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Alzheimer disease (AD) is the most prevalent form of dementia among elderly people. Owing to its varied and multicausal etiopathology, intervention strategies have been highly diverse. Despite ongoing advances in the field, efficient therapies to mitigate AD symptoms or delay their progression are still of limited scope. Neuroplasticity, in broad terms the ability of the brain to modify its structure in response to external stimulation or damage, has received growing attention as a possible therapeutic target, since the disruption of plastic mechanisms in the brain appear to correlate with various forms of cognitive impairment present in AD patients. Several pre-clinical and clinical studies have attempted to enhance neuroplasticity via different mechanisms, for example, regulating glucose or lipid metabolism, targeting the activity of neurotransmitter systems, or addressing neuroinflammation. In this review, we first describe several structural and functional aspects of neuroplasticity. We then focus on the current status of pharmacological approaches to AD stemming from clinical trials targeting neuroplastic mechanisms in AD patients. This is followed by an analysis of analogous pharmacological interventions in animal models, according to their mechanisms of action.
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Alzheimer's disease (AD) is a common form of dementia that leads to multiple repercussions in the patient's life. This condition's clinical characteristics include loss of memory, temporal and spatial disorientation, language or executive dysfunction, and subsequent decline of social function. Dysexecutive syndrome (DS), the second most frequent neuropsychological dysfunction in AD, affects multiple brain areas and causes cognitive, behavioral, and emotional difficulties. We aimed to analyze the association between DS and AD and elucidate possible lack of evidence that may urge further research on this theme. Especially when dealing with such a disabling disease, where new findings can directly imply a better prognosis.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Qualidade de Vida , Encéfalo , Testes NeuropsicológicosRESUMO
INTRODUCTION: Dementias, including Alzheimer´s disease (AD), are one of the leading causes of disability and mortality in older people. It is a growing health problem in low- and middle-income countries, where epidemiological information is scarce and deficient. The aim of this study was to analyze the burden of AD and other dementias in Mexico from 1990 to 2019 by sex, subnational level, and age groups. METHODS: A secondary analysis was conducted using data from the 2019 Global Burden of Disease, Injury, and Risk Factors Study (GBD). Data on prevalence, incidence, mortality, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALY) due to AD and other dementias were obtained. A joinpoint regression analysis was performed to describe the changes in the trend of age-standardized DALY rates by AD and other dementias during the analysis period. RESULTS: AD and other dementias ranked second among neurological disorders producing the most DALY in Mexico. Between 1990 and 2019, prevalence and incidence increased by almost 203%. In 2019, the age-standardized rate per 100,000 inhabitants was: 512 for prevalence, 79.3 for incidence, 73.3 for YLD, 256.9 for YLL and 272.2 for DALY. Likewise, five states concentrated 39% of AD and other dementias cases: Ciudad de México, Estado de México, Veracruz, Jalisco and Puebla. Differences were also observed by sex and age groups. DISCUSSION: Given that the number of older adults in Mexico will significantly rise over the next few decades, AD and other dementias represent one of the most important health challenges. The fact that epidemiological and demographic transformations take place in Mexico in a very diverse way makes it difficult for the country to adequately plan for the growing demands of both people with AD and other dementias and their families.
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Doença de Alzheimer , Humanos , Idoso , Doença de Alzheimer/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , México/epidemiologia , Carga Global da Doença , PrevalênciaRESUMO
Efforts have been made to diagnose and predict the course of different neurodegenerative diseases through various imaging techniques. Particularly tauopathies, where the tau polypeptide is a key participant in molecular pathogenesis, have significantly increased their morbidity and mortality in the human population over the years. However, the standard approach to exploring the phenomenon of neurodegeneration in tauopathies has not been directed at understanding the molecular mechanism that causes the aberrant polymeric and fibrillar behavior of the tau protein, which forms neurofibrillary tangles that replace neuronal populations in the hippocampal and cortical regions. The main objective of this work is to implement a novel quantification protocol for different biomarkers based on pathological post-translational modifications undergone by tau in the brains of patients with tauopathies. The quantification protocol consists of an adaptation of the U-Net neural network architecture. We used the resulting segmentation masks for the quantification of combined fluorescent signals of the different molecular changes tau underwent in neurofibrillary tangles. The quantification considers the neurofibrillary tangles as an individual study structure separated from the rest of the quadrant present in the images. This allows us to detect unconventional interaction signals between the different biomarkers. Our algorithm provides information that will be fundamental to understanding the pathogenesis of dementias with another computational analysis approach in subsequent studies.
