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Spatial navigation entropy suggests allocentric dysfunction in PPPD
(Frontiers Media SA, 2025-05-16)
Felipe Faúndez
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Camilo Arévalo-Romero
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Karen Villarroel
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Gustavo Vial
;
Claudio Lavín
Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve functional dysfunction of the construction of inner cognitive maps, leading to disrupted spatial cognition processes as a core feature. The present studies attempt to unravel the neural mechanisms that underlie spatial navigation in PPPD.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Fifty-two participants completed the study: 19 PPPD patients, 20 control subjects with vestibular disorders but without PPPD (with comparable peripheral vestibular function to the PPPD group, and 13 healthy volunteers). All underwent a virtual Morris Water Maze (vMWM) task in both, non-immersive (NI) and virtual reality (VR) modalities, assessing spatial navigation performance, gaze behavior, and head kinematics.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>PPPD patients exhibited significantly worse navigation performance than both control groups across all metrics, with greater impairments in predominantly allocentric tasks. They also showed increased exploratory gaze behavior, unaffected by NI vs. VR modality or task condition. Head kinematics did not significantly differ between the three groups, though a non-significant trend indicated reduced head movement in both PPPD and vestibular controls. VR intolerance was highest in PPPD patients, followed by vestibular controls, with healthy volunteers showing the lowest discomfort.</jats:p></jats:sec><jats:sec><jats:title>Discussion</jats:title><jats:p>Our findings suggest that PPPD involves deficits in allocentric spatial navigation, likely due to predictive coding errors and impaired internal model updating, rather than sensory input dysfunction. Increased gaze scanning may reflect compensatory mechanisms for spatial uncertainty. Notably, VR immersion did not alter navigation performance, suggesting visuo-vestibular conflict is not the primary driver of PPPD-related spatial deficits. These findings offer new insights into PPPD as a disorder of spatial cognition, opening avenues for novel diagnostic and therapeutic approaches.
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Chronic dizziness in older adults: Disrupted sensorimotor EEG beta oscillations during postural instability
(Elsevier BV, 2025-06)
Toby J. Ellmers
;
Richard Ibitoye
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CASTRO ABARCA, PATRICIA BERNARDITA
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Elmar C. Kal
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Diego Kaski
Scopus© Citations 2 1
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Functional Capacity in Activities of Daily Living in the Alzheimer’s Disease Continuum
(Wiley, 2024-12)
Fernando Henriquez
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Carmen Dominguez
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Fabrissio Grandi
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Cecilia Gonzalez Campo
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Patricio Riquelme Contreras
The most common and prevalent dementia worldwide is Alzheimer’s disease (AD). AD is a continuum composed of Subjective Cognitive Impairment (SCD), Mild Cognitive Impairment (MCI), and Alzheimer’s Disease dementia (ADD) stage. One of the main clinical variables in patients with dementia is performance in functional capacity since its alterations are associated with poor prognosis and disease progression. Functional capacity is measured through activities of daily living (ADL), which are divided into three domains: i) Basic (BADL), ii) Instrumental (IADL), and iii) Advanced (AADL). The study aimed to characterize the performance of the different stages of the AD continuum in the ADL domains and their association with cognitive abilities.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>A cross‐sectional study of subjects at different stages of the AD continuum was conducted: Healthy Controls (CTR) (n = 17), SCD (n = 77), MCI (n = 30), and ADD (n = 23), who were matched for age, sex, and education. ADLs were estimated using The Technology‐Activities of Daily Living Questionnaire (T‐ADLQ), which assesses the three domains and a total score. T‐ADLQ performance was compared across groups and correlated with cognitive ability instruments (ACE‐III and IFS).</jats:p></jats:sec><jats:sec><jats:title>Result</jats:title><jats:p>The results showed that patients with ADD performed worse on the BADL, IADL, and total ADLs compared to the other three groups. There were no significant differences between the CTR, SCD, and MCI on the BADL, IADL, and total ADLs. However, the AADL, in addition to differentiating the ADD patients from the other three groups, also showed differences between CTR and MCI subjects and between SCD and MCI subjects (Table 1 and Figure 1). The correlation study showed that AADL correlated significantly with global cognitive and executive function assessment (Figure 2).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>AADL shows progressive functional impairment at different stages of the AD continuum, which is further associated with global cognitive and executive function performances. As one progresses to a more advanced stage of the disease continuum, the performance of ADLs, especially AADLs, worsens, which could indicate a marker of disease progression, allowing for better patient follow‐up.
