Repositorio Institucional Fleni
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Cutaneous amyloid is a biomarker in early ATTRv neuropathy and progresses across disease stages
No full textObjective: To determine the sensitivity and specificity of cutaneous amyloid deposition in relation to patient-reported measures in the earliest disease stage of hereditary ATTR amyloidosis (ATTRv).
Methods: In a cross-sectional study, we analyzed 88 individuals with TTR mutations, 47 of whom were in the earliest disease stage and without clinically evident neuropathy, 12 healthy controls, and 13 disease controls with diabetes. All participants' neuropathy symptoms and signs were assessed using validated patient and clinician-reported measures and 3-mm skin punch biopsies were immunostained using protein gene product 9.5 and Congo Red.
Results: Amyloid can be detected in the earliest disease stages in up to 86% of patients with ATTRv amyloidosis. Amyloid was not detected in healthy individuals or individuals with diabetic peripheral neuropathy supporting a sensitivity of 86% and a specificity of 100%. The cutaneous deposition of amyloid correlates with neuropathy sensory symptoms, measured with the Neuropathy Total Symptom Score-6 (R = 0.46, p < 0.01); pain measured with the Brief Pain Symptom Inventory (R = 0.44, p < 0.05); autonomic symptoms, measured with the Boston Autonomic Symptom Questionnaire (R = 0.38, p < 0.05); and quality of life measured with the Norfolk Diabetic Neuropathy Quality of Life Questionnaire (R = 0.44, p < 0.05). Individuals with amyloid deposition were more likely to have sensory symptoms, pain, autonomic impairment, and reduced quality of life than ATTRv patients without amyloid deposition.
Interpretation: These findings have implications for understanding the earliest manifestations of the clinical phenotype of ATTRv-associated neuropathy, for the pathophysiological construct of disease staging, and for timing the introduction of disease-modifying therapy.Fil: Barroso, Fabio Adrián. Fleni. Departamento de Neurología; Argentina.Fil: Freeman, Roy. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: González-Duarte, Alejandra. Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán; México.Fil: Campagnolo, Marta. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: Rajan, Sharika. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: Garcia, Jennifer. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: Young Kim, Jee. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: Wang, Ningshan. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos.Fil: Orellana, Lucas. Fleni. Departamento de Neurología; Argentina.Fil: Gibbons, Christopher. Harvard Medical School. Beth Israel Deaconess Medical Center; Estados Unidos
Theory of mind, emotion recognition and emotional reactivity factors in early multiple sclerosis: Results from a South American cohort
No full textObjectives: To study different components of social cognition and quality of life in patients with early multiple sclerosis and low Expanded Disability Status Scale and to test the influence of cognitive performance, fatigue and neuropsychiatric symptoms on social cognition performance.
Methods: Thirty-four patients with relapsing-remitting MS, with ≤2 years of disease duration and scores ≤2 on the EDSS and 30 healthy controls underwent neuropsychological assessment with the Brief Repeatable Neuropsychological Test Battery. Components of social cognition, such as emotion recognition, theory of mind, empathy, and emotional reactivity, were assessed with the Reading the Mind in the Eyes test, the Faux Pas task, the International Affective Imagery System, and the Empathy Quotient. Anxiety, depression, fatigue and quality of life were measured.
Results: Patients showed significant differences in verbal memory, executive functions and social cognition, especially emotion recognition and ToM. Regarding emotional reactivity, patients showed a positive bias in the interpretation of the valence of neutral images.
