Long-Term Treatment with Citicoline Prevents Cognitive Decline and Predicts a Better Quality of Life after a First Ischemic Stroke

Stroke, as the leading cause of physical disability and cognitive impairment, has a very significant impact on patients' quality of life (QoL). The objective of this study is to know the effect of citicoline treatment in Qol and cognitive performance in the long-term in patients with a first ischemic stroke. This is an open-label, randomized, parallel study of citicoline vs. Usual treatment. All subjects were selected 6 weeks after suffering a first ischemic stroke and randomized into parallel arms. Neuropsychological evaluation was performed at 1 month, 6 months, 1 year and 2 years after stroke, and QoL was measured using the EuroQoL-5D questionnaire at 2 years. 163 patients were followed during 2 years. The mean age was 67.5 years-old, and 50.9% were women. Age and absence of citicoline treatment were independent predictors of both utility and poor quality of life. Patients with cognitive impairment had a poorer QoL at 2 years (0.55 vs. 0.66 in utility, p = 0.015). Citicoline treatment improved significantly cognitive status during follow-up (p = 0.005). In conclusion, treatment with long-term citicoline is associated with a better QoL and improves cognitive status 2 years after a first ischemic stroke

Bullying victimization in young females with fragile-X-syndrome

The aim of this study is to investigate the risk associated with girls with fragile X syndrome (FXS) suffering bullying in the role of a victim and its effects on their adaptive behavior, socialization style, and emotional state. A neuropsychological assessment was carried out on a sample of 40 participants (26 FXS positive and 14 control group) using the following instruments: WISC-V, SENA, BAS-2, ABAS-II. The results show that the group of girls with FXS presented higher ratios of lack of social support and isolation from classmates. This finding suggests that problems with social interaction and communication in the group of girls with FXS could lead to difficulties in interpreting social signals and identifying situations of bullying correctly, placing them in a very vulnerable situation

El rol de la depresión en el déficit cognitivo del paciente con síndrome de fatiga crónica

Fundamento y objetivo Analizar el rol de la depresión en el déficit cognitivo del paciente con síndrome de fatiga crónica (SFC). Pacientes y método Un total de 57 mujeres con diagnóstico de SFC fueron evaluadas mediante tests neuropsicológicos que incluían medidas de atención (CalCap, Control Mental del WMS-III, PASAT, dígitos directos e inversos del WAIS-III y symbol digit modalities test [SDMT]) funciones ejecutivas (test Stroop, Trail Making Test [TMT A y B], FAS y Torre de Londres), memoria (Test de Aprendizaje Auditivo-Verbal [TAAVL] y Test de la Figura Compleja de Rey [FCR]) y velocidad psicomotora (Grooved Pegboard). Las puntuaciones directas fueron ajustadas de acuerdo a datos normativos y transformadas a puntuaciones típicas. La muestra fue dividida en dos grupos en función de la presencia o no de depresión, evaluada mediante entrevista clínica y la administración de la Escala Hospitalaria de Ansiedad y Depresión (HAD). Las puntuaciones de los test neuropsicológicos fueron comparadas entre ambos grupos de pacientes. Resultados Los pacientes con SFC presentaron déficit cognitivo en funciones atencionales y ejecutivas, independientemente de la presencia de depresión. No se observaron diferencias significativas en funciones cognitivas entre los dos grupos de pacientes. Conclusiones Estos datos sugieren que el déficit cognitivo que presentan los pacientes con SFC no es secundario a la depresión. Se debería tener en cuenta este resultado en la implementación de un programa terapéutico en estos enfermos

Study of the Interaction between Executive Function and Adaptive Behavior at School in Girls with Fragile X Syndrome

