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Accurate diagnosis of upper extremity motor function in stroke patients is important for effective rehabilitation. However, the approach to correctly perform clinical assessments is still a matter of discussion and requires both trained personnel and specialized materials, thus, limiting the availability of stroke upper extremity diagnosis. Computer-aided methods have been scarcely reported for stroke upper extremity motor function estimation and could support personnel training and clinical decision-making. For these reasons, in the present study, linear regression and regression tree ensembles were applied to estimate upper extremity assessments’ scores using neurophysiological measurements, including electroencephalography (EEG) and transcranial magnetic stimulation (TMS). A database was used to evaluate these approaches and was comprised by measurements of upper extremity sensorimotor and functional performance of stroke patients assessed with the Fugl-Meyer Assessment for the Upper Extremity (FMA-UE) and the Action Research Arm Test (ARAT). Regression tree ensembles outperformed linear models, estimating 66.7% of the FMA-UE scores and 70% of the ARAT scores with errors below the minimal clinically important difference. The median absolute errors were 3.5 points for the FMA-UE and 1.8 points for the ARAT, within clinically acceptable ranges. Variables that were associated with a higher upper extremity function measured with FMA-UE and ARAT were a higher corticospinal integrity in patients’ affected hemisphere, lower interhemispheric functional connectivity in the central region of the cortex during hand motor intention and, higher alpha activation in the central and lower activation in the parietal regions of the cortex during hand motor intention. Limitations of the study considered, the performance of the proposed approach implied that computer-aided estimation of upper extremity motor function is feasible using physiological information and nonlinear models. These models could be used to create expert systems that support clinical personnel training and decision making regarding upper extremity assessment in stroke.

Introduction: Guillain-Barré syndrome (GBS) is the most frequent cause of acute flaccid paralysis. However, few studies have investigated short-term prognostic factors. Objectives: The objectives of the study were to describe the clinical characteristics of a sample of GBS patients treated at the General Hospital of Mexico and to identify the prognostic factors at discharge. Methods: A descriptive and analytical cohort study, including patients with GBS, was conducted from April 2020 to May 2022. Demographic information, comorbidities, clinical variants, neurophysiological alterations, modified Erasmus GBS Outcome Score (mEGOS) and Erasmus GBS Respiratory Insufficiency Score scales, etc., were collected. Functional recovery at discharge was measured with Hughes scales and Medical Research Council (MRC). A case-control analysis was performed among patients with good and poor functional recovery on discharge based on the Hughes scale. Results: Total sample was 69 patients: 74% men and 26% women, mean age: 43.7 ± 16.3 years; 38 (55%) patients presented classic variant, 22 pure motor variant (31%). Evolution time: 6.8 ± 6.7 days. Most common Hughes score at admission was 4 points (n = 54, 78%). 87% (n = 60) received plasmapheresis. 23 (33.3%) presented an axonal pattern and 46 (66.6%) demyelinating. On discharge, 31 patients had Hughes 3 or less (ambulatory) and 27 Hughes 4 or greater (non-ambulatory). When performing factor analysis, it was found that mEGOS, MRC, total lymphocytes, and creatine phosphokinase (CPK) were associated with the prognosis at discharge. Conclusions: The most frequent clinical variant was the classic (sensitive-motor) with demyelinating alteration; the factors related to better recovery at discharge were mEGOS, MRC on admission, total lymphocyte count, and serum CPK levels.

