concomitant stroke were risk factors associated to mortality; and oxygen saturation, a high score in GCS and haemoglobin were protective factors., Conclusion: Our study shows that prehospital variables could reflect the clinical impairment and mortality of patients suffering from seizures. The incorporation of such variables in the prehospital decision-making process could improve patient outcomes., (© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.) more...
- Published
- 2023
- Full Text
- View/download PDF
14. Modified Rapid Emergency Medicine Score-Lactate (mREMS-L) performance to screen non-anticipated 30-day-related-mortality in emergency department.
- Author
-
Donoso Calero MI, Mordillo-Mateos L, Martín-Conty JL, Polonio-López B, López-González Á, Durantez-Fernández C, Viñuela A, Rodríguez Hernández M, Mohedano-Moriano A, López-Izquierdo R, Jorge Soto C, and Martín-Rodríguez F more...
- Subjects
- Adult, Humans, Prospective Studies, Prognosis, Retrospective Studies, ROC Curve, Hospital Mortality, Emergency Service, Hospital, Lactic Acid, Emergency Medicine
- Abstract
Background: The aim of this study was to compare the ability to predict 30-day in-hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS-L)., Methods: A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS-L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days., Results: A total of 5371 participants were included, and the in-hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut-off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut-off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS-L showed a cut-off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS-L for 30-day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases)., Conclusions: The new score generated, mREMS-L, obtained better statistical results than its components (mREMS and lactate) separately., (© 2023 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.) more...
- Published
- 2023
- Full Text
- View/download PDF
15. COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study.
- Author
-
Martín-Conty JL, Polonio-López B, Sanz-García A, Del Pozo Vegas C, Mordillo-Mateos L, Bernal-Jiménez JJ, Conty-Serrano R, Castro Villamor MA, López-Izquierdo R, and Martín-Rodríguez F
- Subjects
- Adult, Humans, Cohort Studies, Prospective Studies, Risk Factors, Ambulances, COVID-19
- Abstract
Introduction: COVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease., Methods: A prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis., Results: Between 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10-1.61); p < 0.001]., Conclusion: The COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Martín-Conty, Polonio-López, Sanz-García, del Pozo Vegas, Mordillo-Mateos, Bernal-Jiménez, Conty-Serrano, Castro Villamor, López-Izquierdo and Martín-Rodríguez.) more...
- Published
- 2023
- Full Text
- View/download PDF
16. Lactate improves the predictive ability of the National Early Warning Score 2 in the emergency department.
- Author
-
Durantez-Fernández C, Martín-Conty JL, Polonio-López B, Castro Villamor MÁ, Maestre-Miquel C, Viñuela A, López-Izquierdo R, Mordillo-Mateos L, Fernández Méndez F, Jorge Soto C, and Martín-Rodríguez F
- Subjects
- Adult, Humans, Cohort Studies, Prospective Studies, Lactic Acid, Hospital Mortality, Emergency Service, Hospital, Retrospective Studies, Early Warning Score
- Abstract
Aims: The aim of this study was to compare the ability to predict 2-, 7-, 14-, and 30-day in-hospital mortality of lactate vs the National Early Warning Score 2 (NEWS2) vs the arithmetic sum of the NEWS2 plus the numerical value of lactate (NEWS2-L)., Methods: This was a prospective, multicentric, emergency department delivery, pragmatic cohort study. To determine the predictive capacity of lactate, we calculated the NEWS2 and NEWS2-L in adult patients (aged >18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon (Spain) between November 1, 2019, and September 30, 2020. The area under the receiver operating characteristic curve of each of the scales was calculated in terms of mortality for every time frame (2, 7, 14, and 30 days). We determined the cut-off point of each scale that offered highest sensitivity and specificity using the Youden index., Results: A total of 1716 participants were included, and the in-hospital mortality rates at 2, 7, 14, and 30 days were of 7.8% (134 cases), 11.6% (200 cases), 14.2% (243 cases), and 17.2% (295 cases), respectively. The best cut-off point determined in the NEWS2 was 6.5 points (sensitivity of 97% and specificity of 59%), and for lactate, the cut-off point was 3.3 mmol/L (sensitivity of 79% and specificity of 72%). Finally, the combined NEWS2-L showed a cut-off point of 11.7 (sensitivity of 86% and a specificity of 85%). The area under the receiver operating characteristic curve of the NEWS2, lactate, and NEWS2-L in the validation cohort for 2-day mortality was 0.889, 0.856, and 0.923, respectively (p<0.001 in all cases)., Conclusions: The new score generated, NEWS2-L, obtained better statistical results than its components (NEWS2 and lactate) separately., (Copyright © 2021 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.) more...
- Published
- 2022
- Full Text
- View/download PDF
17. Hand Motor Fatigability Induced by a Simple Isometric Task in Spinal Cord Injury.
- Author
-
Onate-Figuérez A, Soto-León V, Avendaño-Coy J, Mordillo-Mateos L, Pérez-Borrego YA, Redondo-Galán C, Arias P, and Oliviero A
- Abstract
This study aimed: (1) to evaluate the hand motor fatigability in people with spinal cord injury (SCI) and compare it with measurements obtained form an able-bodied population; (2) to compare the hand motor fatigability in people with tetraplegia and in people with paraplegia; and (3) to analyse if motor fatigability is different in people with SCI with and without clinical significant perceived fatigability., Materials and Methods: 96 participants with SCI (40 cervical and 56 thoracolumbar) and 63 able-bodied controls performed a simple hand isometric task to assess motor fatigability. The Fatigue Severity Scale was used for perceived fatigability evaluation., Results: The main results of this study can be summarized as follows: (1) the waning in muscle force (motor fatigability) during a fatiguing task is similar in controls and participants with SCI; (2) the motor fatigability is influenced by the maximal muscle force (measured at the beginning of the task); and (3) the perceived fatigability and the motor fatigability are largely independent in the individuals with SCI., Conclusion: Our findings suggest that the capability to maintain a prolonged effort is preserved in SCI, and this capacity depends on the residual maximal muscle force in people with SCI. more...
