Repositorio Institucional Fleni
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Prediction of Balance After Inpatient Rehabilitation in Stroke Subjects with Severe Balance Alterations at the Admission
No full textBackground: Patients with severe motor alterations would be those on who the prediction of the expected motor response after inpatient rehabilitation programs is most required.
Objectives: To analyze if the balance progress measured by the Berg Balance Scale and the time of hospitalization could be independent predictors of the Berg Balance at the end of a post stroke rehabilitation program in patients with severe balance alteration at the admission. Secondly, to compare a Berg Balance prediction model at the time of discharge based on the Berg Balance at the time of admission (model 1) to a Berg Balance prediction model at the time of discharge based on Berg Balance progress and the time of hospitalization (model 2).
Methods: Subjects suffering a first subacute supratentorial stroke admitted for inpatient rehabilitation between 2010 through 2018 were included to develop two linear regression models of predicted Berg Balance at discharge (n=149).
Results: According to model 1 (p < 0.0001, R2= 0.166), the Berg Balance at the admission would be a predictor of the Berg Balance at discharge from hospitalization. According to model 2 (p < 0.0001, R2= 0.993) the Berg Balance progress (β= 1.026; p < 0.0001) and the hospitalization time (β=-0.006; p < 0.0001) would be independent predictors of the Berg Balance at discharge.
Conclusions: The motor response to the rehabilitation programs in subacute patients with severe motor alterations could be explained on the basis of balance condition at the admission, but this explanation may be improved considering the progress on the balance the patients achieve during inpatient rehabilitation irrespective the time of hospitalization.Fil: Gath, Christian Federico. Fleni. Centro de Rehabilitación Adultos CR. Servicio de Kinesiología; Argentina.Fil: Gianella, Matías Gabriel. Fleni. Centro de Rehabilitación Adultos CR. Servicio de Kinesiología; Argentina.Fil: Bonamico, Lucas. Fleni. Centro de Rehabilitación Adultos CR. Servicio de Neurorehabilitación; Argentina.Fil: Olmos, Lisandro Emilio. Fleni. Centro de Rehabilitación Adultos CR; Argentina.Fil: Russo, María Julieta. Fleni. Centro de Rehabilitación Adultos CR; Argentina
Low-Frequency Oscillations at The Limbic Globus Pallidus Internus Seem to Be Associated With Premonitory Urges in Tourette's Syndrome
No full textResumen no disponibleFil: Wilken, Miguel. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Fleni. Departamento de Neurología. Servicio de Neurofisiología; Argentina.Fil: Cerquetti, Daniel. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina.Fil: Rossi, Malco. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Obeso, José A. Hospital Universitario HM Puerta del Sur; España.Fil: Merello, Marcelo. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina
Radiologically isolated syndrome: from biological bases to practical management
No full textBackground: Technological advances and greater availability of magnetic resonance imaging have prompted an increment on incidental and unexpected findings within the central nervous system. The concept of radiologically isolated syndrome characterizes a group of subjects with images suggestive of demyelinating disease in the absence of a clinical episode compatible with multiple sclerosis. Since the description of this entity, many questions have arisen; some have received responses but others remain unanswered. A panel of experts met with the objective of performing a critical review of the currently available evidence. Definition, prevalence, biological bases, published evidence, and implications on patient management were reviewed. Thirty to 50% of subjects with radiologically isolated syndrome will progress to multiple sclerosis in 5 years. Male sex, age < 37 years old, and spinal lesions increase the risk. These subjects should be evaluated by a multiple sclerosis specialist, carefully excluding alternative diagnosis. An initial evaluation should include a brain and complete spine magnetic resonance, visual evoked potentials, and identification of oligoclonal bands in cerebrospinal fluid. Disease-modifying therapies could be considered when oligoclonal bands or radiological progression is present.
Conclusion: At present time, radiologically isolated syndrome cannot be considered a part of the multiple sclerosis spectrum. However, a proportion of patients may evolve to multiple sclerosis, meaning it represents much more than just a radiological finding.Fil: Barboza, Andrés G. Hospital Central de Mendoza. Servicio de Neurología; Argentina.Fil: Carnero Contentti, Edgar. Hospital Alemán. Departamento de Neurociencias. Unidad de Neuroinmunología; Argentina.Fil: Curbelo, María Celeste. Hospital Británico. Sección de Esclerosis Múltiple; Argentina.Fil: Halfon, Mario Javier. Hospital Británico. Sección de Esclerosis Múltiple; Argentina.Fil: Rojas, Juan Ignacio. Hospital Italiano. Centro de Esclerosis Múltiple de Buenos Aires; Argentina.Fil: Silva, Berenice Anabel. Hospital Ramos Mejía. Clínica de Esclerosis Múltiple; Argentina.Fil: Sinay, Vladimiro. Fundación Favaloro; Argentina.Fil: Tizio, Santiago. Hospital Español de La Plata; Argentina.Fil: Ysrraelit, María Célica. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Alonso, Ricardo. Hospital Ramos Mejía. Clínica de Esclerosis Múltiple; Argentina
Emerging drugs for the treatment of adult MOG-IgG-associated diseases
No full textResumen no disponibleFil: Carnero Contentti, Edgar. Hospital Alemán. Departamento de Neurociencias. Unidad de Neuroinmunología; Argentina.Fil: Marrodán, Mariano. 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
Segregation of functional networks is associated with cognitive resilience in Alzheimer's disease
No full textCognitive resilience is an important modulating factor of cognitive decline in Alzheimer's disease, but the functional brain mechanisms that support cognitive resilience remain elusive. Given previous findings in normal aging, we tested the hypothesis that higher segregation of the brain's connectome into distinct functional networks represents a functional mechanism underlying cognitive resilience in Alzheimer's disease. Using resting-state functional MRI, we assessed both resting-state-fMRI global system segregation, i.e. the balance of between-network to within-network connectivity, and the alternate index of modularity Q as predictors of cognitive resilience. We performed all analyses in two independent samples for validation: First, we included 108 individuals with autosomal dominantly inherited Alzheimer's disease and 71 non-carrier controls. Second, we included 156 amyloid-PET positive subjects across the spectrum of sporadic Alzheimer's disease as well as 184 amyloid-negative controls. In the autosomal dominant Alzheimer's disease sample, disease severity was assessed by estimated years from symptom onset. In the sporadic Alzheimer's sample, disease stage was assessed by temporal-lobe tau-PET (i.e. composite across Braak stage I & III regions). In both samples, we tested whether the effect of disease severity on cognition was attenuated at higher levels of functional network segregation. For autosomal dominant Alzheimer's disease, we found higher fMRI-assessed system segregation to be associated with an attenuated effect of estimated years from symptom onset on global cognition (p = 0.007). Similarly, for sporadic Alzheimer's disease patients, higher fMRI-assessed system segregation was associated with less decrement in global cognition (p = 0.001) and episodic memory (p = 0.004) per unit increase of temporal lobe tau-PET. Confirmatory analyses using the alternate index of modularity Q revealed consistent results. In conclusion, higher segregation of functional connections into distinct large-scale networks supports cognitive resilience in Alzheimer's disease.Fil: Ewers, Michael. Ludwig-Maximilian-University; Alemania.Fil: Luan, Ying. Ludwig-Maximilian-University; Alemania.Fil: Frontzkowski, Lukas. Ludwig-Maximilian-University; Alemania.Fil: Neitzel, Julia. Ludwig-Maximilian-University; Alemania.Fil: Rubinski, Anna. Ludwig-Maximilian-University; Alemania.Fil: Dichgans, Martin. Ludwig-Maximilian-University; Alemania.Fil: Hassenstab, Jason. Washington University in St. Louis; Estados Unidos.Fil: Gordon, Brian A. Washington University in St. Louis; Estados Unidos.Fil: Chhatwal, Jasmeer P. Harvard Medical School; Estados Unidos.Fil: Levin, Johannes. Ludwig-Maximilians-Universität München; Alemania.Fil: Schofield, Peter. Neuroscience Research Australia; Australia.Fil: Benzinger, Tammie L.S. Washington University in St Louis; Estados Unidos.Fil: Morris, John C. Washington University in St Louis; Estados Unidos.Fil: Goate, Alison M. Icahn School of Medicine at Mount Sinai; Estados Unidos.Fil: Karch, Celeste M. Washington University in St. Louis; Estados Unidos.Fil: Fagan, Anne M. Washington University in St. Louis; Estados Unidos.Fil: McDade, Eric. Washington University in St. Louis; Estados Unidos.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Berman, Sarah B. University of Pittsburgh; Estados Unidos.Fil: Chui, Helena. Keck School of Medicine at the University of Southern California; Estados Unidos
Posterior fossa endoscopic assisted surgery: A systematization of its surgical corridors
No full textResumen no disponibleIntroduction: The use of endoscopic-assisted techniques in neurosurgery has been implemented to improve better visualization and predict extent of resection. We aim to systematize the posterior fossa surgical regions and the endoscopic surgical corridors providing a quick reference of the anatomy and surgical nuances.
Methods: A retrospective review of patients undergoing endoscopic-assisted surgery of the posterior fossa at a single institution between 2019 and 2020 was conducted along with a description of the microsurgical anatomy from cadaveric specimens and surgical cases.
