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Asociación entre daños en la sustancia blanca y metabolismo de la glucosa cerebral en pacientes con disfunción cognitiva
Association between white matter lesions and the cerebral glucose metabolism in patients with cognitive impairment
Hyun-Jung Noa, Hyon-Ah Yib, Kyoung Sook Wona, Hyuk Won Changc, Hae Won Kima,
Autor para correspondencia
hwkim.nm@gmail.com

Autor para correspondencia.
a Department of Nuclear Medicine, Keimyung University Dongsan Medical Center, Daegu, República de Corea
b Department of Neurology, Keimyung University Dongsan Medical Center, Daegu, República de Corea
c Department of Radiology, Semyung Radiology Clinic, Gumi, República de Corea
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Las lesiones de la sustancia blanca &#40;LSB&#41; cerebral representan afecci&#243;n de vaso peque&#241;o en el cerebro y aparecen como lesiones hiperintensas en la sustancia blanca en las im&#225;genes de resonancia magn&#233;tica &#40;RM&#41; potenciadas en T2&#46; Las LSB se observan con frecuencia en la RM de sujetos ancianos&#44; especialmente de aquellos con hipertensi&#243;n e ictus<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">1</span></a>&#46; Un estudio necr&#243;psico reciente revel&#243; que las LSB se asocian a neuropatolog&#237;a vascular cerebral &#40;angiopat&#237;a amiloidea&#44; microinfartos&#44; infartos lacunares&#41;&#44; as&#237; como a afectaci&#243;n de la prote&#237;na tau<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">2</span></a>&#46; Aunque la fisiopatolog&#237;a de las LSB no est&#225; dilucidada del todo&#44; existen varios estudios que han mostrado el papel de las LSB en la aparici&#243;n de la enfermedad de Alzheimer &#40;EA&#41;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">3&#8211;5</span></a>&#46; Concretamente&#44; se ha visto que las LSB se asocian a atrofia de la sustancia gris en regiones relacionadas con la EA&#44; como el l&#243;bulo temporal medial<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">6</span></a>&#46; Adem&#225;s&#44; se ha descrito que la aparici&#243;n de LSB duplica el riesgo de demencia por EA<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La EA es una enfermedad neurodegenerativa progresiva caracterizada por la disfunci&#243;n neuronal y por la p&#233;rdida de sinapsis junto con el dep&#243;sito extracelular de placas de sustancia amiloide &#946; &#40;A&#946;&#41;&#44; as&#237; como de ovillos neurofribrilares intracelulares<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">8</span></a>&#46; El conocimiento de la asociaci&#243;n existente entre la carga cerebral de A&#946; y el trastorno neuronal tiene una gran importancia para la caracterizaci&#243;n de la evoluci&#243;n natural de la enfermedad&#44; as&#237; como para la evaluaci&#243;n de nuevos planteamientos terap&#233;uticos para la EA&#46; La tomograf&#237;a por emisi&#243;n de positrones &#40;PET&#41; constituye un instrumento adecuado para el seguimiento in vivo de la progresi&#243;n natural de la EA&#46; La <span class="elsevierStyleSup">18</span>F-fluorodesoxiglucosa &#40;<span class="elsevierStyleSup">18</span>F-FDG&#41; y el compuesto B de Pittsburgh marcado con <span class="elsevierStyleSup">11</span>C&#44; el <span class="elsevierStyleSup">18</span>F-florbetaben &#40;<span class="elsevierStyleSup">18</span>F-FBB&#41;&#44; el <span class="elsevierStyleSup">18</span>F-florbetapir o el <span class="elsevierStyleSup">18</span>F-flutemetamol constituyen los biomarcadores PET m&#225;s habitualmente utilizados en la EA&#59; estos radiotrazadores