Aug 30, 2013

Transcranial Direct Current Stimulation Improves Sleep in Patients with Post-Polio Syndrome

lunes, 26 de agosto de 2013 IOS Press BV

According to Novel Study Published in Restorative Neurology and Neuroscience
Amsterdam, NL, August 26, 2013 – Of the 15 million people around the world who have survived poliomyelitis, up to 80% report progressive deteriorating strength and endurance many years after infection, a condition known as post-polio syndrome (PPS). Researchers in Italy from the National Hospital for Poliomyelitis, the Policlinico G.B. De Rossi in Verona, and the University of Milan have found that transcranial direct current stimulation (tDCS) for 15 days improved sleep and fatigue symptoms in patients with PPS, suggesting this non-invasive tool may be a new therapeutic option for this condition. Their results are published in Restorative Neurology and Neuroscience.
Post-polio syndrome (PPS) is a neurological disorder that may first appear years after an acute polio infection. In addition to worsening weakness and fatigue, pain, depression, cold intolerance, and sleep disturbances also may occur. Although polio vaccines have drastically decreased the incidence of new cases of polio in industrialized countries, new cases still occur in areas of Asia and Africa. As polio survivors age, PPS symptoms emerge, even in people who have been stable for 15 years or more. The cause of PPS still remains elusive, and there are no definitive treatment options.  
The study enrolled 32 patients who had contracted polio at a mean age of 31 months, but then were stable clinically for an average of 55 years. They were referred to a national reference center, the Physical Rehabilitation Medicine Unit at Malcesine Hospital in Verona, Italy, for the treatment of PPS after complaining of progressively worsening weakness and fatigue. Half of the patients were randomly assigned to receive anodal tDCS applied bilaterally to the premotor cortex every day, 5 days a week, for three weeks. The control group received current for 5 seconds (sham tDCS). In preliminary testing, subjects said they could not distinguish between real and sham tDCS.
Patients underwent a battery of tests at baseline and then three weeks later. The tests looked at quality of life, multiple aspects of fatigue, depression, and sleep quality.
The authors found that tDCS treated patients improved more than sham-treated patients on several measures of a patient health survey (the Short Form Health Survey or SF-36), including physical functioning, role limitations due to physical health, vitality, social functioning and role limitations due to emotional health. No significant differences were found between the groups on questions related to bodily pain, general health, or mental health.
One of the most noticeable effects of tDCS treatment was an improvement in sleep quality. Scores on the Pittsburgh Sleep Quality Index (PSQI) decreased 65% compared to 25% in the control group, a significant difference (p<0.05). Significant correlations were found between PSQI scores and physical functioning, social functioning, and emotional health. Interestingly, sleep quality improved more in patients who were younger when poliomyelitis developed.
Whether tDCS relieves fatigue directly is still unclear. While fatigue-related sub-items of the SF-36 improved after tDCS, no significant changes were found using specific fatigue-assessment tests such as the Piper Fatigue Scale or the Fatigue Severity Scale. No changes were noted between groups in depression scores.
“tDCS might work by improving sleep. Because changes in sleep quality affect physical and psychological states, improving sleep quality could improve perceived vitality, social and emotional functioning, and, indirectly, also fatigue,” says lead investigator Laura Bertolasi, MD, Department of Neurological, Neuropsychological, Morphological and Movement Sciences, University of Verona, Italy. “tDCS effects on sleep fit in with results in healthy subjects, fibromyalgia, and schizophrenia.”
Post Polio Litaff, Association A.C _APPLAC Mexico

Aug 26, 2013

Accept the existence the Post Polio Syndrome opens opportunities for those who have PPS : Liliana Marasco

To read original whit imagines
Dis - 
By: Karent Mendoza Mendoza Arizmendi Arizmendi

 Mexico City - On July 28 will be held the 2nd National Symposium on Post Polio Syndrome (CAP) Approval of the existence of Post Polio Syndrome in Mexico, which aims to educate the medical, paramedical and therapists. The signs and symptoms of this disease establish an early diagnosis to enable patients to have better quality of life .
The Symposium is organized by the Post Polio Association Litaff and the Ministry of Health.Dis - spoke with Liliana Marasco Garrido, president and founder of the Post Polio Association Litaff who told us that the main objective is to recognize the existence of PPS in Mexico.  She said, "doctors, and people with polio, may prevent actions that may reduce our quality of life because they were not clearly recognized as SSP. "
She explained that on 28th July in Auditorium 1 of the Congress Unit of the Medical Center Siglo XXI , doctors will be trained to carry out an appropriate differential diagnosis in all health sector clinics. "This opens a range of opportunities for those who have polio and PPS. The generations of doctors who treated the polio epidemics in the 50s, 60s and early 70s , are mostly retired or have died, and the younger physicians are not familiar with the disease.  Hence the importance this Symposium and current medical updates."
Although, due to the complexity and medical terminology the symposium is addressed to practitioners.  Between 300 and 500 doctors of different specialties are expected to attend.  Liliana extends the invitation to people with polio and PPS worldwide to attend this event, as well as their families and friends.
For Liliana, the symposium represents the completion of nine years of work and a constant struggle for recognition of the syndrome and says, "It is my ultimate dream come true, I am proud to be able to meet people with polio and PSS.  I promised that one day, if God lends me life and gave me health, PSS would be classified and  certified in the world medical codes, which we have achieved with the help and interest of Health Secretary Mauricio Hernández Avila. I am finally satisfied we know that the Health Department accepts the existence and evidence of the syndrome."
    This satisfaction is even greater because this year, the World Health Organization (WHO) finally included this syndrome in Clasificación Internacional de Enfermedades within the G14 code corresponding to the central nervous system diseases . WHO states that PPS is, "an evolution of an irreversible and incurable clinical situation in relation to the progressive dysfunction of the motor units, which can not be classified as sequelae of polio."
She said, "Add to that the existence of evidence and acceptance, we already have the complete package.  Now everyone with SSP can be properly treated and their needs covered, receiving care and rehabilitation, including therapies, orthotics and prosthetic devices to enable people to lead a better quality of life."  The main themes of the Symposium are: Epidemiology and diagnosis, rehabilitation and treatment, classification in the CIF and family involvement .
And while Liliana is so excited to have fulfilled one of her dreams, nervous tension has her in bed with a strong bronchopneumonia. But that is unimportant, she says, "I am very happy because this symposium opens the possibility to its attendees to hear the latest treatments for the care of this and other mobility impairments."
Liliana Marasco thanks all those who directly and indirectly supported the realization of this great project. "I thank the physicians from the United States, partly because I know they do it for the great love they have for LITAFF, for me this was a beautiful detail that they helped me close this circle."
The main expectation of this symposium, Marasco said, "is not to lose sight of the G14 classification.  Although the Secretary of Health who conducted the symposium, he must be very attentive to the application of the G14 and can not be beyond the month of October.
The president of LITAFF has faith that the end of the symposium the medical authorities will be more interested in the care of patients with SSP.  "They need more clinics because there are not enough with only the National Rehabilitation Institute; many people from other states can not come to be treated at the DF so it is important to build clinics in other states.  They do not need to be large; doctors only need to be prepared.  Perhaps there is no polio in Mexico at this time, but SSP and those who have it, need attention."
Liliana said, "This event is the result of a great effort and I can only thank God, my family, my loved ones and all the institutions that worked with me."
The symposium is sponsored by the Ministry of Health and the National Council for Persons with Disabilities (CONADIS). The Symposium is at: Av Cuahutemoc No. 300 , Col. Doctores, July 28 from 8:00        
Asociación Post Polio Litaff, A.C_APPLAC
Liliana Marasco Garrido Founder President
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