Antecedente de vida rural ou de vida urbana e doença de Parkinson

Although the precise etiology of Parkinson's disease (PD) is as yet unknown, it appears that certain environmental factors are involved. Prior living in a rural area has been implicated as a possible risk factor for PD, particularly in the early onset type. We evaluated the role of previous living conditions in the clinical correlates and outcome characteristics of 118 PD patients. All of them were seen from January 1987 to October 1992. The Rural Group (RG) comprised 71 patients (60.2%) who had lived in the rural area for at least 10 years (mainly in early phase of life) and the Urban Group (UG) consisted of 47 patients (39.8%) who had lived their entire life in an urban environment. The average age at the beginning of the symptoms was 58.8 in the RG and 54.1 in the UG. The mixed form of the disease (tremor, rigidity and akinesia) was the most frequent in both groups. A minimum 6-month follow-up period was undertaken with 63 patients (average 20 months) and no difference in response to treatment or in progression of the illness was detected between the two groups. Our data show that the previous living environment does not appear to be a determining factor in either the clinical or outcome characteristics of PD.A etiologia da doença de Parkinson (DP) é ainda desconhecida mas parece que fatores ambientais podem estar envolvidos. A incidência da DP, particularmente a de início precoce, parece ser maior em indivíduos com antecedente de moradia na zona rural. Avaliamos as características clínicas e a progressão da DP em 118 pacientes segundo os antecedentes de área de moradia pregressa. Havia 71 pacientes (60,2%) com antecedente de no mínimo 10 anos na zona rural (especialmente nas fases iniciais da vida), o chamado Grupo Rural (GR), e 47 pacientes (39,8%) que tiveram antecedente de vida exclusivamente urbana, o chamado Grupo Urbano (GU). A média de idade de início dos sintomas foi 58,8 anos no GR e de 54,1 anos no GU. A forma mista da DP (com tremor, bradicinesia e rigidez) foi a mais frequente em ambos os grupos. Um período de acompanhamento de no mínimo 6 meses foi obtido em 63 pacientes (média de 20 meses de acompanhamento) e a progressão da sintomatologia foi semelhante nos dois grupos (GR e GU). Nossos dados indicam que o antecedente de moradia não parece ser determinante para o padrão de manifestação clínica e de evolução da DP.Universidade Federal de São Paulo (UNIFESP) Department of Neurology and Neurosurgery Movement Disorders UnitUniversidade de São Paulo Faculdade de Medicina Department of Neurology, Psychiatry and Medical PsychologyUNIFESP, Department of Neurology and Neurosurgery Movement Disorders UnitSciEL

I'm looking through you: Mentalizing in frontotemporal dementia and progressive supranuclear palsy

Mentalizing and emotion recognition are impaired in behavioral variant frontotemporal dementia (bvFTD). It is not clear whether these abilities are also disturbed in other conditions with prominent frontal lobe involvement, such as progressive supranuclear palsy (PSP). Our aim was to investigate social cognition (facial emotion recognition, recognition of social norms violation and mentalizing) in bvFTD and PSP. The neural basis of these functions in PSP and bvFTD groups, by analysis of structural neuroimaging, were also investigated. Twenty-three bvFTD patients, 21 PSP patients and 23 healthy controls were included. All participants underwent 3T brain MRI and a full cognitive exam including the short version of Social and Emotional Assessment (Mini-SEA), which is composed of a facial emotion recognition test (FERT) and the faux pas test. Two components of the faux pas test were distinguished: a score assessing the recognition of social norms violation and a score assessing mentalizing. Compared to controls, bvFTD and PSP patients had significantly reduced scores in all tests of social cognition but did not differ on these measures. PSP and bvFTD had cerebral atrophy in critical regions for social cognition processes, when compared to controls. The cortical correlates of emotion recognition partially overlapped in bvFTD and PSP, with correlations retrieved within the frontal medial cortex, cingulate, insula and limbic structures. PSP and bvFTD patients also displayed similar patterns of brain correlations for the composite score of social norms, with a significant cluster in anterior temporal lobes. Mentalizing scores were associated with frontal and temporal poles bilaterally, in both bvFTD and PSP. These findings support previous observations that PSP patients exhibit impairment in complex cognitive abilities, such as mentalizing. Moreover, these data extend previous findings showing that PSP and bvFTD share key clinical, cognitive and neuroimaging features

Anormalidades do potencial evocado visual por padrão reverso em pacientes com esclerose múltipla definida Pattern reversal visual evoked potential abnormalities in patients with defined multiple sclerosis

O potencial evocado visual por padrão reverso, obtido por padrões de 14' e 28', foi analisado retrospectivamente em 28 pacientes com diagnóstico de esclerose múltipla definida. Observamos respostas anormais em 27/28 (96,4%) pacientes, em 31/36 (86%) dos olhos considerados sintomáticos e em 16/20 (80%) dos ollhos assintomáticos. Classificando os achados em cada olho segundo as respostas obtidas aos dois estímulos, observamos uma possível relação entre essa classificação e a gravidade de comprometimento visual pela doença. Detectamos em alguns olhos anormalidades isoladas do N75 e também de P100 apenas à estimulação de 28'. Dessa forma, a técnica empregada foi considerada sensível e pôde definir inclusive comprometimento visual subclínico. Entretanto, não teve sensibilidade absoluta para detectar anormalidades em alguns olhos sintomáticos. O tipo de resposta aos estímulos empregados pode sugerir o grau de extensão de envolvimento do sistema visual pela doença. Os achados mostram ainda o envolvimento irregular e predominante das fibras mais centrais da visão pela esclerose múltipla, e sugerem processadores neurais distintos e paralelos para as respostas aos dois padrões utilizados.<br>The pattern reversal visual evoked potential with checks of 14' and 28' was restropectivelly studied in 28 patients with definite multiple sclerosis. We observed abnormal responses in 27/28 (96.4%) patients, in 31/36 (86%) of symptomatic eyes, and in 16/20 (80%) of asymptomatic eyes. When we classified the abnormalities in each eye according to the findings obtained with each check, there was a correlation between the pattern of abnormalities and the severity of visual involvement. Occasionally there were isolated abnormalities of N75 or only in P100 obtained with 28' checks. In conclusion the methodology applied was very sensible in detecting abnormalities in visual pathway. We could classify the findings in each eye and correlate them with the severity of visual involvement. The findings showed uneven distribution of lesions in visual pathway, affecting preferentially the central vision afferents