Letter to the Editor
Neuropsychological rehabilitation program for patients with post-COVID-19 syndrome: a clinical experience
Programa de rehabilitación neuropsicológica en pacientes con síndrome post-COVID-19: una experiencia clínica
Read
4075
Timeswas read the article
933
Total PDF
3142
Total HTML
Share statistics
array:25 [ "pii" => "S2173580821000808" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2021.03.003" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1605" "copyright" => "Sociedad Española de Neurología" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2021;36:565-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S021348532100061X" "issn" => "02134853" "doi" => "10.1016/j.nrl.2021.03.008" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1605" "copyright" => "Sociedad Española de Neurología" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2021;36:565-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>" "titulo" => "Programa de rehabilitación neuropsicológica en pacientes con síndrome post-COVID-19: una experiencia clínica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "565" "paginaFinal" => "566" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neuropsychological rehabilitation program for patients with post-COVID-19 syndrome: A clinical experience" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. García-Molina, M. Espiña-Bou, P. Rodríguez-Rajo, R. Sánchez-Carrión, A. Enseñat-Cantallops" "autores" => array:5 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "García-Molina" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Espiña-Bou" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Rodríguez-Rajo" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Sánchez-Carrión" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Enseñat-Cantallops" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173580821000808" "doi" => "10.1016/j.nrleng.2021.03.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580821000808?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021348532100061X?idApp=UINPBA00004N" "url" => "/02134853/0000003600000007/v1_202108290608/S021348532100061X/v1_202108290608/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S217358082100122X" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2021.04.002" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1609" "copyright" => "Sociedad Española de Neurología" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2021;36:567-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Bell’s palsy following COVID-19 vaccination: a case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "567" "paginaFinal" => "568" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Parálisis de Bell tras vacunación COVID-19: a propósito de un caso" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 534 "Ancho" => 905 "Tamanyo" => 48822 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Bell’s palsy in our patient.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Gómez de Terreros Caro, S. Gil Díaz, M. Pérez Alé, M.L. Martínez Gimeno" "autores" => array:4 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Gómez de Terreros Caro" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Gil Díaz" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Pérez Alé" ] 3 => array:2 [ "nombre" => "M.L." "apellidos" => "Martínez Gimeno" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0213485321000657" "doi" => "10.1016/j.nrl.2021.04.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0213485321000657?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217358082100122X?idApp=UINPBA00004N" "url" => "/21735808/0000003600000007/v1_202109160551/S217358082100122X/v1_202109160551/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173580821001267" "issn" => "21735808" "doi" => "10.1016/j.nrleng.2021.04.004" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "1608" "copyright" => "Sociedad Española de Neurología" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Neurologia. 2021;36:564-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Reply" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "564" "paginaFinal" => "565" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Réplica" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José María Trejo-Gabriel-Galán" "autores" => array:1 [ 0 => array:2 [ "nombre" => "José María" "apellidos" => "Trejo-Gabriel-Galán" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580821001267?idApp=UINPBA00004N" "url" => "/21735808/0000003600000007/v1_202109160551/S2173580821001267/v1_202109160551/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Neuropsychological rehabilitation program for patients with post-COVID-19 syndrome: a clinical experience" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "565" "paginaFinal" => "566" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. García-Molina, M. Espiña-Bou, P. Rodríguez-Rajo, R. Sánchez-Carrión, A. Enseñat-Cantallops" "autores" => array:5 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "García-Molina" "email" => array:1 [ 0 => "agarciam@guttmann.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Espiña-Bou" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Rodríguez-Rajo" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "Sánchez-Carrión" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Enseñat-Cantallops" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Programa de rehabilitación neuropsicológica en pacientes con síndrome post-COVID-19: una experiencia clínica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Most patients with SARS-CoV-2 infection recover within days or weeks. However, symptoms persist in some 10% of patients.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Post–COVID-19 syndrome, as it has been called, is a series of symptoms that appear during or after SARS-CoV-2 infection, persist for longer than 12 weeks, and cannot be explained by other causes. It usually presents as a combination of symptoms that frequently overlap and may fluctuate and change over time, affecting multiple systems.