Repositorio Institucional Fleni
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The impact of an early strict nationwide lockdown on the pattern of consultation for neurological diseases
No full textFil: Allegri, Ricardo Francisco. 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: Marrodán, Mariano. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Hawkes, Maximiliano Alberto. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina
Differential diagnosis in acute inflammatory myelitis
No full textIntroduction: Establishing differential diagnosis between different inflammatory causes of acute transverse myelitis (ATM) can be difficult. The objective of this study was to see which clinical, imaging or laboratory findings best contribute to confirm ATM etiology.
Methods: We reviewed clinical history, MRI images, CSF and serum laboratory tests in a retrospective study of patients presenting ATM. Univariate and multivariate multinomial logistic regression analysis was performed for each of the items listed above.
Results: One hundred and seventy-two patients were analyzed in the study: 68 with multiple sclerosis (MS), 67 presenting idiopathic myelitis (IM; 23 of which were recurrent), 21 who developed positive systemic-antibodies associated myelitis (SAb-M) and 16 with neuromyelitis optica spectrum disorders (NMOSD). The following factors were associated with increased risk of developing MS: lower values in the modified Rankin scale at admission; positive oligoclonal bands (OCB); higher spinal cord lesion load; presence of brain demyelinating lesions; and disease recurrence. Longitudinally extended (LE) lesions, brain demyelinating lesions, and recurrences also contributed to final diagnosis of NMOSD. Multivariate multinomial logistic regression analysis showed presence of LE lesions increased risk of NMOSD and recurrence of ATM. Whereas, brain demyelinating lesions, and presence of OCB increased risk of MS.
Conclusions: ATM etiology may be clarified on the basis of spinal cord and brain MRI findings, together with CSF biochemistry and serum laboratory test results, allowing more timely and exact diagnosis as well as specific therapy for cases of uncertain origin.Fil: Marrodán, Mariano. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Hernandez, Micaela Anahí. Fleni. Departamento de Neurología; Argentina.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Köhler, Alejandro Alfredo. Fleni. Departamento de Neurología; Argentina
What is happening with not recommended drugs for dementia in Argentina? Prescription patterns and direct costs analysis
No full textOBJECTIVES:
The only recommended pharmacological treatment for specific dementias are donepezil, galantamine, rivastigmine, and memantine (Recommended Drugs: RD). However, other drugs without recommendations (Not Recommended Drugs: NRD) are often used to treat patients with Cognitive Impairment (CI) in Argentina. The INSSJyP is the largest health insurance in Argentina. The objective of this study is to analyze the prescription pattern, cost and implications of NRD used for the treatment of CI in the INSSJyP.
MATERIALS:
This is a retrospective, population-based study of the INSSJyP outpatients' prescriptions database for drugs usually prescribed for CI during 2015. These data were compared to the same database in 2009. The number of "prescriptions" always refers to dispensed packages.
RESULTS:
A total of 3.255.438 packages of drugs usually indicated for CI were prescribed during 2015: 1.912.476 packages of RD (59%), and 1.342.962 packages of NRD (41%).Comparing the results with those obtained in 2009, there is a 148% gross increase in the prescription of both RD and NRD for CI, although the rates/1000 affiliates/year show a lesser rise for NRD (70.1%) compared to RD (103.9 %).The expenditure on CI drugs prescribed during 2015 was 77 millions USD. NRD cost represented approximately 20 millions USD.