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BACKGROUND: Dementia is a major public health problem. Estrogen is a regulator of the central nervous system and its deficit could be involved in cognitive decline in older women. OBJECTIVE: This study aimed to evaluate the association of bilateral oophorectomy, menopause hormone therapy (MHT) and other factors on mild cognitive impairment (MCI). METHOD: The case-control study included 941 otherwise healthy postmenopausal women aged 60 years and over from six Latin American countries. Personal and family data were recorded and MCI was assessed using the Montreal Cognitive Assessment test (MoCA). RESULTS: Average age, years of education and body mass index were 66.1 ± 5.8 years, 12.4 ± 5.0 years and 26.0 ± 4.3 kg/m2, respectively. A total of 30.2% had undergone bilateral oophorectomy and 40.3% had used MHT. A total of 232 women (24.7%) had MCI. The prevalence of MCI was higher in women with intact ovaries and non-MHT users as compared to MHT users (29.3% vs. 11.7% [odds ratio (OR) 0.32; 95% confidence interval (CI) 0.20-0.51]). Among oophorectomized women, MCI prevalence was higher among non-MHT users as compared to MHT users (45.2% vs. 12.8% [OR 0.18; 95% CI 0.10-0.32]). Logistic regression analysis determined that the variables associated with MCI were age >65 years (OR 1.69; 95% CI 1.20-2.38), parity (having >2 children; OR 1.69; 95% CI 1.21-2.37), bilateral oophorectomy (OR 1.56; 95% CI 1.09-2.24), hypertension (OR 1.41; 95% CI 1.01-1.96), being sexually active (OR 0.56; 95% CI 0.40-0.79), education >12 years (OR 0.46; 95% CI 0.32-0.65) and MHT use (OR 0.31; 95% CI 0.21-0.46). CONCLUSION: Age, parity, bilateral oophorectomy and hypertension are independent factors associated with MCI; contrary to this, higher educational level, maintaining sexual activity and using MHT are protective factors.
Assuntos
Disfunção Cognitiva , Hipertensão , Idoso , Estudos de Casos e Controles , Criança , Disfunção Cognitiva/epidemiologia , Feminino , Terapia de Reposição Hormonal , Humanos , Menopausa , Pessoa de Meia-Idade , OvariectomiaRESUMO
Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.
A síndrome de Ekbom, também conhecida como delírio parasitário ou parasitose psicogênica, é uma condição rara na qual os pacientes apresentam crença fixa de estarem infestados por parasitas, vermes ou insetos, acompanhada de alucinações táteis (como prurido ou sensação dos parasitas andando sobre ou sob a pele). A síndrome pode ocorrer de forma idiopática ou associada a outras condições médicas ou uso de drogas. Este relato de caso descreve a ocorrência da síndrome de Ekbom em um paciente diagnosticado com Demência com corpos de Lewy (DCL), uma doença degenerativa que comumente se apresenta com desordens de sensopercepção e pensamento, e outros sintomas neuropsiquiátricos. A alucinação visual é considerada um dos critérios diagnósticos nucleares, entretanto outras modalidades de sintomas psiquiátricos podem ocorrer criando desafios adicionais ao diagnóstico correto. O reconhecimento apropriado permite o diagnóstico precoce e tratamento adequado, prevenindo o uso arriscado de antipsicóticos nesses pacientes.