Results: The posterior fossa was segmented into three topographic regions, (upper, middle and lower), with three surgical corridors within each of these. Upper region is accessed through a supracerebellar infratentorial approach and comprises the pineal and pericuadrigeminal region constituted by the median corridor, the lateral corridor, and the extreme lateral corridor. Middle region is accessed through a retrosigmoid approach and comprises the cerebellopontine angle region constituted by the supralateral corridor containing the upper neurovascular complex (NVC), the median corridor containing the median NVC, and the infralateral corridor containing the lower NVC. The lower region is accessed through a far-lateral approach and contains the craniocervical junction region constituted by the upper corridor in between the VII-VIII and IX cranial nerves (CNs), the median corridor between the X and XI CNs, and the lower corridor between the cranial and spinal rootlets of the XI CN.
Conclusion: We propose a simple and concise systematization, dividing the area into three regions with predefined corridors.Fil: Ries Centeno, Tomás. Fleni. Departamento de Neurocirugía; Argentina.Fil: Villamil, Facundo. Fleni. Departamento de Neurocirugía; Argentina.Fil: Marco Del Pont, Francisco. Fleni. Departamento de Neurocirugía; Argentina.Fil: Giovannini, Sebastián. Fleni. Departamento de Neurocirugía; Argentina.Fil: Caffaratti, Guido. Fleni. Departamento de Neurocirugía; Argentina.Fil: Cervio, Andrés Eduardo. Fleni. Departamento de Neurocirugía; Argentina
Stroke Knowledge in the EstEPA Project, a Population-Based Study
No full textObjectives: Stroke knowledge is poor in the general population worldwide. Yet, data from Spanish-Speaking populations, particularly in Latin America, are scant. We aim to evaluate stroke awareness using personal interviews in a population-based study.
Materials and methods: A questionnaire of stroke awareness was administered to a randomly selected sample of households. "Good stroke knowledge for action" was defined as recognition of impaired strength, sensation and language plus intention to seek urgent medical attention in a hypothetical stroke situation. Demographics, the term to name stroke, recognition of warning signs and attitude towards seeking medical attention were compared between individuals with and without "good stroke knowledge for action".
Results: From 1986 respondents (87%, median age 59 years [IQR 23], 50.7% female), most recognized stroke as ACV (cerebrovascular accident, [63%]). Weakness/decreased sensation were recognized as stroke warning signs by 83.5% of respondents, followed by aphasia (77.9%), incoordination (71.6%) and headache (70.5%). Chest pain was misclassified as stroke warning sign by 25% of subjects. In a hypothetical stroke situation, most respondents would go to the hospital (52.3%), or activate the EMS (39%). Individuals with a good stroke knowledge for action (63.5%) recognized visual symptoms (60.4% vs 43.8, p<0.0001), incoordination (78.8% vs 34.4%, p<0.0001) and headache (70.5% vs. 57.8%, p<0.0001) more frequently, and were less likely to misrecognize chest pain as stroke warning sign (23.8% vs. 28.9%, p=0.015). Neither, age (OR 1 CI 0.99-1.00, p=0.94), gender (OR 0.95, CI 0.79-1.16, p=0.61) or race (OR 1.17, CI 0.97-1.42, p=0.097) predicted good stroke knowledge for action.
Conclusions: Most people recognize stroke as ACV. The recognition of stroke warning signs and the attitude towards seeking emergent medical attention appears acceptable. Yet, most respondents would go directly to the hospital avoiding the EMS.Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Gomez Schneider, Maia Macarena. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Dossi, Daiana Elizabeth. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Melcon, Mario O. Fundación Para Investigaciones Neuroepidemiológicas; Argentina.Fil: Hawkes, Maximiliano Alberto. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina
miR-302 family, miR-145 and miR-296 temporal expression profile along the cell cycle of human pluripotent stem cells
No full textHuman pluripotent stem cells (hPSCs), like embryonic (hESCs) and induced pluripotent stem cells (hiPSCs), exhibit an unusual cell cycle structure characterized by a short G1 phase and cells being most of time in S phase. hPSCs are receptive to differentiation cues during their transition through G1 phase when lineage determination is decided. Although several MicroRNAs (miRNAs) have been shown to target transcripts that directly or indirectly coordinate the cell cycle of pluripotent cells, its temporal expression profile along hPSCs cell cycle remains poorly characterized. miR-145 and miR-296 are induced during differentiation and silence the self-renewal and pluripotency program. miR-302 family is essential for hPSCs stemness and its expression decreases during differentiation. We aimed to study how the aforementioned miRNAs are regulated along the cell cycle of hPSCs. We demonstrated by pharmacological synchronization and block and release experiments that miR-145, miR-296 and miR-302 family are periodically expressed in hPSCs. Importantly, miR-302 family expression is induced at G1/S boundary and remained high at S phase, presumably to impede differentiation onset. Besides, we confirmed by a gene ontology analysis that many validated miR-302 family target genes are involved in cell cycle regulation.Fil: Rodríguez-Varela, María Soledad. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Mucci, Sofía. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Videla-Richardson, Guillermo Agustín. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Isaja, Luciana. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Sevlever, Gustavo Emilio. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Scassa, María Elida. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Romorini, Leonardo. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina
Childhood adversity modulation of central autonomic network components during cognitive regulation of emotion in major depressive disorder and borderline personality disorder
No full textAdverse childhood experiences (ACEs) have lifelong effects on emotional behavior and are frequent in Borderline Personality Disorder (BPD) and Major Depressive Disorder (MDD). The Central Autonomic Network (CAN), which modulates heart rate variability (HRV), comprises brain regions that mediate emotion regulation processes. However, it remains unclear the effect of ACEs on CAN dynamics and its relationship with HRV in these disorders. We studied the effects of ACEs on the brain and HRV simultaneously, during regulation of psychological stress in 19 BPD, 20 MDD and 20 healthy controls (HC). Participants underwent a cognitive reappraisal task during fMRI with simultaneous ECG acquisition. ACEs exposure was associated with increased activity of CAN and salience network components in patients with MDD compared to BPD during cognitive reappraisal. A brain-autonomic coupling was found in BPD relative to HC during emotion regulation, whereby greater activity of left anterior cingulate and medial superior frontal gyrus areas was coupled with increased HRV. Results suggest that ACEs exposure is associated with a distinct activation of the CAN and salience network regions governing responses to psychological stress in MDD compared to BPD. These alterations may constitute a distinctive neurobiological mechanism for abnormal emotion processing and regulation related to ACEs in MDD.Fil: Wainsztein, Agustina Edith. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad Católica Argentina; Argentina.Fil: Castro, Mariana Nair. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires; Argentina.Fil: Goldberg, Ximena. Universitat Autònoma de Barcelona; España.Fil: Camacho Téllez, Vicente. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina. Fleni. Servicio de Psiquiatría; Argentina.Fil: Vulcano, Mercedes. Fleni. Servicio de Psiquiatría; Argentina. Universidad de Buenos Aires; Argentina.Fil: Abulafia, Carolina. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad Católica Argentina; Argentina.Fil: Ladrón-de-Guevara, Soledad. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina.Fil: Cardoner, Narcís. Universitat Autònoma de Barcelona; España.Fil: Nemeroff, Charles B. The University of Texas at Austin; Estados Unidos.Fil: Menchón, José M. Bellvitge University Hospital; España.Fil: Soriano-Mas, Carles. Bellvitge University Hospital; España.Fil: Villarreal, Mirta Fabiana. Fleni. Grupo de Investigación en Neurociencias
Aplicadas a las Alteraciones de la Conducta; Argentina. Universidad de Buenos Aires; Argentina.Fil: Guinjoan, Salvador Martín. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Psiquiatría y Salud Mental; Argentina
Generation of a human induced pluripotent stem cell line from a familial Alzheimer's disease PSEN1 T119I patient
No full textHuman induced pluripotent stem cells (hiPSC) line FLENIi001-A was reprogrammed from dermal fibroblasts using the lentiviral-hSTEMCCA-loxP vector. Fibroblasts were obtained from a skin biopsy of a 72-year-old Caucasian male familial Alzheimer's disease patient carrying the T119I mutation in the PSEN1 gene. PSEN1 genotype was maintained and stemness and pluripotency confirmed in the FLENIi001-A hiPSC line.Fil: Isaja, Luciana. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Rodríguez Varela, María Soledad. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Marazita, Mariela Claudia. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Mucci, Sofía. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Itzcovich, Tatiana. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina.Fil: Chrem Méndez, Patricio Alexis. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría. Centro de Memoria y Envejecimiento; Argentina.Fil: Niikado, Matías. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina.Fil: Ferriol-Laffouillere, Sofía Luján. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatríaa. Centro de Memoria y Envejecimiento; Argentina.Fil: Martinetto, Horacio. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina.Fil: Sevlever, Gustavo Emilio. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina.Fil: Scassa, María Elida. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina.Fil: Surace, Ezequiel Ignacio. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina.Fil: Romorini, Leonardo. Fleni. Laboratorio de Investigación Aplicada a las Neurociencias; Argentina