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Patients with post–COVID-19 syndrome may present memory and concentration problems, brain fog, anxiety, and mood disorders.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> These alterations have a negative impact on the patient’s performance in family, social, or work settings. Neuropsychological rehabilitation may help these patients to recover brain function, improve functional capacity, and increase emotional well-being.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In June 2020, Institut Guttmann started an 8-week outpatient neurorehabilitation programme for patients with post–COVID-19 syndrome. The programme includes respiratory therapy, physical therapy, and neuropsychological rehabilitation (mood intervention, compensatory strategies, and cognitive therapy). Patients received cognitive therapy at home, using the Guttmann NeuroPersonalTrainer® platform (5 sessions/week of one-hour duration). The programme’s planning assistant designed the intervention based on pre-treatment assessment results,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> selecting the tasks to be completed during each session and adjusting the difficulty through a combination of parameters (number of stimuli, type of stimulus, speed of presentation, task duration, etc). The platform’s task plan addresses several cognitive domains (attention, memory, executive function, and language, among others).</p><p id="par0020" class="elsevierStylePara elsevierViewall">We present the results from 50 patients with no history of neurological disease who completed our neuropsychological rehabilitation programme between June 2020 and January 2021.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mean age (SD) was 53.3 (12.78) years (range, 26-76). Women accounted for 54% (n = 27) of the total. Level of education was low (≤8 years of formal schooling) in 9 patients, average (9-12 years) in 14, and high (≥13 years) in 27. The mean time elapsed between the first positive PCR test and inclusion in the neurorehabilitation programme was 24.18 weeks (SD: 7.91; range, 12-37). A total of 31 patients (62%) were admitted to hospital (either to the intensive care unit or to other wards). Significant differences were observed between hospitalised and non-hospitalised patients in sex (<span class="elsevierStyleItalic">P</span> < .001) and age (<span class="elsevierStyleItalic">P</span> = .001). Men accounted for 67.7% of hospitalised patients (n = 21), whereas 89.5% (n = 17) of non-hospitalised patients were women. Non-hospitalised patients were younger (mean [SD] of 45.6 years [10.2], vs 58 [11.9] years in hospitalised patients).</p><p id="par0030" class="elsevierStylePara elsevierViewall">Patients were administered a short assessment test battery before and after completion of the neuropsychological rehabilitation programme, including the following tests: forward and backward digit span, Rey Auditory Verbal Learning Test (RAVLT; learning, recall, and recognition), a formal phonemic fluency task (PMR), and the Hospital Anxiety and Depression Scale (HADS). Pre- and post-treatment results were compared with the Wilcoxon test for related samples (α < .05). Effect size was calculated with the Pearson correlation coefficient. Effect size was considered small for r ≈ 0.10, median for r ≈ 0.30, and large for r ≈ 0.50.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In neuropsychological rehabilitation, and in neurorehabilitation in general, observing psychometric changes after an intervention inevitably leads us to question whether these differences reflect a true change (recovery) or rather constitute a consequence of the practice effect (change or improvement resulting from practice or repeated exposure to an assessment test). We attempted to minimise the impact of the practice effect on post-treatment results by correcting raw scores according to the procedure used by Lubrini et al.,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> which is in turn based on a study by Calamia et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In the group of non-hospitalised patients, significant differences were observed between pre- and (corrected) post-treatment scores in the backward digit span (<span class="elsevierStyleItalic">P</span> = .048; r = 0.32), RAVLT-learning (<span class="elsevierStyleItalic">P</span> = .004; r = 0.47), RAVLT-recall (<span class="elsevierStyleItalic">P</span> = .002; r = 0.5), RAVLT-recognition (<span class="elsevierStyleItalic">P</span> = .004; r = 0.46), HADS-anxiety (<span class="elsevierStyleItalic">P</span> = .021; r = 0.39), and HADS-depression (<span class="elsevierStyleItalic">P</span> = .046; r = 0.34). In the group of hospitalised patients, significant differences were observed in RAVLT-learning (<span class="elsevierStyleItalic">P</span> = .005; r = 0.36), RAVLT-recall (<span class="elsevierStyleItalic">P</span> < .001; r = 0.5), RAVLT-recognition (<span class="elsevierStyleItalic">P</span> = .033; r = 0.27), PMR (<span class="elsevierStyleItalic">P</span> = .042; r = 0.25), HADS-anxiety (<span class="elsevierStyleItalic">P</span> = .002; r = 0.42), and HADS-depression (<span class="elsevierStyleItalic">P</span> = .001; r = 0.46).</p><p id="par0045" class="elsevierStylePara elsevierViewall">All patients included in the neuropsychological rehabilitation programme performed better on memory tasks after treatment. Hospitalised patients also performed better on the phonemic fluency task after the intervention (this test is sensitive to alterations in executive control, particularly response initiation and maintenance, inhibition, organisation, cognitive flexibility, and monitoring). Pre-treatment HADS scores revealed symptoms of anxiety and depression in both hospitalised and non-hospitalised patients. After the intervention, the likelihood of presenting symptoms of anxiety or depression decreased significantly.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Our study did not include a control group due to its practical nature and the circumstances surrounding the implementation of the rehabilitation programme. We are aware that this limits the possibility of extrapolating our results on the effectiveness of this intervention. However, our experience suggests that neuropsychological rehabilitation is useful in the treatment of cognitive and mood disorders in patients with post–COVID-19 syndrome. Studies with longer follow-up periods are needed to determine whether improvements persist in the medium and long term.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">Guttmann NeuroPersonalTrainer® is in part property of Institut Guttmann. García-Molina, Rodríguez-Rajo, and Sánchez-Carrión participated in the theoretical and conceptual development of the platform.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Molina A, Espiña-Bou M, Rodríguez-Rajo P, Sánchez-Carrión R, Enseñat-Cantallops A. Programa de reha-bilitación neuropsicológica en pacientes con síndrome post-COVID-19: una experiencia clínica. Neurología. 2021;36:565–566.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of post-acute covid-19 in primary care" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Greenhalgh" 1 => "M. Knight" 2 => "C. A’Court" 3 => "M. Buxton" 4 => "L. Husain" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.m3026" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2020" "volumen" => "370" "paginaInicial" => "m3026" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32784198" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "COVID-19 rapid guideline: managing the long term effects of COVID-19. Available from: <a target="_blank" href="http://www.nice.org.uk/guidance/ng188">www.nice.org.uk/guidance/ng188</a>. [Accessed 9 March 2021]." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Managing the long term effects of covid-19: summary of NICE, SIGN, and RCGP rapid guideline" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W. Shah" 1 => "T. Hillman" 2 => "E.D. Playford" 3 => "L. Hishmeh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "BMJ" "fecha" => "2021" "volumen" => "372" "paginaInicial" => "n136" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann Neuropersonal Trainer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Solana" 1 => "C. Cáceres" 2 => "A. García-Molina" 3 => "E. Opisso" 4 => "T. Roig" 5 => "J.M. Tormos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "IEEE J Biomed Health Inf" "fecha" => "2015" "volumen" => "19" "paginaInicial" => "124" "paginaFinal" => "131" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Magnitud del efecto, una guía rápida" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Dominguez-Lara" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Educación Médica" "fecha" => "2018" "volumen" => "19" "paginaInicial" => "251" "paginaFinal" => "254" "itemHostRev" => array:3 [ "pii" => "S0735109712046499" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evolución de las alteraciones cognitivas tras un traumatismo craneoencefálico: ¿hay mejoría tras controlar el efecto de la práctica?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Lubrini" 1 => "R. Viejo-Sobera" 2 => "J.A. Periáñez" 3 => "M. Cicuendez" 4 => "A.M. Castaño" 5 => "J. González-Marqués" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.33588/rn.7002.2019233" "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2020" "volumen" => "70" "paginaInicial" => "37" "paginaFinal" => "44" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31930469" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Scoring higher the second time around: meta-analyses of practice effects in neuropsychological assessment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Calamia" 1 => "K. Markon" 2 => "D. Tranel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/13854046.2012.680913" "Revista" => array:6 [ "tituloSerie" => "Clin Neuropsychol" "fecha" => "2012" "volumen" => "26" "paginaInicial" => "543" "paginaFinal" => "570" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22540222" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735808/0000003600000007/v1_202109160551/S2173580821000808/v1_202109160551/en/main.assets" "Apartado" => array:4 [ "identificador" => "9409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735808/0000003600000007/v1_202109160551/S2173580821000808/v1_202109160551/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173580821000808?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 1 | 8 |
| 2024 October | 32 | 11 | 43 |
| 2024 September | 61 | 21 | 82 |
| 2024 August | 34 | 13 | 47 |
| 2024 July | 47 | 6 | 53 |
| 2024 June | 35 | 5 | 40 |
| 2024 May | 30 | 8 | 38 |
| 2024 April | 35 | 3 | 38 |
| 2024 March | 65 | 17 | 82 |
| 2024 February | 54 | 12 | 66 |
| 2024 January | 88 | 23 | 111 |
| 2023 December | 57 | 18 | 75 |
| 2023 November | 92 | 13 | 105 |
| 2023 October | 91 | 13 | 104 |
| 2023 September | 65 | 3 | 68 |
| 2023 August | 45 | 9 | 54 |
| 2023 July | 56 | 11 | 67 |
| 2023 June | 66 | 13 | 79 |
| 2023 May | 99 | 7 | 106 |
| 2023 April | 63 | 7 | 70 |
| 2023 March | 57 | 8 | 65 |
| 2023 February | 70 | 17 | 87 |
| 2023 January | 74 | 9 | 83 |
| 2022 December | 64 | 18 | 82 |
| 2022 November | 77 | 25 | 102 |
| 2022 October | 79 | 30 | 109 |
| 2022 September | 120 | 24 | 144 |
| 2022 August | 105 | 38 | 143 |
| 2022 July | 114 | 43 | 157 |
| 2022 June | 87 | 50 | 137 |
| 2022 May | 94 | 55 | 149 |
| 2022 April | 151 | 75 | 226 |
| 2022 March | 143 | 68 | 211 |
| 2022 February | 127 | 11 | 138 |
| 2022 January | 117 | 30 | 147 |
| 2021 December | 102 | 30 | 132 |
| 2021 November | 113 | 22 | 135 |
| 2021 October | 169 | 74 | 243 |
| 2021 September | 105 | 43 | 148 |
| 2021 August | 30 | 18 | 48 |
| 2021 July | 16 | 11 | 27 |
| 2021 June | 6 | 20 | 26 |
Show all