CONCLUSION:
Inappropriate drug use increases health costs in developing countries. We found a high number of patients with a probable diagnosis of CI treated with NRD. It is extremely relevant that all the healthcare professionals can update their knowledge and modified behavioural insights about appropiate prescription for specific dementias.Fil: Bustin, Julian. Instituto Nacional de Servicios Sociales para Jubilados y Pensionados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas - Universidad Favaloro - Fundación INECO. Instituto de Neurociencia Cognitiva y Traslacional; Argentina.Fil: Rojas, Galeno J. Sanatorio de la Trinidad Mitre; Argentina. Fundación Favaloro; Argentina. Hospital Británico de Buenos Aires; Argentina.Fil: O´Neill, Santiago. Fundación Favaloro; Argentina.Fil: Sarasola, Diego. Instituto "Alexander Luria"; Argentina.Fil: Triskier, Fabian. Instituto Nacional de Servicios Sociales para Jubilados y Pensionados; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas - Universidad Favaloro - Fundación INECO. Instituto de Neurociencia Cognitiva y Traslacional; Argentina.Fil: Urtasun, Martín. Fundación FEMEBA. Área Farmacología; Argentina. Universidad Nacional "Arturo Jauretche". Instituto de Ciencias de la Salud; Argentina.Fil: Cañás, Martín. Fundación FEMEBA. Área Farmacología; Argentina. Universidad Nacional "Arturo Jauretche". Instituto de Ciencias de la Salud; Argentina.Fil: Mastai, Ricardo. Instituto Nacional de Servicios Sociales para Jubilados y Pensionados; Argentina.Fil: Demey, Ignacio. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina
Ofatumumab versus Teriflunomide in Multiple Sclerosis
No full textBackground: Ofatumumab, a subcutaneous anti-CD20 monoclonal antibody, selectively depletes B cells. Teriflunomide, an oral inhibitor of pyrimidine synthesis, reduces T-cell and B-cell activation. The relative effects of these two drugs in patients with multiple sclerosis are not known.
Methods: In two double-blind, double-dummy, phase 3 trials, we randomly assigned patients with relapsing multiple sclerosis to receive subcutaneous ofatumumab (20 mg every 4 weeks after 20-mg loading doses at days 1, 7, and 14) or oral teriflunomide (14 mg daily) for up to 30 months. The primary end point was the annualized relapse rate. Secondary end points included disability worsening confirmed at 3 months or 6 months, disability improvement confirmed at 6 months, the number of gadolinium-enhancing lesions per T1-weighted magnetic resonance imaging (MRI) scan, the annualized rate of new or enlarging lesions on T2-weighted MRI, serum neurofilament light chain levels at month 3, and change in brain volume.
Results: Overall, 946 patients were assigned to receive ofatumumab and 936 to receive teriflunomide; the median follow-up was 1.6 years. The annualized relapse rates in the ofatumumab and teriflunomide groups were 0.11 and 0.22, respectively, in trial 1 (difference, -0.11; 95% confidence interval [CI], -0.16 to -0.06; P<0.001) and 0.10 and 0.25 in trial 2 (difference, -0.15; 95% CI, -0.20 to -0.09; P<0.001). In the pooled trials, the percentage of patients with disability worsening confirmed at 3 months was 10.9% with ofatumumab and 15.0% with teriflunomide (hazard ratio, 0.66; P = 0.002); the percentage with disability worsening confirmed at 6 months was 8.1% and 12.0%, respectively (hazard ratio, 0.68; P = 0.01); and the percentage with disability improvement confirmed at 6 months was 11.0% and 8.1% (hazard ratio, 1.35; P = 0.09). The number of gadolinium-enhancing lesions per T1-weighted MRI scan, the annualized rate of lesions on T2-weighted MRI, and serum neurofilament light chain levels, but not the change in brain volume, were in the same direction as the primary end point. Injection-related reactions occurred in 20.2% in the ofatumumab group and in 15.0% in the teriflunomide group (placebo injections). Serious infections occurred in 2.5% and 1.8% of the patients in the respective groups.
Conclusions: Among patients with multiple sclerosis, ofatumumab was associated with lower annualized relapse rates than teriflunomide. (Funded by Novartis; ASCLEPIOS I and II ClinicalTrials.gov numbers, NCT02792218 and NCT02792231.).Fil: Hauser, Stephen L. University of California. Department of Neurology. UCSF Weill Institute for Neurosciences; Estados Unidos.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Bar-Or, Amit. University of Pennsylvania. Perelman School of Medicine. Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology; Estados Unidos
Transverse Myelitis in Systemic Lupus Erythematosus: Clinical Features and Prognostic Factors in a Large Cohort of Latin American Patients.