Comportamiento adaptativo; Escuela; NiñasComportament adaptatiu; Escola; NenesAdaptive behavior; School; Young femalesThe aim of this research is to analyze the relationship between executive functions and adaptive behavior in girls with Fragile X syndrome (FXS) in the school setting. This study is part of a larger investigation conducted at the Hospital Parc Tauli in Sabadell. The sample consists of a total of 40 girls (26 with FXS and 14 control) aged 7–16 years, who were administered different neuropsychological tests (WISC-V, NEPSY-II, WCST, TOL) and questionnaires answered by teachers (ABAS-II, BRIEF 2, ADHD Rating Scale). The results show that there is a greater interaction between some areas of executive function (cognitive flexibility, auditory attention, and visual abstraction capacity) and certain areas of adaptive behavior (conceptual, practical, social, and total domains) in the FXS group than in the control group. These results suggest that an alteration in the executive functions was affecting the daily functioning of the girls with FXS to a greater extent.The study was awarded two scholarships by the “Parc Tauli Foundation”: (1) Financial assistance to cover part of the travel expenses (transportation and accommodation). Grant number: 2018.0035; (2) “Intensifica’t al Tauli” Scholarship: grant program for the institutions’ healthcare professionals who led research projects. This financial assistance partially frees them from their professional activity for a period of 12 months so that they can make a greater commitment to research. Grant number: 2020.0081

Length of Illness Does Not Predict Cognitive Dysfunction in Chronic Fatigue Syndrome

Neuropsychological studies have shown cognitive impairment in chronic fatigue syndrome (CFS), particularly in information-processing speed. The aim of this study was to examine the evolution of cognitive impairment in CFS. The evolution is one of the most disabling aspects of the CFS, and it has received little attention in the literature. Fifty-six women with CFS were assessed with neuropsychological tests. Patients were divided into three groups based on the duration of the disease. There were no differences between groups in terms of cognitive function. The cognitive impairment in CFS was not found to be more severe with longer disease duration. These data suggest that there is no progressive cognitive impairment in patients with CFS. Therefore, the cognitive deficits in CFS should be treated with cognitive rehabilitation programs focused on improving emotional distress associated to the illness and on promoting functional abilities

Driving and legal status of Spanish opioid-dependent patients

Producción CientíficaBackground: Opioid dependent patients have legal problems, driving violations and accidents more frequently than the general population. We have hypothesized that those patients currently driving may have better legal outcomes than those who do not possess a valid driving license. With this aim we have analyzed the information gathered in the PROTEUS study regarding the legal and driving statuses and assessed the possible association between them. The PROTEUS study was an observational, cross-sectional, descriptive, multicenter nationwide representative study, conducted in Spanish healthcare centers for opioid dependent patients. Findings: The driving and legal statuses of a population of opioid dependent patients ≥18 years and enrolled in Opioid Agonist Therapy treatment centers in Spain, were assessed using a short specific questionnaire and the EuropASI questionnaire to highlight distinct individual clinical needs. 621 patients were evaluable (84% men, 24.5% active workers). 321 patients (52%) drove on a regular basis. Nineteen percent of patients had some problem with the criminal justice system. There was a significant difference (p = 0.0433) in status, according to the criminal justice system, between patients who drove on a regular basis and those who did not, with a higher percentage of patients with non-pending charges among usual drivers. Conclusions: Regular drivers showed fewer legal problems than non-regular drivers, with the exception of those related to driving (driving violations and drunk driving). Driving is a good prognostic factor for the social integration of the patients and policies should be implemented to enable these patients to drive safely under medical authorization. The legal description will be useful to assess treatment efficacy.Instituto de Salud Carlos III (grants RD06/0001/0020, RD06/0001/0018, RD12/0028/0012 and RD12/ 0028/0018

Hypothalamic ceramide levels regulated by CPT1C mediate the orexigenic effect of ghrelin.