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ABSTRACT Ekbom Syndrome, also known as parasitosis delusion or psychogenic parasitosis, is a rare condition in which patients present with a fixed belief of being infested by parasites, vermin or small insects, along with tactile hallucinations (such as pruritus or sensations of the parasites crawling over or under the skin). The syndrome may occur idiopathically or be associated with other medical conditions and drug use. This case report describes the occurrence of Ekbom syndrome in a patient diagnosed with Lewy Body Dementia (LBD), a neurodegenerative disease that commonly presents with sensory perception and thought disorders and other neuropsychiatric symptoms. Although visual hallucination is considered a core diagnostic criterion, other modalities of psychiatric symptoms can also occur posing a further challenge for correct diagnosis. Proper recognition allows early diagnosis and adequate treatment, preventing hazardous antipsychotic use in these patients.
RESUMO A síndrome de Ekbom, também conhecida como delírio parasitário ou parasitose psicogênica, é uma condição rara na qual os pacientes apresentam crença fixa de estarem infestados por parasitas, vermes ou insetos, acompanhada de alucinações táteis (como prurido ou sensação dos parasitas andando sobre ou sob a pele). A síndrome pode ocorrer de forma idiopática ou associada a outras condições médicas ou uso de drogas. Este relato de caso descreve a ocorrência da síndrome de Ekbom em um paciente diagnosticado com Demência com corpos de Lewy (DCL), uma doença degenerativa que comumente se apresenta com desordens de sensopercepção e pensamento, e outros sintomas neuropsiquiátricos. A alucinação visual é considerada um dos critérios diagnósticos nucleares, entretanto outras modalidades de sintomas psiquiátricos podem ocorrer criando desafios adicionais ao diagnóstico correto. O reconhecimento apropriado permite o diagnóstico precoce e tratamento adequado, prevenindo o uso arriscado de antipsicóticos nesses pacientes.
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Humanos , Síndrome das Pernas Inquietas , Automutilação , Doença por Corpos de Lewy , Delírio , Demência , Delírio de ParasitoseRESUMO
Abstract Mental disorders (MD) are commonly comorbid with cardiovascular, metabolic, and some infectious diseases. Since the current SARS-CoV-2 epidemic is affecting the most multimorbid individuals, we might expect that the epidemic will be particularly problematic for people with MD. Understanding the burden of an outbreak on mental health is fundamental to effective action towards containing the spread of the disease, as psychopathology might reduce endurance during the lockdown. This can potentially reduce adhesion to ongoing treatment resulting in avoidable recurrence of a disorder. Additionally, there is the stress caused by the eminent risk of infection or economic uncertainty, especially in low-middle income settings. This is an overview on the expected influence of the COVID-19 on mental health from a research group that has not long ago been involved in the Zika epidemic. It aims to discuss the effects of the pandemic on a Low and Middle-Income country (LMIC), Brazil.
Resumo Os Transtornos Mentais (TM) são comorbidades comuns associadas a doenças cardiovasculares, metabólicas e algumas doenças infecciosas. Como a atual epidemia de SARS-CoV-2 está afetando mais os indivíduos multimórbidos, podemos esperar que a epidemia seja particularmente problemática para pessoas com TM. Compreender o ônus de um surto na saúde mental é fundamental para uma ação de contenção eficaz da propagação da doença, pois a psicopatologia pode reduzir a resistência durante o confinamento. Que pode potencialmente reduzir a adesão ao tratamento em andamento, resultando na recorrência evitável de um distúrbio. Além disso, há o estresse causado pelo risco eminente de infecção ou incerteza econômica, especialmente em ambientes de baixa e média renda. Esta é uma "overview" sobre a potencial influência do COVID-19 na saúde mental realizada por um grupo de pesquisa que não faz muito tempo esteve envolvido na epidemia de Zika. Ela tem como objetivo discutir os efeitos da pandemia do COVID-19 em um país de baixa e média renda, Brasil.