- Published
- 2022
- Full Text
- View/download PDF
18. Static magnetic field stimulation over motor cortex modulates resting functional connectivity in humans.
- Author
-
Soto-León V, Torres-Llacsa M, Mordillo-Mateos L, Carrasco-López C, Pineda-Pardo JA, Velasco AI, Abad-Toribio L, Tornero J, Foffani G, Strange BA, and Oliviero A
- Subjects
- Humans, Magnetic Fields, Magnetic Resonance Imaging, Rest, Transcranial Magnetic Stimulation, Cortical Excitability, Motor Cortex physiology
- Abstract
Focal application of transcranial static magnetic field stimulation (tSMS) over the human motor cortex induces local changes in cortical excitability. Whether tSMS can also induce distant network effects, and how these local and distant effects may vary over time, is currently unknown. In this study, we applied 10 min tSMS over the left motor cortex of healthy subjects using a real/sham parallel design. To measure tSMS effects at the sensori-motor network level, we used resting-state fMRI. Real tSMS, but not sham, reduced functional connectivity within the stimulated sensori-motor network. This effect of tSMS showed time-dependency, returning to sham levels after the first 5 min of fMRI scanning. With 10 min real tSMS over the motor cortex we did not observe effects in other functional networks examined (default mode and visual system networks). In conclusion, 10 min of tSMS over a location within the sensori-motor network reduces functional connectivity within the same functional network., (© 2022. The Author(s).) more...
- Published
- 2022
- Full Text
- View/download PDF
19. Comparison of Nine Early Warning Scores for Identification of Short-Term Mortality in Acute Neurological Disease in Emergency Department.
- Author
-
Durantez-Fernández C, Polonio-López B, Martín-Conty JL, Maestre-Miquel C, Viñuela A, López-Izquierdo R, Mordillo-Mateos L, Jorge-Soto C, Otero-Agra M, Dileone M, Rabanales-Sotos J, and Martín-Rodríguez F more...
- Abstract
(1) Background: The aim was screening the performance of nine Early Warning Scores (EWS), to identify patients at high-risk of premature impairment and to detect intensive care unit (ICU) admissions, as well as to track the 2-, 7-, 14-, and 28-day mortality in a cohort of patients diagnosed with an acute neurological condition. (2) Methods: We conducted a prospective, longitudinal, observational study, calculating the EWS [Modified Early Warning Score (MEWS), National Early Warning Score (NEWS), VitalPAC Early Warning Score (ViEWS), Modified Rapid Emergency Medicine Score (MREMS), Early Warning Score (EWS), Hamilton Early Warning Score (HEWS), Standardised Early Warning Score (SEWS), WHO Prognostic Scored System (WPSS), and Rapid Acute Physiology Score (RAPS)] upon the arrival of patients to the emergency department. (3) Results: In all, 1160 patients were included: 808 patients were hospitalized, 199 cases (17%) required ICU care, and 6% of patients died (64 cases) within 2 days, which rose to 16% (183 cases) within 28 days. The highest area under the curve for predicting the need for ICU admissions was obtained by RAPS and MEWS. For predicting mortality, MREMS obtained the best scores for 2- and 28-day mortality. (4) Conclusions: This is the first study to explore whether several EWS accurately identify the risk of ICU admissions and mortality, at different time points, in patients with acute neurological disorders. Every score analyzed obtained good results, but it is suggested that the use of RAPS, MEWS, and MREMS should be preferred in the acute setting, for patients with neurological impairment. more...
- Published
- 2022
- Full Text
- View/download PDF
20. Female Genital Mutilation: Knowledge and Skills of Health Professionals.
- Author
-
Molina-Gallego B, Mordillo-Mateos L, de Corral GM, Gómez-Cantarino S, Polonio-López B, and Ugarte-Gurrutxaga MI
- Abstract
Background: Female genital mutilation (FGM) is any process that injures female genitals for non-medical reasons and is a violation of women's human rights. An important number of women from countries where FGM is performed are arriving to Western countries. Health professionals are important for detecting cases of FGM. No surveys to assess knowledge, attitudes and practices on FGM among healthcare professionals has been conducted in Castilla la Mancha (Spain) until now., Methods: The main goal of the study is assessing knowledge, attitudes and perceptions of healthcare professionals in relation to FGM. A cross-sectional descriptive study was conducted based on self-administered online surveys to nurses, midwives, family doctors, pediatricians, obstetrics and gynecologists., Results: In total, 1168 professionals answered the surveys. Just 13.9% indicated that they had received training in FGM, however just 10.7% correctly identified the three types of FGM, 10.7% the countries where it is usually practiced, 33.9% knew the legislation in Spain and only 4.4% found a case of FGM during their professional practice. Regarding the knowledge about protocols, 8.64% of the sample indicated to know one of them., Conclusion: The present study demonstrate that it is necessary to improve the training and awareness of healthcare professionals related to FGM in Castilla la Mancha. more...
- Published
- 2021
- Full Text
- View/download PDF
21. Neuropsychological Study in Patients with Spinal Cord Injuries.
- Author
-
Molina-Gallego B, Gómez-Cantarino S, Ugarte-Gurrutxaga MI, Molina-Gallego L, and Mordillo-Mateos L
- Abstract
The present investigation was designed to determinate the nature, pattern, and extent of cognitive deficits in a group of participants with subacute and chronic spinal cord injury (SCI)., Methods: A cross-sectional study was conducted in both patients with subacute and chronic SCI. Different cognitive functions were evaluated through a neuropsychological protocol designed for this purpose, taking into account the patient's emotional state., Results: A total of 100 patients suffering a spinal cord injury were evaluated. There were no differences between the two groups when age, sex, level of education, and region of origin were studied. The chronic injured patients obtained lower scores in the neuropsychological evaluation protocol respective to the subacute injured patients., Conclusions: Subjects with chronic spinal cord injury presented a cognitive profile that differed greatly in the number of altered cognitive functions as well as in their magnitude from the subacute spinal cord injured patient profile. Moreover, cognitive dysfunction may be important beyond the end of the first stage of rehabilitation as it can affect an individual's quality of life and possible integration in society. more...
