RESUMEN
OBJECTIVES: The objective of the present study was to assess the presence of cognitive deficits in patients with chronic migraine, and to assess the main factors that trigger cognitive disorders, such as comorbidities or the use of medications. METHODS: Chronic migraine and control groups were interviewed in a case-control study. The frequency and intensity of the headache, medication used and associated comorbidities were determined. All patients were submitted to an extended neuropsychological assessment. RESULTS: The chronic migraine group (n = 30) had a worse performance in the Montreal Cognitive Assessment Test (p = 0.00), Verbal Fluency (p = 0.00), Stroop (p = 0.00), Clock Drawing Test (p = 0.00), Digit Span (p = 0.00) and Matrix Reasoning (p = 0.01). After statistical adjustment by linear regression, migraine continued to be the only relevant factor in the poorer performance in the Montreal Cognitive Assessment, Verbal Fluency, Clock Drawing and Stroop tests. CONCLUSIONS: Patients with chronic migraine have cognitive deficits in multiple tasks, regardless of the presence of comorbidities or the use of medications.
Asunto(s)
Disfunción Cognitiva/psicología , Trastornos Migrañosos/psicología , Pruebas Neuropsicológicas , Adolescente , Adulto , Estudios de Casos y Controles , Enfermedad Crónica , Disfunción Cognitiva/complicaciones , Estudios Transversales , Escolaridad , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Trastornos Migrañosos/diagnóstico , Conducta Verbal/fisiología , Adulto JovenRESUMEN
ABSTRACT The objective of the present study was to assess the presence of cognitive deficits in patients with chronic migraine, and to assess the main factors that trigger cognitive disorders, such as comorbidities or the use of medications. Methods: Chronic migraine and control groups were interviewed in a case-control study. The frequency and intensity of the headache, medication used and associated comorbidities were determined. All patients were submitted to an extended neuropsychological assessment. Results: The chronic migraine group (n = 30) had a worse performance in the Montreal Cognitive Assessment Test (p = 0.00), Verbal Fluency (p = 0.00), Stroop (p = 0.00), Clock Drawing Test (p = 0.00), Digit Span (p = 0.00) and Matrix Reasoning (p = 0.01). After statistical adjustment by linear regression, migraine continued to be the only relevant factor in the poorer performance in the Montreal Cognitive Assessment, Verbal Fluency, Clock Drawing and Stroop tests. Conclusion: Patients with chronic migraine have cognitive deficits in multiple tasks, regardless of the presence of comorbidities or the use of medications.
RESUMO O objetivo do presente estudo foi avaliar a presença de déficits cognitivos em pacientes com migrânea crônica e avaliar os principais fatores que desencadeiam transtornos cognitivos, como comorbidades e uso de medicações. Métodos: Pacientes com migrânea crônica (n = 30) e controles foram entrevistados, em um estudo caso-controle. A frequência e intensidade da cefaleia, medicações utilizadas e comorbidades associadas foram determinadas. Todos os pacientes foram submetidos a uma avaliação neuropsicológica estendida. Resultados: Os pacientes com migrânea crônica apresentaram uma pior performance no Montreal Cognitive Assessment (p = 0.00), Fluência Verbal (p = 0.00), Teste de Stroop (p = 0.00), Teste do Relógio (p = 0.00), Subteste Dígitos (p = 0.00) e Raciocínio matricial da WAIS-III (p = 0.01). Após ajuste estatístico através de Regressão Linear, a migrânea se manteve como único fator relevante para pior desempenho em MoCA, Fluência verbal, Teste do relógio e Teste de Stroop. Conclusão: Pacientes com migrânea crônica apresentam déficits cognitivos incluindo múltiplas tarefas, independentes da presença de comorbidades e uso de medicações.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Disfunción Cognitiva/psicología , Trastornos Migrañosos/psicología , Pruebas Neuropsicológicas , Conducta Verbal/fisiología , Estudios de Casos y Controles , Modelos Lineales , Enfermedad Crónica , Estudios Transversales , Escolaridad , Disfunción Cognitiva/complicaciones , Trastornos Migrañosos/diagnósticoRESUMEN
Seven F1 strains of Aedes aegypti (L.) were evaluated by bottle bioassay for resistance to the pyrethroids d-phenothrin, permethrin, deltamethrin, lambda-cyalothrin, bifenthrin, cypermethrin, alpha-cypermethrin, and z-cypermethrin. The New Orleans strain was used as a susceptible control. Mortality rates after a 1 h exposure and after a 24 h recovery period were determined. The resistance ratio between the 50% knockdown values (RR(KC50)) of the F1 and New Orleans strains indicated high levels of knockdown resistance. The RR(KC50) with alpha-cypermethrin varied from 10 to 100 among strains indicating high levels of knockdown resistance. Most of the strains had moderate resistance to d-phenothrin. Significant but much lower levels of resistance were detected for lambda-cyalothrin, permethrin, and cypermethrin. For zeta-cypermethrin and bifenthrin, only one strain exhibited resistance with RR(KC50) values of 10- and 21-fold, respectively. None of the strains showed RR(KC50) >10 with deltamethrin, and moderate resistance was seen in three strains, while the rest were susceptible. Mosquitoes from all strains exhibited some recovery from all pyrethroids except d-phenothrin. Regression analysis was used to analyze the relationship between RR(LC50) and RR(KC50). Both were highly correlated (R2 = 0.84-0.97) so that the slope could be used to determine how much additional pyrethroid was needed to ensure lethality. Slopes ranged from 0.875 for d-phenothrin (RR(LC50) approximately equal to RR(KC50)) to 8.67 for lambda-cyalothrin (-8.5-fold more insecticide needed to kill). Both RR(LC50) and RR(KC50) values were highly correlated for all pyrethroids except bifenthrin indicating strong cross-resistance. Bifenthrin appears to be an alternative pyrethroid without strong cross-resistance that could be used as an alternative to the current widespread use of permethrin in Mexico.