Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
Sleep Med ; 66: 33-50, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31786427

RESUMO

Sleep has a crucial role in brain functioning and cognition, and several sleep electroencephalography (EEG) hallmarks are associated with intellectual abilities, neural plasticity, and learning processes. Starting from this evidence, a growing interest has been raised regarding the involvement of the sleep EEG in brain maturation and cognitive functioning during typical development (TD). The aim of this review is to provide a general framework about the maturational changes and the functional role of the human sleep EEG during TD from birth to late adolescence (≤22 years). The reviewed findings show large developmental modifications in several sleep EEG hallmarks (slow wave activity, sleep spindles, theta activity, and cyclic alternating pattern) during TD, and many studies support the notion of an active role of sleep slow wave activity in supporting brain maturation. Moreover, we focus on the possible relation between sleep microstructure, intelligence, and several memory domains (declarative, emotional, procedural), showing that sleep EEG oscillations seem involved in intellectual abilities and learning processes during TD, although results are often conflicting and divergent from findings in adults. Starting from the present literature, we propose that larger methodological uniformity, greater attention to the topographical and maturational aspects of the sleep EEG oscillations and their mutual interactions, and a higher number of longitudinal studies will be essential to clarify the role of the sleep EEG in cognitive functioning during TD.


Assuntos
Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil , Cognição/fisiologia , Eletroencefalografia , Sono/fisiologia , Criança , Pré-Escolar , Estudos Transversais , Humanos , Estudos Longitudinais , Plasticidade Neuronal , Portugal , Inquéritos e Questionários
2.
Behav Brain Funct ; 14(1): 19, 2018 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-30587203

RESUMO

Narcolepsy is a chronic sleep disorder characterized by excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, and sleep paralysis. This disease affects significantly the overall patient functioning, interfering with social, work, and affective life. Some symptoms of narcolepsy depend on emotional stimuli; for instance, cataplectic attacks can be triggered by emotional inputs such as laughing, joking, a pleasant surprise, and also anger. Neurophysiological and neurochemical findings suggest the involvement of emotional brain circuits in the physiopathology of cataplexy, which seems to depending on the dysfunctional interplay between the hypothalamus and the amygdala associated with an alteration of hypocretin levels. Furthermore, behavioral studies suggest an impairment of emotions processing in narcolepsy-cataplexy (NC), like a probable coping strategy to avoid or reduce the frequency of cataplexy attacks. Consistently, NC patients seem to use coping strategies even during their sleep, avoiding unpleasant mental sleep activity through lucid dreaming. Interestingly, NC patients, even during sleep, have a different emotional experience than healthy subjects, with more vivid, bizarre, and frightening dreams. Notwithstanding this evidence, the relationship between emotion and narcolepsy is poorly investigated. This review aims to provide a synthesis of behavioral, neurophysiological, and neurochemical evidence to discuss the complex relationship between NC and emotional experience and to direct future research.


Assuntos
Emoções/fisiologia , Narcolepsia/fisiopatologia , Narcolepsia/psicologia , Cataplexia/diagnóstico , Cataplexia/fisiopatologia , Cataplexia/psicologia , Humanos , Narcolepsia/diagnóstico , Polissonografia/tendências , Sono REM/fisiologia
3.
Neurol Sci ; 32(6): 1043-6, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21584740

RESUMO

Approximately, 3-10% of patients with multiple sclerosis (MS) present a disease onset before the age of 18 years. Although growing attention is dedicated to cognitive impairment and its functional consequences in paediatric MS, so far no study has explored possible neurophysiologic correlates. The study's aim was to describe event-related potentials in relationship with cognitive performance in children and adolescents with MS compared with demographically matched healthy controls (HC), providing two-year follow-up data. Six MS subjects aged between 9 and 17 years were assessed through an extensive neuropsychological battery at two time points. Event-related potentials with an odd-ball acoustic paradigm were also recorded in the patients and in nine HC. At baseline, four out of six patients failed three or more cognitive tasks and were classified as cognitively impaired. In all the cognitively impaired patients, we found abnormal latencies and amplitudes of the P300. After 2 years, five patients exhibited a deteriorating cognitive performance and a corresponding deterioration of the P300 parameters. In our group of children and adolescents with MS, changes in P300 parameters proceeded in parallel with deteriorating cognitive performance. P300 might represent an objective parameter to monitor cognitive changes in paediatric MS.


Assuntos
Transtornos Cognitivos/etiologia , Deficiências do Desenvolvimento/etiologia , Potenciais Evocados/fisiologia , Esclerose Múltipla/complicações , Pediatria , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Testes Neuropsicológicos , Tempo de Reação/fisiologia , Estatísticas não Paramétricas
4.
Neurophysiol Clin ; 39(2): 85-93, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19467438

RESUMO

AIMS: To monitor acute brain injury in the neurological intensive care unit (NICU), we used EEG and somatosensory evoked potentials (SEP) in combination to achieve more accuracy in detecting brain function deterioration. METHODS: Sixty-eight patients (head trauma and intracranial hemorrhage; GCS<9) were monitored with continuous EEG-SEP and intracranial pressure monitoring (ICP). RESULTS: Fifty-five patients were considered "stable" or improving, considering the GCS and CT scan: in this group, SEP didn't show significant changes. Thirteen patients showed neurological deteriorations and, in all patients, cortical SEP showed significant alterations (amplitude decrease>50% often till complete disappearance). SEP deterioration anticipated ICP increase in 30%, was contemporary in 38%, and followed ICP increase in 23%. Considering SEP and ICP in relation to clinical course, all patients but one with ICP less than 20 mmHg were stable, while the three patients with ICP greater than 40 mmHg all died. Among the 26 patients with ICP of 20-40 mmHg, 17 were stable, while nine showed clinical and neurophysiological deterioration. Thus, there is a range of ICP values (20-40 mmHg) were ICP is scarcely indicative of clinical deterioration, rather it is the SEP changes that identify brain function deterioration. Therefore, SEP have a twofold interest with respect to ICP: their changes can precede an ICP increase and they can constitute a complementary tool to interpret ICP trends. It has been very important to associate SEP and EEG: about 60% of our patients were deeply sedated and, because of their relative insensitivity to anesthetics, only SEP allowed us to monitor brain damage evolution when EEG was scarcely valuable. CONCLUSIONS: We observed 3% of nonconvulsive status epilepticus compared to 18% of neurological deterioration. If the aim of neurophysiological monitoring is to "detect and protect", it may not be limited to detecting seizures, rather it should be able to identify brain deterioration, so we propose the combined monitoring of EEG with SEP.


Assuntos
Lesões Encefálicas/fisiopatologia , Eletroencefalografia/métodos , Potenciais Somatossensoriais Evocados , Monitorização Fisiológica/métodos , Adolescente , Adulto , Idoso , Lesões Encefálicas/etiologia , Isquemia Encefálica/complicações , Isquemia Encefálica/fisiopatologia , Progressão da Doença , Feminino , Escala de Coma de Glasgow , Humanos , Hemorragia Intracraniana Traumática/fisiopatologia , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/etiologia , Hipertensão Intracraniana/mortalidade , Hipertensão Intracraniana/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estado Epiléptico/fisiopatologia , Hemorragia Subaracnóidea/etiologia , Hemorragia Subaracnóidea/fisiopatologia , Adulto Jovem
5.
Neurophysiol Clin ; 36(4): 195-205, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17095409

RESUMO

AIMS: To evaluate the feasibility of a continuous neurophysiologic monitoring (electroencephalography (EEG)-somatosensory evoked potentials (SEPs)) in the neuro-intensive care unit (NICU), taking into account both the technical and medical aspects that are specific of this environment. METHODS: We used an extension of the recording software that is routinely used in our unit of clinical neurophysiology. It performs cycles of alternate EEG and SEP recordings. Raw traces and trends are simultaneously displayed. Patient head and stimulator box are placed behind the bed and linked to the ICU monitoring terminal through optic fibers. The NICU staff has been trained to note directly clinical events, main artefacts and therapeutic changes. The hospital local area network (LAN) enables remote monitoring survey. RESULTS: Continuous EEG (CEEG)-SEP monitoring was performed in 44 patients. Problems of needle detachment were seldomly encountered, thanks to the use of a sterile plastic dressing, which covers needles. We never had infection or skin lesions due to needles or the electrical stimulator. The frequent administration of sedative at high doses prevented us from having a clinically valuable EEG in several cases but SEPs were always monitorable, independently of the level of EEG suppression. The diagnosis of seizures and non-epileptic status was based on raw EEG, while quantitative EEG (QEEG) was used to quantify ictal activity as a guide to treatment. CONCLUSIONS: EEG and EP waveforms collected in NICU were of comparable quality to routine clinical measurements and contained the same clinical information. A continuous SEP monitoring in a comatose and sedated patient in NICU is not technically more difficult and potentially less useful than in operating room. This monitoring appears to be feasible provided the observance of some requirement regarding setting, electrodes, montages, personnel integration, consulting and software.


Assuntos
Lesões Encefálicas/fisiopatologia , Eletroencefalografia , Potenciais Somatossensoriais Evocados/fisiologia , Cuidados Críticos , Coleta de Dados , Eletrodos , Eletroencefalografia/instrumentação , Eletrofisiologia , Humanos , Hipnóticos e Sedativos/uso terapêutico , Monitorização Fisiológica , Software , Estado Epiléptico/diagnóstico
6.
Surg Endosc ; 19(7): 974-6, 2005 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-15920696

RESUMO

BACKGROUND: Inguinal neuralgia after open and laparoscopic hernia, repair occurs in about 0.5% of treated patients. If the pain and the functional inability persist, it is possible that the genitofemoral nerve and ileoinguinal nerve are involved in entrapment, and surgical treatment is a possible option. This paper reports a personal endoscopic retroperitoneal approach for ileoinguinal and genitofemoral branches neurectomy. METHODS: A 12-mm trocar is inserted into the lower retroperitoneum and insufflated to create a work space. Neurectomy is performed under endoscopic guidance. RESULTS: Six patients were treated using this technique. The operating time was 55 min, and all patients were completely pain-free after surgery. All patients were discharged the first day after operation and there were no complications. CONCLUSION: This retroperitoneal endoscopic approach is proposed as a new surgical technique for treating inguinal entrapment neuralgia. It is simple and feasible.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Hérnia Femoral/cirurgia , Hérnia Inguinal/cirurgia , Síndromes de Compressão Nervosa/cirurgia , Humanos , Masculino , Procedimentos Neurocirúrgicos/métodos , Pelve/inervação , Espaço Retroperitoneal
7.
Eur J Obstet Gynecol Reprod Biol ; 73(2): 111-4, 1997 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-9228488

RESUMO

OBJECTIVES: (1) to evaluate the incidence of preterm delivery in patients with gestational diabetes mellitus; (2) to determine the association between glycaemic control and preterm delivery in these patients. STUDY DESIGN: (1) The incidence of spontaneous preterm singleton deliveries was determined in 550 intensively-treated patients with gestational diabetes mellitus. A total of 14 552 consecutive patients without gestational diabetes mellitus who delivered during the same interval served as a control population; (2) Glycaemic profiles (i.e., mean blood glucose, percent of hypoglycaemic [ < 60 mg/dl] and hyperglycaemic [ > 120 mg/dl] episodes) were compared in 34 patients with gestational diabetes mellitus who delivered preterm, and 68 matched controls with gestational diabetes mellitus who delivered at term. RESULTS: (1) The incidence of preterm delivery in gestational diabetics was similar to that found in the non-diabetic population (6.2% vs. 6.5%, respectively, P = 0.82; confidence limits: 0.65, 1.36); (2) women with gestational diabetes mellitus who delivered at term, or preterm had similar glycaemic profiles for both the entire treatment period and the week preceding delivery. CONCLUSIONS: (1) There is no increased risk for preterm delivery in intensively-treated gestational diabetes mellitus patients; (2) In a population such as this women with gestational diabetes mellitus who deliver preterm cannot be characterised by their glycaemic profile.


Assuntos
Glicemia/metabolismo , Diabetes Gestacional/sangue , Trabalho de Parto Prematuro/sangue , Adulto , Bases de Dados Factuais , Feminino , Humanos , Incidência , Trabalho de Parto Prematuro/epidemiologia , Gravidez , Estudos Prospectivos , Fatores de Risco
8.
J Natl Med Assoc ; 87(10): 757-8, 1995 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7473851

RESUMO

This study examines the hypothesis that twin gestation is a risk factor for gestational diabetes. In a retrospective analysis, the incidence of gestational diabetes in twin and singleton pregnancies was determined in groups matched for maternal age, weight, and parity. One-hour oral glucose challenge tests (50 g) were used to screen 9185 pregnant women. Gestational diabetes was diagnosed when abnormal screens (> or = 130 mg/dL) were followed by two or more abnormal values on a 3-hour (100 g) glucose tolerance test using National Diabetes Data Group (NDDG) criteria. A twin gestation was identified in 1.5% (138/9185) of the pregnancies. Gestational diabetes was diagnosed in 5.8% (8/138) and 5.4% (439/9047) of the twin and singleton pregnancies, respectively. The incidence of gestational diabetes is similar for singleton and twin gestations.