Antecedentes: Para reducir la propagación de la COVID-19, se implementaron medidas como el confinamiento y el distanciamiento físico/social, generando preocupación sobre el impacto de estas medidas en la funcionalidad y desempeño de los adultos mayores en diferentes áreas. Objetivo: Comparar el funcionamiento de la memoria episódica y la memoria autopercibida entre hombres y mujeres mayores de 60 años durante el confinamiento por la pandemia de COVID-19. Material y métodos: Estudio transversal, descriptivo y comparativo. Se obtuvieron características sociodemográficas y de funcionamiento de la memoria en 50 adultos mayores. Para comparar desempeño entre sexos se realizaron pruebas t de Student y Chi-cuadrado. Además, se realizaron correlaciones para determinar la asociación entre la memoria episódica, la memoria autopercibida y los años de escolaridad. Resultados: Se encontró similar autopercepción de la memoria y buen funcionamiento de la memoria episódica en ambos sexos, excepto en la codificación en curva de memoria y la figura de Rey-Osterrieth. Los años de escolaridad se asociaron con el funcionamiento de la memoria episódica. Conclusión: El confinamiento y el distanciamiento físico/social durante la pandemia por COVID-19 influyó negativamente en la autopercepción del funcionamiento de la memoria. El mantenimiento de buen funcionamiento de la memoria episódica pudo beneficiarse por el uso de dispositivos electrónicos y aplicaciones que funcionaron como fuentes de estimulación cognitiva.

Introduction: At the beginning of the pandemic, it was suggested that lockdown and social distancing could affect the physical, emotional, and cognitive aspects of people, especially the elderly. Objective: To determine the characteristics of physical activity, mental health, support networks, and lifestyle of the elderly in lockdown by COVID-19 and its relationship with memory functioning. Method: 100 healthy elderlies (age ≥60 years) participated and answered a set of online instruments that evaluated 6 variables: demographic data, physical activity, mental health, social support networks, lifestyle, and subjective memory. MoCA and Neuropsi tests were applied through a video call. The study was conducted between September 2021 and May 2022. Results: Participants reported being and having been physically active, the presence of trait and state anxiety was found in 100%, also a higher perception of support from the family network. Insomnia was found in 46% of the sample, increased consumption of stimulant beverages and tobacco, and adequate competence in handling information and communication media. The memory functioning of 97% of the participants was normal or high normal, with fair self-perception of memory functioning. Correlations were moderate between mental health and self-perceived memory. Conclusions: The results suggest that having social support networks, good mental health, and staying physically and cognitively active favour memory function. Resumen: Introducción: Al inicio de la pandemia se planteó que el confinamiento y el distanciamiento físico y social pudieran afectar aspectos físicos, emocionales y cognitivos de las personas, en especial de los adultos mayores (AM). Objetivo: Determinar las características de la actividad física, la salud mental, las redes de apoyo y el estilo de vida de AM en el confinamiento por COVID-19 y su relación con el funcionamiento de la memoria. Método: Participaron 100 AM saludables (edad ≥60 años) quienes contestaron un conjunto de instrumentos en línea que evaluaron seis variables: datos demográficos, actividad física, salud mental, redes de apoyo social, estilo de vida y memoria subjetiva. Mediante una videollamada se aplicó el MoCA y el Neuropsi. El estudio se realizó entre septiembre 2021-mayo 2022. Resultados: Los participantes refieren ser y haber sido activos físicamente, se encontró presencia de ansiedad rasgo y estado en el 100%, mayor percepción de porcentaje de apoyo de la red familiar. Se encontró insomnio en el 46% de la muestra, incremento en el consumo de bebidas estimulantes y tabaco, y competencia adecuada en el manejo de medios informativos y comunicativos. El funcionamiento de la memoria del 97% de los participantes fue normal o normal alto, con una autopercepción regular del funcionamiento de la memoria. Las correlaciones fueron moderadas entre salud mental y memoria autopercibida. Conclusiones: Los resultados sugieren que contar con redes de apoyo social, una buena salud mental y mantenerse activos física y cognitivamente, favorece el funcionamiento de la memoria.

Multiple sclerosis (MS) is a chronic inflammatory autoimmune neurological disease characterized by the recurrent appearance of demyelinating lesions and progressive disability. Currently, there are multiple disease-modifying treatments, however, there is a significant need to develop new therapeutic targets, especially for the progressive forms of the disease. This review article provides an overview of the most recent studies aimed at understanding the inflammatory processes that are activated in response to the accumulation of kynurenine pathway (KP) metabolites, which exacerbate an imbalance between immune system cells (e.g., Th1, Th2, and T reg) and promote the release of pro-inflammatory interleukins that modulate different mechanisms: membrane-receptors function; nuclear factors expression; and cellular signals. Together, these alterations trigger cell death mechanisms in brain cells and promote neuron loss and axon demyelination. This hypothesis could represent a remarkable approach for disease-modifying therapies for MS. Here, we also provide a perspective on the repositioning of some already approved drugs involved in other signaling pathways, which could represent new therapeutic strategies for MS treatment.

