Neurología : publicación oficial de la Sociedad Española de Neurología
-
All pharmacological treatment is surrounded by a psychosocial context that contributes in part to the outcome of the therapy. The placebo effect is the improvement observed after a simulated treatment in which the subject, without his or her knowledge, is exposed only to the psychosocial context surrounding the treatment, without receiving the pure "pharmacodynamic" effect of the medication. The aim of this paper is to examine which brain regions and neurochemical mechanisms are responsible for the analgesia resulting from the placebo. ⋯ In placebo analgesia at least two anatomically differentiated cerebral systems work together. The guiding mechanism, which appears to be located prefrontally, is activated first. This system would influence other cortical regions (cingulate and insula), attenuating the processing of nociceptive information at these higher levels.
-
Recent studies have begun to unveil some of the biochemical bases of the placebo effect. Thus, while placebo analgesia is related to the release of endogenous opioids, placebo-induced dopamine release leads to motor improvement in Parkinson's disease. ⋯ These biochemical findings indicate that the placebo effect is real, and suggest that many ethical arguments and controversies regarding the use of placebos should perhaps be reconsidered. While it may be advisable to minimize the placebo effect in clinical trials in order to estimate the pure effect of the active treatment, acting in the patient's best interest may require maximizing the placebo effect in the usual clinical setting.
-
Comparative Study
[Spanish versus English as a language of publication and impact factor of Neurologia].
Although the English language is considered nowadays as the international language of medical publications, some important Spanish journals with impact factor in the Journal Citation Reports as Neurologia, they bet for the publication in Spanish. Neurologia is the official publication of the Sociedad Española de Neurología and there is the conviction that you can have a Spanish language journal with a high quality and a strong impact. ⋯ From the point of view of citation, the repercussion of the language for Neurologia, is reflected in the fact that the 46,8 % of the citations that receive are from journals that are published in Spanish. The main factor to improve the impact of the journal is the quality of their papers, as well as the fulfillment of the international rules about periodical publications, the punctuality in its edition and distribution, the presence in national and international bibliographical data bases, its free diffusion in Internet, the training of its researchers and their sensitivity to consult and cite articles that have been published in quality Spanish journals, when necessary.
-
Room tilt illusion is a distorted perception of the spatial distribution of objects due to complex rotations in different planes. This distortion usually occurs in the vertical plane and is usually associated to vertebrobasilar ischemia. The etiology of the phenomenon varies greatly and only rarely corresponds to migraine aura. ⋯ Room tilt illusion might be a rare symptom of migraine aura. In this setting a functional depression of neurons from the posterior parietal cortex may occur, possibly mediated by chemical factors.
-
Both single photon emission computed tomography (SPECT) and positron emission tomography (PET) are helpful in the practice of neurology. Ictal SPECT is useful to determine the origin of focal seizures in the pre-surgical evaluation. ⋯ Given its higher resolution and some other factors, PET is more useful in the evaluation of brain tumors, dementia and the parkinsonian syndromes. It is also useful in the presurgical evaluation of epilepsy.