Browsing by Author "Ciampi Diaz, Ethel Leslie"

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    Assessment and Impact of Cognitive Impairment in Multiple Sclerosis : an Overview
    (2019) Macías I., M.; Ciampi Diaz, Ethel Leslie
    Cognitive impairment affects 40-60% of patients with multiple sclerosis. It may be present early in the course of the disease and has an impact on a patient's employability, social interactions, and quality of life. In the last three decades, an increasing interest in diagnosis and management of cognitive impairment has arisen. Neuropsychological assessment and neuroimaging studies focusing on cognitive impairment are now being incorporated as primary outcomes in clinical trials. However, there are still key uncertainties concerning the underlying mechanisms of damage, neural basis, sensitivity and validity of neuropsychological tests, and efficacy of pharmacological and non-pharmacological interventions. The present article aimed to present an overview of the assessment, neural correlates, and impact of cognitive impairment in multiple sclerosis.
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    Frontoparietal connectivity correlates with working memory performance in multiple sclerosis
    (2020) Figueroa Vargas, Alejandra; Carcamo, Claudia; Henriquez Ch, Rodrigo; Zamorano, Francisco; Ciampi Diaz, Ethel Leslie; Uribe San Martín, Reinaldo; Vásquez, Macarena; Aboitiz, Francisco; Billeke, Pablo
    Working Memory (WM) impairment is the most common cognitive deficit of patients with Multiple Sclerosis (MS). However, evidence of its neurobiological mechanisms is scarce. Here we recorded electroencephalographic activity of twenty patients with relapsing-remitting MS and minimal cognitive deficit, and 20 healthy control (HC) subjects while they solved a WM task. In spite of similar performance, the HC group demonstrated both a correlation between temporoparietal theta activity and memory load, and a correlation between medial frontal theta activity and successful memory performances. MS patients did not show theses correlations leading significant differences between groups. Moreover, cortical connectivity analyses using granger causality and phase-amplitude coupling between theta and gamma revealed that HC group, but not MS group, presented a load-modulated progression of the frontal-to-parietal connectivity. This connectivity correlated with working memory capacity in MS groups. This early alterations in the oscillatory dynamics underlaying working memory could be useful for plan therapeutic interventions.
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    Imágenes de resonancia magnética funcional en el estudio de la esclerosis múltiple
    (2018) Labbe, T.; Ciampi Diaz, Ethel Leslie; Cruz, J. P.; Zurita Soler, Mariana; Uribe, S.; Carcamo, C.
    Introducción: La esclerosis múltiple (EM), una enfermedad neuroinflamatoria y desmielinizante, modifica la conectividad normal entre las diferentes regiones del cerebro involucradas en funciones específicas. La resonancia magnética funcional (RMf), basada en cambios locales en el nivel de oxígeno como respuesta al aumento de la actividad neuronal, proporciona un enfoque a la conectividad neuronal y la dinámica cerebral que ofrece una visión general de la disfunción visual, motora y cognitiva y sus mecanismos. Desarrollo: Se realizó una búsqueda avanzada en PubMed considerando los términos «fMRI», «visual», «motor», «cognitive» y «multiple sclerosis» incluidos en el título y el resumen. La búsqueda se centró en artículos originales disponibles en inglés, con énfasis en los útiles para comprender los cambios funcionales en la EM. Numerosos estudios han utilizado la RMf como una herramienta complementaria en el estudio de la EM y las alteraciones clínicamente relevantes de la afectación visual, motora y cognitiva. Desde las primeras etapas de la EM, la actividad local y la dinámica neural global parecen estar afectadas. Incluso cuando el desempeño funcional aún se conserva, surge un reclutamiento diferente de los recursos neuronales como respuesta compensatoria a la desconexión observada en la enfermedad. Conclusiones: Los principales hallazgos de la RMf aplicada a la EM están fuertemente relacionados con la naturaleza desmielinizante de la enfermedad y proporcionan una visión adecuada de los mecanismos subyacentes a las alteraciones funcionales. La RMf también parece ser útil para estudiar la evolución de la enfermedad y la respuesta al tratamiento en la EM y otros trastornos.
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    Neuromyelitis optica spectrum disorders: Profile of a cohort according to the 2015 diagnostic criteria
    (Revista de Neurologia, 2017) Uribe San Martin, Reinaldo Moisés; Ciampi Diaz, Ethel Leslie; Galilea Izquierdo, Antonia; Sandoval Rubio, Patricio Alberto Mario; Miranda Vera, Héctor David; Mellado Talesnik, Patricio Andrés; Cárcamo Rodríguez, Claudia Andrea; Albornoz Cruz, Juan Pablo; Huete Garin, Isidro Álvaro
    The new 2015 criteria for neuromyelitis optica spectrum disorders (NMOSD) have been recently incorporated in the study of different international cohorts. Aim. To describe clinical-radiological characteristics and prognostic factors in patients with NMOSD according to the 2015 criteria. Patients and methods. Retrospective analysis of 36 patients diagnosed with NMOSD according to serologic AQP4 status (positive, negative, unknown and negative + unknown). Clinical and radiological characteristics were compared and possible disability prognostic factors were evaluated. Results. AQP4 were positive in 7 patients, negative in 12 and unknown in 17. Age of presentation was 36.6 ± 16 years, with higher female proportion (4:1). Mean disease duration was 7.4 ± 7.6 years. Most frequent presenting symptoms were acute myelitis (61%), optic neuritis (33%) and area postrema syndrome (11%). Most frequent MRI lesion was longitudinally extensive transverse myelitis (75%). All patients received acute treatment during attacks, and preventive treatment was used in 81% (azathioprine and rituximab mostly prescribed). Median EDSS was 2.0 at the end of follow-up. No differences were observed in any of the variables comparing serologic status. Age of first attack was prognostic, with direct correlation with EDSS. First attack in < 30 years was protective, meanwhile > 50 years old patients had increased risk of disability. Conclusions. The 2015 criteria allow the description and classification of NMOSD patients within different cohorts. Age of first attack seems to be a prognostic factor for developing disability.
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    Practical Issues Concerning the Approval and Use of Biosimilar Drugs for the Treatment of Multiple Sclerosis in Latin America
    (2019) Steinberg, Judith; Dadalti Fragoso, Yara; Duran Quiroz, Juan Carlos; García,Juan Raul; Guerra, Caroline; Rodriguez, Virginia; Cárcamo Rodríguez, Claudia Andrea; Ciampi Diaz, Ethel Leslie; Correa-Diaz, Edgar; Macías, Miguel; Novarro, Nelson; Vizcarra, Darwin; Oehninger Gatti, Carlos; Orozco, Geraldine; Carrá, Adriana
    The use of biosimilar drugs for multiple sclerosis (MS) has become widespread in Latin America, with the goal of reducing costs of treatments, promoting the sustainability of healthcare systems, and improving patient access to these therapies. There is currently a need to define and comply with requirements to guarantee the efficacy, safety, and quality of these drugs. Thus, the objective of the present study was to compile up-to-date information from each Latin American country assessed on (a) approval of biosimilar drugs by regulatory agencies; (b) use of biosimilar drugs, pharmacovigilance plans, risk management; and (c) update in the knowledge on different molecules. To do so, a group of experts from Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, Uruguay, and Venezuela met to discuss the current situation regarding good practices and risks associated with the use of biosimilar drugs in their respective countries. Regulation, risk management plans, and pharmacovigilance in the whole continent must guide the strategies on the commercialization and access of biosimilar drugs and copies of complex molecules. Current regulations must be implemented for the registration of biosimilar drug products and complex molecules. It is paramount to ensure that new products follow the best quality standards at all stages beyond being safe and efficient. Uncontrolled interchangeability between original biological and biosimilar should be avoided. Latin America requires the implementation and full use of strong pharmacovigilance programs. National and multinational clinical studies are required to demonstrate the similarity in safety, efficacy, and immunogenicity profiles of complex molecules, as well as biological and biosimilar products.
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    Regional brain atrophy is related to social cognition impairment in multiple sclerosis
    (ASSOC ARQUIVOS NEURO- PSIQUIATRIA, 2021) Labbe Atenas, Tomás Pablo; Montalba Zalaquett, Cristian Andrés; Zurita Soler, Mariana; Ciampi Diaz, Ethel Leslie; Albornoz Cruz, Juan Pablo; Vásquez Torres, Macarena; Uribe Arancibia, Sergio Andrés; Crossley Karmelic, Nicolás Andrés; Cárcamo Rodríguez, Claudia Andrea
    Background: Multiple sclerosis exhibits specific neuropathological phenomena driving to both global and regional brain atrophy. At the clinical level, the disease is related to functional decline in cognitive domains as the working memory, processing speed, and verbal fluency. However, the compromise of social-cognitive abilities has concentrated some interest in recent years despite the available evidence suggesting the risk of disorganization in social life. Recent studies have used the MiniSEA test to assess the compromise of social cognition and have found relevant relationships with memory and executive functions, as well as with the level of global and regional brain atrophy. Objective: The present article aimed to identify structural changes related to socio-cognitive performance in a sample of patients with relapsing-remitting multiple sclerosis. Methods: 68 relapsing-remitting multiple sclerosis Chilean patients and 50 healthy control subjects underwent MRI scans and neuropsychological evaluation including social-cognition tasks. Total brain, white matter, and gray matter volumes were estimated. Also, voxel-based morphometry was applied to evaluate regional structural changes. Results: Patients exhibited lower scores in all neuropsychological tests. Social cognition exhibited a significant decrease in this group mostly related to the declining social perception. Normalized brain volume and white matter volume were significantly decreased when compared to healthy subjects. The regional brain atrophy analysis showed that changes in the insular cortex and medial frontal cortices are significantly related to the variability of social-cognitive performance among patients. Conclusions: In the present study, social cognition was only correlated with the deterioration of verbal fluency, despite the fact that previous studies have reported its link with memory and executive functions. The identification of specific structural correlates supports the comprehension of this phenomenon as an independent source of cognitive disability in these patients.