Muscular dystrophies (MDs) are a heterogeneous group of diseases of genetic origin characterized by progressive skeletal muscle degeneration and weakness. There are several types of MDs, varying in terms of age of onset, severity, and pattern of the affected muscles. However, all of them worsen over time, and many patients will eventually lose their ability to walk. In addition to skeletal muscle effects, patients with MDs may present cardiac and respiratory disorders, generating complications that could lead to death. Interdisciplinary management is required to improve the surveillance and quality of life of patients with an MD. At present, pharmacological therapy is only available for Duchene muscular dystrophy (DMD)—the most common type of MD—and is mainly based on the use of corticosteroids. Other MDs caused by alterations in dystrophin-associated proteins (DAPs) are less frequent but represent an important group within these diseases. Pharmacological alternatives with clinical potential in patients with MDs and other proteins associated with dystrophin have been scarcely explored. This review focuses on drugs and molecules that have shown beneficial effects, mainly in experimental models involving alterations in DAPs. The mechanisms associated with the effects leading to promising results regarding the recovery or maintenance of muscle strength and reduction in fibrosis in the less-common MDs (i.e., with respect to DMD) are explored, and other therapeutic targets that could contribute to maintaining the homeostasis of muscle fibers, involving different pathways, such as calcium regulation, hypertrophy, and maintenance of satellite cell function, are also examined. It is possible that some of the drugs explored here could be used to affordably improve the muscular function of patients until a definitive treatment for MDs is developed.

Objective: This systematic review aimed to identify the prevalence of CAM use in patients with neurological disorders, and also to know most frequent types of CAM used. Methods: Five databases: PubMed, Science Direct, EBSCO, Latindex and Scielo (in English and Spanish) were searched from January 2010 to May 2021. Only original cross-sectional, retrospective and cohort studies were included, whose primary objective was to describe the frequency of CAM use in neurological disorders and/or the related factors to its use in adults. Based on the data, a descriptive analysis was performed, covering the characteristics of studies, measuring methods, prevalence, types and related factors. To control the risk of bias, a quality assessment of each study was performed using STROBE checklist. Results: For the final analysis, 40 studies were included. Most common pathologies observed in the studies were multiple sclerosis, headache, stroke, Parkinson and epilepsy. The STROBE score of studies ranged from 13 to 22 points, with an average of 18.2. Prevalence of CAM use was highly variable from one study to another (16% in stroke patients, to 100% in amyotrophic lateral sclerosis or spinal cord injury patients). Biological therapies (dietary supplements and herbal medicine) were the most commonly CAM types used. The associated factors identified were female sex, an age between 40 and 50 years, and higher socioeconomic level. Not all studies investigated about the results of CAMs but these ranged from 35% to more than 80% of reporting positive effects. Conclusions: The prevalence of CAM use in neurological diseases is highly variable (16%−100%); the most used type of CAM was biological therapies and the associated factors were female sex, age between 40 and 50 years old and high socioeconomic level.