1
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Clinical Profile of Stroke Chameleons Receiving Intravenous Thrombolysis: Insights from a Single-Center Experience
(S. Karger AG, 2024-11-13)
BRUNSER RABOVICH, ALEJANDRO MICHEL
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LAVADOS GERMAIN, PABLO MANUEL
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MUÑOZ VENTURELLI, PAULA ANDREA
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OLAVARRIA IANISZEWSKY, VERONICA VIVIANA
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Eloy Mansilla
<jats:p>Introduction: In emergency rooms (ERs), 5% of patients experiencing an acute ischemic stroke (AIS) receive an alternative diagnosis; these cases are known as stroke chameleons (SC). The percentage of SC treated with intravenous thrombolysis (IVT) and the characteristics have not been well described. We aimed at investigating the variables associated with the probability receiving IVT. Methods: In this prospective study, we included consecutive patients with SC admitted at the ER of Clínica Alemana between September 2014 and October 2023. Results: Among 1,193 stroke patients; sixty-three (5.2%) corresponded to SC. Ten of these cases (15.8%, 95% CI: 8.8–26.8) were treated with IVT, mean door-to-needle (DTN) time of 85.7 (SD 35) min, median of 73.5 (IQR 62–113) min. SCs who underwent IVT were younger (p = 0.01), with higher NIHSS (p = 0.05). They presented more frequently with altered level of consciousness in the NIHSS (p = 0.01), language abnormities (p = 0.001), and dysarthria (p = 0.01). In multivariate analysis, none of the variables were significantly associated with IVT. A secondary analysis showed that only time to brain imaging was significantly associated with IVT (OR: 0.99; 95% CI: 0.98–0.99; p = 0.01). Conclusions: Almost 1 out of every 7 SC could be treated with IVT but with a prolonged DTN time; the chance of being treated is associated with time to brain imaging. <p>Introduction: In emergency rooms (ERs), 5% of patients experiencing an acute ischemic stroke (AIS) receive an alternative diagnosis; these cases are known as stroke chameleons (SC). The percentage of SC treated with intravenous thrombolysis (IVT) and the characteristics have not been well described. We aimed at investigating the variables associated with the probability receiving IVT. Methods: In this prospective study, we included consecutive patients with SC admitted at the ER of Clínica Alemana between September 2014 and October 2023. Results: Among 1,193 stroke patients; sixty-three (5.2%) corresponded to SC. Ten of these cases (15.8%, 95% CI: 8.8–26.8) were treated with IVT, mean door-to-needle (DTN) time of 85.7 (SD 35) min, median of 73.5 (IQR 62–113) min. SCs who underwent IVT were younger (p = 0.01), with higher NIHSS (p = 0.05). They presented more frequently with altered level of consciousness in the NIHSS (p = 0.01), language abnormities (p = 0.001), and dysarthria (p = 0.01). In multivariate analysis, none of the variables were significantly associated with IVT. A secondary analysis showed that only time to brain imaging was significantly associated with IVT (OR: 0.99; 95% CI: 0.98–0.99; p = 0.01). Conclusions: Almost 1 out of every 7 SC could be treated with IVT but with a prolonged DTN time; the chance of being treated is associated with time to brain imaging. </p></jats:p>
1
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Early prediction of functional mobility severity after stroke: two key milestones
(2024)
Patricia Vargas
;
Marcos Maldonado-Diaz
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Tania Gutiérrez-Panchana
Scopus© Citations 4
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Translation and Cross‐Cultural Adaptation of the Toronto Extremity Salvage Score (TESS) for Latin American Spanish–Speaking Patients With Limb Sarcoma
(2024)
Oscar Ceballos
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Jorge Cabrolier
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Begoña Chehade
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Francisco Hardoy
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Francisco Cortes
