Estudio clínico, neurocognitivo y análisis espectral del electroencefalograma en pacientes con enfermedad de Alzheimer

INTRODUCCIÓN: La enfermedad de Alzheimer (EA) es uno de los principales problemas de salud asociados al envejecimiento. OBJETIVOS: 1. Realizar un estudio clínico, neurocognitivo y neurofisiológico de un grupo de pacientes con EA. 2. Determinar la asociación entre variables clínicas, neurocognitivas y neurofisiológicas. METODOLOGÍA: Se estudiaron dos grupos homogéneos de enfermos y controles. Se utilizó el test Minimental como herramienta de cribado y se realizó un registro EEG. Se aplicaron los test Stroop, Trail Making y TAVEC al grupo de enfermos. Se estudió la asociación entre los test anteriores y varios parámetros extraídos del EEG: potencia relativa, dos parámetros espectrales (IAF, SEF90) y dos parámetros no lineales (LZC, CTM). RESULTADOS: Se obtuvieron correlaciones estadísticamente significativas entre la mayoría de las variables estudiadas del TAVEC y los parámetros espectrales (IAF, SEF90) y los no lineales (LZC, CTM). CONCLUSIONES: Los parámetros extraídos del EEG reflejan las alteraciones neurocognitivas observadas en la EA.Departamento de Biología Celular, Histología y Farmacologí

Classification of alzheimer’s electroencephalograms using artificial neural networks and logistic regression

The Artificial Neural Networks have been used over the years to solve complex problems and their development has strongly grown in recent years. In particular, this work, focused on the development and a comparison between Artificial Neural Networks (ANN) and a traditional statistical technic known as Logistic Regression (LR) in Electroencephalogram (EEG) classification. The Wavelet Transform was seen as the main technique of signal processing, in order to analyze the EEG signals of this study. Some features were extracted by the EEG signals like relative power (RP) in conventional frequency bands and two spectral ratios. The best feature combination was selected by Principal Components Analysis method to increase the accuracy of the ANN and LR to discriminate their entries between Alzheimer Disease and Controls

Evaluation of EEG spectralfeatures in Alzheimer disease discrimination

Alzheimer’s disease (AD) is considered one of the most disabling diseases and it has a high prevalence in developed countries. It is as well the most common cause of dementia and it affects particularly the elderly. The current AD diagnosis accuracy is relatively low. It is therefore necessary to optimize the methods for AD detection. The electroencephalogram (EEG) is an inexpensive and noninvasive technique, that is able to record the electromagnetic fields produced by the brain activity. It has shown in the recent past a growing quality of the contribution to show brain disorders. The aim of this study was to evaluate the individual and combined power of several EEG features in AD discrimination. 95.00% of sensitivity, 100.00% of specificity, 97.06% of accuracy and 0.98 of AUC were the best classification results obtained in this work

Pressure pain sensitivity map of multifocal nummular headache:a case report

BACKGROUND: Nummular headache (NH) is most commonly a localized unifocal headache; however, some patients infrequently exhibit multifocal symptomatic painful head areas retaining all features of NH. We present the pressure pain sensitivity map of an adolescent with multifocal NH. CASE PRESENTATION: We describe a case of a 14 year-old-girl with a 3-year history of continuous pain in four rounded areas, all of them with the same size and shape. Pressure pain thresholds (PPT) were assessed on 21 points over the scalp and over the symptomatic areas. A pressure pain sensitivity map of the head was constructed. The neurological exam was unremarkable, with neither sensory symptoms nor trophic changes within the painful areas. As previously shown, symptomatic points exhibited lower PPTs compared to the surrounding areas. The map reflected 4 restricted areas of mechanical hyperalgesia confined just to the painful areas. Treatment with gabapentin achieved complete remission. CONCLUSION: This is the first pain sensitivity map of a patient with multifocal NH. Our results support peripheral mechanisms are maintained in multifocal NH

Analysis of Spontaneous EEG Activity in Alzheimer’s Disease Using Cross-Sample Entropy and Graph Theory

