Repositorio Institucional Fleni
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Monoclonal antibodies against CGRP pathway in patients with migraine. Experience in a Headache
No full textFil: Nagel, Vanesa. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Cavanagh, Sol. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Grandinetti, Mariela. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Calvo, Daniela. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Gutierrez, Teresa. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Larripa, Natalia. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Bravo, Yasmín. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Tajan, Emilia. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Bonamico, Lucas. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina.Fil: Goicochea, María Teresa. Fleni. Departamento de Neurología. Clínica del Dolor. Clínica de Cefaleas; Argentina
Accelerated longitudinal changes and ordering of Alzheimer disease biomarkers across the adult lifespan
No full textThe temporal evolutions and relative orderings of Alzheimer disease biomarkers, including CSF amyloid-β42 (Aβ42), Aβ40, total tau (Tau) and phosphorylated tau181 (pTau181), standardized uptake value ratio (SUVR) from the molecular imaging of cerebral fibrillar amyloid-β with PET using the 11C-Pittsburgh Compound-B (PiB), MRI-based hippocampal volume and cortical thickness and cognition have been hypothesized but not yet fully tested with longitudinal data for all major biomarker modalities among cognitively normal individuals across the adult lifespan starting from 18 years. By leveraging a large harmonized database from 8 biomarker studies with longitudinal data from 2609 participants in cognition, 873 in MRI biomarkers, 519 in PET PiB imaging and 475 in CSF biomarkers for a median follow-up of 5-6 years, we estimated the longitudinal trajectories of all major Alzheimer disease biomarkers as functions of baseline age that spanned from 18 to 103 years, located the baseline age window at which the longitudinal rates of change accelerated and further examined possible modifying effects of apolipoprotein E (APOE) genotype. We observed that participants 18-45 years at baseline exhibited learning effects on cognition and unexpected directions of change on CSF and PiB biomarkers. The earliest acceleration of longitudinal change occurred for CSF Aβ42 and Aβ42/Aβ40 ratio (with an increase) and for Tau, and pTau181 (with a decrease) at the next baseline age interval of 45-50 years, followed by an accelerated increase for PiB SUVR at the baseline age of 50-55 years and an accelerated decrease for hippocampal volume at the baseline age of 55-60 years and finally by an accelerated decline for cortical thickness and cognition at the baseline age of 65-70 years. Another acceleration in the rate of change occurred at the baseline age of 65-70 years for Aβ42/Aβ40 ratio, Tau, pTau181, PiB SUVR and hippocampal volume. Accelerated declines in hippocampal volume and cognition continued after 70 years. For participants 18-45 years at baseline, significant increases in Aβ42 and Aβ42/Aβ40 ratio and decreases in PiB SUVR occurred in APOE ɛ4 non-carriers but not carriers. After age 45 years, APOE ɛ4 carriers had greater magnitudes than non-carriers in the rates of change for all CSF biomarkers, PiB SUVR and cognition. Our results characterize the temporal evolutions and relative orderings of Alzheimer disease biomarkers across the adult lifespan and the modification effect of APOE ɛ4. These findings may better inform the design of prevention trials on Alzheimer disease.Fil: Allegri, Ricardo Francisco. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría. Centro de Memoria y Envejecimiento; Argentina.Fil: Luo, Jingqin. Washington University School of Medicine. Department of Surgery. Division of Public Health Sciences; Estados Unidos. Washington University School of Medicine. Siteman Cancer Center Biostatistics Core; Estados Unidos. Washington University School of Medicine. Division of Biostatistics; Estados Unidos.Fil: Agboola, Folasade. Washington University School of Medicine. Division of Biostatistics; Estados Unidos. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos.Fil: Grant, Elizabeth. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Division of Biostatistics; Estados Unidos.Fil: Morris, John C. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos. Washington University School of Medicine. Departments of Pathology and Immunology; Estados Unidos.Fil: Masters, Colin L. University of Melbourne. The Florey Institute of Neuroscience and Mental Health; Estados Unidos.Fil: Albert, Marilyn S. Johns Hopkins University School of Medicine, Baltimore. Department of Neurology; Estados Unidos.Fil: Johnson, Sterling C. University of Wisconsin-Madison School of Medicine and Public Health. Wisconsin Alzheimer's Institute and Alzheimer's Disease Research Center; Estados Unidos. Middleton Veterans Memorial Hospital. Geriatric Research Education and Clinical Center; Estados Unidos.Fil: McDade, Eric M. Washington University School of Medicine. Department of Neurology; Estados Unidos.Fil: Fagan, Anne M. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos.Fil: Benzinger, Tammie L.S. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Radiology; Estados Unidos.Fil: Hassenstab, Jason. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos.Fil: Bateman, Randall J. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos.Fil: Perrin, Richard J. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos. Washington University School of Medicine. Departments of Pathology and Immunology; Estados Unidos.Fil: Wang, Guoqiao. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Division of Biostatistics; Estados Unidos.Fil: Li, Yan. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Neurology; Estados Unidos.Fil: Gordon, Brian. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Middleton Veterans Memorial Hospital. Geriatric Research Education and Clinical Center; Estados Unidos.Fil: Cruchaga, Carlos. Washington University School of Medicine. Knight Alzheimer Disease Research Center; Estados Unidos. Washington University School of Medicine. Department of Radiology; Estados Unidos.Fil: Day, Gregory S. Mayo Clinic. Department of Neurology; Estados Unidos
Polisomnografía nocturna y test múltiple de latencias del sueño. Nociones básicas e indicaciones. Guía práctica. Grupo de sueño – Sociedad Neurológica Argentina.