Recent data suggest that ghrelin exerts its orexigenic action through regulation of hypothalamic AMP-activated protein kinase (AMPK) pathway, leading to a decline in malonyl-CoA levels and desinhibition of carnitine palmitoyltransferase 1A (CPT1A), which increases mitochondrial fatty acid oxidation and ultimately enhances the expression of the orexigenic neuropeptides agouti-related protein (AgRP) and neuropeptide Y (NPY). However, it is unclear whether the brain-specific isoform CPT1C, which is located in the endoplasmic reticulum (ER) of neurons, may play a role on this action. Here, we demonstrate that ghrelin's orexigenic action is totally blunted in CPT1C knock-out (KO) mice, despite having the canonical ghrelin signaling pathway activated. We also demonstrate that ghrelin elicits a marked upregulation of hypothalamic C18:0-ceramide levels mediated by CPT1C. Notably, central inhibition of ceramide synthesis with myriocin negated ghrelin's orexigenic action and normalized the levels of AgRP and NPY, as well as their key transcription factors pCREB and FoxO1. Finally, central treatment with ceramide induced food intake and orexigenic neuropeptides expression in CPT1C KO mice. Overall, these data indicate that, in addition to formerly reported mechanisms, ghrelin also induces food intake through regulation of hypothalamic CPT1C and ceramide metabolism, a finding of potential importance for the understanding and treatment of obesity

Influencia de la temperatura y el tiempo de síntesis sobre la acidez y morfología de una zeolita tipo ZSM-5

Aunque las propiedades que confieren el carácter general a una zeolita están bien determinadas, algunas de ellas como la acidez y morfología pueden variar dentro de ciertos límites. Factores tan importantes como la relación Si/Al y la naturaleza del átomo central de los grupos TO4(o del catión que compensa la carga negativa de la red cristalina), pueden ser controlados o modificados a través de la síntesis o por transformaciones posteriores realizadas sobre el material. Se estudiaron muestras de zeolita tipo ZSM-5 sintetizadas a diferentes temperaturas, en presencia de etanol y semillas de crecimiento. Las muestras fueron caracterizadas por Difracción de Rayos X, Microscopia Electrónica de Barrido, Espectroscopia infrarroja y adsorción de piridina. Se estudió la cinética del proceso de cristalización y se reportan y discuten los parámetros cinéticos k (constante de velocidad), n (factor geométrico) y Ea (energía de activación). Se investigó la influencia de la temperatura y del tiempo de tratamiento hidrotermal sobre la morfología y acidez de las muestras. Los resultados evidencian que tanto el mecanismo de transporte iónico en fase líquida como por transformación en fase sólida en el hidrogel (o nucleación superficial) están presentes en este proceso, siendo su predominio relativo función de la temperatura. El predominio de uno u otro mecanismo da lugar a variaciones en las características morfológicas y fisicoquímicas de los cristales

Central Ceramide-Induced Hypothalamic Lipotoxicity and ER Stress Regulate Energy Balance

Hypothalamic endoplasmic reticulum (ER) stress is a key mechanism leading to obesity. Here, we demonstrate that ceramides induce lipotoxicity and hypothalamic ER stress, leading to sympathetic inhibition, reduced brown adipose tissue (BAT) thermogenesis, and weight gain. Genetic overexpression of the chaperone GRP78/BiP (glucoseregulated protein 78 kDa/binding immunoglobulin protein) in the ventromedial nucleus of the hypothalamus (VMH) abolishes ceramide action by reducing hypothalamic ER stress and increasing BAT thermogenesis, which leads to weight loss and improved glucose homeostasis. The pathophysiological relevance of this mechanism is demonstrated in obese Zucker rats, which show increased hypothalamic ceramide levels and ER stress. Overexpression of GRP78 in the VMH of these animals reduced body weight by increasing BAT thermogenesis as well as decreasing leptin and insulin resistance and hepatic steatosis. Overall, these data identify a triangulated signaling network involving central ceramides, hypothalamic lipotoxicity/ER stress, and BAT thermogenesis as a pathophysiological mechanism of obesity