Producción CientíficaThe aim of this pilot study was to analyze spontaneous electroencephalography (EEG) activity in Alzheimer’s disease (AD) by means of Cross-Sample Entropy (Cross-SampEn) and two local measures derived from graph theory: clustering coefficient (CC) and characteristic path length (PL). Five minutes of EEG activity were recorded from 37 patients with dementia due to AD and 29 elderly controls. Our results showed that Cross-SampEn values were lower in the AD group than in the control one for all the interactions among EEG channels. This finding indicates that EEG activity in AD is characterized by a lower statistical dissimilarity among channels. Significant differences were found mainly for fronto-central interactions (p < 0.01, permutation test). Additionally, the application of graph theory measures revealed diverse neural network changes, i.e. lower CC and higher PL values in AD group, leading to a less efficient brain organization. This study suggests the usefulness of our approach to provide further insights into the underlying brain dynamics associated with AD.Ministerio de Economía y Competitividad (TEC2014-53196-R)Junta de Castilla y León (proyecto VA037U16 y BIO/VA08/15

Problemas familiares generadores de conductas disruptivas en alumnos

El trabajo que presentamos trata las distintas realidades familiares y sus correspondientes problemas que repercuten de forma negativa en el comportamiento de algunos alumnos. Analizando esta problemática vamos tomando conciencia de la importancia que el ambiente familiar tiene en el estado emocional de los alumnos, lo que repercute en su motivación hacia la tarea escolar, en la relación con sus compañeros y con los profesores. Según Goleman (1996): “Los problemas emocionales de los discípulos entorpecen el funcionamiento de la mente. Los estudiantes que se hallan atrapados por el enojo, la ansiedad o la depresión tienen dificultades para aprender porque no perciben adecuadamente la información y en consecuencia no pueden procesarla correctamente”. Tratamos de comprenderlos observando de qué forma sus problemas familiares provocan estados de estrés emocional y sus dificultades para canalizarlo, lo que origina en ellos conductas disruptivas de forma sistemática y sin que se precisen demasiados estímulos que las desencadenen. A través del estudio de casos, trataremos de diseñar estrategias de afrontamiento que permitan resolver adecuadamente su problemática de relación y motivación.The present paper deals with different family situations and related problems that negatively affect the behavior of some students. Analyzing this problem we become aware of the importance that family environment has on students' emotional state, which affects their motivation for school work, in relationships with peers and teachers. According to Goleman (1996): "The emotional problems of the disciples hinder the functioning of the mind. Students who are trapped by anger, anxiety or depression have difficulty learning because they do not receive adequate information and therefore can not be handled properly”. Try to understand how watching their family problems cause emotional stress status and the difficulties in channeling, resulting in disruptive them systematically and without requiring too many stimuli that trigger. Through case studies, try to devise coping strategies to resolve relationship problems adequately and motivation

Problemas familiares generadores de conductas disruptivas en alumnos

The present paper deals with different family situations and related problems that negatively affect the behavior of some students. Analyzing this problem we become aware of the importance that family environment has on students' emotional state, which affects their motivation for school work, in relationships with peers and teachers. According to Goleman (1996): "The emotional problems of the disciples hinder the functioning of the mind. Students who are trapped by anger, anxiety or depression have difficulty learning because they do not receive adequate information and therefore can not be handled properly”. Try to understand how watching their family problems cause emotional stress status and the difficulties in channeling, resulting in disruptive them systematically and without requiring too many stimuli that trigger. Through case studies, try to devise coping strategies to resolve relationship problems adequately and motivationEl trabajo que presentamos trata las distintas realidades familiares y sus correspondientes problemas que repercuten de forma negativa en el comportamiento de algunos alumnos. Analizando esta problemática vamos tomando conciencia de la importancia que el ambiente familiar tiene en el estado emocional de los alumnos, lo que repercute en su motivación hacia la tarea escolar, en la relación con sus compañeros y con los profesores. Según Goleman (1996): “Los problemas emocionales de los discípulos entorpecen el funcionamiento de la mente. Los estudiantes que se hallan atrapados por el enojo, la ansiedad o la depresión tienen dificultades para aprender porque no perciben adecuadamente la información y en consecuencia no pueden procesarla correctamente”. Tratamos de comprenderlos observando de qué forma sus problemas familiares provocan estados de estrés emocional y sus dificultades para canalizarlo, lo que origina en ellos conductas disruptivas de forma sistemática y sin que se precisen demasiados estímulos que las desencadenen. A través del estudio de casos, trataremos de diseñar estrategias de afrontamiento que permitan resolver adecuadamente su problemática de relación y motivación