No full textLos estudios de sueño son registros no invasivos en los que se graban señales de diferentes variables fisiológicas durante el sueño y la vigilia. El objetivo de esta guía es brindar conocimientos sobre polisomnografía (PSG) que ayuden en la práctica diaria de la neurología. No se darán detalles técnicos relativos a las normas del laboratorio de sueño, protocolos, instrumentación ni específicos de puntuación e informe.
La PSG consiste en el registro simultáneo de diferentes señales biológicas. Es una herramienta en la evaluación de los trastornos del sueño, tiene indicaciones específicas y sus resultados deben ser interpretados en el contexto clínico y medicación habitual del paciente.
Se debe realizar en horario nocturno o en el habitual de sueño del sujeto, con un registro no menor a seis horas y debe incluir por lo menos tres horas de sueño.Fil: Berrozpe, Elda Cecilia. Fleni. Departamento de Neurología. Servicio de Sueño y Vigilia. Laboratorio de Sueño; Argentina.Fil: Folgueira, Agustín. Hospital Italiano de Buenos Aires; Argentina.Fil: Gonzalez Cardozo, Agustín. Hospital Italiano de Buenos Aires; Argentina.Fil: Ponce de León, Marcela. Hospital Italiano de Buenos Aires; Argentina.Fil: Valiensi, Stella Maris. Hospital Italiano de Buenos Aires; Argentina
Intermittent apomorphine use for off period rescue in Parkinson's Disease: a pragmatic review of over three decades of clinical experience
No full textBackground
Although proven very efficacious as treatment for Parkinson's disease by Schwab as far back as the nineteen-fifties, and later confirmed by Cotzias and colleagues in the early nineteen-seventies, use of intermittent subcutaneous injections of the dopamine agonist apomorphine remains limited worldwide.
Objectives
To review evidence regarding use of intermittent, on-demand apomorphine as a treatment for off-period disability in Parkinson's disease.
Methods
A PRISMA-compliant structured literature search was carried out with a focus on clinical effect (motor improvement, daily off time decrease; latency, duration), antiemetic prophylaxis, and adverse events.
Results
Fifty-eight studies were evaluated. Apomorphine administration route was subcutaneous in 29 (50%), sublingual in 14 (24.1%), intranasal in 6 (10.3%), inhaled in 5 (8.6%), rectal in 3 (5.2%) and transdermal in 1 (1.7%). Irrespective of the route, motor disability improved 19–74% and daily off time decreased 36–68%, with subcutaneous having the fastest onset of action ranging from 6 to 24 minutes and lasting 28 to 96 minutes. Antiemetic prophylaxis was used in almost all studies. Systemic side effects like nausea and yawning were mild and well tolerated, but sedation led to discontinuation of subcutaneous apomorphine in 5.5%. Local side effects to subcutaneous administration did not result in discontinuation. Stomatitis with the early sublingual formulations led to discontinuation in nearly half of patients and was reduced to 16.7% with novel film strips.