- Published
- 2021
- Full Text
- View/download PDF
22. Facilitating Factors of Professional Health Practice Regarding Female Genital Mutilation: A Qualitative Study.
- Author
-
Ugarte-Gurrutxaga MI, Molina-Gallego B, Mordillo-Mateos L, Gómez-Cantarino S, Solano-Ruiz MC, and Melgar de Corral G
- Subjects
- Child, Cross-Sectional Studies, Female, Humans, Interviews as Topic, Qualitative Research, Circumcision, Female ethnology, Health Personnel psychology
- Abstract
Introduction: According to figures released by UNICEF (United Nations Children's Fund), more than 200 million girls and women have suffered female genital mutilation (FGM) in 30 African and Middle East countries. An increasing number of African women who come from ethnic groups where FGM is practised are arriving in Western countries. Healthcare professionals play a fundamental role in its prevention. Goals: To learn about the factors that healthcare professionals consider as facilitators for prevention and action when faced with female genital mutilation. Methods: A cross-sectional descriptive study developed on the basis of the qualitative methodological perspective, where 43 healthcare professionals participated. A series of analysis dimensions were established, based on which, the interview and discussion group scripts were designed. Results: Addressing FGM requires a series of structural adaptations of the healthcare system that facilitate the recording and monitoring of cases, both for treatment and for prevention. In addition, it is necessary to establish coordination between the healthcare, social services and education sectors. Conclusions: The existence of a protocol of action and training in its use is one of the key tools to take into account. more...
- Published
- 2020
- Full Text
- View/download PDF
23. Effects of fatigue induced by repetitive movements and isometric tasks on reaction time.
- Author
-
Soto-Leon V, Alonso-Bonilla C, Peinado-Palomino D, Torres-Pareja M, Mendoza-Laiz N, Mordillo-Mateos L, Onate-Figuerez A, Arias P, Aguilar J, and Oliviero A
- Subjects
- Adolescent, Adult, Case-Control Studies, Exercise, Female, Humans, Male, Middle Aged, Young Adult, Cognition physiology, Hand physiopathology, Muscle Fatigue, Muscle, Skeletal physiopathology, Reaction Time
- Abstract
Purpose: The understanding of fatigue of the human motor system is important in the fields of ergonomics, sport, rehabilitation and neurology. In order to understand the interactions between fatigue and reaction time, we evaluated the effects of two different fatiguing tasks on reaction time., Methods: 83 healthy subjects were included in a case-control study with three arms where single and double choice reaction time tasks were performed before and after 2 min fatiguing task (an isometric task, a finger tapping task and at rest)., Results: After an isometric task, the right-fatigued hand was slower in the choice component of a double choice reaction time task (calculated as the individual difference between single and double choice reaction times); also, the subjects that felt more fatigued had slower choice reaction time respect to the baseline assessment. Moreover, in relationship to the performance decay after two minutes, finger tapping task produces more intense fatigability perception., Conclusions: We confirmed that two minutes of isometric or repetitive tasks are enough to produce fatigue. The fatigue perception is more intense for finger tapping tasks in relation to the performance decay. We therefore confirmed that the two fatiguing tasks produced two different kind of fatigue demonstrating that with a very simple protocol it is possible to test subjects or patients to quantify different form of fatigue., (Copyright © 2020 Elsevier B.V. All rights reserved.) more...
- Published
- 2020
- Full Text
- View/download PDF
24. Physiological Response of Quality Cardiopulmonary Resuscitation, Crossover Trial on Mannequin in Extreme Temperature Conditions.
- Author
-
Martin-Conty JL, Polonio-López B, Maestre-Miquel C, Mohedano-Moriano A, Durantez-Fernández C, Mordillo-Mateos L, Jurado-Palomo J, Viñuela A, Bernal-Jiménez JJ, and Martin-Rodríguez F
- Subjects
- Cross-Over Studies, Female, Humans, Male, Prospective Studies, Temperature, Cardiopulmonary Resuscitation, Cold Temperature, Fatigue, Hot Temperature, Manikins
- Abstract
Background: To determine the relationship between physiological fatigue and the quality of cardiopulmonary resuscitation (CPR) in trained resuscitators in hostile thermal environments (extreme cold and heat) simulating the different conditions found in an out-of-hospital cardiorespiratory arrest., Methods: Prospective observational study involving 60 students of the health sciences with training in resuscitation, who simulated CPR on a mannequin for 10 min in different thermal environments: thermo-neutral environment (21 °C and 60% humidity), heat environment (41 °C and 98% humidity) and cold environment (-35 °C and 80% humidity). Physiological parameters (heart rate and lactic acid) and CPR quality were monitored., Results: We detected a significant increase in the number of compressions per minute in the "heat environment" group after three minutes and in the mean rate after one minute. We observed a negative correlation between the total number of compressions and mean rate with respect to mean depth. The fraction of compressions (proportion of time in which chest compressions are carried out) was significant over time and the mean rate was higher in the "heat environment". Physiological parameters revealed no differences in heart rate depending on the resuscitation scenario; however, there was a greater and faster increase in lactate in the "heat environment" (significant at minute 3). The total proportion of participants reaching metabolic fatigue was also higher in the "heat environment"., Conclusions: A warm climate modifies metabolic parameters, reducing the quality of the CPR maneuver. more...
- Published
- 2020
- Full Text
- View/download PDF
25. Significant influence of static magnetic field stimulation applied for 30 minutes over the human M1 on corticospinal excitability.
- Author
-
Dileone M, Mordillo-Mateos L, Oliviero A, and Foffani G
- Subjects
- Humans, Magnetic Fields, Magnetic Phenomena, Evoked Potentials, Motor, Motor Cortex
- Abstract
Competing Interests: Declaration of competing interest A.O. and G.F. are cofounders of the company Neurek SL, which is a spinoff of the Foundation of the Hospital Nacional de Parapléjicos. L.M-M., A.O. and G.F. are inventors listed on the following patents: P201030610 and PCT/ES2011/070290 (patent abandoned). more...
- Published
- 2020
- Full Text
- View/download PDF
26. Development of chronic pain in males with traumatic spinal cord injury: role of circulating levels of the chemokines CCL2 and CXCL10 in subacute stage.
- Author
-
Mordillo-Mateos L, Sánchez-Ramos A, Coperchini F, Bustos-Guadamillas I, Alonso-Bonilla C, Vargas-Baquero E, Rodriguez-Carrión I, Rotondi M, and Oliviero A
- Subjects
- Adult, Biomarkers blood, Chronic Pain diagnosis, Humans, Longitudinal Studies, Male, Middle Aged, Pain Measurement trends, Spinal Cord Injuries diagnosis, Young Adult, Chemokine CCL2 blood, Chemokine CXCL10 blood, Chronic Pain blood, Chronic Pain etiology, Spinal Cord Injuries blood, Spinal Cord Injuries complications
- Abstract
Study Design: Longitudinal study., Objectives: To assess the impact of spinal cord injury (SCI) on circulating levels of chemokines (CCL2 and CXCL10) and its relation with pain development., Setting: National Hospital for SCI patients., Methods: We longitudinally studied changes in the circulating levels of CCL2 and CXCL10 in 27 male patients with complete SCI who were evaluated in the early subacute phase and indeed 3 and 6 months after injury measuring at each time-point serum levels of CCL2 and CXCL10. Patients were telephonically interviewed about pain 1 year after SCI., Results: In the early subacute phase, patients with pain showed higher CXCL10 and similar CCL2 levels as opposed to those without pain. Moreover, CCL2 concentrations were positively associated with pain intensity. The results obtained by analysing the temporal profile of the chemokines suggested that CXCL10 was inclined to decrease over time, while CCL2 increased over time., Conclusion: The results of this preliminary study, the first performed in humans with traumatic SCI, suggest a link between changes in the circulating chemokine profile and pain development in subacute SCI stage as well as with severity in a more chronic stage. Large series studies will evaluate whether the circulating chemokine status can be useful as a biomarker for assessing the patients' risk for pain development. more...
- Published
- 2019
- Full Text
- View/download PDF
27. Fatigue in Multiple Sclerosis: General and Perceived Fatigue Does Not Depend on Corticospinal Tract Dysfunction.
- Author
-
Mordillo-Mateos L, Soto-Leon V, Torres-Pareja M, Peinado-Palomino D, Mendoza-Laiz N, Alonso-Bonilla C, Dileone M, Rotondi M, Aguilar J, and Oliviero A
- Abstract
Background: Multiple sclerosis (MS) is an autoimmune disorder of the CNS in which inflammation, demyelination, and axonal damage of the central nervous system coexist. Fatigue is one of the most disabling symptoms in MS and little is known about the neurophysiological mechanisms involved. Methods: To give more mechanistic insight of fatigue in MS, we studied a cohort of 17 MS patients and a group of 16 age-matched healthy controls. Baseline Fatigue Severity Scales and Fatigue Rating were obtained from both groups to check the level of fatigue and to perform statistical correlations with fatigue-induced neurophysiologic changes. To induce fatigue we used a handgrip task. During the fatiguing task, we evaluated fatigue state (using a dynamometer) and after the task we evaluated the Borg Rating of Perceived Exertion Scale. Transcranial magnetic stimulation and peripheral electric stimulation were used to assess corticospinal tract and peripheral system functions before and after the task. Results: Clinically significant fatigue and central motor conduction time were greater in patients than in controls, while motor cortex excitability was decreased and maximal handgrip strength reduced in patients. Interestingly, fatigue state was positively correlated to perceived fatigue in controls but not in patients. Furthermore, in the presence of similar fatigue state over time, controls showed a significant fatigue-related reduction in motor evoked potential (a putative marker of central fatigue) whereas this effect was not seen in patients. Conclusions: in MS patients the pathogenesis of fatigue seems not driven by the mechanisms directly related to corticospinal function (that characterize fatigue in controls) but seems probably due to other "central abnormalities" upstream to primary motor cortex. more...
- Published
- 2019
- Full Text
- View/download PDF
28. Long-lasting effects of transcranial static magnetic field stimulation on motor cortex excitability.
- Author
-
Dileone M, Mordillo-Mateos L, Oliviero A, and Foffani G
- Abstract
Background: Transcranial static magnetic field stimulation (tSMS) was recently added to the family of inhibitory non-invasive brain stimulation techniques. However, the application of tSMS for 10-20 min over the motor cortex (M1) induces only short-lasting effects that revert within few minutes., Objective: We examined whether increasing the duration of tSMS to 30 min leads to long-lasting changes in cortical excitability, which is critical for translating tSMS toward clinical applications., Methods: The study comprised 5 experiments in 45 healthy subjects. We assessed the impact of 30-min-tSMS over M1 on corticospinal excitability, as measured by the amplitude of motor evoked potentials (MEPs) and resting motor thresholds (RMTs) to single-pulse transcranial magnetic stimulation (TMS) (experiments 1-2). We then assessed the impact of 30-min-tSMS on intracortical excitability, as measured by short-interval intracortical facilitation (SICF) and short-interval intracortical inhibition (SICI) using paired-pulse TMS protocols (experiments 2-4). We finally assessed the impact of 10-min-tSMS on SICF and SICI (experiment 5)., Results: 30-min-tSMS decreased MEP amplitude compared to sham for at least 30 min after the end of the stimulation. This long-lasting effect was associated with increased SICF and reduced SICI. 10-min-tSMS -previously reported to induce a short-lasting decrease in MEP amplitude- produced the opposite changes in intracortical excitability, decreasing SICF while increasing SICI., Conclusions: These results suggest a dissociation of intracortical changes in the consolidation from short-lasting to long-lasting decrease of corticospinal excitability induced by tSMS. The long-lasting effects of 30-min-tSMS open the way to the translation of this simple, portable and low-cost technique toward clinical trials., (Copyright © 2018. Published by Elsevier Inc.) more...