permiten el estudio no invasivo de la disfunci&#243;n neuronal y de la carga cerebral de A&#946;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; Un estudio longitudinal reciente ha mostrado que el aumento de la carga cerebral de A&#946; en la sustancia gris del cerebro precede a los patrones anat&#243;micos espec&#237;ficos de disminuci&#243;n del metabolismo gluc&#237;dico en los pacientes con EA<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">De forma similar a las placas cerebrales de A&#946;&#44; tambi&#233;n se ha visto que las LSB contribuyen a una disminuci&#243;n en el metabolismo cerebral de la glucosa y al deterioro cognitivo<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">12</span></a>&#46; Estudios previos que han utilizado la PET con <span class="elsevierStyleSup">18</span>F-FDG han mostrado que el aumento en la carga de LSB se asociaba a una disminuci&#243;n generalizada del metabolismo cerebral de la glucosa<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">13&#44;14</span></a>&#46; Debido a que la disminuci&#243;n sobrea&#241;adida en el metabolismo de la glucosa inducida por las LSB en regiones caracter&#237;sticamente afectadas por las placas cerebrales de A&#946; es muy probable que suponga un efecto aditivo en los s&#237;ntomas provocados por la propia dolencia de la EA&#44; deber&#237;a clarificarse la superposici&#243;n existente entre la disminuci&#243;n del metabolismo cerebral de la glucosa provocado por la LSB del provocado por las placas cerebrales de A&#946;&#46; Sin embargo&#44; no existe evidencia suficiente de que el deterioro cognitivo en los pacientes con EA est&#233; provocado por las LSB adem&#225;s de por el dep&#243;sito amiloide&#46; Por ello&#44; el objetivo de este estudio fue evaluar la relaci&#243;n existente entre las LSB y el metabolismo cerebral de la glucosa en pacientes con deterioro cognitivo despu&#233;s del ajuste seg&#250;n la carga cerebral de A&#946;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n del estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">Este estudio transversal incluy&#243; una serie de pacientes consecutivos de edades comprendidas entre los 50 y los 90 a&#241;os que acudieron a nuestro departamento de trastornos de la memoria para una evaluaci&#243;n de su funci&#243;n cognitiva entre junio de 2015 y enero de 2017&#46; Todos los sujetos se clasificaron en 3 categor&#237;as de s&#237;ndrome cognitivo basadas en el 2018 National Institute on Aging-Alzheimer&#39;s Association Research Framework &#40;Contexto de Investigaci&#243;n del Instituto Nacional para el Envejecimiento y la Asociaci&#243;n para el Alzheimer&#41;&#58; ausencia de deterioro cognitivo &#40;ADC&#41;&#44; deterioro cognitivo leve &#40;DCL&#41; y demencia tipo EA<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">15</span></a>&#46; Para la evaluaci&#243;n de la funci&#243;n cognitiva se utilizaron el Mini-Mental State Examination &#40;MMSE&#41;&#44; conocido por Mini-Examen Cognoscitivo en su versi&#243;n castellana&#44; la prueba de retenci&#243;n de d&#237;gitos &#40;Digit Span Memory Test en ingl&#233;s&#41;&#44; el test de denominaci&#243;n Korean-Boston &#40;Korean-Boston Naming Test en ingl&#233;s&#41; y el test de la figura compleja de Rey-Osterrieth y ensayo de reconocimiento &#40;Rey-Osterrieth Complex Figure Test and Recognition Trial en ingl&#233;s&#41;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">16</span></a>&#46; Todos los pacientes fueron sometidos a una RM cerebral&#44; una PET con <span class="elsevierStyleSup">18</span>F-FDG y otra PET con <span