RESUMO
During the 1990s, Cuba was struck by a rare epidemic disease. Up to 50,000 people were affected by a pathology compromising primarily the optic nerve but also peripheral nerves and even spinal cord. This is a testimony from a direct witness and participant in the initial study of the epidemics showing that in spite of claims of a "multifactorial" etiology, still in the literature, the root cause of this disease is just result of the deliberate deprivation of the most elementary economic rights by extreme Government control over a population left unable to tend to its elementary survival by itself, in spite of a thorough Government-sponsored, universally celebrated Universal Healthcare System.
RESUMO
OBJECTIVE: To assess possible differences in intracranial source distribution of surface QEEG power between depressed and non-depressed alcoholic patients in order to find any symptom-related topographic features of physiopathologic relevance. METHODS: Low-Resolution Electromagnetic Tomography (LORETA) for the delta, theta, alpha and beta bands of EEG spectra was estimated from 38 alcoholic patients, 20 with and 18 without clinical depression, in which QEEG showed decreased slow and increased beta activity diffusely. Statistical non-parametric mapping was used to compare depressed and non-depressed groups. Measures of intracranial current density in individual patients at areas of significant differences were correlated with BDI scores. RESULTS: Patients with clinical depression showed areas of significantly lower current density than non-depressed patients in delta band at left anterior temporal, left midtemporal (including amygdala and hippocampus), and both frontopolar cortices mostly on the right; and in theta band at bilateral parietal lobe, anterior cingulate and medial frontal cortex. No differences were found at alpha and beta band. Intracranial current density in delta band at left parahippocampal, left midfrontal cortex and right frontopolar cortex was negatively correlated with BDI score. Theta band also showed negative correlations with BDI at sites of significant differences. CONCLUSIONS: Diffusely decreased delta and theta activity in the surface QEEG of alcoholic patients has a different intracranial distribution linked to the presence or not of clinical depression that seems to reveal a dysfunctional neuronal state at several specific limbic and other cortical locations that have been related to a specific clinical disorder such as depression. SIGNIFICANCE: These results provided further evidence on the effects of depression in the context of alcohol dependence, in this case decreased slow activity as a possible marker of neuronal damage secondary to alcohol toxicity, clinically expressed as depressive symptoms when present in structures that are known to be related to clinical depression.
Assuntos
Alcoolismo/fisiopatologia , Mapeamento Encefálico , Encéfalo/fisiopatologia , Depressão/fisiopatologia , Alcoolismo/complicações , Depressão/complicações , Eletroencefalografia , Fenômenos Eletromagnéticos , Humanos , Masculino , TomografiaRESUMO
OBJECTIVE: To evaluate the incidence and clinical correlations of abnormal QEEG features in alcoholic patients. METHODS: Quantitative EEG (frequency analysis, absolute and relative powers of the four classical bands) was assessed in 191 male alcoholic patients admitted in our facility for detoxification process. All underwent psychiatric, medical and neurological examination prior to the EEG recording, in search for specific clinical or paraclinical findings. The presence or absence of relevant clinical features was codified as nominal dichotomic variables to be related to specific QEEG features. RESULTS: Only 7 patients had normal QEEG. The most frequent alteration (81 cases) was decreased power in slow (delta and theta) bands with a concurrent increase in beta band, followed by decreased power only in slow bands (33), increase only in beta band (29), decrease in both slow and alpha bands without beta alterations (28), decrease only in alpha band (6) and others. Alterations in slow and beta bands were uncorrelated. However, a significant correlation was found between decreased power in slow bands and cortical atrophy as revealed by MRI (especially in patients with early onset of alcoholism), time elapsed from the beginning of alcoholic habits (but only in younger or early onset subjects) and in a lesser degree arterial hypertension, but neither with age nor any other clinical or psychiatric feature. On the other hand, increased power in beta band correlated mainly with the use of benzodiazepines, sensoperceptual alterations (hallucinations, illusions), clinical seizures and family history of alcoholism. The effects of those variables were strongly interrelated. CONCLUSIONS: Decreased power in slow bands in alcoholic patients may be an indicator of brain atrophy or chronic brain damage, while increase in beta band is related to medication use, family history of alcoholism, hallucinations and seizures, suggesting a state of cortical hyperexcitability. SIGNIFICANCE: This study show the relation of specific QEEG alterations to certain clinical features found in alcoholics, in a further attempt to elucidate the semiological value of those alterations in individual patients.
Assuntos
Transtornos do Sistema Nervoso Induzidos por Álcool/diagnóstico , Alcoolismo/complicações , Córtex Cerebral/efeitos dos fármacos , Eletroencefalografia/métodos , Etanol/efeitos adversos , Adulto , Fatores Etários , Idoso , Convulsões por Abstinência de Álcool/fisiopatologia , Transtornos do Sistema Nervoso Induzidos por Álcool/fisiopatologia , Atrofia/induzido quimicamente , Atrofia/diagnóstico , Atrofia/fisiopatologia , Benzodiazepinas/efeitos adversos , Dano Encefálico Crônico/induzido quimicamente , Dano Encefálico Crônico/diagnóstico , Dano Encefálico Crônico/fisiopatologia , Depressores do Sistema Nervoso Central/efeitos adversos , Córtex Cerebral/fisiopatologia , Interações Medicamentosas/fisiologia , Predisposição Genética para Doença/genética , Ácido Glutâmico/metabolismo , Alucinações/induzido quimicamente , Alucinações/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Neurológicos , Degeneração Neural/induzido quimicamente , Degeneração Neural/genética , Degeneração Neural/metabolismo , Neurotoxinas/metabolismo , Ácido gama-Aminobutírico/metabolismoRESUMO
Se estudiaron 162 sujetos normales en los culaes se midieron la latencia de los picos N75, P100, N135 y la amplitud de P100. Todas las variables se distribuyeron de forma normal, excepto la amplitud de P100. Al realizarse el análisis estadístico no se encontraron diferencias significativas entre ambos ojos para las variables estudiadas. En cuanto al comportamiento con respecto a la edad, en ambos sexos se observó una disminución significativa de las latencias entre los 20 y 40 años. En el estudio de los resultados por sexo se observó una diferencia significativa en todas las variables, encontrándose latencias y amplitudes menores en el sexo femenino, con respecto al masculino. Los resultados obtenidos coinciden en su mayoría con los obtenidos en la literatura internacional revisada (AU)
Assuntos
Humanos , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Potenciais Evocados VisuaisRESUMO
Se presenta una revisión actualizada de las evidencias clínicas, anatómicas y experimentales del papel de distintas áreas de la corteza cerebral en la realización de la actividad motora voluntaria, haciéndose especial énfasis en los datos más recientes obtenidos en seres humanos sanos mediante el empleo de técnicas no invasivas como el flujo sanguíneo cerebral y el análisis de la actividad eléctrica cerebral. Se constata que el consenso actual en el ámbito internacional es que la participación de la corteza cerebral en la actividad motora es un proceso dinámico y multilocalizado en dependencia de las características específicas de la tarea a realizar, acorde a la teoría de los órganos funcionales de Anojin
Assuntos
Humanos , Córtex Cerebral/fisiologia , Atividade Motora/fisiologiaRESUMO
Se presentan los resultados del estudio de los potenciales evocados somatosensoriales de corta latencia por estimulación del nervio mediano de un grupo de sujetos sanos y en pacientes con lesiones en distintos niveles del sistema nerviosos que comprometían las vías de la sensibilidad somática
Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Potenciais Somatossensoriais Evocados , Nervo Mediano , Estimulação Elétrica Nervosa TranscutâneaRESUMO
Se presentan los resultados del estudio de los potenciales evocados somatosensoriales de corta latencia por estimulación del nervio mediano de un grupo de sujetos sanos y en pacientes con lesiones en distintos niveles del sistema nerviosos que comprometían las vías de la sensibilidad somática
Assuntos
Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Potenciais Somatossensoriais Evocados , Nervo Mediano , Estimulação Elétrica Nervosa TranscutâneaRESUMO
Se produce la obtención de los PEV ante la presentación de un optotipo cuadriculado en blanco y negro semejante a un tablero de ajedrez en un grupo de 10 sujetos sanos. Se describe la Morfología de los potenciales y se presentan los datos normativos correspondientes a los valores de latencia y amplitud de los componentes principales y a algunas medidas de la simetría entre los potenciales obtenidos con la estimulación de ojos distintos. Se discute la utilidad potencial de esta técnica en su aplicación al diagnóstico de afecciones de la vía visual (AU)
Assuntos
Adolescente , Adulto , Humanos , Masculino , Feminino , Potenciais Evocados VisuaisRESUMO
Se produce la obtención de los PEV ante la presentación de un optotipo cuadriculado en blanco y negro semejante a un tablero de ajedrez en un grupo de 10 sujetos sanos. Se describe la Morfología de los potenciales y se presentan los datos normativos correspondientes a los valores de latencia y amplitud de los componentes principales y a algunas medidas de la simetría entre los potenciales obtenidos con la estimulación de ojos distintos. Se discute la utilidad potencial de esta técnica en su aplicación al diagnóstico de afecciones de la vía visual
Assuntos
Adolescente , Adulto , Humanos , Masculino , Feminino , Potenciais Evocados VisuaisRESUMO
Se describe una técnica para el registro de los potenciales auditivos de corta latencia o potenciales evocados de tallo cerebral, presentándose los valores medios y desviaciones estándares de las latencias de los 7 componentes descritos y de las amplitudes de las ramas ascendentes y descendentes de la onda V. Se describe la influencia de los parámetros del estímulo auditivo sobre las amplitudes y latencias de los potenciales de tallo cerebral. Se observa un aumento paralelo en las latencias de todos los componentes al reducir la intensidad y la frecuencia del estímulo (AU)