- Published
- 2018
- Full Text
- View/download PDF
29. Effects of patterned peripheral nerve stimulation on soleus spinal motor neuron excitability.
- Author
-
Jimenez S, Mordillo-Mateos L, Dileone M, Campolo M, Carrasco-Lopez C, Moitinho-Ferreira F, Gallego-Izquierdo T, Siebner HR, Valls-Solé J, Aguilar J, and Oliviero A
- Subjects
- Adult, Female, H-Reflex, Humans, Male, Middle Aged, Spinal Cord cytology, Young Adult, Median Nerve physiology, Motor Neurons physiology, Muscle, Skeletal innervation, Spinal Cord physiology, Tibial Nerve physiology, Transcutaneous Electric Nerve Stimulation methods
- Abstract
Spinal plasticity is thought to contribute to sensorimotor recovery of limb function in several neurological disorders and can be experimentally induced in animals and humans using different stimulation protocols. In healthy individuals, electrical continuous Theta Burst Stimulation (TBS) of the median nerve has been shown to change spinal motoneuron excitability in the cervical spinal cord as indexed by a change in mean H-reflex amplitude in the flexor carpi radialis muscle. It is unknown whether continuous TBS of a peripheral nerve can also shift motoneuron excitability in the lower limb. In 26 healthy subjects, we examined the effects of electrical TBS given to the tibial nerve in the popliteal fossa on the excitability of lumbar spinal motoneurons as measured by H-reflex amplitude of the soleus muscle evoked by tibial nerve stimulation. Continuous TBS was given at 110% of H-reflex threshold intensity and compared to non-patterned regular electrical stimulation at 15 Hz. To disclose any pain-induced effects, we also tested the effects of TBS at individual sensory threshold. Moreover, in a subgroup of subjects we evaluated paired-pulse inhibition of H-reflex. Continuous TBS at 110% of H-reflex threshold intensity induced a short-term reduction of H-reflex amplitude. The other stimulation conditions produced no after effects. Paired-pulse H-reflex inhibition was not modulated by continuous TBS or non-patterned repetitive stimulation at 15 Hz. An effect of pain on the results obtained was discarded, since non-patterned 15 Hz stimulation at 110% HT led to pain scores similar to those induced by EcTBS at 110% HT, but was not able to induce any modulation of the H reflex amplitude. Together, the results provide first time evidence that peripheral continuous TBS induces a short-lasting change in the excitability of spinal motoneurons in lower limb circuitries. Future studies need to investigate how the TBS protocol can be optimized to produce a larger and longer effect on spinal cord physiology and whether this might be a useful intervention in patients with excessive excitability of the spinal motorneurons. more...
- Published
- 2018
- Full Text
- View/download PDF
30. Prevalence of Fatigue and Associated Factors in a Spinal Cord Injury Population: Data from an Internet-Based and Face-to-Face Surveys.
- Author
-
Cudeiro-Blanco J, Onate-Figuérez A, Soto-León V, Avendaño-Coy J, Mordillo-Mateos L, Brocalero-Camacho A, Esclarin-Ruz A, Rotondi M, Aguilar J, Arias P, and Oliviero A
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Internet, Male, Middle Aged, Prevalence, Surveys and Questionnaires, Young Adult, Fatigue epidemiology, Fatigue etiology, Spinal Cord Injuries complications
- Abstract
Fatigue has a profound impact on patients with spinal cord injury (SCI), but only limited treatments are available. The aim of this study was to determine the prevalence of fatigue in SCI and its association with clinical and demographic factors. We used an internet-based survey and a face-to-face interview to estimate the prevalence of fatigue in a SCI population. Fatigue was measured using the Fatigue Severity Scale (FSS). Clinically significant fatigue was defined as FSS scores greater than or equal to four. A total of 253 participants with SCI were included in the study. Clinically significant fatigue was present in one third of our sample. There was no relationship between fatigue and injury level or completeness. We found significant correlations between depression, pain, and level of injury. The relation of fatigue with completeness of injury and spasticity is less clear. Moreover, the online survey and the standard face-to-face interview showed similar results concerning fatigue evaluation. Several factors may contribute to fatigue, however. Future studies should be conducted to clarify which are the most relevant ones and, if possible, to determine which factors are modifiable. more...
- Published
- 2017
- Full Text
- View/download PDF
31. Dopamine-dependent changes of cortical excitability induced by transcranial static magnetic field stimulation in Parkinson's disease.
- Author
-
Dileone M, Carrasco-López MC, Segundo-Rodriguez JC, Mordillo-Mateos L, López-Ariztegui N, Alonso-Frech F, Catalan-Alonso MJ, Obeso JA, Oliviero A, and Foffani G
- Subjects
- Adult, Aged, Cerebral Cortex drug effects, Dopamine Agents pharmacology, Dopamine Agents therapeutic use, Evoked Potentials, Motor, Female, Humans, Male, Middle Aged, Motor Cortex metabolism, Motor Cortex physiopathology, Parkinson Disease drug therapy, Cerebral Cortex metabolism, Cerebral Cortex physiopathology, Cortical Excitability, Dopamine metabolism, Parkinson Disease metabolism, Parkinson Disease physiopathology, Transcranial Magnetic Stimulation
- Abstract
Transcranial static magnetic field stimulation (tSMS) is a recent low-cost non-invasive brain stimulation technique that decreases cortical excitability in healthy subjects. The objective of the present study was to test the ability of tSMS to modulate cortical excitability in patients with Parkinson's disease. We performed a randomized double-blind sham-controlled cross-over study to assess cortical excitability before and immediately after tSMS (or sham) applied for 10 min to the more affected motor cortex of patients with Parkinson's disease. Cortical excitability was quantified by the amplitude of motor evoked potentials (MEPs) elicited by single-pulse transcranial magnetic stimulation (TMS). tSMS significantly decreased MEP amplitudes in patients OFF medication (after overnight withdrawal of dopaminergic drugs), but not ON medication (after an acute dose of levodopa). The between-patients variability of tSMS-induced changes was significantly greater ON medication. The variability ON medication could be partly explained by disease progression, i.e. the more advanced the patient, the more likely it was to observe a switch from inhibitory tSMS plasticity OFF medication to paradoxical facilitatory plasticity ON medication. These results suggest that tSMS induces dopamine-dependent changes of cortical excitability in patients with Parkinson's disease. more...
- Published
- 2017
- Full Text
- View/download PDF
32. Effects of transcranial direct current stimulation on temperature and pain perception.
- Author
-
Mordillo-Mateos L, Dileone M, Soto-León V, Brocalero-Camacho A, Pérez-Borrego YA, Onate-Figuerez A, Aguilar J, and Oliviero A
- Subjects
- Adult, Female, Healthy Volunteers, Humans, Male, Motor Cortex physiology, Pain Threshold, Parietal Lobe physiology, Temperature, Transcranial Magnetic Stimulation, Pain Perception, Thermosensing, Transcranial Direct Current Stimulation
- Abstract
Transcranial direct current stimulation modifies cortical excitability and in consequence some cerebral functions. In the present study we aimed to elucidate whether tDCS could affect temperature and pain perceptions in healthy subjects testing different stimulation parameters. A total of 20 healthy subjects were studied by means of quantitative sensory testing. Two different experiments were performed. First, we studied the effects of 15 minutes 2 mA anodal transcranial direct current stimulation applied over left M1 and parietal cortex in two separated sessions. Then, we tested the effects of 5 minutes tDCS over M1 by means of a sham controlled design to optimize the possibility to study minimal effects of tDCS using different polarities (cathodal and anodal) and intensities (1 and 2 mA). 2 mA anodal tDCS, when applied for both 15 and 5 minutes over the motor cortex, increased cold perception threshold. Conversely, motor cortex cathodal tDCS modulated cold perception threshold only when 1 mA intensity was used. M1-tDCS can modify the temperature perception; these effects are polarity and intensity dependent. As stimulation intensity seems critical to determine the effects, we suggest that for clinical application strong anodal tDCS (>1 mA) or weak cathodal tDCS (<2 mA) should be used for pain control. more...