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Humanos , Pneumonia Viral/psicologia , Pneumonia Viral/epidemiologia , Saúde Mental , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/epidemiologia , Países em Desenvolvimento , Pandemias , Betacoronavirus , Sensação , Isolamento Social , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Brasil , Família , Cuidadores , Infecções por Coronavirus , Demência/enfermagem , Multimorbidade , Acessibilidade aos Serviços de Saúde , Transtornos Mentais/psicologia , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologiaRESUMO
RESUMEN Introducción: La demencia es un síndrome clínico, que se acompaña de trastornos neuropsiquiátricos y emocionales, la enfermedad de Alzheimer es la más frecuente. El cuidado de estos pacientes representa un desafío porque sus síntomas afectan la salud y calidad de vida del cuidador, así como sobrecarga. Objetivo: Identificar la relación que existe entre los síntomas psicológicos-conductuales de pacientes con enfermedad de Alzheimer leve y moderada, y la sobrecarga percibida por sus cuidadores principales. Métodos: Estudio descriptivo correlacional en el Policlínico "Carlos Manuel Portuondo" del municipio Marianao desde enero de 2010 hasta septiembre de 2012, en un universo de 35 cuidadores principales de pacientes con enfermedad de Alzheimer en los estadios leve y moderado, seleccionados por un muestreo por conveniencia. La información fue recolectada con el uso del Inventario Neuropsiquiátrico y la Escala de Zarit. Para el procesamiento y análisis estadístico de la información se confeccionaron tablas de frecuencia absoluta, porcentaje. Se evaluó la asociación a través de la prueba paramétrica coeficiente de correlación de Pearson (r). Resultados: Se evidenció correlación positiva débil para las variables repeticiones (r= 0,412) (s=0,014), depresión (r= 0,269) (s=0,118), agitación o agresión (r= 0,433) (s=0,009), desinhibición (r=0,433) (s=0,009), irritabilidad (r=0,433) (s=0,009), ansiedad (r= 0,331) (s=0,052), apatía (r= 0,416) (s=0,013) y delusiones (r= 0,242) (s=0,151); y correlación positiva media para las alucinaciones (r=0,589) (s=0,000). Conclusión: Se identificó relación entre algunos síntomas psicológicos y conductuales de los pacientes con enfermedad de Alzheimer y la sobrecarga percibida por sus cuidadores principales(AU)
ABSTRACT Introduction: Dementia is a clinical syndrome characterized by neuropsychiatric and emotional disorders and the Alzheimer's disease is the cause more frequent. This means a challenge in the care of these patients because of its symptom affect the caregiver's health and quality of life, and this causes them overload. Objective: to identify the relationship between psychological-behavioral symptoms in patients with Alzheimer diseases and the overload perceived by its principal caregivers. Methods: a descriptive and correlative study of 35 principal caregivers of patients with minor and moderate Alzheimer disease from the policlinic "Carlos Manuel Portuondo" of Marianao municipality, from January of 2010 to September of 2012, they were select by a self - interest sampling. The information was picked up with the Neuropsychiatric inventory and the Zarit scale; it was processing with absolute and percentage frequency distributions, also the association were evaluated with the Pearson Correlation coefficient (r). Results: It was show a weak positive relationship for the repetitions (r= 0.412) (s=0.014), the depression (r= 0.269) (s=0.118), the agitation or aggression (r= 0.433) (s=0.009), the disinhibition (r=0.433) (s=0.009), the irritability (r=0.433) (s=0.009), anxiety (r= 0.331) (s=0.052), the apathy (r= 0.416) (s=0.013) and the delusions (r= 0.242) (s=0.151); and a mean positive relationship for the hallucinations (r=0.589) (s=0.000). Conclusions: It was identifying the relationship between some psychological-behavioral symptoms in patients with Alzheimer diseases and the overload perceived by its principal caregivers(AU)
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Humanos , Ansiedade/etiologia , Cuidadores/psicologia , Demência/epidemiologia , Doença de Alzheimer/diagnóstico , Epidemiologia Descritiva , Interpretação Estatística de DadosRESUMO
RESUMEN Introducción: Las demencias constituyen unos de los problemas de salud pública más importantes del siglo XXI, la enfermedad de Alzheimer es la causa más frecuente. El mayor costo es el humano, en especial, los cuidadores principales, que contraen riesgos sobre la salud física y mental, provocándole depresión. Objetivo: Identificar la relación que existe entre la depresión y algunas características sociodemográficas de los cuidadores principales. Métodos: Estudio descriptivo correlacional en el Policlínico "Carlos Manuel Portuondo" del municipio Marianao, desde enero de 2010 hasta septiembre de 2012, en un universo de 35 cuidadores principales de pacientes con enfermedad de Alzheimer en estadios leve y moderado. La información se obtuvo con el Cuestionario sociodemográfico y clínico, e Inventario de depresión de Beck, se procesó y analizó con frecuencias absolutas y porcentaje. Se evaluó la asociación a través de la prueba paramétrica coeficiente de correlación de Pearson. Resultados: De los 35 cuidadores principales, el 82,85 por ciento pertenecían al sexo femenino; el 60,00 por ciento eran las hijas; el 45,71 por ciento tenía 60 años y más, sin vínculo laboral (85,71 por ciento), con un nivel superior de escolaridad (45,71 por ciento) y el 68,60 por ciento no recibía apoyo en el cuidado del paciente; el 37,10 por ciento mostró depresión leve. Se evidenció correlación negativa y positiva débil entre la depresión y algunas de las características sociodemográficas y clínicas del cuidador principal. Conclusión: Se identificó relación negativa y positiva débil entre la depresión y algunas características sociodemográficas de los cuidadores principales de pacientes con enfermedad de Alzheimer(AU)
ABSTRACT Introduction: Dementias are one of the issues most important public health of the century, Alzheimer's disease is the most common cause. The biggest cost is the human, especially primary caregivers, who contract risks on physical and mental health, causing depression. Objective: To identify the relationship between depression and some sociodemographic characteristics of the main caregivers. Methods: Descriptive correlational Polyclinic "Carlos Manuel Portuondo" Marianao municipality, from January 2010 to September 2012, in a universe of 35 primary caregivers of patients with Alzheimer's disease in mild and moderate. The information was obtained with the sociodemographic and clinical questionnaire, and Beck Depression Inventory, processed and analyzed with absolute and percentage frequencies. The association through parametric test Pearson correlation coefficient was evaluated. Results: Of the 35 primary caregivers the 82.85 percent were female; The 60.00 percent were daughters; 45.71 percent were 60 years and over, without employment (85.71 percent), with a higher level of education (45.71 percent) and 68.60 percent did not receive support patient care; the 37.10 percent showed mild depression. negative and weak positive correlation was found between depression and some sociodemographic and clinical characteristics of primary caregiver. Conclusion: Negative and weak positive relationship between depression and some sociodemographic of primary caregivers of patients with Alzheimer's disease characteristics were identified(AU)
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Humanos , Feminino , Pessoa de Meia-Idade , Cuidadores/psicologia , Depressão/epidemiologia , Doença de Alzheimer/etiologia , Epidemiologia DescritivaRESUMO
ABSTRACT Background: Creutzfeldt-Jakob Disease (CJD) is the prototypical cause of rapidly progressive dementia (RPD). Nonetheless, efforts to exclude reversible causes of RPD that mimic prion disease are imperative. The recent expanding characterization of neurological syndromes associated with antibodies directed against neuronal cell surface or sympathic antigens, namely autoimmune encephalitis is shifting paradigms in neurology. Such antigens are well known proteins and receptors involved in synaptic transmission. Their dysfunction results in neuropsychiatric symptoms, psychosis, seizures, movement disorders and RPD. Faciobrachial dystonic seizure (FBDS) is a novel characterized type of seizure, specific for anti-LGI1 encephalitis. Objective: In order to improve clinical recognition we report the cases of two Brazilian patients who presented with characteristic FDBS (illustrated by videos) and anti-LGI1 encephalitis. Methods: We have included all patients with FBDS and confirmed anti-LGI1 encephalitis and video records of FDBS in two tertiary Brazilian centers: Department of Neurology of Hospital das Clínicas, Sao Paulo University, Sao Paulo, Brazil and Hospital Geral de Fortaleza, Fortaleza, Brazil between January 1, 2011 and December 31, 2015. Results: Both patients presented with clinical features of limbic encephalitis associated with FBDS, hyponatremia and normal CSF. None of them presented with tumor and both showed a good response after immunotherapy. Conclusion: FBDSs may be confounded with myoclonus and occurs simultaneously with rapid cognitive decline. Unawareness of FDBS may induce to misdiagnosing a treatable cause of RPD as CJD.
RESUMO Embasamento: A doença de Creutzfeldt-Jakob (DCJ) é o protótipo de demência rapidamente progressiva (DRP). No entanto, é imperativo que sejam excluídas causas reversíveis de DRPs que possam simular doença priônica. A recente caracterização de síndromes neurológicas associadas a anticorpos direcionados contra antígenos de superfície neuronal ou sinapse, assim denominadas de encefalites autoimunes, está mudando paradigmas em neurologia. Esses antígenos estão envolvidos na transmissão sináptica, sendo que as disfunções destes podem resultar em sintomas neuropsiquiátricos, psicose, crises epilépticas, distúrbios do movimento e DRP. A crise distônica faciobraquial (CDFB) é um tipo de crise recentemente caracterizada e específica da encefalite anti-LGI1. Objetivo: Para promover um melhor reconhecimento da doença relatamos os casos de 2 pacientes brasileiros que apresentaram CDFBs (ilustradas com vídeos) associadas à encefalite anti-LGI1. Métodos: Foram incluídos todos os pacientes com CDFBs e encefalite anti-LGI1 confirmados em 2 centros brasileiros terciários: Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil e o Hospital Geral de Fortaleza entre 01 de janeiro de 2011 e 31 de dezembro de 2015. Resultados: Ambos os casos apresentaram quadro clinico típico de encefalite límbica associada a CDFBs e exame do LCR sem alterações. Nenhum caso associou-se à presença de neoplasia e ambos apresentaram boa resposta à imunoterapia. Conclusão: A CDFB podem ser confundidas com mioclonias e ocorrer simultaneamente com rápido declínio cognitivo, o seu não reconhecimento pode induzir ao diagnóstico errôneo de uma causa potencialmente tratável de DRP como sendo DCJ.
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Humanos , Demência , EncefaliteRESUMO
BACKGROUND: Creutzfeldt-Jakob Disease (CJD) is the prototypical cause of rapidly progressive dementia (RPD). Nonetheless, efforts to exclude reversible causes of RPD that mimic prion disease are imperative. The recent expanding characterization of neurological syndromes associated with antibodies directed against neuronal cell surface or sympathic antigens, namely autoimmune encephalitis is shifting paradigms in neurology. Such antigens are well known proteins and receptors involved in synaptic transmission. Their dysfunction results in neuropsychiatric symptoms, psychosis, seizures, movement disorders and RPD. Faciobrachial dystonic seizure (FBDS) is a novel characterized type of seizure, specific for anti-LGI1 encephalitis. OBJECTIVE: In order to improve clinical recognition we report the cases of two Brazilian patients who presented with characteristic FDBS (illustrated by videos) and anti-LGI1 encephalitis. METHODS: We have included all patients with FBDS and confirmed anti-LGI1 encephalitis and video records of FDBS in two tertiary Brazilian centers: Department of Neurology of Hospital das Clínicas, Sao Paulo University, Sao Paulo, Brazil and Hospital Geral de Fortaleza, Fortaleza, Brazil between January 1, 2011 and December 31, 2015. RESULTS: Both patients presented with clinical features of limbic encephalitis associated with FBDS, hyponatremia and normal CSF. None of them presented with tumor and both showed a good response after immunotherapy. CONCLUSION: FBDSs may be confounded with myoclonus and occurs simultaneously with rapid cognitive decline. Unawareness of FDBS may induce to misdiagnosing a treatable cause of RPD as CJD.
EMBASAMENTO: A doença de Creutzfeldt-Jakob (DCJ) é o protótipo de demência rapidamente progressiva (DRP). No entanto, é imperativo que sejam excluídas causas reversíveis de DRPs que possam simular doença priônica. A recente caracterização de síndromes neurológicas associadas a anticorpos direcionados contra antígenos de superfície neuronal ou sinapse, assim denominadas de encefalites autoimunes, está mudando paradigmas em neurologia. Esses antígenos estão envolvidos na transmissão sináptica, sendo que as disfunções destes podem resultar em sintomas neuropsiquiátricos, psicose, crises epilépticas, distúrbios do movimento e DRP. A crise distônica faciobraquial (CDFB) é um tipo de crise recentemente caracterizada e específica da encefalite anti-LGI1. OBJETIVO: Para promover um melhor reconhecimento da doença relatamos os casos de 2 pacientes brasileiros que apresentaram CDFBs (ilustradas com vídeos) associadas à encefalite anti-LGI1. MÉTODOS: Foram incluídos todos os pacientes com CDFBs e encefalite anti-LGI1 confirmados em 2 centros brasileiros terciários: Departamento de Neurologia do Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brasil e o Hospital Geral de Fortaleza entre 01 de janeiro de 2011 e 31 de dezembro de 2015. RESULTADOS: Ambos os casos apresentaram quadro clinico típico de encefalite límbica associada a CDFBs e exame do LCR sem alterações. Nenhum caso associou-se à presença de neoplasia e ambos apresentaram boa resposta à imunoterapia. CONCLUSÃO: A CDFB podem ser confundidas com mioclonias e ocorrer simultaneamente com rápido declínio cognitivo, o seu não reconhecimento pode induzir ao diagnóstico errôneo de uma causa potencialmente tratável de DRP como sendo DCJ.
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El envejecimiento de la población y probables factores ligados a sus estilos de vida parecen ser de-terminantes en la presentación de la Enfermedad de Alzheimer que viene teniendo una tenden-cia de crecimiento en la frecuencia de ocurrencia en la población que resulta afectada no solo en sus desempeños cognitivos sino en condiciones de movimiento que conjuntamente van a limitar la calidad de vida de las personas afectadas por la entidad. Objetivo. Conocer la prevalencia de la enfermedad de Alzheimer entre las entidades neurológicas atendidas en Fisioterapia. Método. Se desarrolló un estudio transversal con los pacientes mayores de 15 años atendidos por causa de afecciones neurológicas en los servicios de Fisioterapia donde se daban Practicas del Programa de Fisioterapia de la Universidad Manuela Beltrán entre febrero y noviembre de 2012, calculando la prevalencia y ocurrencia de la enfermedad de Alzheimer por género. Resultados. Durante el periodo de tiempo del estudio se atendieron un total 1062 personas a causa de enfermedades neurológicas, 19.67% de estas personas registraron como motivo de remisión a Fisioterapia la En-fermedad de Alzheimer (n=209, Error Estándar=0.02), correspondiendo un 77.51% de las personas con esta patología al genero femenino (n=162, Error Estándar=0.01) Conclusiones La enfermedad de Alzheimer tiene una prevalencia importante dentro de las entidades neurológicas, y muestra un predominio en su presentación en las mujeres
The aging of the population and probable factors related to their lifestyles seem to be decisive in the presentation of Alzheimer's disease that has taken an upward trend in the frequency of occurrence in the population that is affected not only in their cognitive performance but able to move that joint will limit the quality of life of people affected by the entity Objective To know the prevalence of Alzheimer disease between the neurological diseases served in the Physical Therapy Services Methodology developed a cross-sectional study of patients older than 15 years treated because of neurological physiotherapy services in which they practiced the Physiothera-py Program Manuela Beltran University between February and November 2012, calculating the prevalence and occurrence of Alzheimer's disease by gender Results During the study period a total 1062 were met people because of neurological diseases, 19.67% of these people recorded as a reason for referral to Physical Therapy Alzheimer's Disease (n = 209, Standard Error = 0.02), corresponding 77.51% of people with this condition the female gender (n = 162, Standard Error = 0.01) Conclusions the disease Alzheimer's is a significant prevalence in neurological entities, and is predominantly in its presentation in women.