<jats:p><jats:bold>Background and Objectives:</jats:bold> This study aims to translate and culturally adapt the Toronto Extremity Salvage Score (TESS) for Latin American Spanish–speaking patients, enhancing the tool’s accessibility for evaluating postsurgical functional outcomes in sarcoma patients across Latin America.</jats:p><jats:p><jats:bold>Methods:</jats:bold> The TESS questionnaires for lower extremity (LE) and upper extremity (UE) were translated and adapted following international guidelines. The process included forward and backward translation, expert committee review, and pretesting with cognitive interviewing. Patients treated for bone or soft tissue tumors in LE or UE were recruited to complete the adapted questionnaires. Test–retest reliability was evaluated by having participants complete the questionnaire again 2 weeks after the initial assessment.</jats:p><jats:p><jats:bold>Results:</jats:bold> A total of 89 participants completed the questionnaires. The study found high internal consistency, with Cronbach’s alpha values reaching 0.9437 for LE and 0.9402 for UE. An agreement rate of 98.4% for the global score of TESS‐LE (95% confidence interval [CI]: 0.909–1.059) and 93.9% for TESS‐UE (95% CI: 0.882–0.995) was observed, demonstrating strong test–retest reliability.</jats:p><jats:p><jats:bold>Conclusions:</jats:bold> The Latin American Spanish version of TESS for both lower and upper extremities is a reliable and culturally appropriate tool for assessing physical function in limb sarcoma patients. Further validation across diverse Latin American populations is encouraged to strengthen its broad applicability.</jats:p>
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Primer Consenso Chileno de Grupo de Estudio de Tuberculosis Ocular
(2023)
Cristhian A. Urzua
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Paulina Liberman
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Nadia Escobar
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Pablo Sabat
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Mariluz Hernández
9Scopus© Citations 1
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Evidence-Based Treatment Algorithm for Freiberg Disease
(2023)
Ichiro Yoshimura
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Masato Takao
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WAGNER HITSCHFFELD, EMILIO
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Sjoerd Stufkens
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Jari Dahmen
<jats:p> Freiberg disease is a type of osteonecrosis of the metatarsal head that predominantly occurs in young females and adolescents, although it may occur at any age. The pathophysiology is multifactorial and may involve trauma, altered foot biomechanics, systemic disorders, and arterial insufficiency. The most typical location is the second metatarsal head, but Freiberg disease may also occur in other lesser toes. Nonoperative treatment is best applied in the early stage of the disease; if this is ineffective, surgical treatment is recommended. Currently available surgical procedures include debridement, osteotomy, osteochondral grafting, microfracture, interposition arthroplasty, implant arthroplasty, and metatarsal shortening arthroplasty. In this article, we propose a treatment algorithm for Freiberg disease based on the current literature and expert opinion. </jats:p>
Scopus© Citations 9 1
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Bone Mineral Density and Aortic Calcification: Evidence for a Bone-vascular Axis After Kidney Transplantation
(2020)
Camilo G. Sotomayor
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Stan Benjamens
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António W. Gomes-Neto
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Robert A. Pol
;
Dion Groothof
2Scopus© Citations 17
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Ecocardiografía Funcional y sus aplicaciones clínicas en Neonatología
(2021)
Irene Montoya Claramunt
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Claudia Sánchez Ramírez
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Raul Nachar Hidalgo
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Jorge Torres Torretti
<jats:p>La Ecocardiografía funcional surge como una herramienta clínica para la valoración del estado hemodinámico del paciente, luego de demostrarse que los métodos clínicos usados tradicionalmente en la unidad de cuidados intensivos neonatales son limitados y muchas veces tardíos. Esto nos permite establecer un diagnóstico hemodinámico más certero y así mejorar la morbimortalidad neonatal ya que permite formular una recomendación basada en la fisiología, que resulta en un plan de tratamiento racional e individualizado. Los escenarios en los cuales se ha visto su utilidad son: transición inadecuada del recién nacido prematuro de muy bajo peso de nacimiento, inestabilidad hemodinámica, valoración del ductus arterioso persitente y su repercusión hemodinámica e hipertensión pulmonar. La presente revisión actualiza la información sobre la utilidad de la ecocardiografía funcional en la unidad de cuidados intensivos neonatales y los escenarios clínicos en donde se recomienda su uso.</jats:p>
1Scopus© Citations 4

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