Conclusions: Patients with early MS showed impairments in several components of social cognition independent of cognitive performance, neuropsychiatric symptoms and fatigue. Social cognition deficits may be present in MS even in the early stages.Fil: Crivelli, Lucía. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Calandri, Ismael Luis. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Helou, Belén. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Corvalán, Nicolás. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; ArgentinaFil: Fiol, Marcela Paula. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Ysrraelit, María Célica. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Gaitan, María Inés. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Negrotto, Laura. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Farez, Mauricio Franco. Fleni. Centro para la Investigación de Enfermedades Neuroinmunológicas; Argentina.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentin
Multiple system atrophy laryngeal stridor treated with radiofrequency-assisted posterior cordotomy and arytenoidectomy
No full textFil: Castillo-Torres, Sergio Andrés. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina.Fil: Viti, María. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno; Argentina.Fil: Martínez-Villota, Viviana Alexandra. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina.Fil: Rossi, Malco. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Merello, Marcelo. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Católica Argentina; Argentina
Evaluation of the times of disability progression and related factors in patients with primary progressive multiple sclerosis from Argentina
No full textBackground PPMS (primary progressive multiple sclerosis) patients represent less than 10% of MS patients in Argentina, men and women were similarly affected and most of them had a severe functional impairment. More rapid progression has been reported in males, but this is not the case in all datasets. The main objective of our study was to determine the time to EDSS (Expanded disability Status Scale) 4, 6 and 7 in PPMS patients. We also compared the times to reach these EDSS in men and women and aimed to identify factors associated with the disability progression. Method This cohort of patients with diagnosis of PPMS (n = 253) was selected from follow-up recorded in the RelevarEM registry database. Result The median times to EDSS 4, 6 and 7 were 24 (IQR 12-48), 72 (IQR 36-96) and 96 (IQR 60-120) months, respectively. Comparison of the survival curves to EDSS 4, 6 and 7 according to gender did not show significant differences (p = 0.33, p = 0.55 and p = 0.59). There is no evidence of an association between the clinical adjustment variables (sex, age >40 years at diagnosis, EDSS > 3 at onset and multifocal MS symptoms at disease onset) and the time of arrival at the EDSS 4, 6 and 7. Conclusion Severe disability was observed six years after the onset of symptoms. No association was found between the studied factors and the time to arrival to severe disability.Fil: Alonso, Ricardo. Hospital Ramos Mejía; Argentina.Fil: Garcea, Orlando. Hospital Ramos Mejía; Argentina.Fil: Rojas, Juan Ignacio. CEMIC; Argentina.Fil: Alonso, Marina. Hospital Italiano; Argentina.Fil: Lázaro, Luciana. Sanatorio Güemes; Argentina.Fil: López, Pablo. Hospital Alemán; Argentina.Fil: Casas, Magdalena. Hospital Ramos Mejía; Argentina.Fil: Tkachuk, Verónica. Hospital de Clínicas; Argentina.Fil: Steinberg, Judith. Hospital Británico; Argentina.Fil: Barboza, Andrés G. Hospital Central de Mendoza; Argentina.Fil: Martínez, Alejandra. Hospital Británico; Argentina.Fil: Ysrraelit, María Célica. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Marrodán, Mariano. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Chertcoff, Aníbal. Hospital Británico; Argentina.Fil: Deri, Norma. Diabaid; Argentina.Fil: Miguez, Jimena. Hospital Italiano; Argentina.Fil: Patrucco, Liliana. CEMBA; Argentina.Fil: Cristiano, Edgardo. CEMBA; Argentina.Fil: Pestchanker, Claudia. Hospital Central Ramón Carrillo; Argentina
Information theory approaches to improve glioma diagnostic workflows in surgical neuropathology
No full textAims: Resource-strained healthcare ecosystems often struggle with the adoption of the World Health Organization (WHO) recommendations for the classification of central nervous system (CNS) tumors. The generation of robust clinical diagnostic aids and the advancement of simple solutions to inform investment strategies in surgical neuropathology would improve patient care in these settings.
Methods: We used simple information theory calculations on a brain cancer simulation model and real-world data sets to compare contributions of clinical, histologic, immunohistochemical, and molecular information. An image noise assay was generated to compare the efficiencies of different image segmentation methods in H&E and Olig2 stained images obtained from digital slides. An auto-adjustable image analysis workflow was generated and compared with neuropathologists for p53 positivity quantification. Finally, the density of extracted features of the nuclei, p53 positivity quantification, and combined ATRX/age feature was used to generate a predictive model for 1p/19q codeletion in IDH-mutant tumors.
Results: Information theory calculations can be performed on open access platforms and provide significant insight into linear and nonlinear associations between diagnostic biomarkers. Age, p53, and ATRX status have significant information for the diagnosis of IDH-mutant tumors. The predictive models may facilitate the reduction of false-positive 1p/19q codeletion by fluorescence in situ hybridization (FISH) testing.
Conclusions: We posit that this approach provides an improvement on the cIMPACT-NOW workflow recommendations for IDH-mutant tumors and a framework for future resource and testing allocation.Fil: Arakaki, Naomi. Fleni. Departamento de Neuropatología y Biología Molecular; Argentina.Fil: Martinetto, Horacio. Fleni. Departamento de Neuropatología y Biología Molecular; Argentina.Fil: Cevik, Lokman. The Ohio State University Wexner Medical Center. Department of Pathology; Estados Unidos.Fil: Vazquez Landrove, Marilyn. The Ohio State University, Columbus. Mathematical Biosciences Institute; Estados Unidos.Fil: Tahir Aslan, Mehmet. The Ohio State University Wexner Medical Center. Department of Pathology; Estados Unidos.Fil: Khammad, Vasilii. Peoples' Friendship University of Russia; Rusia.Fil: Garagorry Guerra, Francisco Jose. Hospital de Clínicas Manuel Quintela. Universidad de la República. Facultad de Medicina. Cátedra de Anatomía Patológica; Uruguay.Fil: Cabello-Izquierdo, Yolanda. The Ohio State University Wexner Medical Center. Department of Pathology; Estados Unidos.Fil: Wang, Wesley. The Ohio State University Wexner Medical Center. Department of Pathology; Estados Unidos.Fil: Zhao, Jing. The Ohio State University College of Medicine. Department of Biomedical Informatic; Estados Unidos.Fil: Paixao Becker, Aline. Barretos Cancer Hospital. Pathology Department; Brasil.Fil: Czeisler, Catherine. The Ohio State University Wexner Medical Center. Department of Pathology; Estados Unidos.Fil: Costa Rendeiro, Anne. Fil: Paixao Becker, Aline. Barretos Cancer Hospital. Pathology Department; Brasil.Fil: Sousa Véras, Lucas Luis. Fil: Paixao Becker, Aline. Barretos Cancer Hospital. Pathology Department; Brasil.Fil: Zanon, Maicon Fernando. Barretos Cancer Hospital. Molecular Oncology Research Center; Brasil.Fil: Reis, Rui Manuel. Barretos Cancer Hospital. Molecular Oncology Research Center; Brasil. University of Minho. School of Medicine. Life and Health Sciences Research Institute; Portugal.Fil: De Medeiros Matsushita, Marcus. MultiPat Laboratório de Anatomia Patológica; Brasil.Fil: Ozduman, Koray. Acibadem MAA University. Department of Neurosurgery; Turquía.Fil: Pamir, M. Necmettin. Acıbadem University School of Medicine. Department of Pathology; Turquía.Fil: Ersen Danyeli, Ayca. Acıbadem University School of Medicine. Department of Pathology; Turquía
Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
No full textBackground and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.
Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020).
Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths.
Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.Fil: Pujol Lereis, Virginia Andrea. Fleni. Centro Integral de Neurología Vascular; Argentina.Fil: Nguyen, Thanh N. Boston University School of Medicine. Boston Medical Center. Department of Neurology; Estados Unidos. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos.Fil: Qureshi, Muhammad M. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos. Boston University School of Medicine. Boston Medical Center. Department of Radiation Oncology; Estados Unidos.Fil: Klein, Piers. Boston University School of Medicine. Boston Medical Center. Department of Neurology; Estados Unidos. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos.Fil: Yamagami, Hiroshi. Osaka National Hospital. National Hospital Organization. Department of Stroke Neurology: Japón.Fil: Abdalkader, Mohamad. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos.Fil: Mikulik, Robert. St. Anne's University Hospital and Faculty of Medicine. International Clinical Research Center. Department of Neurology; República Checa.Fil: Sathya, Anvitha. Boston University School of Medicine. Boston Medical Center. Department of Neurology; Estados Unidos. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos.Fil: Mansour, Ossama Yassin. Alexandria University. Department of Neurology; Egipto.Fil: Czlonkowska, Anna. Institute of Psychiatry and Neurology. Department of Neurology; Polonia.Fil: Lo, Hannah. Boston University School of Medicine. Boston Medical Center. Department of Neurology; Estados Unidos. Boston University School of Medicine. Boston Medical Center. Department of Radiology; Estados Unidos.Fil: Field, Thalia S. University of British Columbia. Division of Neurology, Dept. Medicine; Canadá.Fil: Charidimou, Andreas. Boston University School of Medicine. Boston Medical Center. Department of Neurology; Estados Unidos.Fil: Banerjee, Soma. Imperial College Healthcare NHS Trust. Charing Cross Hospital. Department of Stroke Medicine; Reino Unido.Fil: Yaghi, Shadi. Brown University. Rhode Island Hospital. Department of Neurology; Estados Unidos.Fil: Siegler, James E. Cooper University. Department of Neurology; Estados Unidos.Fil: Sedova, Petra. St. Anne's University Hospital and Faculty of Medicine. International Clinical Research Center. Department of Neurology; República Checa.Fil: Kwan, Joseph. Imperial College Healthcare NHS Trust. Charing Cross Hospital. Department of Stroke Medicine; Reino Unido.Fil: Aguiar de Sousa, Diana. North Lisbon University Hospital Center. Hospital de Santa María. Department of Neurology; Portugal.Fil: Demeestere, Jelle. Leuven University Hospital. Neurology Department; Bélgica
Patrón electrocardiográfico prevalente en pacientes con miocardiopatía hipertrófica y arritmias auriculares distintas a fibrilación auricular
No full textIntroducción y Objetivo. El trazado electrocardiográfico juega un rol importante en el diagnóstico y la estratificación pronóstica de los pacientes con Miocardiopatía Hipertrófica. Los signos electrocardiográficos presentes en dichos pacientes y su correlación con la prevalencia de arritmias auriculares aisladas y en salvas autolimitadas podrían crear un patrón predictor de Fibrilación Auricular. Material y Método. Estudio observacional, descriptivo, transversal, y de correlación estadística de pacientes españoles y argentinos con MCH en quienes se realizó anamnesis, examen físico, electrocardiograma, Ecocardiograma Doppler transtorácico y estudio Holter. Resultados. Se incluyeron 117 pacientes, edad media 47 años, 56% de sexo masculino. La prevalencia de extrasístoles auriculares aisladas fue del 79,8%, alta densidad de las mismas 14,9%, pares auriculares el 47,3%, salvas auriculares autolimitadas el 38,9%, Aleteo Auricular 4,7%, y Arritmias Auriculares Distintas a Fibrilación Auricular (AADFA) 57,7%. Los signos electrocardiográficos que se correlacionaron estadísticamente con la presencia de AADFA fueron la onda P ≥100ms, dispersión de onda P 80ms, presencia de alta densidad de Extrasistolia Ventricular Aislada y salvas de Taquicardias Ventriculares No Sostenidas en estudio Holter. La presencia de ondas Q patológicas evidenció sólo una tendencia estadística. Conclusiones. En pacientes con Miocardiopatía Hipertrófica, las arritmias auriculares distintas a Fibrilación Auricular evidenciaron una elevada prevalencia y se asociaron al patrón electrocardiográfico compuesto por onda P ≥100ms, dispersión de P 80ms, EV >10/hora, y salvas de TVNS. Dicho patrón podría asociarse al desarrollo de FA en pacientes con MCH.Fil: Abello, Mauricio S. Fleni. Servicio de Cardiología; Argentina.Fil: Moreno, Gerardo A. Instituto de Cardiología y Cirugía Cardiovascular; Argentina. Universidad Católica de las Misiones; Argentina. Hospital Universitario Ramón y Cajal; España.Fil: Doxastakis Florida, Griselda B. Instituto de Cardiología y Cirugía Cardiovascular; Argentina.Fil: Lépori, Augusto J. Instituto de Cardiología y Cirugía Cardiovascular; Argentina. Universidad Católica de las Misiones; Argentina.Fil: Amigo Gottschalk, Romina. Instituto de Cardiología y Cirugía Cardiovascular; Argentina. Universidad Católica de las Misiones; Argentina.Fil: Baez, Julio D. Instituto de Cardiología y Cirugía Cardiovascular; Argentina. Universidad Católica de las Misiones; Argentina.Fil: Pedroso, Williams R. Universidad Católica de las Misiones; Argentina.Fil: Fleitas Paez, Maximiliano. Instituto de Cardiología y Cirugía Cardiovascular; Argentina.Fil: Ramirez, Héctor M. Instituto de Cardiología y Cirugía Cardiovascular; Argentina
La necesidad de la detección temprana de la hipertensión arterial pulmonar
