Objectives: Characterizing pharmacological response in Parkinson’s Disease (PD) patients may be a challenge in early stages but gives valuable clues for diagnosis. Neurotropic drugs may modulate Electroencephalography (EEG) microstates (MS). We investigated EEG-MS default-mode network changes in response to dopaminergic stimulation in PD.Methods: Fourteen PD subjects in HY stage III or less were included, and twenty-one healthy controls. All patients were receiving dopaminergic stimulation with levodopa or dopaminergic agonists. Resting EEG activity was recorded before the first daily PD medication dose and 1 h after drug intake resting EEG activity was again recorded. Time and frequency variables for each MS were calculated.Results: Parkinson’s disease subjects MS A duration decreases after levodopa intake, MS B appears more often than before levodopa intake. MS E was not present, but MS G was. There were no significant differences between control subjects and patients after medication intake.Conclusion: Clinical response to dopaminergic drugs in PD is characterized by clear changes in MS profile.Significance: This work demonstrates that there are clear EEG MS markers of PD dopaminergic stimulation state. The characterization of the disease and its response to dopaminergic medication may be of help for early therapeutic diagnosis.

Background During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain. Materials and methods Healthcare workers from inpatient and outpatient facilities ( N = 2053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted. Results Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression ( B = 2.4, 95 percent CI: 1.8, 2.9) and psychological distress ( B = 1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR = 2.0, 95 percent CI: 1.4, 3.1). Conclusions Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Objective: To examine any prospective association between neutrophil-to-lymphocyte ratio (NLR) at hospital admission and subsequent delirium in older COVID-19 hospitalized patients comparing by sex and age groups.Methods: The sample consisted of 1,785 COVID-19 adult inpatients (minimum sample size required of 635 participants) admitted to a public general hospital in Madrid (Spain) between March 16th and April 15th, 2020. Variables were obtained from electronic health records. Binary logistic regression models were performed between baseline NLR and delirium adjusting for age, sex, medical comorbidity, current illness severity, serious mental illness history and use of chloroquine and dexamethasone. An NLR cut-off was identified, and stratified analyses were performed by age and sex. Also, another biomarker was tested as an exposure (the systemic immune-inflammation index –SII).Results: 55.3% of the patients were men, with a mean age of 66.8 years. Roughly 13% of the patients had delirium during hospitalization. NLR on admission predicted subsequent delirium development (adjusted OR = 1.02, 95 percent CI: 1.00–1.04, p = 0.024). Patients between 69 and 80 years with NLR values > 6.3 presented a twofold increased risk for delirium (p = 0.004). There were no sex differences in the association between baseline NLR and delirium (p > 0.05) nor SII predicted delirium development (p = 0.341).Conclusion: NLR is a good predictor of delirium during hospitalization, especially among older adults, independently of medical comorbidity, illness severity, and other covariates. Routine blood tests on admission might provide valuable information to guide the decision-making process to be followed with these especially vulnerable patients.

<b><i>Background:</i></b> Parkinson’s disease (PD) patients are known to suffer from subtle cognitive and balance deficits from the early stages although they usually manifest in advanced stages. Postural instability (PI) has been correlated with slower information processing speed. Simple reaction time (SRT) tasks can be used to measure the speed of information processing. The main objective of this study was to examine the usefulness of SRT as a valid predictor of balance in PD, thus providing a simple and complementary assessment method. <b><i>Methods:</i></b> This cross-sectional study included 52 PD patients without dementia who were evaluated for balance using the pull test (PT) maneuver and Biodex® limits of stability (LOS). In addition, a reaction time task was used to measure processing speed. Correlation and linear regression analyses were performed. <b><i>Results:</i></b> The performance of SRT tasks was correlated with the evaluation of LOS% and PT, suggesting that the SRT may be a predictor of balance performance. Longer reaction time and poorer postural stability were also associated with disease duration but not with age. <b><i>Conclusions:</i></b> Poor performance in a simple reaction task can predict altered PI and can complement staging and evaluation in PD patients.