Browsing by Author "Cruz, Juan Pablo"
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Item Abnormal nodal and global network organization in resting state functional MRI from subjects with the 22q11 deletion syndrome(2021) Pelgrim, Teuntje A.D.; Bosson, Matthijs G.; Cuiza, Analía; Alliende, Luz María; Mena, Carlos; Tepper, Angeles; Ramirez‑Mahaluf, Juan Pablo; Iruretagoyena, Bárbara; Ornstein, Claudia; Fritsch, Rosemarie; Cruz, Juan Pablo; Tejos, Cristian; Repetto, Gabriela; Crossley, NicolásThe 22q11 deletion syndrome is a genetic disorder associated with a high risk of developing psychosis, and is therefore considered a neurodevelopmental model for studying the pathogenesis of schizophrenia. Studies have shown that localized abnormal functional brain connectivity is present in 22q11 deletion syndrome like in schizophrenia. However, it is less clear whether these abnormal cortical interactions lead to global or regional network disorganization as seen in schizophrenia. We analyzed from a graph-theory perspective fMRI data from 40 22q11 deletion syndrome patients and 67 healthy controls, and reconstructed functional networks from 105 brain regions. Between-group differences were examined by evaluating edge-wise strength and graph theoretical metrics of local (weighted degree, nodal efficiency, nodal local efficiency) and global topological properties (modularity, local and global efficiency). Connectivity strength was globally reduced in patients, driven by a large network comprising 147 reduced connections. The 22q11 deletion syndrome network presented with abnormal local topological properties, with decreased local efficiency and reductions in weighted degree particularly in hub nodes. We found evidence for abnormal integration but intact segregation of the 22q11 deletion syndrome network. Results suggest that 22q11 deletion syndrome patients present with similar aberrant local network organization as seen in schizophrenia, and this network configuration might represent a vulnerability factor to psychosis.Item Breaking the breach in Latin America: A pilot study of mechanical thrombectomy in the public healthcare system in Chile(2021) Rivera, Rodrigo; Amudio, Cristian; Brunetti, Enzo; Catalan, Pascual; Sordo, Juan Gabriel; Badilla, Lautaro; Echeverria, Daniel; Cruz, Juan Pablo; Ojeda, Hector; Bravo, Loreto; Bravo, Fabian; González, Walter; Orellana, Maria Luisa; Pinto, Camila; Merino, Catalina; Oportus, Monica; Salazar, AlejandroBackground: Mechanical Thrombectomy (MT) is the standard of care for treatment of large vessel occlusion stroke. Until the beginning of 2020 MT was not funded nor widely implemented at the public healthcare level in Chile. Objective: To describe the results of a pilot program created to provide access to public MT in Santiago - Chile. Methods: Analysis from a prospectively collected database of MT cases performed between September 2017 and September 2019 in one center. A stroke network was developed with a single MT capable stroke center and five primary stroke centers. The primary efficacy endpoint was the rate of functional independence (mRS 0-2) at 90 days. Successful reperfusion was defined as 2 b-3 according to the thrombolysis in cerebral infarction scale. Safety outcomes include the rates of symptomatic intracranial hemorrhage and 90-day mortality. Results: A total of 100 patients were treated over the study period. Their mean age was 62.8 11.8 years and median baseline National Institute of Health Stroke Scale (NIHSS) measurement was 17. Seventy-seven percent of the patients received intra venous thrombolysis. Successful reperfusion was achieved in 95% of the cases. NIHSS at 24 hours showed a median drop of 7 points from baseline (p < 0.00001) and 50% of the follow-up patients were functionally independent at 90 days. Symptomatic Intracerebral hemorrhage occurred in 5% of the patients and 90-day all case mortality was 11%. Conclusions: We demonstrated the feasibility of a publicly funded MT program in Chile, with similar results as other international randomized control trials.