No full textBackground: Acute transverse myelitis (ATM) is an infrequent but severe complication of systemic lupus erythematosus (SLE). The purpose of study was to describe clinical features and prognostic factors of patients with SLE-related ATM.
Methods: In this medical records review study, data were collected from 60 patients from 16 centers seen between 1996 and 2017 who met diagnostic criteria for SLE and myelitis as defined by the American College of Rheumatology/Systemic International Collaborating Clinics and the Working Group of the Transverse Myelitis Consortium, respectively. Objective neurological impairment was measured with American Spinal Injury Association Impairment Scale (AIS) and European Database for Multiple Sclerosis Grade Scale (EGS).
Results: Among patients included, 95% (n = 57) were female, and the average age was 31.6 ± 9.6 years. Myelitis developed after diagnosis of SLE in 60% (n = 36). Symmetrical paraparesis with hypoesthesia, flaccidity, sphincter dysfunction, AIS = A/B, and EGS ≥ 8 was the most common presentation. Intravenous methylprednisolone was used in 95% (n = 57), and 78.3% (n = 47) received intravenous cyclophosphamide. Sensory/motor recovery at 6 months was observed in 75% (42 of 56), but only in 16.1% (9 of 56) was complete. Hypoglycorrhachia and EGS ≥ 7 in the nadir were associated with an unfavorable neurological outcome at 6 months (p < 0.05). A relapse rate during follow-up was observed in 30.4% (17 of 56). Hypoglycorrhachia and hypocomplementemia seem to be protective factors for relapse. Intravenous cyclophosphamide was associated with time delay to relapse.
Conclusions: Systemic lupus erythematosus-related ATM may occur at any time of SLE course, leading to significant disability despite treatment. Relapses are infrequent and intravenous cyclophosphamide seems to delay it. Hypoglycorrhachia, hypocomplementemia, and EGS at nadir are the most important prognostic factors.Fil: Carnero Contentti, Edgar. Hospital Alemán de Buenos Aires. Department of Neuroscience. Neuroimmunology Unit; Argentina.Fil: Chiganer, Edson Hernán. Hospital Carlos G. Durand. Departments of Immunology and Histocompatibility; Argentina.Fil: Lessa, Carmen Flora. Hospital Carlos G. Durand. Departments of Immunology and Histocompatibility; Argentina.Fil: Di Pace, José Luis. Hospital Carlos G. Durand. Departamento de Neurología; Argentina.Fil: Perassolo, Mónica Beatriz. Hospital Carlos G. Durand. Departamento de Neurología; Argentina.Fil: Alessandro, Lucas. Fleni. Fleni. Departamento de Neurología. Servicio de Neurología; Argentina.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Farfan, María Fernanda. Hospital Luis C. Lagomaggiore. Department of Neurology; Argentina.Fil: Galiana, Graciana Lourdes. Hospital Luis C. Lagomaggiore. Department of Neurology; Argentina.Fil: Benavides, Marvin Sánchez. Hospital Rafael Ángel Calderón Guardia. Department of Rheumatology; Costa Rica.Fil: Pacello, Franco. Hospital Galán y Rocha. Department of Internal Medicine; Uruguay.Fil: Stagno, Mauro. Hospital Galán y Rocha. Department of Internal Medicine; Uruguay.Fil: Elizaur López, Juan Gabriel. Hospital Central del Instituto de Previsión Social. Rheumatology; Paraguay.Fil: Delgadillo, Pedro Daniel. Hospital Central del Instituto de Previsión Social. Rheumatology; Paraguay.Fil: Melgarejo, Patricia. Hospital Central del Instituto de Previsión Social. Rheumatology; Paraguay.Fil: Vázquez Báez, Marcos Aurelio. Hospital de Clínicas Universidad Nacional de Asunción. Department of Rheumatology; Paraguay.Fil: Jácome Sánchez, Elisa Carolina. Hospital Carlos Andrade Marin. Department of Neurology; Ecuador.Fil: Correa Díaz, Edgar Patricio. Hospital Carlos Andrade Marin. Department of Neurology; Ecuador.Fil: Linares, Magaly Alva. Hospital Nacional Edgardo Rebagliati Martins. Rheumatology Division; Perú.Fil: Zamora Tehozol, Erick Adrian. Hospital de Especialidades. Centro Médico Nacional Siglo XXI. Department of Rheumatology; MéxicoFil: Quintanilla-González, Lauro. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran. Department of Immunology and Rheumatology; Mexico.Fil: Batún-Garrido, José Antonio de Jesús. Hospital de Alta Especialidad Dr Gustavo A. Rovirosa Perez. Department of Internal Medicine; Mexico.Fil: Sato, Emilia Inoue. Universidade Federal de Sao Paulo, São Paulo. Department of Medicine. Rheumatology Division; Brasil.Fil: do Reis-Neto, Edgard Torres. Universidade Federal de Sao Paulo, São Paulo. Department of Medicine. Rheumatology Division; Brasil.Fil: Carreño Nigro, María Angela. Clinica Las Condes. Department of Rheumatology; Chile.Fil: Hryb, Javier Pablo. Hospital Carlos G. Durand. Departamento de Neurología; Argentina
Prognostic value of ATN Alzheimer biomarkers: 60-month follow-up results from the Argentine Alzheimer’s Disease Neuroimaging Initiative.
No full textPurpose: To describe results of the Amyloid, Tau, Neurodegeneration (ATN) research
framework classification in the Argentine-Alzheimer’s Disease Neuroimaging Initiative
(arg-ADNI) cohort.
Methods: Twenty-three patients with mild cognitive impairment (MCI), 12 dementia of
Alzheimer’s type (DAT), and 14 normal controls were studied following the ADNI2 protocol.
Patients were categorized according to presence or absence of the biomarkers for
amyloid beta (A;A: amyloid positron emission tomography [PET] scan or cerebrospinal
fluid [CSF] A42), tau (T: CSF phosphorylated-tau), and neurodegeneration (N: CSF
total-tau, fluorodeoxyglucose [FDG]-PET scan, or structural magnetic resonance imaging
[MRI] scan).
Results: A+T+N+ biomarker profile was identified at baseline in 91% of mild dementia
patients, 20% of early MCI patients, 46% of late MCI patients, and 14% of control
subjects. Suspected non-AD pathophysiology (SNAP, A-T-N+) was found in 8% of mild
dementia, 20% of early MCI, 15% of late MCI, and 7% of control subjects. Conversion
rates to dementia after 5-year follow-up were 85% in A+T+N+ MCI patients and 50%
in A-T-N+ patients.
