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Neurología
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Bradicardia en la demencia frontotemporal

Authors: A. Robles Bayón; J.M. Torregrosa Quesada; F. Gude Sampedro;

Bradicardia en la demencia frontotemporal

Abstract

Resumen: Introducción: Diversas áreas cerebrales, como la corteza orbitofrontal y frontomedial, la ínsula y la amígdala, intervienen en el control del sistema nervioso autónomo sobre funciones cardiovasculares como la frecuencia cardíaca. El proceso degenerativo de la demencia frontotemporal (DFT) involucra estas estructuras anatómicas y, por tanto, podría producir síntomas cardiovasculares disautonómicos. Objetivo: Observar si la bradicardia de origen cerebral es más frecuente en pacientes con DFT que en enfermos con deterioro cognitivo ligero o demencia de otra etiología. Pacientes y método: Una vez excluidos los pacientes con arritmia de origen cardíaco, se registró la frecuencia cardíaca de 258 pacientes con síntomas cognitivos (36 con DFT, 22 con enfermedad de Alzheimer, 23 con demencia vascular, 10 con otras demencias y 167 con deterioro cognitivo sin demencia). Resultados: La bradicardia (< 60 ppm) fue estadísticamente más frecuente en los pacientes con DFT. La diferencia se mantuvo significativa tras excluir a los que estaban en tratamiento con potencial efecto bradicardizante. La bradicardia fue más prevalente en la DFT conductual que en la DFT afásica, y hubo tendencia al predominio en los pacientes con mayor atrofia en el hemisferio derecho. La presión arterial sistólica de los pacientes con DFT fue inferior a la de los otros sujetos del estudio, y fue mayor la prevalencia de hipotensión sistólica (< 120 y < 100 mmHg). Conclusión: Se ha observado mayor frecuencia de bradicardia en los pacientes con DFT que en otros pacientes con síntomas cognitivos. Antes de considerar este dato semiológico como un signo de apoyo al diagnóstico de DFT, será necesario realizar nuevas observaciones. Abstract: Introduction: Numerous regions of the brain, such as the medial frontal cortex, orbitofrontal cortex, insula, and amygdala, participate in the autonomic control of cardiovascular functions such as heart rate. The degenerative process in frontotemporal dementia (FTD) involves the listed anatomical structures and may therefore produce dysautonomic cardiovascular symptoms. Aim: To observe whether or not non-cardiogenic bradycardia was more frequent in a group of patients with FTD than in subjects with mild cognitive impairment or dementia of a different aetiology. Patients and method: Once patients with primary cardiac arrhythmia were excluded, we registered the heart rates of 258 patients with cognitive symptoms (36 with FTD, 22 with Alzheimer disease, 23 with vascular dementia, 10 with other dementias, and 167 with non-dementia cognitive impairment). Results: Bradycardia (< 60 beats/minute) was significantly more frequent in patients with FTD. This difference remained significant after excluding subjects undergoing treatment with a potentially bradycardic effect. Bradycardia was more prevalent in behavioural FTD cases than in cases of the aphasic variant, and we detected a trend toward higher frequency among patients with more pronounced right hemisphere atrophy. Moreover, mean systolic blood pressure in FTD patients was lower than in other participants, and systolic hypotension (< 120 and < 100 mm Hg) was more prevalent. Conclusion: Bradycardia was more frequent in the FTD sample than in other patients with cognitive symptoms. Further investigations will be necessary before we may consider bradycardia to be a sign supporting diagnosis of FTD or its behavioural variant. Palabras clave: Alzheimer, Amígdala, Bradicardia, Demencia frontotemporal, Hipotensión, Ínsula, Keywords: Alzheimer, Amygdala, Bradycardia, Frontotemporal dementia, Hypotension, Insula

Related Organizations
Keywords

Clinical Neurology, Neurology. Diseases of the nervous system, RC346-429

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Top 10%
gold