Objectives: This cross-sectional study is aimed to investigate the prevalence of the use of complementary and alternative medicine (CAM), types of CAMs used, as well as reasons and factors found in patients with neurological diseases or neurological disability. Methods: An anonymous, self-administered survey was designed to collect information about demographics, personal medical history, CAM usage habits, and different opinions about CAM vs. conventional medicine (CM). The survey was applied by non-medical personnel in a rehabilitation hospital to patients older than 18 years, with a confirmed diagnosis of neurological disorder or neurological disability. Results: 453 patients were included, 59.7 % were female. Mean age: 49 years (SD: 18.2). 200 patients (44.2 %) had a history of chronic diseases. Depression was found in 139 patients (30.7 %). Neurological disorders were: peripheral neuropathy: 97 (21.4 %), headache or migraine: 78 (17.2 %), neurodegenerative diseases: 69 (15.2 %) and stroke: 58 (12.8 %). 60.2 % (n = 273) had some degree of disability. Prevalence of CAM use was 36 % (n = 163). Most common CAMs were: Biological therapies: 133 (71.1 %), energy-based therapies: 63 (33.7 %) and body manipulation therapies: 51 (27.3 %). Reasons to use CAM were: “to complement the pharmacological treatment” (45 = 27.6 %), and “treatment failure with CM” (43 = 26.4 %). Finally, older age (p = 0.0280) and having a chronic disease (p = 0.0229) or depression (p

This work presents the design, implementation, and feasibility evaluation of a Motor Imagery (MI) based Brain-Computer Interface (BCI) developed to control a Functional Electrical Stimulation (FES) device. The aim of this system is to assist the upper limb motor recovery of patients with spinal cord injury (SCI). With this BCI-controlled FES system, the user performs open and close MI with either the left or right hand, which if detected is used to provide visual feedback and electroestimulation to muscles in the forearm to perform the corresponding grasping movement. The system was evaluated with seven healthy subjects (HS group) and two SCI patients (SC group) in several experimental sessions across different days. Each experimental session consisted of a training routine devoted to collect calibration EEG data to train the BCI machine learning model, and of a validation routine devoted to validate system in online operation. The online system validation showed an accuracy of the recognition of the MI task that ranged between 78% and 81% for HS participants and between 63% and 93% for SCI participants. Additionally, the time taken by the BCI system to trigger the FES device ranged between 7.05 and 7.29 s for HS participants and between 8.43 s and 13.91 s for SCI participants. Finally, significant negative correlations were observed ( $r=-0.418$ , $p=0.024$ and $r=-0.437$ , $p=0.018$ for left and right hand MI conditions, respectively) between the online BCI performance with a quantitative EEG parameter based on event-related desynchronization/synchronization analysis. The results of this work indicate the feasibility of the proposed BCI coupled to a FES device to be used for SCI patients with a moderate level of disability and provides evidence of the functionality of the proposed BCI system in a motor rehabilitation context.

IntroductionBrain-Computer Interfaces (BCI) can allow control of external devices using motor imagery (MI) decoded from electroencephalography (EEG). Although BCI have a wide range of applications including neurorehabilitation, the low spatial resolution of EEG, coupled to the variability of cortical activations during MI, make control of BCI based on EEG a challenging task.MethodsAn assessment of BCI control with different feedback timing strategies was performed. Two different feedback timing strategies were compared, comprised by passive hand movement provided by a robotic hand orthosis. One of the timing strategies, the continuous, involved the partial movement of the robot immediately after the recognition of each time segment in which hand MI was performed. The other feedback, the discrete, was comprised by the entire movement of the robot after the processing of the complete MI period. Eighteen healthy participants performed two sessions of BCI training and testing, one with each feedback.ResultsSignificantly higher BCI performance (65.4 ± 17.9% with the continuous and 62.1 ± 18.6% with the discrete feedback) and pronounced bilateral alpha and ipsilateral beta cortical activations were observed with the continuous feedback.DiscussionIt was hypothesized that these effects, although heterogenous across participants, were caused by the enhancement of attentional and closed-loop somatosensory processes. This is important, since a continuous feedback timing could increase the number of BCI users that can control a MI-based system or enhance cortical activations associated with neuroplasticity, important for neurorehabilitation applications.