class="elsevierStyleSup">18</span>F-FBB dentro de un plazo de tiempo de 4 semanas tras su visita a nuestro departamento&#46; Se excluyeron aquellos pacientes con una puntuaci&#243;n del MMSE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>10&#44; as&#237; como aquellos con alguna enfermedad que pudiera afectar a la funci&#243;n cognitiva&#44; como la demencia vascular&#44; antecedentes de episodios psiqui&#225;tricos o de drogodependencia&#44; o un diagn&#243;stico previo de demencia&#46; Este estudio fue autorizado por el Comit&#233; de Revisi&#243;n Institucional del Centro M&#233;dico de Dongsan y se obtuvo el consentimiento informado por escrito de todos los participantes o de sus cuidadores&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">RM cerebral</span><p id="par0025" class="elsevierStylePara elsevierViewall">Todos los pacientes fueron sometidos a una RM cerebral con un equipo de 3-T Signa Excite &#40;GE Healthcare&#44; Milwaukee&#44; WI&#44; EE&#46; UU&#46;&#41; y utilizando una bobina cerebral de 8 canales y de alta resoluci&#243;n&#46; Se obtuvo una serie de im&#225;genes anat&#243;micas mediante una secuencia de eco de gradiente con disrupci&#243;n &#40;&#171;spoiled&#187; en ingl&#233;s&#41; tridimensional&#46; Se adquirieron im&#225;genes en secuencia r&#225;pida de eco de esp&#237;n potenciada en T2 bajo las siguientes condiciones&#58; tiempo de repetici&#243;n&#44; 4&#46;000<span class="elsevierStyleHsp" style=""></span>ms&#59; tiempo de eco&#44; 110<span class="elsevierStyleHsp" style=""></span>ms&#59; campo de detecci&#243;n&#44; 210<span class="elsevierStyleHsp" style=""></span>mm&#59; matriz&#44; 512<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>320&#59; grosor de corte&#44; 5<span class="elsevierStyleHsp" style=""></span>mm&#44; y grosor de espacio&#44; 2<span class="elsevierStyleHsp" style=""></span>mm&#46; Dos investigadores sin conocimiento de la informaci&#243;n cl&#237;nica de los pacientes puntuaron de forma independiente las hiperintensidades de la sustancia blanca periventricular y profunda mediante una escala modificada de Fazekas con el fin de evaluar el grado de severidad de las LSB en las im&#225;genes RM en T2<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">17</span></a>&#46; La puntuaci&#243;n de la hiperintensidad en la sustancia blanca periventricular vari&#243; entre 0 y 3 seg&#250;n los siguientes criterios&#58; 0&#44; ausente&#59; 1&#44; recubrimiento focal o muy fino&#59; 2&#44; recubrimiento uniforme&#59; y 3&#44; hiperintensidad irregular de la sustancia blanca periventricular que se extend&#237;a hacia la sustancia blanca profunda&#46; La puntuaci&#243;n de la hiperintensidad en la sustancia blanca profunda vari&#243; entre 0 y 3&#58; 0&#44; ausencia&#59; 1&#44; focos puntuales&#59; 2&#44; focos que conflu&#237;an inicialmente&#59; y 3&#44; &#225;reas confluyentes extensas&#46; La escala de Fazekas adopta la m&#225;xima puntuaci&#243;n en las hiperintensidades de la sustancia blanca periventricular o de la sustancia blanca profunda&#46; En el caso de desacuerdo entre ambos evaluadores&#44; se lleg&#243; a una decisi&#243;n de consenso con la ayuda de un neurorradi&#243;logo &#40;HWC&#41;&#46; Aquellos pacientes con una puntuaci&#243;n en la escala de Fazekas de 0 o 1 se clasificaron dentro del grupo de LSB baja&#44; y aquellos pacientes con una puntuaci&#243;n de 2 o 3 se clasificaron dentro del grupo de LSB alta&#46; Se evaluaron las diferencias en el metabolismo regional de la glucosa cerebral entre los grupos con LSB baja y alta&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">PET con <span