Assuntos
Humanos , Doença de Alzheimer , Idoso , Neurologia , Especialidade de FisioterapiaRESUMO
A população idosa é a que mais cresce em todo o mundo. Com os avanços da medicina e novas noções de qualidade de vida, a expectativa de vida foi aumentando. Por essa razão, a medicina viu-se diante de um novo desafio: o aumento de enfermidades neurovegetativas,que na maioria dos casos, estão ligadas ao processo de envelhecimento. Dentre as doenças do envelhecimento, a doença de Alzheimer é de alta prevalência e tornou-se um problema de saúde pública. Atualmente cerca de 35 milhões de pessoas no mundo são portadoras de algum tipo de demência, sendo essa uma patologia que envolve perda de memória e acarreta distúrbios cognitivos importantes. Diante disso, o objetivo deste trabalho foi verificar a literatura existente no que se refere à prevenção das demências ou ao atraso da instalação de um quadro demencial. Estudos recentes mostram relações entre dieta, depressão, risco cardiovascular, engajamento social, atividades intelectuais, atividade física e a probabilidade de desenvolvimento de Alzheimer da população. A necessidade de estudos adicionais é importante para o esclarecimento da relação desses fatores com a prevenção ou o atraso das demências, em especial da doença de Alzheimer.
The elderly population is the fastest growing worldwide. With medical advances and new concepts of quality of life, life expectancy has been increasing. And on that basis, the medicine confronted a new challenge: the rise of neurodegenerative diseases, which in most cases, are linked to the aging process. Among the diseases of aging, Alzheimers disease is highly prevalent and has become a public health problem. Currently, about 35 million people worldwide are suffering from some form of dementia. This pathology involves loss of memory and leads to important cognitive disorders. Therefore, the objective of this study was to verify the existing literature regarding the prevention of dementias or the delaying of the installation of a dementia. Recent studies show links between diet, depression, cardiovascular risk, social engagement, intellectual activities, physical activity and the likelihood of developing Alzheimers population. The need for additional studies is important for clarifying the relationship of these factors to the prevention or delay of dementias, especially Alzheimers Disease.
Assuntos
Doença de Alzheimer/prevenção & controleRESUMO
A população idosa é a que mais cresce em todo o mundo. Com os avanços da medicina e novas noções de qualidade de vida, a expectativa de vida foi aumentando. Por essa razão, a medicina viu-se diante de um novo desafio: o aumento de enfermidades neurovegetativas,que na maioria dos casos, estão ligadas ao processo de envelhecimento. Dentre as doenças do envelhecimento, a doença de Alzheimer é de alta prevalência e tornou-se um problema de saúde pública. Atualmente cerca de 35 milhões de pessoas no mundo são portadoras de algum tipo de demência, sendo essa uma patologia que envolve perda de memória e acarreta distúrbios cognitivos importantes. Diante disso, o objetivo deste trabalho foi verificar a literatura existente no que se refere à prevenção das demências ou ao atraso da instalação de um quadro demencial. Estudos recentes mostram relações entre dieta, depressão, risco cardiovascular, engajamento social, atividades intelectuais, atividade física e a probabilidade de desenvolvimento de Alzheimer da população. A necessidade de estudos adicionais é importante para o esclarecimento da relação desses fatores com a prevenção ou o atraso das demências, em especial da doença de Alzheimer.(AU)
The elderly population is the fastest growing worldwide. With medical advances and new concepts of quality of life, life expectancy has been increasing. And on that basis, the medicine confronted a new challenge: the rise of neurodegenerative diseases, which in most cases, are linked to the aging process. Among the diseases of aging, Alzheimers disease is highly prevalent and has become a public health problem. Currently, about 35 million people worldwide are suffering from some form of dementia. This pathology involves loss of memory and leads to important cognitive disorders. Therefore, the objective of this study was to verify the existing literature regarding the prevention of dementias or the delaying of the installation of a dementia. Recent studies show links between diet, depression, cardiovascular risk, social engagement, intellectual activities, physical activity and the likelihood of developing Alzheimers population. The need for additional studies is important for clarifying the relationship of these factors to the prevention or delay of dementias, especially Alzheimers Disease.(AU)