Conclusions
Intermittent subcutaneous injections remain the most reliable and safest route of apomorphine administration, with an efficacy for off period treatment supported by nearly four decades of clinical experience.Fil: Castillo-Torres, Sergio Andrés. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina.Fil: Merello, Marcelo. Fleni. Departamento de Neurología. Servicio de Movimientos Anormales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina.Fil: Lees, Andrew J. Reta Lila Weston Institute of Neurological Studies. Department of Clinical Movement Disorder and Neuroscience; Inglaterra. University College London. Institute of Neurology; Inglaterra
Astrocitoma pilocítico cerebeloso Estudio de cohorte retrospectivo evaluando el resultado funcional postoperatorio, el mutismo y la hidrocefalia.
No full textObjetivo: Analizar una serie de pacientes pediátricos con APc evaluando factores que puedan modificar el desenlace en cuanto a “outcome” neurológico, mutismo e hidrocefalia.Materiales y métodos: Estudio unicéntrico, de cohorte retrospectivo, de pacientes quirúrgicos con APc y al menos 12 meses de seguimiento. Se evaluaron factores clínicos, imagenológicos y quirúrgicos, histopatología y adyuvancia. El resultado clínico se categorizó mediante la FSS y Bloom-Scale a corto y largo plazo.Resultados: Se incluyeron un total de 100 pacientes con un seguimiento medio de 53,9 meses, sin predileccion por sexo y con una edad media de 7,6 años. La localización más frecuente fue central y el 24% de los tumores presentó invasión troncoencefálica. 79 pacientes presentaban hidrocefalia al diagnóstico y 48% requirieron tratamiento preoperatorio. Se logró RT en el 67% de los casos. Se observó mutismo en 15 pacientes, asociado estadísticamente a la localización, la invasión pontina, el BSm preoperatorio y la meningitis/ventriculitis postoperatoria.El “outcome” funcional se correlacionó con complicaciones como meningitis/ventriculitis y hematoma cerebeloso, mutismo y recurrencia. Se observó recurrencia en el 26% de los casos y la reintervención quirúrgica fue la terapéutica elegida.Conclusión: El tratamiento de los APc en pacientes pediátricos se asocia a resultados relativamente favorables. La recidiva, el mutismo y las complicaciones quirúrgicas juegan un valor pronóstico en el desenlace y por lo tanto deben manejarse adecuadamente. Debe considerarse el tratamiento temprano con intención de RT, optando, de no ser posible, dejar un residuo tumoral por sobre el daño neurológico. El tratamiento de la hidrocefalia en instancia preoperatoria requiere un manejo individualizado.Fil: Ruella, Mauro. Fleni. Departamento de Neurocirugía; Argentina.Fil: Giovannini, Sebastián Juan María. Fleni. Departamento de Neurocirugía; Argentina.Fil: Pirozzi Chiusa, Christian. Hospital de Pediatría Juan P. Garrahan. Departamento de Neurocirugía; Argentina.Fil: Pérez Zabala, Joaquín. Hospital de Pediatría Juan P. Garrahan. Departamento de Neurocirugía; Argentina
Current Perspectives: Evidence to Date on BTK Inhibitors in the Management of Multiple Sclerosis
No full textMultiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system leading to demyelination and neurodegeneration. Basic and translational studies have shown that B cells and myeloid cells are critical players for the development and course of the disease. Bruton's tyrosine kinase (BTK) is essential for B cell receptor-mediated B cell activation and for normal B cell development and maturation. In addition to its role in B cells, BTK is also involved in several functions of myeloid cells. Although significant number of disease-modifying treatments (DMTs) have been approved for clinical use in MS patients, novel targeted therapies should be studied in refractory patients and patients with progressive forms of the disease. On the basis of its role in B cells and myeloid cells, BTK inhibitors can provide attractive therapeutic benefits for MS. In this article, we review the main effects of BTK inhibitors on different cell types involved in the pathogenesis of MS and summarise recent advances in the development of BTK inhibitors as novel therapeutic approaches in different MS clinical trials. Available data regarding the efficacy and safety of these drugs are described.Fil: Carnero Contentti, Edgar. Hospital Alemán de Buenos Aires. Department of Neuroscience. Neuroimmunology Unit; Argentina.Fil: Correale, Jorge. Fleni. Departamento de Neurología. Servicio de Neuroinmunología y Enfermedades Desmielinizantes; Argentina. Universidad de Buenos Aires-CONICET. Instituto de Química y Fisicoquimíca Biológicas; Argentina
Are Brain Responses to Emotion a Reliable Endophenotype of Schizophrenia? An Image-Based Functional Magnetic Resonance Imaging Meta-analysis
No full textBackground: Impaired emotion processing constitutes a key dimension of schizophrenia and a possible endophenotype of this illness. Empirical studies consistently report poorer emotion recognition performance in patients with schizophrenia as well as in individuals at enhanced risk of schizophrenia. Functional magnetic resonance imaging studies also report consistent patterns of abnormal brain activation in response to emotional stimuli in patients, in particular, decreased amygdala activation. In contrast, brain-level abnormalities in at-risk individuals are more elusive. We address this gap using an image-based meta-analysis of the functional magnetic resonance imaging literature.
