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BACKGROUND: Multiple sclerosis (MS) is a demyelinating disease with a lifetime prevalence of 4.41/100000 in Bogota, Colombia. It is known that it can be related with neuropsychiatric disorders, increasing by a factor of three the prevalence of depression in MS patients compared to general population. However, less attention has been given to the association between MS and impulsive behavior. METHODS: This cross-sectional study compared the levels of impulsivity controlling for the presence of MS. 60 patients with MS and 60 sex- and age-matched subjects without MS were included. In order to assess depression and impulsivity, participants completed the 13-item short form of the Beck Depression Inventory (BDI-SF), the self-report Barratt Impulsiveness Scale version 11 (BIS-11) and the Immediate and Delayed Memory Tasks (IMT-DMT) as an objective measure of impulsive behavior. RESULTS: Total scores, motor and cognitive subscales on the BIS-11 were significantly higher in the MS group. However, median BDI-SF score was also higher in MS patients than in subjects without MS (p < 0.001). To rule out depression as a confounding factor, stratification was performed using the BDI-SF score. In the subgroup of individuals with a BDI-SF< 8, the BIS-11 cognitive subscale scores were significantly higher in patients with MS than in subjects without MS (p = 0.041). In the IMT/DMT test, subjects with MS had a fewer number of correct detections than did subjects without MS, after controlling for BDI-SF score (p = 0.0001/p = 0.003). The ratio of commission errors to correct detections in the IMT was significantly higher in the MS group (p = 0.011). CONCLUSION: Patients with MS showed higher levels of cognitive impulsivity than subjects without MS. Objective measures for impulsiveness further support this finding. Impulsiveness scales scores might be biased by depression, which should be considered when assessing impulsivity in MS.

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Introducción:Discutir aspectos metodológicos relacionados con la calidad de las investigaciones preclínicas y la aplicabilidad de principios de investigación clínica y medicina basada en la evidencia para evaluar la validez y calidad de los estudios preclínicos. Método: Análisis crítico de publicaciones selectas. Resultados: El ejercicio de la investigación (preclínica y clínica) exige indicadores rigurosos que permitan determinar la validez y generalización de sus hallazgos. Es deseable el desarrollo de metodologías para determinar su peso y hacer posible su revisión sistemática. Conclusiones: Se exige un replanteamiento del que hacer científico, a la luz del reconocimiento de sus limitaciones, la urgencia de sus aportes y la responsabilidad que esta tiene frente al bienestar de la humanidad...

Introduction: To discuss methodological issues concerning the quality and applicability of clinical research and evidence-based medicine principles to pre-clinical research. Methods: Critical analysis of selected writings. Results: Rigorous standards to determine the quality and generalization of pre-clinical fiindings are needed; methods to systematically review the evidence and its weight have not been developed for pre-clinical research. Conclusions: Never before has a debate about the limitations of pre-clinical research been more relevant, given the omentousness of its contributions and its obligation towards the well-being of humankind...

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Introducción: Las intervenciones en línea constituyen una de las tantas opciones terapéuticas disponibles para pacientes con trastornos por abuso/dependencia a sustancias y otras condiciones psiquiátricas. No obstante, su utilidad ha sido ampliamente cuestionada a la luz de falta de rigurosidad. Objetivo: Revisar y discutir la literatura existente acerca de los recursos e intervenciones en línea para trastornos por abuso/dependencia de sustancias psicoactivas. Método: Búsqueda sistemática de literatura sobre los recursos e intervenciones en línea relacionados con trastornos por abuso/dependencia a sustancias. Resultados: Existen numerosos recursos informativos para el público general, pero la calidad de la información disponible no es siempre adecuada. También hay, aunque en menor número, intervenciones y programas de autoayuda en línea, específicamente para tabaquismo y alcoholismo. No obstante, su efectividad no ha sido determinada en estudios clínicos aleatorizados y controlados, adecuadamente diseñados. Conclusión: Son necesarios estudios clínicos aleatorizados y controlados que permitan evaluar la efectividad de este tipo de intervenciones. Los resultados iluminarán el desarrollo de estrategias de intervención integrales que usen esta poderosa herramienta de comunicación...

Introduction: Online interventions are one of the many treatment options available for patients with substance use disorders and other psychiatric conditions. However, its usefulness has been widely questioned due to a lack of rigorous scientific research. Objective: To review and discuss the literature about online resources and interventions for substance use disorders. Methods: Systematic search of literature on online resources and interventions related to substance use disorders. Results: There are many sources of information for the general public, but the quality of information available is not always appropriate. There are, though in smaller numbers, interventions and online self-help programs specifically for smoking and alcoholism. However, their effectiveness has not been determined in properly designed randomized controlled trials. Conclusion: It is necessary to evaluate the safety and efficacy of online interventions using rigorous randomized controlled trials. The results illuminate the development of comprehensive intervention strategies that may use this powerful communication tool...

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INTRODUCTION: Impulsivity is a complex personality trait related to the control of behavior and emotions and it is present in a wide variety of psychiatric diseases, including eating disorders and particularly in bulimia nervosa (BN). Yet, the relationship between impulsivity and bulimia nervosa, as well as the neurobiological substrates of these disorders, are difficult to discern. OBJECTIVES: The present manuscript reviews the neural substrates for impulsivity, including executive function, preference formation and emotional regulation, and the function of these circuits in individuals with BN. METHODS: A selective review of the literature related to the subject was performed. RESULTS AND CONCLUSIONS: The discussion illustrates the complex relationship between impulsivity and BN, where impulsivity may serve as a vulnerability factor that sensitizes the subjects with BN to negative emotional states that bias the impact of environmental and internal stimuli over behavioral regulation processes, favoring maladaptive and inflexible behavioral patterns.

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Consciousness and impulsivity are multidimensional constructs related to the control of thoughts and behavior. Impulsivity is a complex personality trait characterized by: acting without thinking, inability to plan ahead of time and poor attention or vigilance. Consciousness is a construct that encompasses a variety of physiological processes related to the experience of awareness and the acquisition of knowledge in human beings. With respect to the control of human behavior, consciousness and impulsivity appear to be related to opposite behaviors. Historically, efforts to understand these constructs by different disciplines have resulted in the development of divergent definitions and a variety of measures, thus causing confusion. The purposes of this article are to: 1) describe examples of solutions to this confusion within impulsivity research and discuss how consciousness research can benefit from the study of impulsivity; 2) discuss how consciousness and impulsivity can be measured within a laboratory and treated as experimental variables; 3) Summarize the lessons learned by comparing impulsive and premeditated acts from an integrated, multidimensional perspective; 4) Discuss the implications of a multidisciplinary model for pursuing consciousness research.

Conciencia e impulsividad son dos constructos multidimensionales relacionados con el control del pensamiento y comportamiento humano. Impulsividad es un rasgo de personalidad complejo caracterizado por una elevada tendencia a actuar sin pensar, incapacidad para planear actividades futuras y disminución de la capacidad de concentración. Conciencia por su parte, es un constructo que cobija una serie de procesos fisiológicos relacionados con la generación de experiencia conciente y la adquisición de conocimientos. Con respecto al control sobre la acción humana, conciencia e impulsividad parece estar relacionados con comportamientos opuestos. Históricamente, los esfuerzos realizados por diversas disciplinas con el fin de estudiar estos constructos han llevado al desarrollo de definiciones divergentes y a una serie de medidas, causando una mayor confusión. Los propósitos de este artículo son: 1) describir ejemplos de posibles soluciones al estado de confusión en el campo de la investigación sobre impulsividad y discutir como el estudio de la conciencia puede beneficiarse de la investigación de la impulsividad; 2) discutir algunas de las maneras utilizadas para medir impulsividad en el laboratorio y cómo hacer de estos constructos variables experimentales; 3) resumir algunas de las lecciones derivadas de la comparación de los actos impulsivos con los premeditados desde una perspectiva integral y multidimensional; 4) discutir las implicaciones derivadas del uso de un enfoque multidimensional para el estudio de la conciencia.

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Trabajos anteriores han demostrado la existencia de actividad eléctrica oscilatoria sincrónica en diversas porciones del sistema nervioso. Con el registro de su coherencia, esta actividad ha sido catalogada como una candidata para ser el sustrato neurobiológico de la conciencia humana. Aquí se explora la posibilidad de la existencia de un lenguaje temporal que represente los objetos de la cognición y, por tanto, de la conciencia humana.

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