- Published
- 2017
- Full Text
- View/download PDF
33. Early spermatogenesis changes in traumatic complete spinal cord-injured adult patients.
- Author
-
Sánchez-Ramos A, Vargas-Baquero E, Martin-de Francisco FJ, Godino-Durán JA, Rodriguez-Carrión I, Ortega-Ortega M, Mordillo-Mateos L, Coperchini F, Rotondi M, Oliviero A, and Mas M
- Subjects
- Adult, Biopsy, Fine-Needle, Disease Progression, Follow-Up Studies, Hormones blood, Humans, Longitudinal Studies, Male, Prospective Studies, Semen Analysis, Spinal Cord Injuries complications, Testis pathology, Time Factors, Young Adult, Spermatogenesis physiology, Spinal Cord Injuries physiopathology
- Abstract
Study Design: Prospective longitudinal study., Objectives: To assess the impact of spinal cord injury (SCI) on the spermatogenesis of patients studied in the early subacute stage and ensuing months., Setting: National hospital for SCI patients., Methods: A prospective follow-up study was conducted on 28 male patients with complete SCI who were evaluated in the early subacute phase (~1 month), and 3 and 6 months after the injury. At each time point, fine needle aspiration biopsy samples were taken from the testes for cytological assessment, and serum levels of relevant hormones were measured. At the end of the study period, ejaculation was attempted for standard semen analyses., Results: Cytological patterns indicative of defective spermatogenesis were found in 61%, 52% and 20% of the patients at 1, 3 and 6 months after SCI, respectively, suggesting an improvement over time. Serum hormone analyses showed a steady elevation of estradiol levels above the reference range, and increasing levels of testosterone, inhibin B and prolactin throughout the study period. Prolactin levels were above the reference range at all time points. Only 2 out of the 10 patients who were able to ejaculate at 6 months post injury showed normal sperm parameters., Conclusion: A majority of the patients showed impaired spermatogenesis soon after the injury, which in most cases recovered over time. That was accompanied by parallel increases in serum levels of inhibin B, testosterone and prolactin, possibly driving or reflecting the spermatogenesis recovery. Further studies are needed to elucidate the biological mechanisms underlying these changes. more...
- Published
- 2017
- Full Text
- View/download PDF
34. Differential Effects of HRAS Mutation on LTP-Like Activity Induced by Different Protocols of Repetitive Transcranial Magnetic Stimulation.
- Author
-
Dileone M, Ranieri F, Florio L, Capone F, Musumeci G, Leoni C, Mordillo-Mateos L, Tartaglia M, Zampino G, and Di Lazzaro V
- Subjects
- Adolescent, Adult, Case-Control Studies, Costello Syndrome physiopathology, Evoked Potentials, Motor, Female, Humans, Male, Motor Cortex physiology, Mutation, Theta Rhythm, Costello Syndrome genetics, Long-Term Potentiation, Proto-Oncogene Proteins p21(ras) genetics, Transcranial Magnetic Stimulation
- Abstract
Background: Costello syndrome (CS) is a rare congenital disorder due to a G12S amino acid substitution in HRAS protoncogene. Previous studies have shown that Paired Associative Stimulation (PAS), a repetitive brain stimulation protocol inducing motor cortex plasticity by coupling peripheral nerve stimulation with brain stimulation, leads to an extremely pronounced motor cortex excitability increase in CS patients. Intermittent Theta Burst Stimulation (iTBS) represents a protocol able to induce motor cortex plasticity by trains of stimuli at 50 Hz. In healthy subjects PAS and iTBS produce similar after-effects in motor cortex excitability. Experimental models showed that HRAS-dependent signalling pathways differently affect LTP induced by different patterns of repetitive synaptic stimulation., Objective: We aimed to compare iTBS-induced after-effects on motor cortex excitability with those produced by PAS in CS patients and to observe whether HRAS mutation differentially affects two different forms of neuromodulation protocols., Methods: We evaluated in vivo after-effects induced by PAS and iTBS applied over the right motor cortex in 4 CS patients and in 21 healthy age-matched controls., Results: Our findings confirmed HRAS-dependent extremely pronounced PAS-induced after-effects and showed for the first time that iTBS induces no change in MEP amplitude in CS patients whereas both protocols lead to an increase of about 50% in controls., Conclusions: CS patients are characterized by an impairment of iTBS-related LTP-like phenomena besides enhanced PAS-induced after-effects, suggesting that HRAS-dependent signalling pathways have a differential influence on PAS- and iTBS-induced plasticity in humans., (Copyright © 2015 Elsevier Inc. All rights reserved.) more...
- Published
- 2016
- Full Text
- View/download PDF
35. Balancing the excitability of M1 circuitry during movement observation without overt replication.
- Author
-
Arias P, Robles-García V, Corral-Bergantiños Y, Espinosa N, Mordillo-Mateos L, Grieve K, Oliviero A, and Cudeiro J
- Abstract
Although observation of a movement increases the excitability of the motor system of the observer, it does not induce a motor replica. What is the mechanism for replica suppression? We performed a series of experiments, involving a total of 66 healthy humans, to explore the excitability of different M1 circuits and the spinal cord during observation of simple movements. Several strategies were used. In the first and second experimental blocks, we used several delay times from movement onset to evaluate the time-course modulation of the cortico-spinal excitability (CSE), and its potential dependency on the duration of the movement observed; in order to do this single pulse transcranial magnetic stimulation (TMS) over M1 was used. In subsequent experiments, at selected delay times from movement-onset, we probed the excitability of the cortico-spinal circuits using three different approaches: (i) electric cervicomedullary stimulation (CMS), to test spinal excitability, (ii) paired-pulse TMS over M1, to evaluate the cortical inhibitory-excitatory balance (short intracortical inhibition (SICI) and intracortical facilitation (ICF)], and (iii) continuous theta-burst stimulation (cTBS), to modulate the excitability of M1 cortical circuits. We observed a stereotyped response in the modulation of CSE. At 500 ms after movement-onset the ICF was increased; although the most clear-cut effect was a decrease of CSE. The compensatory mechanism was not explained by changes in SICI, but by M1-intracortical circuits targeted by cTBS. Meanwhile, the spinal cord maintained the elevated level of excitability induced when expecting to observe movements, potentially useful to facilitate any required response to the movement observed. more...
- Published
- 2014
- Full Text
- View/download PDF
36. The effects of expectancy on corticospinal excitability: passively preparing to observe a movement.
- Author
-
Arias P, Robles-García V, Espinosa N, Corral-Bergantiños Y, Mordillo-Mateos L, Grieve K, Oliviero A, and Cudeiro J
- Subjects
- Adult, Analysis of Variance, Electromyography, Female, Hand physiology, Humans, Male, Motion Perception physiology, Muscle, Skeletal physiology, Photic Stimulation, Transcranial Magnetic Stimulation, Young Adult, Attention physiology, Evoked Potentials, Motor physiology, Movement physiology, Observation, Pyramidal Tracts physiology
- Abstract
The corticospinal tract excitability is modulated when preparing movements. Earlier to movement execution, the excitability of the spinal cord increases waiting for supraspinal commands to release the movement. Movement execution and movement observation share processes within the motor system, although movement observation research has focused on processes later to movement onset. We used single and paired pulse transcranial magnetic stimulation on M1 (n = 12), and electrical cervicomedullary stimulation (n = 7), to understand the modulation of the corticospinal system during the "preparation" to observe a third person's movement. Subjects passively observed a hand that would remain still or make an index finger extension. The observer's corticospinal excitability rose when "expecting to see a movement" vs. when "expecting to see a still hand." The modulation took origin at a spinal level and not at the corticocortical networks explored. We conclude that expectancy of seeing movements increases the excitability of the spinal cord. more...
- Published
- 2014
- Full Text
- View/download PDF
37. Effects of simultaneous bilateral tDCS of the human motor cortex.
- Author
-
Mordillo-Mateos L, Turpin-Fenoll L, Millán-Pascual J, Núñez-Pérez N, Panyavin I, Gómez-Argüelles JM, Botia-Paniagua E, Foffani G, Lang N, and Oliviero A
- Subjects
- Adult, Dose-Response Relationship, Radiation, Female, Humans, Male, Radiation Dosage, Evoked Potentials, Motor physiology, Evoked Potentials, Motor radiation effects, Motor Cortex physiology, Motor Cortex radiation effects, Transcranial Magnetic Stimulation methods
- Abstract
Background: Transcranial direct current stimulation (tDCS) is a noninvasive technique that has been investigated as a therapeutic tool for different neurologic disorders. Neuronal excitability can be modified by application of DC in a polarity-specific manner: anodal tDCS increases excitability, while cathodal tDCS decreases excitability. Previous research has shown that simultaneous bilateral tDCS of the human motor cortex facilitates motor performance in the anodal stimulated hemisphere much more than when the same hemisphere is stimulated using unilateral anodal motor cortex tDCS., Objective: The main purpose of this study was to determine whether simultaneous bilateral tDCS is able to increase cortical excitability in one hemisphere whereas decreasing cortical excitability in the contralateral hemisphere. To test our hypothesis, cortical excitability before and after bilateral motor cortex tDCS was evaluated. Moreover, the effects of bilateral tDCS were compared with those of unilateral motor cortex tDCS., Methods: We evaluated cortical excitability in healthy volunteers before and after unilateral or bilateral tDCS using transcranial magnetic stimulation., Results: We demonstrated that simultaneous application of anodal tDCS over the motor cortex and cathodal tDCS over the contralateral motor cortex induces an increase in cortical excitability on the anodal-stimulated side and a decrease in the cathodal stimulated side. We also used the electrode montage (motor cortex-contralateral orbit) method to compare the bilateral tDCS montage with unilateral tDCS montage. The simultaneous bilateral tDCS induced similar effects to the unilateral montage on the cathode-stimulated side. On the anodal tDCS side, the simultaneous bilateral tDCS seems to be a slightly less robust electrode arrangement compared with the placement of electrodes in the motor cortex-contralateral orbit montage. We also found that intersubject variability of the excitability changes that were induced by the anodal motor cortex tDCS using the bilateral montage was lower than that with the unilateral montage., Conclusions: This is the first study in which cortical excitability before and after bilateral motor cortex tDCS was extensively evaluated, and the effects of bilateral tDCS were compared with unilateral motor cortex tDCS. Simultaneous bilateral tDCS seems to be a useful tool to obtain increases in cortical excitability of one hemisphere whereas causing decreases of cortical excitability in the contralateral hemisphere (e.g.,to treat stroke)., (Copyright © 2012 Elsevier Inc. All rights reserved.) more...
- Published
- 2012
- Full Text
- View/download PDF
38. CB1 receptor antagonism/inverse agonism increases motor system excitability in humans.
- Author
-
Oliviero A, Arevalo-Martin A, Rotondi M, García-Ovejero D, Mordillo-Mateos L, Lozano-Sicilia A, Panyavin I, Chiovato L, Aguilar J, Foffani G, Di Lazzaro V, and Molina-Holgado E
- Subjects
- Adult, Drug Inverse Agonism, Humans, Male, Neural Inhibition drug effects, Rimonabant, Transcranial Magnetic Stimulation, Motor Cortex drug effects, Motor Neurons drug effects, Piperidines pharmacology, Pyrazoles pharmacology, Receptor, Cannabinoid, CB1 antagonists & inhibitors
- Abstract
CB1 receptor is highly expressed in cerebral structures related to motor control, such as motor cortex, basal ganglia and cerebellum. In the spinal cord, the expression of CB1 receptors has also been observed in ventral motor neurons, interneurons and primary afferents, i.e., in the cells that may be part of the circuits involved in motor control. It is known that the antagonist/inverse agonist of CB1 receptors Rimonabant penetrates the blood-brain barrier and produces a broad range of central psychoactive effects in humans. Based on the occurrence of central effects in humans treated with Rimonabant and on the location of CB1 receptors, we hypothesized that the application of Rimonabant can also affect the motor system. We tested the effects of a single dose of 20mg of Rimonabant on the excitability of motor cortex and of spinal motor neurons in order to detect a possible drug action on motor system at cortical and spinal levels. For this purpose we use classical protocols of transcranial magnetic and electrical stimulation (TMS and TES). Single and paired pulse TMS and TES were used to assess a number of parameters of cortical inhibition and cortical excitability as well as of the excitability of spinal motor neurons. We demonstrated that a single oral dose of 20mg of Rimonabant can increase motor system excitability at cortical and spinal levels. This opens new avenues to test the CB1R antagonists/inverse agonists for the treatment of a number of neurological dysfunctions in which can be useful to increase the excitability levels of motor system. Virtually all the disorders characterized by a reduced output of the motor cortex can be included in the list of the disorders that can be treated using CB1 antagonists/reverse agonists (e.g. stroke, traumatic brain injury, spinal cord injury, multiple sclerosis, fatigue syndromes, parkinsonisms, etc.)., (Copyright © 2011 Elsevier B.V. All rights reserved.) more...
- Published
- 2012
- Full Text
- View/download PDF
39. Transcranial static magnetic field stimulation of the human motor cortex.
- Author
-
Oliviero A, Mordillo-Mateos L, Arias P, Panyavin I, Foffani G, and Aguilar J
- Subjects
- Adult, Double-Blind Method, Evoked Potentials, Motor, Female, Humans, Male, Middle Aged, Young Adult, Magnetic Fields, Motor Cortex physiology, Transcranial Magnetic Stimulation
- Abstract
The aim of the present study was to investigate in healthy humans the possibility of a non-invasive modulation of motor cortex excitability by the application of static magnetic fields through the scalp. Static magnetic fields were obtained by using cylindrical NdFeB magnets. We performed four sets of experiments. In Experiment 1, we recorded motor potentials evoked by single-pulse transcranial magnetic stimulation (TMS) of the motor cortex before and after 10 min of transcranial static magnetic field stimulation (tSMS) in conscious subjects. We observed an average reduction of motor cortex excitability of up to 25%, as revealed by TMS, which lasted for several minutes after the end of tSMS, and was dose dependent (intensity of the magnetic field) but not polarity dependent. In Experiment 2, we confirmed the reduction of motor cortex excitability induced by tSMS using a double-blind sham-controlled design. In Experiment 3, we investigated the duration of tSMS that was necessary to modulate motor cortex excitability. We found that 10 min of tSMS (compared to 1 min and 5 min) were necessary to induce significant effects. In Experiment 4, we used transcranial electric stimulation (TES) to establish that the tSMS-induced reduction of motor cortex excitability was not due to corticospinal axon and/or spinal excitability, but specifically involved intracortical networks. These results suggest that tSMS using small static magnets may be a promising tool to modulate cerebral excitability in a non-invasive, painless, and reversible way. more...
- Published
- 2011
- Full Text
- View/download PDF
40. Prefrontal hemodynamic changes produced by anodal direct current stimulation.
- Author
-
Merzagora AC, Foffani G, Panyavin I, Mordillo-Mateos L, Aguilar J, Onaral B, and Oliviero A
- Subjects
- Adult, Electric Stimulation, Female, Humans, Male, Spectroscopy, Near-Infrared, Hemodynamics physiology, Prefrontal Cortex blood supply
- Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that has been investigated for the treatment of many neurological or neuropsychiatric disorders. Its main effect is to modulate the cortical excitability depending on the polarity of the current applied. However, understanding the mechanisms by which these modulations are induced and persist is still an open question. A possible marker indicating a change in cortical activity is the subsequent variation in regional blood flow and metabolism. These variations can be effectively monitored using functional near-infrared spectroscopy (fNIRS), which offers a noninvasive and portable measure of regional blood oxygenation state in cortical tissue. We studied healthy volunteers at rest and evaluated the changes in cortical oxygenation related to tDCS using fNIRS. Subjects were tested after active stimulation (12 subjects) and sham stimulation (10 subjects). Electrodes were applied at two prefrontal locations; stimulation lasted 10 min and fNIRS data were then collected for 20 min. The anodal stimulation induced a significant increase in oxyhemoglobin (HbO(2)) concentration compared to sham stimulation. Additionally, the effect of active 10-min tDCS was localized in time and lasted up to 8-10 min after the end of the stimulation. The cathodal stimulation manifested instead a negligible effect. The changes induced by tDCS on HbO(2), as captured by fNIRS, agreed with the results of previous studies. Taken together, these results help clarify the mechanisms underlying the regional alterations induced by tDCS and validate the use of fNIRS as a possible noninvasive method to monitor the neuromodulation effect of tDCS., (Copyright (c) 2009 Elsevier Inc. All rights reserved.) more...
- Published
- 2010
- Full Text
- View/download PDF
41. Functional involvement of central nervous system at high altitude.
- Author
-
Miscio G, Milano E, Aguilar J, Savia G, Foffani G, Mauro A, Mordillo-Mateos L, Romero-Ganuza J, and Oliviero A
- Subjects
- Adult, Altitude Sickness physiopathology, Evoked Potentials, Motor, Humans, Male, Multivariate Analysis, Neural Inhibition, Statistics as Topic, Transcranial Magnetic Stimulation, Altitude, Motor Cortex physiology
- Abstract
Acute mountain sickness is a common discomfort experienced by unacclimatized persons on ascent to high altitude. We tested the hypothesis that exposure to high altitude affects cortical excitability using transcranial magnetic stimulation. We specifically analyzed the motor cortex excitability in normal subjects at high altitude and in a control condition near sea level. Mean resting motor threshold (RMT) was significantly higher at high altitude than at sea level (69.3 +/- 10.4 versus 56.3 +/- 10.9%; P = 0.042). Mean short intracortical inhibition (SICI) was significantly lower at high altitude than at sea level (percentage of test motor-evoked potential = 79.3 +/- 19.8 versus 28.7 +/- 17.5%; P = 0.0004). Symptoms of acute mountain sickness correlated with resting motor threshold changes induced by high altitude (R 2 = 0.53, P = 0.037). SaO2 correlated with SICI changes induced by high altitude (R 2 = 0.45, P = 0.036). We suggest that high altitude deeply changes cortical excitability by affecting both inhibitory and excitatory circuits and that this is reflected in acute mountain sickness symptoms. more...
- Published
- 2009
- Full Text
- View/download PDF
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.