Methods: Functional magnetic resonance imaging studies investigating brain responses to negative emotional stimuli and reporting a comparison between at-risk individuals and healthy control subjects were identified. Frequentist and Bayesian voxelwise meta-analyses were performed separately, by implementing a random-effect model with unthresholded group-level T-maps from individual studies as input.
Results: In total, 17 studies with a cumulative total of 677 at-risk individuals and 805 healthy control subjects were included. Frequentist analyses did not reveal significant differences between at-risk individuals and healthy control subjects. Similar results were observed with Bayesian analyses, which provided strong evidence for the absence of meaningful brain activation differences across the entire brain. Region of interest analyses specifically focusing on the amygdala confirmed the lack of group differences in this region.
Conclusions: These results suggest that brain activation patterns in response to emotional stimuli are unlikely to constitute a reliable endophenotype of schizophrenia. We suggest that future studies instead focus on impaired functional connectivity as an alternative and promising endophenotype.Fil: Villarreal, Mirta Fabiana. Instituto de Neurociencias FLENI-CONICET; Argentina.Fil: Fiorito, Anna M. University of Lyon; Francia. University Hospital of Saint-Etienne, Saint-Etienne. Department of Psychiatry; Francia.Fil: Aleman, André. University of Groningen; Países Bajos. University Medical Center Groningen. Department of Biomedical Sciences of Cells & Systems; Países Bajos.Fil: Blasi, Giuseppe. University of Bari Aldo Moro. Department of Basic Medical Sciences, Neuroscience and Sense Organs. Group of Psychiatric Neuroscience; Italia.Fil: Bourque, Josiane. University of Pennsylvania. Perelman School of Medicine. Department of Psychiatry; Estados Unidos.Fil: Cao, Hengyi. Feinstein Institute for Medical Research. Center for Psychiatric Neuroscience; Estados Unidos.Fil: Chan, Raymond C.K. Institute of Psychology. Sciences Key Laboratory of Mental Health; China.Fil: Chowdury, Asadur. Wayne State University. Department of Psychiatry & Behavioral Neurosciences; Estados Unidos.Fil: Conrod, Patricia. University of Montréal. Department of Psychiatry and Addiction. CHU Sainte-Justine Research Center; Canadá.Fil: Diwadkar, Vaibhav A. University of Montréal. Department of Psychiatry and Addiction. CHU Sainte-Justine Research Center; Canadá.Fil: Goghari, Vina M. University of Toronto. Department of Psychological Clinical Science; Canadá.Fil: Guinjoan, Salvador. Laureate Institute for Brain Research; Estados Unidos.Fil: Gur, Raquel E. University of Pennsylvania. Department of Psychiatry, Perelman School of Medicine; Estados Unidos.Fil: Gur, Ruben C. University of Pennsylvania. Department of Psychiatry, Perelman School of Medicine; Estados Unidos.Fil: Kwon, Jun Soo. Seoul National University College of Medicine. Department of Psychiatry; Corea.Fil: Lieslehto, Johannes. Niuvanniemi Hospital. University of Eastern Finland, Department of Forensic Psychiatry; Finlandia.Fil: Lukow, Paulina B. King's College London. Institute of Psychiatry, Psychology & Neuroscience. Department of Psychosis Studies; Reino Unido.Fil: Meyer-Lindenberg, Andreas. Medical Faculty Mannheim/Heidelberg University. Central Institute of Mental Health; Alemania.Fil: Modinos, Gemma. King's College London. Institute of Psychiatry, Psychology & Neuroscience. Department of Psychosis Studies; Reino Unido.Fil: Quarto, Tiziana. University of Foggia. Department of Law; Italia
Treatment-related fluctuations in Guillain-Barré syndrome: clinical features and predictors of recurrence
No full textBackground: A treatment-related fluctuation (TRF) in a patient with Guillain-Barré syndrome (GBS) is defined as clinical deterioration within two months of symptom onset following previous stabilization or improvements with treatment.
Objective: To investigate the clinical characteristics and factors that could increase the risk of relapse of GBS in patients with and without TRFs.