No full textPulmonary arterial hypertension (PAH), Group 1 of the pulmonary hypertension classification, is a rare, highly complex and progressive disorder that ultimately leads to premature death. PAH causes significant physical, social, occupational, and emotional inconveniences among affected patients and their caregivers. Early diagnosis and initiation of the most optimal treatment possible are required in order to achieve the best results, trying to stop vascular remodeling and right heart failure; however, the clinical presentation of PAH is nonspecific and is often associated with other comorbidities, leading to delayed diagnosis or misdiagnosis. In recent decades, a greater understanding of the pathophysiology of PAH has led to changes in its definition, diagnosis, and treatment. In addition, contemporary PAH registries have shown higher survival rates among PAH patients and have allowed the development of risk calculation tools that are now used to drive therapeutic targets. To date, multiple PAH-specific treatments have been developed that target all 3 pathways that contribute to the pathogenesis of PAH endothelial dysfunction (prostacyclin, endothelin, and nitric oxide pathways). Because PAH is subdivided into 7 subgroups, it is essential that individuals be properly grouped to optimize treatment efficacy and complication prevention and improve outcome. Since the impairment of health-related quality of life in PAH is multifactorial, it is important for patients to be educated in the pathology, participate in the clinical decision-making process, and have access to multidisciplinary care, which will improve compliance with medical indications. There is convincing evidence that screening for PAH in high-risk populations will enable earlier diagnosis and intervention, offering a promising opportunity to improve patient outcomes. However, detection methods commonly used in clinical practice have limitations and a combination of tools or parameters may be required to improve the sensitivity and selectivity of current programs. The creation of detection algorithms for patients at risk of PAH with systemic sclerosis has increased the speed and specificity of diagnosis, potentially improving survival, and although the costs of detection remain significant, they are irrelevant given the high cost of treatment of this disease in advanced stages. The development and validation of detection algorithms for PAH of other aetiologies is required. Screening for PAH in asymptomatic patients at risk and developing screening-based approaches in symptomatic patients, where diagnosis is rarely considered, are needed to improve detection rates and reduce time to diagnosis. There is a clear and unmet need for improvements in the diagnosis, characterization and management of patients with PAH. PAH is a rapidly progressing disease, even in patients with mild symptoms, and timely therapeutic intervention is essential to influence the long-term prognosis of patients with PAH.Fil: Bevacqua, Raúl J. Hospital General de Agudos Dr. J. M. Ramos Mejía. División Cardiología; Argentina.Fil: Perrone, Sergio Victor. Fleni. Departamento de Neurología. Servicio de Cardiología; Argentina
Association between infections, the microbiome, vaccination, and neuromyelitis optica spectrum disorder
No full textNeuromyelitis optica spectrum disorder (NMOSD) is a devastating antibody-mediated condition of the central nervous system. As in other autoimmune diseases, there is considerable evidence to suggest that NMOSD arises from complex interactions between genetic susceptibility and environmental factors. However, whether factors like aquaporin-4-Antibody production initiate NMOSD attacks, currently remains unclear, and requires further investigation. Infectious diseases have also been proposed as possible environmental factors associated with NMOSD onset or relapses, some of which are more common in Asia and Latin America than in Europe and North America, in parallel with the higher incidence of NMOSD in these geographic locations. In this review, we examine current evidence on specific infections and vaccines associated with NMOSD onset and/or attacks, as well as the most recent data on gut microbiome composition and SARS-CoV-2 infection in NMOSD patients.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Carnero Contentti, Edgar. Hospital Alemán de Buenos Aires; Argentina
George Huntington’s “On chorea” after 150 years How a “few words” changed the history of a disease.
No full textResumen no disponibleFil: Castillo-Torres, Sergio Andrés. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina