Lucia Ameghino - Academia.edu (original) (raw)

Papers by Lucia Ameghino

Revista Argentina de Bioingeniería, May 13, 2020

Background: Movement disorders are neurologic syndromes that produce abnormal movements, being Pa... more Background: Movement disorders are neurologic syndromes that produce abnormal movements, being Parkinson's disease (PD) the most frequent. Current diagnosis of Parkinson's disease is clinical: it is based on expertise, which can result in diagnostic errors and treatment deficits. Quantitative diagnosis is reached searching objective parameters, a quantity that correlates with the phenomenon we want to quantify. Quantitative measures of movement are a novel approach to assist physicians in the diagnosis of Parkinson's disease. Objective: To find a quantitative feature in accelerometery signals that distinguishes parkinsonian patients from age-matched control subjects. Method: We designed and developed an ergonomic wristband with proper electronics attached, including inertial sensors and control logic to manage the data signals. Additionally, we developed a mobile app for logging and administration of data signals. We measured limb acceleration in two groups of people: a group of patients with Parkinson's disease (n = 11) and an age-matched control group (n = 10). Acceleration signals were measured during the evaluation of finger tapping (from the motor subscore of the Unified Parkinson's Disease Rating Scale-UPDRS part III). To characterize the signals, we developed mathematical tools based on the analysis of temporal and frequency patterns. Power spectrum analysis of the signals exhibited a power law relationship between variables with different frequency ranges. Results: Interpreting the finger tapping task as an input to the motor system, variations in the scale invariance bandwidth can be related to the mechanic system's control response. Analyzing the power spectrum of the patient group signals, a statistical relevant reduction (p<0.005) is found in the frequency range that follows a power law (Linear Invariance Range, LIR) compared to the control group. LIR quantity calculated correlates with the gold standard clinical diagnosis MDS-UPDRS-III. Conclusion: The LIR quantity allows proposing a reduction of the scale. The quantity LIR found is proposed as a possible signal related biomarker of Parkinson's disease.

Journal of Oral & Facial Pain and Headache, 2019

Aims: To describe headache characteristics among celiac disease (CD) patients and to analyze the ... more Aims: To describe headache characteristics among celiac disease (CD) patients and to analyze the relationship between CD and headache. Methods: An online survey analyzing the characteristics of headache and its response to the glutenfree diet (GFD) in celiac patients was published on Argentinean Celiac social networks, open to the public to complete. The results were analyzed using chisquare test or Mann-Whitney test accordingly. Results: A total of 1,517 subjects completed the survey, and 866 (55.2%) met the inclusion criteria (headache and CD confirmed with positive biopsy). The subjects were predominantly female (94.5%) and had a median age of 39 ± 11.27 years. Tension-type headache was the most prevalent headache type (52%), followed by migraine without (32.5%) and with aura (15.4%), respectively. Of the included participants, 24% reported headache as the main symptom that resulted in the diagnosis of CD. Following initiation of GFD, headache frequency and intensity improved significantly more in participants with migraine than tension-type headache (P = .02 and P = .013, respectively). Compliance to GFD was higher among subjects with severe manifestations (77% vs 66%, P = .05), and compliant individuals showed a 48% improvement in headache frequency (P = .049). An association between food transgressions and headache was better recognized by migraineurs (P = .02). Conclusion: These results suggest that strict compliance to the GFD could improve headache in celiac patients with headache, even in those without gastrointestinal symptoms. This observation could provide an additional factor when convincing patients to follow a GFD, thus reducing the morbidity related to CD.

Parkinsonism & Related Disorders, 2019

Movement Disorders, 2019

Background: Hand position for rest tremor evaluation in PD is not standardized. We evaluated the ... more Background: Hand position for rest tremor evaluation in PD is not standardized. We evaluated the sensitivity and specificity of different hand positions commonly used to evaluate rest tremor. Methods: Twenty patients with PD and rest tremor were included as cases and 20 patients with essential tremor without rest tremor as controls. Video and accelerometric recordings were conducted in semiprone, completely prone, and with hands hanging down from armrest positions. Three movement disorder specialists rated tremor in each different position using Movement Disorder Society UPDRS items 3.17 and 3.18. Results: Hands hanging showed the highest amplitude (P = 0.004) and constancy (P = 0.015) scores. Sensitivity and specificity analysis for each position showed the following sensitivity/specificity results: semiprone, 95%/80%; completely prone, 85%/98.33%; and hands hanging, 96.66%/63.33%, respectively. Conclusions: The hands-hanging position was shown to be the most suitable for evaluating rest tremor amplitude in PD, whereas the completely prone position proved to be more specific to detect rest tremor. The preferred hand position would depend on the purpose of the examination.

Clinical Neuropharmacology, 2018

The aim of this study was to evaluate the relationship between antiparkinsonian treatments, espec... more The aim of this study was to evaluate the relationship between antiparkinsonian treatments, especially dopamine agonist (DAs) and the development of postural disorders in patients with Parkinson's disease (PD). Methods: We performed an exploratory case-control study. Cases were PD patients with camptocormia, Pisa syndrome, or anterocollis. Control subjects were PD patients without postural disorders matched by sex and age. Demographic and clinical data including pharmacologic treatments history were collected retrospectively. Characteristics of cases and control subjects were compared using parametric and nonparametric tests accordingly, and logistic regression models were used to analyze correlations. Results: We included 63 patients with PD and postural disorders and 63 control subjects. Cases were more exposed to DAs (74.60% vs 58.73%, P = 0.05) and amantadine (30.16% vs 7.94%, P < 0.05) than control subjects. Cases showed longer disease duration (7.63 ± 7.83 vs 4.27 ± 3.87 years, P < 0.05), higher Hoehn and Yahr stage (2.83 ± 0.80 vs 2.15 ± 0.73, P < 0.05), higher Movement Disorder Society Unified Parkinson's Disease Rating Scale part III score (29.61 ± 1.39 vs 20.76 ± 10.94, P = 0.05), and more dyslipidemia (28.57% vs 12.70%, P < 0.05) than control subjects, as well as lower prevalence of depression (46.03% vs 28.57%, P < 0.05). We found no clinical predictors for the development of postural disorders after multivariable adjusted regression. Conclusions: Our results suggest a possible association between the use of DAs and amantadine and the development of postural disorders in PD and suggest potential risk factors including advanced disease and more severe motor symptoms. These results support the need of a cautious use of these medications in patients with advanced disease due to the possibility of increasing the risk-benefit ratio.

World journal of gastroenterology, Jan 14, 2017

Medicina, 2017

Early recognition and prompt specific treatment are crucial factors influencing the outcome of pa... more Early recognition and prompt specific treatment are crucial factors influencing the outcome of patients with acute encephalitis. The aim of this study was to determine the main causes of acute encephalitis in our population and to find predictors that may lead to specific diagnosis. Adult patients admitted to our hospital with suspected diagnosis of encephalitis in the period 2006-2013 were included. One hundred and five medical records were analyzed. Eighty-two patients with infectious encephalitis were identified (78% of total cases), 53 (65%) men and 29 (35%) women, mean age 47.8 years. The most common microorganisms identified were: HSV-1 (11%), VZV (10%), HSV-2 (5%) and EBV (5%). Twenty-three patients (22% of the series) had non-infectious encephalitis. Headache (p < 0.0001) and fever (p = 0.008) were more frequent in encephalitis of infectious origin. Protein levels and white blood cell counts in the cerebrospinal fluid were significantly higher in patients affected by infe...

Journal of the Neurological Sciences, 2017

Movement Disorders Clinical Practice, 2016

Postural abnormalities in Parkinson's disease (PD) are considered the rule more than the exceptio... more Postural abnormalities in Parkinson's disease (PD) are considered the rule more than the exception and are disabling complications of the disease. These deformities include camptocormia, antecollis, Pisa syndrome, and scoliosis. Evidence to date suggests that postural deformities have a multifactorial pathophysiology, including muscular rigidity, axial dystonia, weakness due to myopathy, body scheme defects due to centrally impaired proprioception, and structural changes in the spine. Antecollis in parkinsonian disorders refers to a forward flexion of the head and neck. It is usually mild in severity and may be considered part of the stooped posture in patients with PD. Some authors that suggest the term antecollis should only be used in patients with at least a minimum of 45 degrees of thoracolumbar flexion. Neither camptocormia nor Pisa syndrome can be evaluated without taking into account the presence or absence of scoliosis. In this regard, the rotating component of the spine and its behavior in the supine position give important clues for a correct diagnosis. In some cases, X-rays in the standing and supine positions are necessary. The presence of marked camptocormia requires a minimum of flexion in the sagittal plane originating in the thoracolumbar spine greater than 45 degrees, with an almost complete resolution in the supine position. Pisa syndrome requires a minimum of 10 degrees of lateral flexion and is almost completely alleviated by passive mobilization or supine positioning. A certain degree of scoliosis is expected in most parkinsonian patients; therefore, both camptocormia and Pisa syndrome do not generally present as pure syndromes.

Movement Disorders Clinical Practice, 2015

Movement Disorders Clinical Practice, 2018

Neurological features in celiac disease (CD) are not rare (5%-36%), but tremor is scarcely descri... more Neurological features in celiac disease (CD) are not rare (5%-36%), but tremor is scarcely described. Subjects with CD and healthy controls completed an online survey using WHIGET tremor rating scale. One thousand five hundred and twelve subjects completed the survey, finally 674 CD patients and 290 healthy subjects were included. A higher prevalence of tremor in CD patients was observed in comparison to controls (28% vs 14%, P < 0.001). Frequency of family history of tremor in CD patients with and without tremor was 25% and 20% (P = 0.2), while in the control group it was 41% and 10% (P < 0.001). Controls with tremor showed a higher frequency of family history of tremor when compared to CD patients with tremor (41.5% vs 24.6%, P = 0.03). The results suggested that tremor in CD might be more frequent and possibly related to the disease itself and not due to associated essential tremor. Core tip: We performed an online inquest, completed by 1512 subjects, 674 had celiac disease and 290 controls. We observed a higher (double) prevalence of tremor in celiac patients in comparison to healthy controls (28% vs 14%, P < 0.001). The frequency of a family history of tremor was higher in controls with tremor, but not in Celiac disease (CD) patients with tremor, suggesting that tremor in CD might be more frequent than controls and possibly related to the disease process itself and not due to essential tremor.