Assuntos
Gravidez em Diabéticas/epidemiologia , Gravidez Múltipla , Adulto , Estudos Transversais , Feminino , Humanos , Incidência , Recém-Nascido , New York/epidemiologia , Gravidez , Gravidez em Diabéticas/etiologia , Cuidado Pré-Natal , Fatores de Risco , Gêmeos
9.
Gynecol Obstet Invest ; 39(3): 167-70, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7789911

RESUMO

Our objective was to study the influence of chronic hypertension on pregnancy outcome in women with gestational diabetes (GDM). 418 women with GDM (30 with chronic hypertension and 388 nonhypertensives) were referred to our diabetes in pregnancy program. All patients were followed and assessed biweekly until delivery. When hypertensive GDM women (n = 30) wer compared to all nonhypertensive GDM (n = 388), there were significant (p < 0.05) differences in mean maternal age (34 +/- 4.1 vs. 30 +/- 4.6 years), maternal weight (90 +/- 21.2 vs. 70.6 +/- 14.9 kg) and gestational age at delivery (38.5 +/- 1.2 vs. 39.6 +/- 1.2 weeks). The mean birth weight for the hypertensive GDM group was significantly higher than that of the nonhypertensive GDM (3,360 +/- 578 vs. 3,293 +/- 581 g; p < 0.05). The frequencies of LGA (23.3 vs. 9.8%) and induction prior to onset of spontaneous labor were significantly (p < 0.05) higher in the hypertensive GDM group when compared to the nonhypertensive GDM. There were no differences with respect to the average blood glucose and frequencies of SGA deliveries. However, when the 30 hypertensive GDM pregnancies were compared to a control group of 60 nonhypertensive GDM women matched for age, weight and height, the only significant difference was a higher rate of inductions of labor (36.7 vs. 6.6%, p < 0.05) in hypertensive diabetic women. There were no significant differences in the incidence of LGA, low Apgar scores and SGA deliveries when hypertensive GDM were compared to nonhypertensive GDM women.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Diabetes Gestacional/complicações , Hipertensão/complicações , Resultado da Gravidez , Adulto , Peso ao Nascer , Doença Crônica , Feminino , Idade Gestacional , Humanos , Gravidez
10.
Am J Obstet Gynecol ; 171(4): 952-5, 1994 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7943108

RESUMO

OBJECTIVE: Our purpose was to determine the association between amniotic fluid volume and recent glucose status in gestational diabetes. STUDY DESIGN: Serial amniotic fluid index values, mean blood glucose levels, and percent hyperglycemia (> or = 120 mg/dl) 1 day and 1 week before the ultrasonographic examinations were prospectively collected in 399 gestational diabetics. Patients demonstrating at least one amniotic fluid index measurement within the normal range (i.e., 5 cm < amniotic fluid index < or = 20 cm) and at least one elevated measurement (i.e., amniotic fluid index > 20 cm) formed the study group. With each patient serving as her own control, glucose index values preceding normal and elevated amniotic fluid index values were compared. RESULTS: Significantly higher mean blood glucose values 1 day (114.7 mg/dl vs 102.8 mg/dl, p < 0.01) and 1 week before (111.0 mg/dl vs. 102.0 mg/dl, p < 0.05) were calculated for examinations resulting in elevated amniotic fluid index values compared with normal amniotic fluid index values, respectively. Similarly, significantly higher percents of hyperglycemia 1 day (32% vs 16.5%, p < 0.05) but not 1 week (30.8% vs 21.7%, p > 0.05) before the elevated amniotic fluid index were documented. CONCLUSION: Amniotic fluid volume reflects recent glycemic status in gestational diabetes mellitus.


Assuntos
Líquido Amniótico/diagnóstico por imagem , Glicemia/metabolismo , Diabetes Gestacional/sangue , Adulto , Diabetes Gestacional/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Hiperglicemia/sangue , Gravidez , Estudos Prospectivos , Ultrassonografia Pré-Natal
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...