COVID-19 in hospitalized HIV-positive and HIV-negative patients : A matched study

CatedresObjectives: We compared the characteristics and clinical outcomes of hospitalized individuals with COVID-19 with [people with HIV (PWH)] and without (non-PWH) HIV co-infection in Spain during the first wave of the pandemic. Methods: This was a retrospective matched cohort study. People with HIV were identified by reviewing clinical records and laboratory registries of 10 922 patients in active-follow-up within the Spanish HIV Research Network (CoRIS) up to 30 June 2020. Each hospitalized PWH was matched with five non-PWH of the same age and sex randomly selected from COVID-19@Spain, a multicentre cohort of 4035 patients hospitalized with confirmed COVID-19. The main outcome was all-cause in-hospital mortality. Results: Forty-five PWH with PCR-confirmed COVID-19 were identified in CoRIS, 21 of whom were hospitalized. A total of 105 age/sex-matched controls were selected from the COVID-19@Spain cohort. The median age in both groups was 53 (Q1-Q3, 46-56) years, and 90.5% were men. In PWH, 19.1% were injecting drug users, 95.2% were on antiretroviral therapy, 94.4% had HIV-RNA < 50 copies/mL, and the median (Q1-Q3) CD4 count was 595 (349-798) cells/μL. No statistically significant differences were found between PWH and non-PWH in number of comorbidities, presenting signs and symptoms, laboratory parameters, radiology findings and severity scores on admission. Corticosteroids were administered to 33.3% and 27.4% of PWH and non-PWH, respectively (P = 0.580). Deaths during admission were documented in two (9.5%) PWH and 12 (11.4%) non-PWH (P = 0.800). Conclusions: Our findings suggest that well-controlled HIV infection does not modify the clinical presentation or worsen clinical outcomes of COVID-19 hospitalization

How do women living with HIV experience menopause? Menopausal symptoms, anxiety and depression according to reproductive age in a multicenter cohort

CatedresBackground: To estimate the prevalence and severity of menopausal symptoms and anxiety/depression and to assess the differences according to menopausal status among women living with HIV aged 45-60 years from the cohort of Spanish HIV/AIDS Research Network (CoRIS). Methods: Women were interviewed by phone between September 2017 and December 2018 to determine whether they had experienced menopausal symptoms and anxiety/depression. The Menopause Rating Scale was used to evaluate the prevalence and severity of symptoms related to menopause in three subscales: somatic, psychologic and urogenital; and the 4-item Patient Health Questionnaire was used for anxiety/depression. Logistic regression models were used to estimate odds ratios (ORs) of association between menopausal status, and other potential risk factors, the presence and severity of somatic, psychological and urogenital symptoms and of anxiety/depression. Results: Of 251 women included, 137 (54.6%) were post-, 70 (27.9%) peri- and 44 (17.5%) pre-menopausal, respectively. Median age of onset menopause was 48 years (IQR 45-50). The proportions of pre-, peri- and post-menopausal women who had experienced any menopausal symptoms were 45.5%, 60.0% and 66.4%, respectively. Both peri- and post-menopause were associated with a higher likelihood of having somatic symptoms (aOR 3.01; 95% CI 1.38-6.55 and 2.63; 1.44-4.81, respectively), while post-menopause increased the likelihood of having psychological (2.16; 1.13-4.14) and urogenital symptoms (2.54; 1.42-4.85). By other hand, post-menopausal women had a statistically significant five-fold increase in the likelihood of presenting severe urogenital symptoms than pre-menopausal women (4.90; 1.74-13.84). No significant differences by menopausal status were found for anxiety/depression. Joint/muscle problems, exhaustion and sleeping disorders were the most commonly reported symptoms among all women. Differences in the prevalences of vaginal dryness (p = 0.002), joint/muscle complaints (p = 0.032), and sweating/flush (p = 0.032) were found among the three groups. Conclusions: Women living with HIV experienced a wide variety of menopausal symptoms, some of them initiated before women had any menstrual irregularity. We found a higher likelihood of somatic symptoms in peri- and post-menopausal women, while a higher likelihood of psychological and urogenital symptoms was found in post-menopausal women. Most somatic symptoms were of low or moderate severity, probably due to the good clinical and immunological situation of these women