Methods: Retrospective review of medical records of patients (>18 years) with GBS evaluated between January/2006 and July/2019. Demographic and clinical characteristics, ancillary studies, treatment received, and the clinical course of patients with and without TRFs were analyzed.
Results: Overall, 124 cases of GBS were included; seven (5.6%) presented TRFs. GBS-TRF cases were triggered more frequently by infectious mononucleosis (28.57 vs. 8.55%; p=0.01). GBS-TRF were initially treated with plasmapheresis more frequently than those without TRF (14.29 vs. 1.70%; p=0.0349). Combined treatment (71.43 vs. 4.27%; p<0.001) and corticosteroids (42.86 vs. 1.71%; p<0.001) were more commonly used in the GBS-TRF group. GBS-TRF patients presented a higher median initial disability score (4 vs. 2; p=0.01).
Conclusions: Patients with GBS triggered by infectious mononucleosis and a high degree of initial disability have higher chances of developing TRFs. Although patients with TRF were treated with plasmapheresis more often, the total number was too low to suggest a link between plasma exchange and TRF.Fil: Alessandro, Lucas. Fleni. Departamento de Neurología. Servicio de Neurología Cognitiva, Neuropsicología y Neuropsiquiatría; Argentina.Fil: Castiglione, Juan Ignacio. Fleni. Departamento de Neurología; Argentina.Fil: Brand, Patricio. Fleni. Departamento de Neurología. Sección de Enfermedades Neuromusculares; Argentina.Fil: Bruno, Verónica. University of Calgary. Hotchkiss Brain Institute. Department of Clinical Neurosciences; Canadá.Fil: Barroso, Fabio Adrián. Fleni. Departamento de Neurología. Servicio de Neurofisiología; Argentina
Calcium supplementation for prevention of primary hypertension
No full textBackground: Hypertension is a major public health problem that increases the risk of cardiovascular and kidney diseases. Several studies have shown an inverse association between calcium intake and blood pressure, as small reductions in blood pressure have been shown to produce rapid reductions in vascular disease risk even in individuals with normal blood pressure ranges. This is the first update of the review to evaluate the effect of calcium supplementation in normotensive individuals as a preventive health measure.
Objectives: To assess the efficacy and safety of calcium supplementation versus placebo or control for reducing blood pressure in normotensive people and for the prevention of primary hypertension.
Search methods: The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to September 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 9), Ovid MEDLINE, Ovid Embase, the WHO International Clinical Trials Registry Platform, and the US National Institutes of Health Ongoing Trials Register, ClinicalTrials.gov. We also contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions.
Selection criteria: We selected trials that randomised normotensive people to dietary calcium interventions such as supplementation or food fortification versus placebo or control. We excluded quasi-random designs. The primary outcomes were hypertension (defined as blood pressure ≥ 140/90 mmHg) and blood pressure measures.
Data collection and analysis: Two review authors independently selected trials for inclusion, abstracted the data and assessed the risks of bias. We used the GRADE approach to assess the certainty of evidence.
Main results: The 2020 updated search identified four new trials. We included a total of 20 trials with 3512 participants, however we only included 18 for the meta-analysis with 3140 participants. None of the studies reported hypertension as a dichotomous outcome. The effect on systolic and diastolic blood pressure was: mean difference (MD) -1.37 mmHg, 95% confidence interval (CI) -2.08, -0.66; 3140 participants; 18 studies; I2 = 0%, high-certainty evidence; and MD -1.45, 95% CI -2.23, -0.67; 3039 participants; 17 studies; I2 = 45%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those younger than 35 years was: MD -1.86, 95% CI -3.45, -0.27; 452 participants; eight studies; I2 = 19%, moderate-certainty evidence; MD -2.50, 95% CI -4.22, -0.79; 351 participants; seven studies ; I2 = 54%, moderate-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for those 35 years or older was: MD -0.97, 95% CI -1.83, -0.10; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence; MD -0.59, 95% CI -1.13, -0.06; 2688 participants; 10 studies; I2 = 0%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for women was: MD -1.25, 95% CI -2.53, 0.03; 1915 participants; eight studies; I2 = 0%, high-certainty evidence; MD -1.04, 95% CI -1.86, -0.22; 1915 participants; eight studies; I2 = 4%, high-certainty evidence, respectively. The effect on systolic and diastolic blood pressure for men was MD -2.14, 95% CI -3.71, -0.59; 507 participants; five