Conclusions: We present initial 5-year follow-up results of a regional ADNI based on
AD biomarkers and the ATN classification.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Chrem Méndez, Patricio Alexis. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría. Centro de Memoria y Envejecimiento; Argentina.Fil: Surace, Ezequiel Ignacio. Fleni. Departamento de Neuropatología y Biología Molecular. Laboratorio de Enfermedades Neurodegenerativas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Calandri, Ismael Luis. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Cohen, Gabriela. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Martín, María Eugenia. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Russo, María Julieta. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Crivelli, Lucía. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Tapajóz, Fernanda. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Clarens, María Florencia. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Campos, Jorge. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Nahas, Federico Ezequiel. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Vázquez, Silvia. Fleni. Centro de Imágenes Moleculares CIM; Argentina.Fil: Sevlever, Gustavo Emilio. Fleni. Departamento de Neuropatología y Biología Molecular; Argentina.Fil: Pertierra, Lucía. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría. Centro de Memoria y Envejecimiento; Argentina
LB62 Ofatumumab vs Teriflunomide in Relapsing Multiple Sclerosis: Analysis of No Evidence of Disease Activity (NEDA-3) from ASCLEPIOS I and II Trials
No full textFil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina.Fil: Hauser, Stephen L. University of California. UCSF Weill Institute for Neurosciences. Department of Neurology; Estados Unidos.Fil: Bar-Or, Amit. University of Pennsylvania. Perelman School of Medicine. Center for Neuroinflammation and Experimental Therapeutics and Department of Neurology; Estados Unidos.Fil: Cohen, Jeffrey A. Cleveland Clinic. Neurological Institute. Mellen MS Center. Department of Neurology; Estados Unidos.Fil: Comi, Giancarlo. University Vita-Salute San Raffaele; Italia.Fil: Coyle, Patricia K. Stony Brook University. Department of Neurology; Estados Unidos.Fil: Cross, Anne H. Washington University. School of Medicine; Estados Unidos.Fil: de Seze, Jérôme. University Hospital of Strasbourg; Francia.Fil: Montalban, Xavier. Hospital Universitario Vall d’ Hebron. Centre d’Esclerosi Multiple de Catalunya (Cemcat). Department of Neurology-Neuroimmunology; España.Fil: Selmaj, Krzysztof. Center for Neurology; Polonia.Fil: Wiendl, Heinz. University of Muenster; Alemania.Fil: Willi, Roman. Novartis Pharma; Suiza.Fil: Li, Bingbing. Novartis Pharmaceuticals Corporation; Estados Unidos.Fil: Häring, Dieter A. Novartis Pharma; Suiza.
.Fil: Ramnathan, Krishnan. Novartis Pharma; Suiza.Fil: Merschhemke, Martin. Novartis Pharma; Suiza.Fil: Kappos, Ludwig. University Hospital and University of Basel. Departments of Medicine, Clinical Research, Biomedicine and Biomedical Engineering. Neurologic Clinic and Policlinic; Suiza
Fall in the Proportion of Atherothrombotic Strokes During the Last Decade
No full textObjective: To determine the proportion of subtypes of ischemic strokes, vascular risk factors and treatment prior to stroke between 1997 and 2018 in a single institution in Argentina.
Methods: Demographics, risk factors, medications and TOAST subtypes were assessed and compared in ischemic stroke patients admitted during two periods of time, 1997-2007 (P1) and 2008-2018 (P2).
Results: There were 2747 patients (64% men, aged 67 ±15 years), 920 subjects in P1 and 1827 in P2. Age and gender distribution did not change over time. Proportion of large artery atherothrombotic strokes decreased from 29% in P1 to 14% in P2 (p <0.0001) and small vessel strokes from 15% to 11% (p <0.05). Cardioembolic and undetermined strokes increased from 17 to 25% (p <0.0001) and from 30% to 41% (p <0.0001), respectively. There were no changes in stroke of other etiologies (9% in both periods). Detection of atrial fibrillation increased from 14% to 19% (p<0.001). Use of medications prior to stroke increased for aspirin from 27% to 45% (p <0.0001), for antihypertensive drugs from 26% to 62% (p <0.0001), for statins from 14% to 42% (p<0.0001) and for anticoagulants from 4% to 9% (p<0.0001).
