ABSTRACT
Objetivo: Evaluar la relación entre el potencial relacionado a eventos P300 con significado atencional visual y los resultados de la evaluación neuropsicológica en pacientes conenfermedad de Parkinson en estadios II y III de Hoehn y Yahr.Métodos: Se realizó un estudio analítico transversal donde se evaluaron 57 pacientes con enfermedad de Parkinson idiopática, atendidos entre diciembre de 2017 y abril de 2018, en el Centro Internacional de Restauración Neurológica, de La Habana. Se realizó el registro de P300, durante la ejecución de una tarea de atención sostenida visual. Se midió latencia y amplitud de la P300, lo que se correlacionó (test de correlaciones de Spearman, p< 0,01)con las variables demográficas, variables de eficiencia en la tarea de atención sostenida y variables neuropsicológicas. Se compararon los resultados de los grupos II y III de Hoehn y Yahr con respecto a todas las variables estudiadas (test de la U de Mann Whitney, p< 0,05).Resultados: Se constató una significativa diferencia de latencia entre grupos del componente P300 en el electrodo Pz. Fue más prolongado en el grupo III de Hoehn y Yahr.Se evidenciaron en el grupo II correlaciones negativas entre la latencia de P300 y el test de batería de evaluación frontal, y positivas entre la latencia de P300 y la prueba de Stroop.Las correlaciones entre el test de ba(AU)
Objective: To evaluate the relationship between the P300 event-related potential with visual attention significance and the results of neuropsychological evaluation in patientswith Parkinson's disease in Hoehn and Yahr stages II and III.Methods: A cross-sectional analytical study was carried out evaluating 57 patients with idiopathic Parkinson's disease, who were treated from December 2017 to April 2018 at theInternational Center for Neurological Restoration, in Havana. P300 was recorded during the execution of a visual sustained attention task. The latency and amplitude of P300 weremeasured, which was correlated (Spearman's correlation test, p <0.01) with demographic variables, efficiency variables in the sustained attention task and neuropsychological variables. The results of Hoehn and Yahr groups II and III were compared with respect to all the variables studied (Mann Whitney U test, p <0.05).Results: Significant latency difference was found between groups of P300 component in Pz electrode. It was more prolonged in Hoehn and Yahr group III. Negative correlations were found in group II between P300 latency and the frontal evaluation battery test, andpositive correlations between P300 latency and Stroop test. The correlations between the frontal evaluation battery test and P300 amplitude were positive, and between Stroop test and P300 amplitude were negative. Similar results were evident in group III regarding P300 amplitude, which corresponded to worse performance in the neuropsychological evaluation.Conclusions: A close relationship between P300 event-related potential with visual attention significance and the results of the neuropsychological evaluation in Parkinson's disease patients, in Hoehn and Yahr stages II and III, was verified. P300 potential was an objective examination that reinforced the validity of the neuropsychological evaluationresults(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Parkinson Disease/diagnosis , Parkinson Disease/drug therapy , Event-Related Potentials, P300 , Antiparkinson Agents/administration & dosage , Antiparkinson Agents/therapeutic use , Neuropsychological Tests , ElectroencephalographyABSTRACT
La ética médica aborda, entre otros aspectos, la relación médico-paciente, de la cual se deriva el término consentimiento informado como su máxima expresión. La epilepsia afecta al 1-2 por ciento de la población mundial, y en la búsqueda de soluciones a esta enfermedad los sujetos son involucrados en diferentes tipos de estudios. En el presente trabajo se realiza una breve revisión de algunos aspectos éticos relacionados con la aprobación dada por los pacientes que padecen epilepsia o su representante legal para participar en estudios que presuponen la realización de exámenes diagnósticos y el empleo de formas novedosas de tratamiento, lo que se materializa a través del consentimiento informado. Especialmente, se hace referencia a la participación de los pacientes en ensayos clínicos y el manejo de las pacientes que quedan embarazadas en el transcurso del ensayo clínico, los efectos adversos de la medicación y de la cirugía de epilepsia(AU)
Medical Ethics addresses, among other aspects, the doctor-patient relationship from which the term informed consent is derived as its maximum expression. Epilepsy affects 1-2 percent of the world population, and in the search for solutions to this disease the subjects are involved in different types of studies. In the present paper, a brief review of some ethical aspects related to the approval given by patients suffering from epilepsy or their legal representative to participate in studies that presuppose the performance of diagnostic tests and the use of novel forms of treatment. This is materialized through informed consent. Especially, there is a reference to the participation of patients in clinical trials, and the management of patients who become pregnant during the clinical trial, the adverse effects of medication, and epilepsy surgery(AU)
Subject(s)
Humans , Informed Consent/ethics , Informed Consent/psychology , Epilepsy/drug therapy , Epilepsy/surgeryABSTRACT
La ética médica aborda, entre otros aspectos, la relación médico-paciente, de la cual se deriva el término consentimiento informado como su máxima expresión. La epilepsia afecta al 1-2 por ciento de la población mundial, y en la búsqueda de soluciones a esta enfermedad los sujetos son involucrados en diferentes tipos de estudios. En el presente trabajo se realiza una breve revisión de algunos aspectos éticos relacionados con la aprobación dada por los pacientes que padecen epilepsia o su representante legal para participar en estudios que presuponen la realización de exámenes diagnósticos y el empleo de formas novedosas de tratamiento, lo que se materializa a través del consentimiento informado. Especialmente, se hace referencia a la participación de los pacientes en ensayos clínicos y el manejo de las pacientes que quedan embarazadas en el transcurso del ensayo clínico, los efectos adversos de la medicación y de la cirugía de epilepsia(AU)
Medical Ethics addresses, among other aspects, the doctor-patient relationship from which the term informed consent is derived as its maximum expression. Epilepsy affects 1-2 percent of the world population, and in the search for solutions to this disease the subjects are involved in different types of studies. In the present paper, a brief review of some ethical aspects related to the approval given by patients suffering from epilepsy or their legal representative to participate in studies that presuppose the performance of diagnostic tests and the use of novel forms of treatment. This is materialized through informed consent. Especially, there is a reference to the participation of patients in clinical trials, and the management of patients who become pregnant during the clinical trial, the adverse effects of medication, and epilepsy surgery(AU)
Subject(s)
Epilepsy/surgery , Epilepsy/drug therapy , Informed Consent/psychology , Informed Consent/ethicsABSTRACT
Auditory and visual pathways may be affected as a consequence of temporal lobe epilepsy surgery because of their anatomical relationships with this structure. The purpose of this paper is to correlate the results of the auditory and visual evoked responses with the parameters of tractography of the visual pathway, and with the state of connectivity between respective thalamic nuclei and primary cortices in both systems after the surgical resection of the epileptogenic zone in drug-resistant epileptic patients. Tractography of visual pathway and anatomical connectivity of auditory and visual thalamus-cortical radiations were evaluated in a sample of eight patients. In general, there was a positive relationship of middle latency response (MLR) latency and length of resection, while a negative correlation was found between MLR latency and the anatomical connection strength and anatomical connection probability of the auditory radiations. In the visual pathway, significant differences between sides were found with respect to the number and length of tracts, which was lower in the operated one. Anatomical connectivity variables and perimetry (visual field defect index) were particularly correlated with the latency of P100 wave which was obtained by quadrant stimulation. These results demonstrate an indirect functional modification of the auditory pathway and a direct traumatic lesion of the visual pathway after anterior temporal lobectomy in patients with drug resistant epilepsy.
