1
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Potashman M, Rudell K, Pavisic I, Suminski N, Doma R, Heinrich M, Abetz-Webb L, Beiner MW, Kuo SH, Rosenthal LS, Zesiwicz T, Fife TD, van de Warrenburg BP, Ristori G, Synofzik M, Perlman S, Schmahmann JD, L'Italien G. Content Validity of the Modified Functional Scale for the Assessment and Rating of Ataxia (f-SARA) Instrument in Spinocerebellar Ataxia. Cerebellum 2024:10.1007/s12311-024-01700-2. [PMID: 38713312 DOI: 10.1007/s12311-024-01700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
The functional Scale for the Assessment and Rating of Ataxia (f-SARA) assesses Gait, Stance, Sitting, and Speech. It was developed as a potentially clinically meaningful measure of spinocerebellar ataxia (SCA) progression for clinical trial use. Here, we evaluated content validity of the f-SARA. Qualitative interviews were conducted among individuals with SCA1 (n = 1) and SCA3 (n = 6) and healthcare professionals (HCPs) with SCA expertise (USA, n = 5; Europe, n = 3). Interviews evaluated symptoms and signs of SCA and relevance of f-SARA concepts for SCA. HCP cognitive debriefing was conducted. Interviews were recorded, transcribed, coded, and analyzed by ATLAS.TI software. Individuals with SCA1 and 3 reported 85 symptoms, signs, and impacts of SCA. All indicated difficulties with walking, stance, balance, speech, fatigue, emotions, and work. All individuals with SCA1 and 3 considered Gait, Stance, and Speech relevant f-SARA concepts; 3 considered Sitting relevant (42.9%). All HCPs considered Gait and Speech relevant; 5 (62.5%) indicated Stance was relevant. Sitting was considered a late-stage disease indicator. Most HCPs suggested inclusion of appendicular items would enhance clinical relevance. Cognitive debriefing supported clarity and comprehension of f-SARA. Maintaining current abilities on f-SARA items for 1 year was considered meaningful for most individuals with SCA1 and 3. All HCPs considered meaningful changes as stability in f-SARA score over 1-2 years, 1-2-point change in total f-SARA score, and deviation from natural history. These results support content validity of f-SARA for assessing SCA disease progression in clinical trials.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sheng-Han Kuo
- Department of Neurology, Columbia University, New York, NY, USA
| | - Liana S Rosenthal
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Theresa Zesiwicz
- Department of Neurology, Ataxia Research Center, University of South Florida, Tampa, FL, USA
| | - Terry D Fife
- Department of Neurology, Barrow Neurological Institute, University of Arizona College of Medicine, Phoenix, AZ, USA
| | | | - Giovanni Ristori
- Department of Neurosciences, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Matthis Synofzik
- Division of Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany
| | - Susan Perlman
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Jeremy D Schmahmann
- Ataxia Center, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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2
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Ranavolo A, Ajoudani A, Bonnet V, De Nunzio AM, Draicchio F, Sartori M, Serrao M. Editorial: Job integration/reintegration of people with neuromuscular disorders in the epoch of "industry 4.0". Front Neurol 2024; 15:1371430. [PMID: 38456151 PMCID: PMC10919900 DOI: 10.3389/fneur.2024.1371430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 03/09/2024] Open
Affiliation(s)
- Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL - National Institute for Insurance Against Accidents at Work, Rome, Italy
| | - Arash Ajoudani
- HRI2 Laboratory, Italian Institute of Technology (IIT), Genova, Italy
| | - Vincent Bonnet
- LAAS-CNRS, Université Paul Sabatier, CNRS, Toulouse, France
| | | | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL - National Institute for Insurance Against Accidents at Work, Rome, Italy
| | - Massimo Sartori
- Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
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3
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Potashman MH, Mize ML, Beiner MW, Pierce S, Coric V, Schmahmann JD. Ataxia Rating Scales Reflect Patient Experience: an Examination of the Relationship Between Clinician Assessments of Cerebellar Ataxia and Patient-Reported Outcomes. Cerebellum 2023; 22:1257-1273. [PMID: 36495470 PMCID: PMC10657309 DOI: 10.1007/s12311-022-01494-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/02/2022] [Indexed: 12/14/2022]
Abstract
Ataxia rating scales are observer administered clinical outcome assessments (COAs) of the cerebellar motor syndrome. It is not known whether these COAs mirror patient experience of their disease. Here we test the hypothesis that ataxia COAs are related to and reflect patient reported symptoms and impact of illness. A concept library of symptoms and activities impacted by ataxia was created by reviewing (a) concept elicitation data from surveys completed by 147 ataxia patients and 80 family members and (b) cognitive debrief data from focus groups of 17 ataxia patients used to develop the Patient Reported Outcome Measure of Ataxia. These findings were mapped across the items on 4 clinical measures of ataxia (SARA, BARS, ICARS and FARS). Symptoms reported most commonly related to balance, gait or walking, speech, tremor and involuntary movements, and vision impairment. Symptoms reported less frequently related to hand coordination, loss of muscle control, dizziness and vertigo, muscle discomfort or pain, swallowing, and incontinence. There was a mosaic mapping of items in the observer-derived ataxia COAs with the subjective reports by ataxia patients/families of the relevance of these items to their daily lives. Most COA item mapped onto multiple real-life manifestations; and most of the real-life impact of disease mapped onto multiple COA items. The 4 common ataxia COAs reflect patient reported symptoms and impact of illness. These results validate the relevance of the COAs to patients' lives and underscore the inadvisability of singling out any one COA item to represent the totality of the patient experience.
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Affiliation(s)
| | - Miranda L Mize
- Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, 100 Cambridge Street, Suite 2000, Boston, MA, 02114, USA
| | | | - Samantha Pierce
- Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Jeremy D Schmahmann
- Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
- Department of Neurology, Massachusetts General Hospital, 100 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
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4
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Ortega Suero G, Abenza Abildúa MJ, Serrano Munuera C, Rouco Axpe I, Arpa Gutiérrez FJ, Adarmes Gómez AD, Rodríguez de Rivera FJ, Quintans Castro B, Posada Rodríguez I, Vadillo Bermejo A, Domingo Santos Á, Blanco Vicente E, Infante Ceberio I, Pardo Fernández J, Costa Arpín E, Painous Martí C, Muñoz JE, Mir Rivera P, Montón Álvarez F, Bataller Alberola L, Gascón Bayarri J, Casasnovas Pons C, Vélez Santamaría V, López de Munain A, Fernández-Eulate G, Gazulla Abío J, Sanz Gallego I, Rojas Bartolomé L, Ayo Martín Ó, Segura Martín T, González Mingot C, Baraldés Rovira M, Sivera Mascaró R, Cubo Delgado E, Echavarría Íñiguez A, Vázquez Sánchez F, Bártulos Iglesias M, Casadevall Codina MT, Martínez Fernández EM, Labandeira Guerra C, Alemany Perna B, Carvajal Hernández A, Fernández Moreno C, Palacín Larroy M, Caballol Pons N, Ávila Rivera A, Navacerrada Barrero FJ, Lobato Rodríguez R, Sobrido Gómez MJ. Epidemiology of ataxia and hereditary spastic paraplegia in Spain: a cross-sectional study. Neurologia 2023:S2173-5808(23)00023-8. [PMID: 37120112 DOI: 10.1016/j.nrleng.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/01/2021] [Indexed: 05/01/2023] Open
Abstract
INTRODUCTION Ataxia and hereditary spastic paraplegia are rare neurodegenerative syndromes. We aimed to determine the prevalence of these disorders in Spain in 2019. PATIENTS AND METHODS We conducted a cross-sectional, multicentre, retrospective, descriptive study of patients with ataxia and hereditary spastic paraplegia in Spain between March 2018 and December 2019. RESULTS We gathered data from a total of 1933 patients from 11 autonomous communities, provided by 47 neurologists or geneticists. Mean (SD) age in our sample was 53.64 (20.51) years; 982 patients were men (50.8%) and 951 were women (49.2%). The genetic defect was unidentified in 920 patients (47.6%). A total of 1371 patients (70.9%) had ataxia and 562 (29.1%) had hereditary spastic paraplegia. Prevalence rates for ataxia and hereditary spastic paraplegia were estimated at 5.48 and 2.24 cases per 100 000 population, respectively. The most frequent type of dominant ataxia in our sample was SCA3, and the most frequent recessive ataxia was Friedreich ataxia. The most frequent type of dominant hereditary spastic paraplegia in our sample was SPG4, and the most frequent recessive type was SPG7. CONCLUSIONS In our sample, the estimated prevalence of ataxia and hereditary spastic paraplegia was 7.73 cases per 100 000 population. This rate is similar to those reported for other countries. Genetic diagnosis was not available in 47.6% of cases. Despite these limitations, our study provides useful data for estimating the necessary healthcare resources for these patients, raising awareness of these diseases, determining the most frequent causal mutations for local screening programmes, and promoting the development of clinical trials.
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Affiliation(s)
- G Ortega Suero
- Servicio de Neurología, Hospital Alcázar de San Juan, Complejo La Mancha-Centro, Ciudad Real, Spain
| | - M J Abenza Abildúa
- Servicio de Neurología, Hospital Universitario Infanta Sofía, Madrid, Spain.
| | | | - I Rouco Axpe
- Servicio de Neurología, Hospital Universitario de Cruces, Bilbao, Spain
| | - F J Arpa Gutiérrez
- Departamento de Anatomía, Histología y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid, Asesoría Docente de Neurología, Hospital Clínico San Carlos, Madrid, Spain
| | - A D Adarmes Gómez
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | - B Quintans Castro
- Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
| | - I Posada Rodríguez
- Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Vadillo Bermejo
- Servicio de Neurología, Hospital Universitario Mancha Centro, Ciudad Real, Spain
| | - Á Domingo Santos
- Servicio de Neurología, Hospital G. Tomelloso, Ciudad Real, Spain
| | | | - I Infante Ceberio
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Cantabria, Spain
| | - J Pardo Fernández
- Servicio de Neurología, Hospital Clínico Santiago de Compostela, Galicia, Spain
| | - E Costa Arpín
- Servicio de Neurología, Hospital Clínico Santiago de Compostela, Galicia, Spain
| | - C Painous Martí
- Servicio de Neurología, Unidad de Neurogenética, Hospital Universitario Clinic, Barcelona, Spain
| | - J E Muñoz
- Servicio de Neurología, Unidad de Neurogenética, Hospital Universitario Clinic, Barcelona, Spain
| | - P Mir Rivera
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - F Montón Álvarez
- Servicio de Neurología, Hospital Nuestra señora de Candelaria, Tenerife, Spain
| | | | - J Gascón Bayarri
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, Spain
| | - C Casasnovas Pons
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, Spain
| | - V Vélez Santamaría
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, Spain
| | - A López de Munain
- Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, Spain
| | - G Fernández-Eulate
- Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, Spain
| | - J Gazulla Abío
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - I Sanz Gallego
- Servicio de Neurología, Hospital Universitario Sonsoles, Ávila, Spain
| | - L Rojas Bartolomé
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, Spain
| | - Ó Ayo Martín
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, Spain
| | - T Segura Martín
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, Spain
| | - C González Mingot
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - M Baraldés Rovira
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, Spain
| | - R Sivera Mascaró
- Servicio de Neurología, Hospital Francesc de Borja, Gandía, Spain
| | - E Cubo Delgado
- Servicio de Neurología, Hospital Universitario de Burgos, Burgos, Spain
| | | | - F Vázquez Sánchez
- Servicio de Neurología, Hospital Universitario de Burgos, Burgos, Spain
| | | | | | | | - C Labandeira Guerra
- Servicio de Neurología, Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - B Alemany Perna
- Servicio de Neurología, Hospital Universitario Josep Trueta, Girona, Spain
| | - A Carvajal Hernández
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | | | - N Caballol Pons
- Sección de Neurología, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - A Ávila Rivera
- Servicio de Neurología, Hospital General L´Hospitalet, Barcelona, Spain
| | | | - R Lobato Rodríguez
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, Spain
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5
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Chini G, Fiori L, Tatarelli A, Varrecchia T, Draicchio F, Ranavolo A. Indexes for motor performance assessment in job integration/reintegration of people with neuromuscular disorders: A systematic review. Front Neurol 2022; 13:968818. [PMID: 36158952 PMCID: PMC9493180 DOI: 10.3389/fneur.2022.968818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/08/2022] [Indexed: 11/28/2022] Open
Abstract
Individuals of working age affected by neuromuscular disorders frequently experience issues with their capacity to get employment, difficulty at work, and premature work interruption. Anyway, individuals with a disability could be able to return to work, thanks to targeted rehabilitation as well as ergonomic and training interventions. Biomechanical and physiological indexes are important for evaluating motor and muscle performance and determining the success of job integration initiatives. Therefore, it is necessary to determinate which indexes from the literature are the most appropriate to evaluate the effectiveness and efficiency of the return-to-work programs. To identify current and future valuable indexes, this study uses a systematic literature review methodology for selecting articles published from 2011 to March 30, 2021 from Scopus, Web of Science, and PubMed and for checking the eligibility and the potential bias risks. The most used indexes for motor performance assessment were identified, categorized, and analyzed. This review revealed a great potential for kinetic, kinematic, surface electromyography, postural, and other biomechanical and physiological indexes to be used for job integration/reintegration. Indeed, wearable miniaturized sensors, kinematic, kinetic, and sEMG-based indexes can be used to control collaborative robots, classify residual motor functions, and assess pre-post-rehabilitation and ergonomic therapies.
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Affiliation(s)
- Giorgia Chini
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
- Department of Physiology and Pharmacology and PhD Program in Behavioral Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL-Istituto Nazionale Assicurazione Infortuni sul Lavoro, Rome, Italy
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Agostini F, Pezzi L, Paoloni M, Insabella R, Attanasi C, Bernetti A, Saggini R, Mangone M, Paolucci T. Motor Imagery: A Resource in the Fatigue Rehabilitation for Return-to-Work in Multiple Sclerosis Patients-A Mini Systematic Review. Front Neurol 2021; 12:696276. [PMID: 34290665 PMCID: PMC8287528 DOI: 10.3389/fneur.2021.696276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/11/2021] [Indexed: 01/13/2023] Open
Abstract
Fatigue is a multidimensional symptom with both physical and cognitive aspects, which can affect the quality of daily and working life activities. Motor Imagery (MI) represents an important resource for use during the rehabilitation processes, useful, among others, for job integration/reintegration, of neurological pathologies, such as Multiple Sclerosis (MS). To define the effective rehabilitation protocols that integrate MI for the reduction of fatigue in patients with MS (PwMS), a literary review was performed through August 2020. Five articles were included in the qualitative synthesis, including two feasibility pilot randomized control trials (RCTs) and 3 RCTs with good quality according to the PEDro score and a low risk of bias according to the Cochrane Collaboration tool. The literature suggested that MI, in association with rhythmic-auditory cues, may be an effective rehabilitation resource for reducing fatigue. Positive effects were observed on perceived cognitive and psychological fatigue. PwMS require greater compensatory strategies than healthy individuals, and the use of rhythmic-auditory cues may be useful for optimizing the cognitive processing of MI, which acts as an internal stimulus that is enhanced and made more vivid by outside cues. These findings provide evidence that MI is a promising rehabilitation tool for reducing fatigue in PwMS and return to work strategies.
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Affiliation(s)
- Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Letizia Pezzi
- Department of Medical and Oral Sciences and Biotechnologies, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Roberta Insabella
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Carmine Attanasi
- Complex Operational Unit (UOC) Physical Medicine and Rehabilitation, Santa Caterina Novella Hospital, Galatina, Italy
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Raoul Saggini
- Department of Medical and Oral Sciences and Biotechnologies, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Teresa Paolucci
- Department of Medical and Oral Sciences and Biotechnologies, University G. d'Annunzio Chieti-Pescara, Chieti, Italy
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7
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Ortega Suero G, Abenza Abildúa MJ, Serrano Munuera C, Rouco Axpe I, Arpa Gutiérrez FJ, Adarmes Gómez AD, Rodríguez de Rivera FJ, Quintans Castro B, Posada Rodríguez I, Vadillo Bermejo A, Domingo Santos Á, Blanco Vicente E, Infante Ceberio I, Pardo Fernández J, Costa Arpín E, Painous Martí C, Muñoz JE, Mir Rivera P, Montón Álvarez F, Bataller Alberola L, Gascón Bayarri J, Casasnovas Pons C, Vélez Santamaría V, López Munain A, Fernández García Eulate G, Gazulla Abío J, Sanz Gallego I, Rojas Bartolomé L, Ayo Martín Ó, Segura Martín T, González Mingot C, Baraldés Rovira M, Sivera Mascaró R, Cubo Delgado E, Echevarría Íñiguez A, Vázquez Sánchez F, Bártulos Iglesias M, Casadevall Codina MT, Martínez Fernández EM, Labandeira Guerra C, Alemany Perna B, Carvajal Hernández A, Fernández Moreno C, Palacín Larroy M, Caballol Pons N, Ávila Rivera A, Navacerrada Barrero FJ, Lobato Rodríguez R, Sobrido Gómez MJ. Epidemiology of ataxia and hereditary spastic paraplegia in Spain: a cross-sectional study. Neurologia 2021; 38:S0213-4853(21)00021-9. [PMID: 33775475 DOI: 10.1016/j.nrl.2021.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/01/2021] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Ataxia and hereditary spastic paraplegia are rare neurodegenerative syndromes. We aimed to determine the prevalence of these disorders in Spain in 2019. PATIENTS AND METHODS We conducted a cross-sectional, multicentre, retrospective, descriptive study of patients with ataxia and hereditary spastic paraplegia in Spain between March 2018 and December 2019. RESULTS We gathered data from a total of 1.809 patients from 11 autonomous communities, provided by 47 neurologists or geneticists. Mean (SD) age in our sample was 53.64 (20.51) years; 920 patients were men (50.8%) and 889 were women (49.2%). The genetic defect was unidentified in 920 patients (47.6%). A total of 1371 patients (70.9%) had ataxia and 562 (29.1%) had hereditary spastic paraplegia. Prevalence rates for ataxia and hereditary spastic paraplegia were estimated at 5.48 and 2.24 cases per 100 000 population, respectively. The most frequent type of dominant ataxia in our sample was SCA3, and the most frequent recessive ataxia was Friedreich ataxia. The most frequent type of dominant hereditary spastic paraplegia in our sample was SPG4, and the most frequent recessive type was SPG7. CONCLUSIONS In our sample, the estimated prevalence of ataxia and hereditary spastic paraplegia was 7.73 cases per 100 000 population. This rate is similar to those reported for other countries. Genetic diagnosis was not available in 47.6% of cases. Despite these limitations, our study provides useful data for estimating the necessary healthcare resources for these patients, raising awareness of these diseases, determining the most frequent causal mutations for local screening programmes, and promoting the development of clinical trials.
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Affiliation(s)
- G Ortega Suero
- Servicio de Neurología, Hospital Alcázar de San Juan, Complejo La Mancha-Centro, Ciudad Real, España
| | - M J Abenza Abildúa
- Servicio de Neurología, Hospital Universitario Infanta Sofía, Madrid, España.
| | - C Serrano Munuera
- Servicio de Neurología, Hospital Sant Joan de Déu, Martorell, España
| | - I Rouco Axpe
- Servicio de Neurología, Hospital Universitario de Cruces, Bilbao, España
| | - F J Arpa Gutiérrez
- Departamento de Anatomía, Histología y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid, Asesoría Docente de Neurología, Hospital Clínico San Carlos, Madrid, España
| | - A D Adarmes Gómez
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F J Rodríguez de Rivera
- Servicio de Neurología, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, España
| | - B Quintans Castro
- Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, España
| | - I Posada Rodríguez
- Servicio de Neurología, Hospital Universitario 12 de Octubre, Madrid, España
| | - A Vadillo Bermejo
- Servicio de Neurología, Hospital Universitario Mancha Centro, Ciudad Real, España
| | - Á Domingo Santos
- Servicio de Neurología, Hospital G. Tomelloso, Ciudad Real, España
| | - E Blanco Vicente
- Servicio de Neurología, Hospital Villarrobledo, Albacete, España
| | - I Infante Ceberio
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Cantabria, España
| | - J Pardo Fernández
- Servicio de Neurología, Hospital Clínico Santiago de Compostela, Galicia, España
| | - E Costa Arpín
- Servicio de Neurología, Hospital Clínico Santiago de Compostela, Galicia, España
| | - C Painous Martí
- Servicio de Neurología, Unidad de Neurogenética, Hospital Universitario Clinic, Barcelona, España
| | - J E Muñoz
- Servicio de Neurología, Unidad de Neurogenética, Hospital Universitario Clinic, Barcelona, España
| | - P Mir Rivera
- Servicio de Neurología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - F Montón Álvarez
- Servicio de Neurología, Hospital Nuestra señora de Candelaria, Tenerife, España
| | | | - J Gascón Bayarri
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, España
| | - C Casasnovas Pons
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, España
| | - V Vélez Santamaría
- Servicio de Neurología, Hospital Universitario Bellvitge, Barcelona, España
| | - A López Munain
- Servicio de Neurología, Hospital Universitario Donostia, San Sebastián, España
| | | | - J Gazulla Abío
- Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España
| | - I Sanz Gallego
- Servicio de Neurología, Hospital Universitario Sonsoles, Ávila, España
| | - L Rojas Bartolomé
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, España
| | - Ó Ayo Martín
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, España
| | - T Segura Martín
- Servicio de Neurología, Hospital Universitario de Albacete, Albacete, España
| | - C González Mingot
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, España
| | - M Baraldés Rovira
- Servicio de Neurología, Hospital Universitario Arnau de Vilanova, Lleida, España
| | - R Sivera Mascaró
- Servicio de Neurología, Hospital Francesc de Borja, Gandía, España
| | - E Cubo Delgado
- Servicio de Neurología, Hospital Universitario de Burgos, Burgos, España
| | | | - F Vázquez Sánchez
- Servicio de Neurología, Hospital Universitario de Burgos, Burgos, España
| | | | | | | | - C Labandeira Guerra
- Servicio de Neurología, Hospital Universitario Álvaro Cunqueiro, Vigo, España
| | - B Alemany Perna
- Servicio de Neurología, Hospital Universitario Josep Trueta, Girona, España
| | - A Carvajal Hernández
- Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España
| | | | | | - N Caballol Pons
- Sección de Neurología, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, España
| | - A Ávila Rivera
- Servicio de Neurología, Hospital General ĹHospitalet, Barcelona, España
| | | | - R Lobato Rodríguez
- Sección de Neurología, Hospital Universitario Infanta Sofía, Madrid, España
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8
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Ranavolo A, Serrao M, Draicchio F. Critical Issues and Imminent Challenges in the Use of sEMG in Return-To-Work Rehabilitation of Patients Affected by Neurological Disorders in the Epoch of Human–Robot Collaborative Technologies. Front Neurol 2020; 11:572069. [PMID: 33414754 PMCID: PMC7783040 DOI: 10.3389/fneur.2020.572069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 11/30/2020] [Indexed: 01/07/2023] Open
Abstract
Patients affected by neurological pathologies with motor disorders when they are of working age have to cope with problems related to employability, difficulties in working, and premature work interruption. It has been demonstrated that suitable job accommodation plans play a beneficial role in the overall quality of life of pathological subjects. A well-designed return-to-work program should consider several recent innovations in the clinical and ergonomic fields. One of the instrument-based methods used to monitor the effectiveness of ergonomic interventions is surface electromyography (sEMG), a multi-channel, non-invasive, wireless, wearable tool, which allows in-depth analysis of motor coordination mechanisms. Although the scientific literature in this field is extensive, its use remains significantly underexploited and the state-of-the-art technology lags expectations. This is mainly attributable to technical and methodological (electrode-skin impedance, noise, electrode location, size, configuration and distance, presence of crosstalk signals, comfort issues, selection of appropriate sensor setup, sEMG amplitude normalization, definition of correct sEMG-related outcomes and normative data) and cultural limitations. The technical and methodological problems are being resolved or minimized also thanks to the possibility of using reference books and tutorials. Cultural limitations are identified in the traditional use of qualitative approaches at the expense of quantitative measurement-based monitoring methods to design and assess ergonomic interventions and train operators. To bridge the gap between the return-to-work rehabilitation and other disciplines, several teaching courses, accompanied by further electrodes and instrumentations development, should be designed at all Bachelor, Master and PhD of Science levels to enhance the best skills available among physiotherapists, occupational health and safety technicians and ergonomists.
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Affiliation(s)
- Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
- *Correspondence: Alberto Ranavolo
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
- Movement Analysis LAB, Policlinico Italia, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
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9
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Ortiz JF, Morillo Cox Á, Tambo W, Eskander N, Wirth M, Valdez M, Niño M. Neurological Manifestations of Wilson's Disease: Pathophysiology and Localization of Each Component. Cureus 2020; 12:e11509. [PMID: 33354453 PMCID: PMC7744205 DOI: 10.7759/cureus.11509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/16/2020] [Indexed: 02/06/2023] Open
Abstract
Wilson's disease (WD) is an autosomal recessive disease that presents mainly with hepatic, neurological, and psychiatric manifestations. Neurological manifestations have been described in the past. Nevertheless, the pathophysiology and the clinical relevance of these manifestations have not been described in great detail in the medical literature. We aim to consolidate the knowledge about the neurological manifestations of WD and present the pathophysiology of each neurological manifestation of the disease. We will give a brief definition, the provenance, and the pathophysiology of the neurological conditions. We collected data from the National Library of Medicine (PubMed) using regular keywords and medical subject headings. Studies were selected applying the following inclusion/exclusion criteria: (1) studies that used exclusively human subjects, (2) papers published in English, and (3) papers from 1990 onward. The exclusion criteria were (1) studies that used animals, (2) papers not published in English, and (3) papers published before 1990. Additional studies were included via reference lists of identified papers and related articles featured in PubMed and Google Scholar. Copper toxicity is the principal factor for brain degeneration seen in WD. Parkinsonism seen in WD has been associated with a nigrostriatal dopaminergic deficit. Resting tremor may have the same pathophysiology as parkinsonism. Action tremor is related to an accumulation of copper in the cerebellum's vermis and hemispheres. At the same time, essential tremor can be explained due to affection of the dentate nucleus. Choreoathetosis is produced due to increased activity of the direct pathway. We did not find specifically associated pathophysiology related to dysarthria. We assume that multiple parts of the brain are involved in that problem. Putamen nucleus damage is the leading cause that explains dystonia seen in WD along with the globus palidus. We did not find a specific localization for seizures in WD, but the pathology seems to be related to decreased levels of B6 and direct toxicity of copper on the brain.
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Affiliation(s)
- Juan Fernando Ortiz
- Neurology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | | | - Willians Tambo
- Neurology, Universidad San Francisco de Quito, Quito, ECU
| | - Noha Eskander
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Martín Wirth
- Neurology, Universidad San Francisco de Quito, Quito, ECU
| | - Margarita Valdez
- Internal Medicine, Universidad Autónoma de Guadalajara, Laredo, USA
| | - Maria Niño
- Emergency Medicine, Universidad del Rosario, Bogotá, COL
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