AimsThe aim of this study was to compare the effects of intraglandular abobotuliniumtoxinA application and oromotor therapy in the management of sialorrhea in patients with cerebral palsy and its effect on sleep quality.MethodsA comparative study (n = 134), mean age 7.1 years (± 3.9 years) was performed in pediatric patients, between the efficacy of abobotuliniumtoxinA in salivary glands and oromotor therapy (JT), with a control group receiving exclusive oromotor therapy (EOMT). Demographic variables, as well as Gross Motor Function Classification System (GMFCS), Drooling Severity and Frequency Scale (DSFS), Sleep Disturbance Scale for Children (SDSC) and Eating and Drinking Ability Classification System (EDACS) were analyzed in 134 patients considering two measurements 6 months apart. Statistical analysis was developed between both groups.ResultsThe greatest improvement in safety and efficacy of swallowing were those in the JT group with initial levels of EDACS IV and V. Both therapies result in favorable changes of all subscales means of SDSC, with joint therapy showing the greater benefit (p = 0.003) over EOMT (p = 0.06), especially for Sleep Breathing Disorders and Disorders of initiating and maintaining sleep (p < 0.01 vs. p = 0.07). No major adverse effects were found, only those expected from the application of the toxin, such as pain, mild, and transient local inflammation.InterpretationA correlation between frequency and intensity of sialorrhea, with the frequency of sleep disorders and dysphagia was found. Conventional EOMT proved to be useful, improving the safety and efficacy of swallowing, sialorrhea and sleep disorder, however it can be enhanced with the application of abobotuliniumtoxinA.

It is increasingly common for healthy people to seek means to improve their alertness, or to try to get better their performance in some cognitive functions; this with the aim of increasing their performance and productivity in the academic or work environment. Several stimulant drugs have been used for many decades and have recently become very popular especially among young people. However, general practitioners and even specialists are rarely informed of their real benefits or potential adverse effects. This review provides an updated overview of the effects (positive and adverse) of some stimulant drugs that have been used to maintain alertness or improve cognitive performance in healthy subjects. For stimulant drugs, the positive effects improving the subjective symptoms of sleep deprivation are well established. However, the cognitive effects of stimulant drugs are still highly variable and inconsistent, since there are few studies that have been carried out with adequate methodological design. In addition, there are several adverse effects, from mild to severe that can be observed and there is a concern of potential addiction effect to some of them. Some stimulant drugs can improve alertness, but their positive effects improving cognition are not yet fully proven.

Objective: The objective of the study was to know the opinion and prevalence of use of central nervous system stimulant drugs (SDs) in healthy people in open population. Methods: An electronic survey was designed with 11 questions to know the frequency of use of SD, and also questions to explore previous knowledge, opinion about the risks associated with its use and about its regulation, etc. The survey was spread by electronic social networks to persons over 18 years old of any gender. Descriptive analysis and a Chi-square test were done to find associations between variables. Results: A total of 526 surveys were conducted, 271 male participants (51.5%) and 249 female (47.3%). The median of age was 22 years old (range 18-83 years). Median scholarship was 12 years (range 6-20 years). About 49.6% were students. About 75% had prior knowledge about stimulants, 13.6% reported prior use, 26% opined these drugs could be dangerous, and 88% opined that they should be regularized. Finally, ages between 18 and 30 years old and scholarship above high school were associated with the use of SD. Conclusion: There was a frequency of 13.6% of SD use. Most of the respondents are worried about its safety and are in favor of their regularization. Being young with high scholarship was associated with SD use.

Brain-Computer Interfaces (BCI) coupled to robotic assistive devices have shown promise for the rehabilitation of stroke patients. However, little has been reported that compares the clinical and physiological effects of a BCI intervention for upper limb stroke rehabilitation with those of conventional therapy. This study assesses the feasibility of an intervention with a BCI based on electroencephalography (EEG) coupled to a robotic hand orthosis for upper limb stroke rehabilitation and compares its outcomes to conventional therapy. Seven subacute and three chronic stroke patients (M = 59.9 ± 12.8) with severe upper limb impairment were recruited in a crossover feasibility study to receive 1 month of BCI therapy and 1 month of conventional therapy in random order. The outcome measures were comprised of: Fugl-Meyer Assessment of the Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), motor evoked potentials elicited by transcranial magnetic stimulation (TMS), hand dynamometry, and EEG. Additionally, BCI performance and user experience were measured. All measurements were acquired before and after each intervention. FMA-UE and ARAT after BCI (23.1 ± 16; 8.4 ± 10) and after conventional therapy (21.9 ± 15; 8.7 ± 11) were significantly higher (p < 0.017) compared to baseline (17.5 ± 15; 4.3 ± 6) but were similar between therapies (p > 0.017). Via TMS, corticospinal tract integrity could be assessed in the affected hemisphere of three patients at baseline, in five after BCI, and four after conventional therapy. While no significant difference (p > 0.05) was found in patients’ affected hand strength, it was higher after the BCI therapy. EEG cortical activations were significantly higher over motor and non-motor regions after both therapies (p < 0.017). System performance increased across BCI sessions, from 54 (50, 70%) to 72% (56, 83%). Patients reported moderate mental workloads and excellent usability with the BCI. Outcome measurements implied that a BCI intervention using a robotic hand orthosis as feedback has the potential to elicit neuroplasticity-related mechanisms, similar to those observed during conventional therapy, even in a group of severely impaired stroke patients. Therefore, the proposed BCI system could be a suitable therapy option and will be further assessed in clinical trials.

Disabilities are estimated to occur in approximately 2% of survivors of traumatic brain injury (TBI) worldwide, and disability may persist even decades after brain injury. Facilitation or modulation of functional recovery is an important goal of rehabilitation in all patients who survive severe TBI. However, this recovery tends to vary among patients because it is affected by the biological and physical characteristics of the patients; the types, doses, and application regimens of the drugs used; and clinical indications. In clinical practice, diverse dopaminergic drugs with various dosing and application procedures are used for TBI. Previous studies have shown that dopamine (DA) neurotransmission is disrupted following moderate to severe TBI and have reported beneficial effects of drugs that affect the dopaminergic system. However, the mechanisms of action of dopaminergic drugs have not been completely clarified, partly because dopaminergic receptor activation can lead to restoration of the pathway of the corticobasal ganglia after injury in brain structures with high densities of these receptors. This review aims to provide an overview of the functionality of the dopaminergic system in the striatum and its roles in functional recovery or rehabilitation after TBI.

Background: Repeated head trauma associated with sports activities can cause subtle cognitive alterations in amateur players, but these are difficult to detect. Objective: The objective of this pilot study was to determine if there is an association between executive functions performance and different sports practice variables in a sample of amateur American football players. Methods: A pilot transversal study with amateur American football male players without previous neurological or psychiatric illnesses, drug abuse, or consumption of psychotropic medications were carried out and evaluated executive functions performance using automated test. In addition, the levels of stress, impulsivity, and symptoms of anxiety and depression were evaluated, as well as multiple variables related to sports practice such as previous concussions, time of sports practice, weekly training time, and position within the game. Results: Fourteen men players were assessed, with an average age of 20.57 (standard deviation [SD] ± 1.61) years, played 7 (50%) in an offensive position, 7 (50%) in defensive position, and 3 (21%) presented previous sport-related brain trauma. The average time of practice football was of 35.07 (SD ± 43.10) months, starting age of football playing 17.71 (SD ± 3.64), and hours of training during the week 5.75 (SD ± 2.83). There was no association between cognitive performance and any sports practice variable, however, the offensive position showed significant association with impairments in the highest span of visual working memory task (β = 0.53, SE = 0.16, p = 0.001). Conclusion: The results suggest that executive tasks with high cognitive demand may reveal alterations in the short term in amateur American football players.

Stroke is a leading cause of motor disability worldwide. Upper limb rehabilitation is particularly challenging since approximately 35% of patients recover significant hand function after 6 months of the stroke’s onset. Therefore, new therapies, especially those based on brain-computer interfaces (BCI) and robotic assistive devices, are currently under research. Electroencephalography (EEG) acquired brain rhythms in alpha and beta bands, during motor tasks, such as motor imagery/intention (MI), could provide insight of motor-related neural plasticity occurring during a BCI intervention. Hence, a longitudinal analysis of subacute stroke patients’ brain rhythms during a BCI coupled to robotic device intervention was performed in this study. Data of 9 stroke patients were acquired across 12 sessions of the BCI intervention. Alpha and beta event-related desynchronization/synchronization (ERD/ERS) trends across sessions and their association with time since stroke onset and clinical upper extremity recovery were analyzed, using correlation and linear stepwise regression, respectively. More EEG channels presented significant ERD/ERS trends across sessions related with time since stroke onset, in beta, compared to alpha. Linear models implied a moderate relationship between alpha rhythms in frontal, temporal, and parietal areas with upper limb motor recovery and suggested a strong association between beta activity in frontal, central, and parietal regions with upper limb motor recovery. Higher association of beta with both time since stroke onset and upper limb motor recovery could be explained by beta relation with closed-loop communication between the sensorimotor cortex and the paralyzed upper limb, and alpha being probably more associated with motor learning mechanisms. The association between upper limb motor recovery and beta activations reinforces the hypothesis that broader regions of the cortex activate during movement tasks as a compensatory mechanism in stroke patients with severe motor impairment. Therefore, EEG across BCI interventions could provide valuable information for prognosis and BCI cortical activity targets.

Resumen: Introducción: El diagnóstico diferencial de la esclerosis múltiple (EM) incluye una gran variedad de enfermedades autoinmunitarias (lupus eritematoso sistémico, síndrome de Sjögren, síndrome antifosfolipídico, etc.). Los anticuerpos antifosfolipídicos (AAFL) en el suero de pacientes con EM se encuentran en cifras tan bajas como en el 10% y tan altas como en el 88% de los casos, pero su significación en la patogenia de la enfermedad o su utilidad diagnóstica aún no se han establecido. El objetivo fue conocer las características clínicas y demográficas de una muestra de pacientes con EM del Hospital General de México (HGM), y determinar presencia y frecuencia de anticuerpos antifosfolipídicos en líquido cefalorraquídeo y suero de estos pacientes. Pacientes y métodos: Se realizó un estudio prospectivo con pacientes captados en la consulta externa de neurología del HGM, con diagnóstico definido de EM a lo largo de 1 año. Se analizaron sus características clinicodemográficas y se determinó VDRL y anticuerpos anticomplejo cardiolipina-β2GP-1 en LCR y suero. Resultados: Se incluyó a 12 pacientes, con predominio del sexo femenino (58%). El cuadro clínico predominante fue la neuritis óptica (66,6%) seguida de la afección medular (58%). La mayoría de los pacientes fueron ambulatorios (< 4 puntos EDSS). Los títulos de los autoanticuerpos fueron negativos en todos los casos, tanto en LCR como en sangre. Conclusiones: Las características clinicodemográficas en la muestra de este estudio son semejantes a las comunicadas con anterioridad y las concentraciones de anticardiolipina-β2GP-1 fueron negativas, lo cual puede indicar que hay diversas variables clínicas y demográficas que influyen en su detección. Abstract: Introduction: The differential diagnosis of multiple sclerosis (MS) includes a wide variety of autoimmune diseases (systemic lupus erythematosus, Sjögren syndrome, antiphospholipid syndrome, etc.). The presence of antiphospholipid antibodies (APLA) in serum of MS patients has been reported to be as low as 10%, or sometimes as high as 88% of the cases, although its significance in the pathogenesis of the disease, or its diagnostic usefulness is still unknown. The goal of this study was to describe the clinic and demographic characteristics of a sample of patients with MS from the Hospital General de México (HGM), as well as to determine the presence and frequency of APLA in cerebrospinal fluid (CSF) and serum samples of these patients. Patients and methods: A prospective study with patients from the Neurology Department at the HGM was performed. These patients were diagnosed with MS over a one-year period. Clinical and demographic characteristics were compiled. VDRL and anti-cardiolipin-β2GP-1 complex antibodies were analyzed in CSF and serum samples. Results: Twelve patients were included in the study, the majority females (58%). The predominant clinic feature was optic neuritis (66.6%) followed by medullary involvement (58%). Most of patients were ambulatory (< 4 EDSS points). Auto-antibody levels were found in negative ranges in all cases, both in CSF and serum. Conclusions: The clinical-demographic characteristics in patients studied in this work were similar to those previously reported, and the levels of anti-cardiolipin-β2GP-1 were negative, thus indicating the existence of different clinical and demographic variables influencing their detection. Palabras clave: Antifosfolípidos, Anti-β2GP-1, Anticardiolipina, Esclerosis múltiple, México, Keywords: Antiphospholipid antibodies, β2GP-1, Cardiolipin, Multiple sclerosis, Mexico

Introduction: The differential diagnosis of multiple sclerosis (MS) includes a wide variety of autoimmune diseases (systemic lupus erythematosus, Sjögren syndrome, antiphospholipid syndrome, etc.). The presence of antiphospholipid antibodies (APLA) in serum of MS patients has been reported to be as low as 10%, or sometimes as high as 88% of the cases, although its significance in the pathogenesis of the disease, or its diagnostic usefulness is still unknown. The goal of this study was to describe the clinic and demographic characteristics of a sample of patients with MS from the Hospital General de México (HGM), as well as to determine the presence and frequency of APLA in cerebrospinal fluid (CSF) and serum samples of these patients. Patients and methods: A prospective study with patients from the Neurology Department at the HGM was performed. These patients were diagnosed with MS over a one-year period. Clinical and demographic characteristics were compiled. VDRL and anti-cardiolipin-β2GP-1 complex antibodies were analyzed in CSF and serum samples. Results: Twelve patients were included in the study, the majority females (58%). The predominant clinic feature was optic neuritis (66.6%) followed by medullary involvement (58%). Most of patients were ambulatory (< 4 EDSS points). Auto-antibody levels were found in negative ranges in all cases, both in CSF and serum. Conclusions: The clinical-demographic characteristics in patients studied in this work were similar to those previously reported, and the levels of anti-cardiolipin-β2GP-1 were negative, thus indicating the existence of different clinical and demographic variables influencing their detection. Resumen: Introducción: El diagnóstico diferencial de la esclerosis múltiple (EM) incluye una gran variedad de enfermedades autoinmunitarias (lupus eritematoso sistémico, síndrome de Sjögren, síndrome antifosfolipídico, etc.). Los anticuerpos antifosfolipídicos (AAFL) en el suero de pacientes con EM se encuentran en cifras tan bajas como en el 10% y tan altas como en el 88% de los casos, pero su significación en la patogenia de la enfermedad o su utilidad diagnóstica aún no se han establecido. El objetivo fue conocer las características clínicas y demográficas de una muestra de pacientes con EM del Hospital General de México (HGM), y determinar presencia y frecuencia de anticuerpos antifosfolipídicos en líquido cefalorraquídeo y suero de estos pacientes. Pacientes y métodos: Se realizó un estudio prospectivo con pacientes captados en la consulta externa de neurología del HGM, con diagnóstico definido de EM a lo largo de 1 año. Se analizaron sus características clinicodemográficas y se determinó VDRL y anticuerpos anticomplejo cardiolipina-β2GP-1 en LCR y suero. Resultados: Se incluyó a 12 pacientes, con predominio del sexo femenino (58%). El cuadro clínico predominante fue la neuritis óptica (66,6%) seguida de la afección medular (58%). La mayoría de los pacientes fueron ambulatorios (< 4 puntos EDSS). Los títulos de los autoanticuerpos fueron negativos en todos los casos, tanto en LCR como en sangre. Conclusiones: Las características clinicodemográficas en la muestra de este estudio son semejantes a las comunicadas con anterioridad y las concentraciones de anticardiolipina-β2GP-1 fueron negativas, lo cual puede indicar que hay diversas variables clínicas y demográficas que influyen en su detección. Keywords: Antiphospholipid antibodies, β2GP-1, Cardiolipin, Multiple sclerosis, Mexico, Palabras clave: Antifosfolípidos, Anti-β2GP-1, Anticardiolipina, Esclerosis múltiple, México

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