ABSTRACT
Introducción. El Inventario Neuropsiquiátrico (NPI) es una escala que valora la presencia de alteraciones psicopatológicas en pacientes con enfermedades neurológicas, principalmente demencias. A pesar de sus ventajas, existen pocos estudios publicado en pacientes con traumatismo craneoencefálico (TCE). Con la información derivada del NPI pretendemos describir las alteraciones psicopatológicas en un grupo de pacientes con TCE severo en fase crónica y determinar si se correlacionan con antecedentes psiquiátricos y medidas de resultado. Método. Se administró el NPI a los informantes de 53 pacientes con traumatismo craneoencefálico grave que se encontraban en fase crónica. Así mismo, se recogieron escalas de funcionalidad y de integración a la comunidad. Resultados. El 92,5% de la muestra estudiada presentaba alguna alteración psicopatológica según el NPI, siendo los síntomas más frecuentes la irritabilidad/labilidad, la apatía y la depresión/disforia. El antecedente de consumo habitual de tóxicos mostró una relación significativa con la presencia de psicopatología. Síntomas como la agitación, la apatía y la desinhibición se correlacionaron de forma significativa con el grado de discapacidad. Conclusiones. Las alteraciones psiquiátricas son frecuentes en pacientes con TCE. El nNPI es una herramienta que recoge de manera sistemática las alteraciones conductuales y emocionales más frecuentes en estos pacientes. Algunos de los síntomas influyen negativamente en el grado de discapacidad(AU)
Introduction. The Neuropsychiatric Inventory (NPI) is a scale that assesses psychiatric symptoms in patients with neurological disorders, principally dementia. Despite its advantages, there are few published studies in traumatic brain injury (TBI) patients. With the NPI information we are going to describe the psychopatologic disorders in a group of TBI chronic patients and look the possible association with psychiatric history and outcome measures. Method. The NPI was applied to caregivers of 53 patients with severe TBI in chronic phase. We also collected functional and community integration scales. Results. 92.5% of patients had some neuropsychiatric symptom, according to NPI. The most frequents were irritability/lability, apathy and depression/dysphoria. Those patients with drugs abuse history had more psychiatric symptoms. Presence of agitation/aggression, apathy and disinhibition were correlated with more disability. Conclusions. Psychiatric disorders are common between patients with TBI. The NPI is a scale that systematically assesses the behavioral and emotional disorders more common in these patients. Some of the symptoms negatively influence the degree of disability(AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Psychopathology/methods , Head Injuries, Penetrating/chemically induced , Head Injuries, Penetrating/complications , Head Injuries, Penetrating/physiopathology , Substance-Related Disorders/complications , Neuropsychiatry/methods , Psychopathology/organization & administration , Psychopathology/standards , Psychopathology/trends , Mental Status Schedule/standards , Head Injuries, Penetrating/rehabilitation , Head Injuries, Penetrating/psychology , Disability Evaluation , Persons with Mental Disabilities/psychology , Persons with Mental Disabilities/statistics & numerical data , Neuropsychiatry/instrumentationABSTRACT
An understanding of feasibility of implanting embryonic stem cells (ESCs), their behavior of migration in response to lesions induced in brain tissues, and the mechanism of their in vivo differentiation into neighboring neural cells is essential for developing and refining ESC transplantation strategies for repairing damages in the nervous system, as well as for understanding the molecular mechanism underlying neurogenesis. We hypothesized that damaged neural tissues offer a niche to which injected ESCs can migrate and differentiate into the neural cells. We inflicted damage in the murine (C57BL/6) brain by injecting phosphate-buffered saline into the left frontal and right caudal regions and confirmed neural damage by histochemistry. Enhanced yellow fluorescent protein-expressing ESCs were injected into the nondamaged left caudal portion of the brain. Using immunohistochemistry and fluorescent microscopy, we observed migration of ESCs from the injection site (left caudal) to the damaged site (right caudal and left frontal). Survival of the injected ESCs was confirmed by the real-time polymerase chain reaction analysis of stemness genes such as Oct4, Sox2, and FGF4. The portions of the damaged neural tissues containing ESCs demonstrated a fourfold increase in expression of these genes after 1 week of injection in comparison with the noninjected ESC murine brain, suggesting proliferation. An increased level of platelet-derived growth factor receptor demonstrated that ESCs responded to damaged neural tissues, migrated to the damaged site of the brain, and proliferated. These results demonstrate that undifferentiated ESCs migrate to the damaged regions of brain tissue, engraft, and proliferate. Thus, damaged brain tissue provides a niche that attracts ESCs to migrate and proliferate.