studies; I2 = 8%, moderate-certainty evidence; MD -1.99, 95% CI -3.25, -0.74; 507 participants; five studies; I2 = 41%, moderate-certainty evidence, respectively. The effect was consistent in both genders regardless of baseline calcium intake. The effect on systolic blood pressure was: MD -0.02, 95% CI -2.23, 2.20; 302 participants; 3 studies; I2 = 0%, moderate-certainty evidence with doses less than 1000 mg; MD -1.05, 95% CI -1.91, -0.19; 2488 participants; 9 studies; I2 = 0%, high-certainty evidence with doses 1000 to 1500 mg; and MD -2.79, 95% CI -4.71, 0.86; 350 participants; 7 studies; I2 = 0%, moderate-certainty evidence with doses more than 1500 mg. The effect on diastolic blood pressure was: MD -0.41, 95% CI -2.07, 1.25; 201 participants; 2 studies; I2 = 0, moderate-certainty evidence; MD -2.03, 95% CI -3.44, -0.62 ; 1017 participants; 8 studies; and MD -1.35, 95% CI -2.75, -0.05; 1821 participants; 8 studies; I2 = 51%, high-certainty evidence, respectively. None of the studies reported adverse events.Fil: Cormick, Maria Sol. Fleni. Departamento de Diagnóstico por Imágenes; Argentina.Fil: Cormick, Gabriela. Instituto de Efectividad Clínica y Sanitaria. Departamento de Investigación en Salud de la Madre y el Niño; Argentina.Fil: Ciapponi, Agustín. Instituto de Efectividad Clínica y Sanitaria. Argentine Cochrane Centre; Argentina.Fil: Cafferata, María Luisa. Instituto de Efectividad Clínica y Sanitaria. Departamento de Investigación en Salud de la Madre y el Niño; Argentina.Fil: Belizán, José M. Instituto de Efectividad Clínica y Sanitaria. Departamento de Investigación en Salud de la Madre y el Niño; Argentina
Microdosing with psilocybin mushrooms: a double-blind placebo-controlled study
No full textThe use of low sub-perceptual doses of psychedelics ("microdosing") has gained popularity in recent years. Although anecdotal reports claim multiple benefits associated with this practice, the lack of placebo-controlled studies severely limits our knowledge of microdosing and its effects. Moreover, research conducted in standard laboratory settings could fail to capture the motivation of individuals engaged or planning to engage in microdosing protocols, thus underestimating the likelihood of positive effects on creativity and cognitive function. We recruited 34 individuals starting to microdose with psilocybin mushrooms (Psilocybe cubensis), one of the materials most frequently used for this purpose. Following a double-blind placebo-controlled experimental design, we investigated the acute and short-term effects of 0.5 g of dried mushrooms on subjective experience, behavior, creativity (divergent and convergent thinking), perception, cognition, and brain activity. The reported acute effects were significantly more intense for the active dose compared to the placebo, but only for participants who correctly identified their experimental condition. These changes were accompanied by reduced EEG power in the theta band, together with preserved levels of Lempel-Ziv broadband signal complexity. For all other measurements there was no effect of microdosing except for few small changes towards cognitive impairment. According to our findings, low doses of psilocybin mushrooms can result in noticeable subjective effects and altered EEG rhythms, but without evidence to support enhanced well-being, creativity and cognitive function. We conclude that expectation underlies at least some of the anecdotal benefits attributed to microdosing with psilocybin mushrooms.Fil: Cavanna, Federico. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina. Fleni. Instituto de Neurociencias FLENI-CONICET; Argentina.Fil: Muller, Stephanie. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina.Fil: de la Fuente, Laura A. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina. Institute of Cognitive and Translational Neuroscience; Argentina.Fil: Zamberlan, Federico. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina. Tilburg University. Department of Cognitive Science and Artificial Intelligence; Países Bajos.Fil: Palmucci, Matías. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina.Fil: Janeckova, Lucie. University of Chemistry and Technology Prague. Department of Chemistry of Natural Compounds. Forensic Laboratory of Biologically Active Substances; República Checa.Fil: Kuchar, Martine. University of Chemistry and Technology Prague. Department of Chemistry of Natural Compounds. Forensic Laboratory of Biologically Active Substances; República Checa. National Institute of Mental Health, Klecany. Department of Experimental Neurobiology; República Checa.Fil: Pallavicini, Carla. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Física. Instituto de Física de Buenos Aires; Argentina. Fleni. Instituto de Neurociencias FLENI-CONICET; Argentina