Conclusions: The proportion of strokes associated to large and small vessel atherosclerosis is declining in our population with an increase in the proportion of cardioembolic and undetermined strokes. Better management of risk factors and higher prevalence and/or better screening for atrial fibrillation could explain, at least in part, these findings.Fil: Rosales, Julieta S. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Alet, Matías Javier. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Pujol Lereis, Virginia Andrea. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina.Fil: Ameriso, Sebastián Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Vascular; Argentina
Asistencia Endoscópica en la Descompresión Microquirúrgica del Hemiespasmo Facial
No full textIntroducción: El hemiespasmo facial primario (HFP) se produce por la hiperexcitabilidad del nervio facial y sus núcleos de origen como consecuencia de la compresión vascular. La cirugía de descompresión neurovascular se plantea como alternativa al tratamiento médico refractario.Objetivos: Presentar nuestra experiencia respecto a esta patología.Material y métodos: Se realizó una revisión retrospectiva de pacientes operados por HPF refractarios a tratamiento médico en nuestra institución en los últimos 5 años (periodo 2014-2019). Todos fueron intervenidos vía retrosigmoidea. Se evaluaron datos demográficos, evaluación prequirúrgica y evolución postoperatoria. Resultados: Se operaron 4 pacientes bajo técnica microquirúrgica asistido por endoscopía. Edad promedio 52 años (rango 41-61) con una relación femenino masculino 3:1. El 25% (n=1) presentaba paresia facial grado 2 (HB) en el prequirúrgico. No hubo cambios en cuanto al grado de paresia facial en el postoperatorio en ningún caso. Sólo un paciente registró caída leve en la audiometría postquirúrgica. El 75% (n=3) resolvieron el HFP. Conclusión: Si bien nuestra serie es acotada a un número reducido de pacientes, la cirugía descompresiva microvascular es efectiva como alternativa al tratamiento médico refractario del HFP.Fil: Lorefice, Emiliano. Fleni. Departamento de Neurocirugía; Argentina.Fil: Ries Centeno, Tomás. Fleni. Departamento de Neurocirugía; Argentina.Fil: Giovannini, Sebastián Juan María. Fleni. Departamento de Neurocirugía; Argentina.Fil: Marcó Del Pont, Francisco. Fleni. Departamento de Neurocirugía; Argentina.Fil: Mormandi, Rubén. Fleni. Departamento de Neurocirugía; Argentina.Fil: Cervio, Andrés Eduardo. Fleni. Departamento de Neurocirugía; Argentina
COVID-19 Epidemic in Argentina: Worsening of Behavioral Symptoms in Elderly Subjects With Dementia Living in the Community
No full textIn Argentina, the quality of care that elderly subjects with dementia living in the community received has been deeply affected by COVID-19 epidemic. Our objective was to study to what extend mandatory quarantine imposed due to COVID-19 had affected behavioral symptoms in subjects with dementia after the first 8 weeks of quarantine. We invited family members to participate in a questionnaire survey. The sample consisted of family caregivers (n = 119) of persons with AD or related dementia living at home. We designed a visual analog scale to test the level of the burden of care of family members. Items inquired in the survey included type and setting (home or day care center) of rehabilitation services (physical/occupational/cognitive rehabilitation) and change in psychotropic medication and in behavioral symptoms that subjects with dementia experienced before and during the epidemic. Characteristics of people with dementia and their caregivers were analyzed with descriptive statistics using the chi-square tests, p < 0.01 was considered significant. Results: The sample included older adults with dementia. Mean age: 81.16 (±7.03), 35% of the subjects had more than 85 years of age. Diagnosess were 67% Alzheimer´s dementia and 26% mixed Alzheimer´s disease (AD). Stages were 34.5% mild cases, 32% intermediate stage, and 33% severe cases as per Clinical dementia Rating score. In 67% of the sample, a family member was the main caregiver. Important findings were increased anxiety (43% of the sample), insomnia (28% of the subjects), depression (29%), worsening gait disturbance (41%), and increase use of psychotropics to control behavioral symptoms. When we compared the frequency of behavioral symptoms within each dementia group category, we found that anxiety, depression, and insomnia were more prevalent in subjects with mild dementia compared to subjects with severe dementia. We analyzed the type and pattern of use of rehabilitation services before and during the isolation period, and we observed that, as a rule, rehabilitation services had been discontinued in most subjects due to the quarantine. We concluded from our analysis that during COVID-19 epidemic there was a deterioration of behavioral symptoms in our population of elderly dementia subjects living in the community. Perhaps, our findings are related to a combination of social isolation, lack of outpatient rehabilitation services, and increased stress of family caregivers. It is necessary to develop a plan of action to help dementia subjects deal with the increased stress that this epidemic imposed on them.Fil: Campos, Jorge. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Cohen, Gabriela. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Russo, María Julieta. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina