<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2631-2581</journal-id>
<journal-title><![CDATA[Revista Ecuatoriana de Neurología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Ecuat Neurol]]></abbrev-journal-title>
<issn>2631-2581</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica Ecuatoriana de Neurología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2631-25812021000200034</article-id>
<article-id pub-id-type="doi">10.46997/revecuatneurol30200034</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Función cognitiva en adultos mayores con y sin dedos de Dawson relacionados con enfermedad de pequeño vaso cerebral.]]></article-title>
<article-title xml:lang="en"><![CDATA[Cognitive performance in older adults with and without Dawson&#8217;s fingers-related cerebral small vessel disease.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Del Brutto]]></surname>
<given-names><![CDATA[Oscar H.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mera]]></surname>
<given-names><![CDATA[Robertino M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[Patricia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Costa]]></surname>
<given-names><![CDATA[Aldo F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Especialidades Espíritu Santo Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Samborondón ]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Gilead Sciences, Inc. Departamento de Epidemiología ]]></institution>
<addr-line><![CDATA[Foster City CA]]></addr-line>
<country>USA</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Grupo Radiológico.  ]]></institution>
<addr-line><![CDATA[Atlanta GA]]></addr-line>
<country>USA</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario Reina Sofía Departamento de Neurología ]]></institution>
<addr-line><![CDATA[Córdoba ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>30</volume>
<numero>2</numero>
<fpage>34</fpage>
<lpage>39</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_arttext&amp;pid=S2631-25812021000200034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_abstract&amp;pid=S2631-25812021000200034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.senescyt.gob.ec/scielo.php?script=sci_pdf&amp;pid=S2631-25812021000200034&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Antecedentes/objetivo: Los dedos de Dawson, tradicionalmente asociados con esclerosis múltiple, han sido - además - recientemente vinculados con hiperintensidades de sustancia blanca causadas por enfermedad de pequeño vaso cerebral. En este contexto, dichas lesiones corresponderían a daño venular, podrían representar estadíos avanzados de enfermedad de pequeño vaso y estarían teóricamente asociados con deterioro cognitivo. En el presente estudio se intentó determinar si los dedos de Dawson se asociaron con un peor desempeño cognitivo en adultos mayores.  Métodos:  Estudio poblacional realizado en personas de 60 años o más, residentes de tres poblados del litoral Ecuatoriano (Atahualpa, El Tambo y Prosperidad). De un total de 712 adultos mayores identificados mediante censos puerta-a-puerta, 590 fueron sometidos a IRM cerebral y de éstos, a 575 también se les realizó valoración cognitiva mediante la prueba de Montreal (MoCA). Se seleccionaron los 157 individuos con hiperintensidades de sustancia blanca de moderada a severa y se determinó la presencia de dedos de Dawson en dichos sujetos. La asociación independiente entre dedos de Dawson y desempeño cognitivo (como variable dependiente) fue evaluada mediante un modelo de regresión linear ajustado por factores demográficos y de riesgo cardiovascular, así como por los demás biomarcadores de enfermedad de pequeño vaso cerebral.  Resultados: De los 157 individuos con hiperintensidades de sustancia blanca de moderada a severa, 17 (11%) presentaron dedos de Dawson en IRM. La puntuación promedio en el MoCA fue de 14.5±6.4 en sujetos con dedos de Dawson y de 17.3±6.2 en aquellos sin este biomarcador de neuroimagen. La asociación entre dedos de Dawson y puntaje en el MoCA fue marginal en el modelo univariado (p=0.082), mientras que dicha asociación se diluyó completamente luego de ajustar por las covariables de interés (&#946;: -0.31; 95% I.C.: -3.23 - 2.60; p=0.833). El 83.5% del efecto de los dedos de Dawson en el desempeño cognitivo estuvo mediado por la edad.  Conclusión:  Los dedos de Dawson no se asocian independientemente con el desempeño cognitivo en individuos con enfermedad de pequeño vaso. La mayor parte de esta asociación se encuentra mediada por la edad.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Background/objective: Dawson&#8217;s fingers have been traditionally associated with multiple sclerosis. However, this imaging biomarker has also been linked to white matter hyperintensities related to cerebral small vessel disease. In the latter, Dawson&#8217;s fingers could represent damage of small venules in subjects with severe small vessel disease and could theoretically be associated with cognitive decline. In this study, we aimed to assess the association between Dawson&#8217;s fingers and cognitive performance in a population of older adults.  Methods:  Population-based study conducted in individuals aged 60 years or older, residing in three rural villages of coastal Ecuador (Atahualpa, El Tambo and Prosperidad). Of 712 older adults identified by means of a door-to-door survey, 590 underwent a brain MRI. Of them, 575 also had the Montreal Cognitive Assessment (MoCA). We selected the 157 individuals with moderate-to-severe white matter hyperintensities to assess the presence of Dawson&#8217;s fingers. The independent association between Dawson&#8217;s fingers and cognitive performance (as the dependent variable) was assessed by means of a linear regression model, after adjusting for demographics, cardiovascular risk factors, and the other biomarkers of cerebral small vessel disease.  Results: Of 157 individuals with moderate-to-severe White matter hyperintensities, 17 (11%) had Dawson&#8217;s fingers on MRI. The mean MoCA score in subjects with Dawson&#8217;s fingers was 14.5±6.4 points and that of those without this neuroimaging biomarker was 17.3±6.2 points. The association between Dawson&#8217;s fingers and the MoCA score was marginal in univariate models (p=0.082), but it completely vanished in a multivariate linear regression model adjusted for relevant covariates (&#946;: -0.31; 95% C.I.: -3.23 - 2.60; p=0.833). A mediation model disclosed that 83.5% of the effect of Dawson&#8217;s finger on cognitive performance was mediated by age.  Conclusion:  Dawson&#8217;s fingers are not independently associated with cognitive performance in individuals with cerebral small vessel disease. Most of the effect of this association is mediated by age.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Dedos de Dawson]]></kwd>
<kwd lng="es"><![CDATA[enfermedad de pequeño vaso cerebral]]></kwd>
<kwd lng="es"><![CDATA[hiperintensidades de sustancia blanca]]></kwd>
<kwd lng="es"><![CDATA[prueba cognitiva de Montreal]]></kwd>
<kwd lng="es"><![CDATA[adultos mayores.]]></kwd>
<kwd lng="en"><![CDATA[Dawson&#8217;s fingers]]></kwd>
<kwd lng="en"><![CDATA[cerebral small vessel disease]]></kwd>
<kwd lng="en"><![CDATA[white matter hyperintensities]]></kwd>
<kwd lng="en"><![CDATA[Montreal Cognitive Assessment]]></kwd>
<kwd lng="en"><![CDATA[older adults.]]></kwd>
</kwd-group>
</article-meta>
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