class="elsevierStyleSup">18</span>F-FBB y con <span class="elsevierStyleSup">18</span>F-FDG</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se utiliz&#243; un equipo PET&#47;TC &#40;Biograph mCT-64&#44; Siemens Healthcare&#44; Knoxville&#44; TN&#44; EE&#46; UU&#46;&#41; para la adquisici&#243;n de las im&#225;genes de la PET con <span class="elsevierStyleSup">18</span>F-FBB y con <span class="elsevierStyleSup">18</span>F-FDG&#46; Todos los pacientes estaban en ayunas de 6<span class="elsevierStyleHsp" style=""></span>h como m&#237;nimo antes de la obtenci&#243;n de las im&#225;genes de la PET con <span class="elsevierStyleSup">18</span>F-FDG&#46; Se utiliz&#243; un dispositivo de espuma y goma para sujetar y fijar la cabeza del paciente&#46; Las im&#225;genes de la PET con <span class="elsevierStyleSup">18</span>F-FBB se adquirieron entre los 90 y 100<span class="elsevierStyleHsp" style=""></span>min tras la administraci&#243;n intravenosa de 300<span class="elsevierStyleHsp" style=""></span>MBq de <span class="elsevierStyleSup">18</span>F-FBB&#46; Las im&#225;genes de la PET con <span class="elsevierStyleSup">18</span>F-FDG se adquirieron entre 30 y 40<span class="elsevierStyleHsp" style=""></span>min tras la administraci&#243;n intravenosa de 4&#44;0<span class="elsevierStyleHsp" style=""></span>MBq&#47;kg de <span class="elsevierStyleSup">18</span>F-FDG de manera tridimensional&#46; Se realiz&#243; una TC en modo helicoidal a dosis bajas y sin administraci&#243;n de contraste para la correcci&#243;n de la atenuaci&#243;n y localizaci&#243;n&#44; con par&#225;metros de 120<span class="elsevierStyleHsp" style=""></span>kVp y 150<span class="elsevierStyleHsp" style=""></span>mAs con el algoritmo X Verdadero&#46; Las im&#225;genes de la PET se sometieron a reconstrucci&#243;n iterativa mediante un algoritmo OSEM&#46; La correcci&#243;n de la atenuaci&#243;n en las im&#225;genes de la PET se realiz&#243; a partir de los datos de atenuaci&#243;n de las im&#225;genes de la TC&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis cuantitativo de los vol&#250;menes de inter&#233;s &#40;VOI&#41; utilizando el programa inform&#225;tico PMOD &#40;PMOD Technologies Ltd&#46;&#44; Z&#250;rich&#44; Suiza&#41;&#44; como ya se ha descrito previamente<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a>&#46; El procesado de las im&#225;genes se llev&#243; a cabo utilizando el SPM12 &#40;Wellcome Department of Imaging Neuroscience&#44; Institute of Neurology&#44; University College of London&#41; dentro del entorno MATLAB 2013a &#40;MathWorks Inc&#46;&#44; MA&#44; EE&#46; UU&#46;&#41; y la versi&#243;n 1&#46;37 de MRIcro &#40;Chris Rorden&#44; Columbia&#44; SC&#44; EE&#46; UU&#46;&#44; <a href="http://www.mricro.com/">www&#46;mricro&#46;com</a>&#41;&#46; Se realiz&#243; un corregistro de las im&#225;genes de RM y PET mediante un algoritmo est&#225;ndar de informaci&#243;n mutua y normalizaci&#243;n espacial&#46; Posteriormente se aplic&#243; una plantilla autom&#225;tica de delimitaci&#243;n anat&#243;mica automatizada para la obtenci&#243;n de muestras de densidad de cuentas en VOI regionales estandarizadas cerebrales<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Para la cuantificaci&#243;n de la carga cerebral de A&#946;&#44; en las im&#225;genes PET con <span class="elsevierStyleSup">18</span>F-FBB se definieron individualmente VOIs en los c&#243;rtex frontal&#44; temporal&#44; parietal y occipital&#59; en el c&#243;rtex del c&#237;ngulo anterior y posterior&#44; y en c&#243;rtex cerebeloso&#46; Se obtuvieron los valores de captaci&#243;n estandarizado de <span class="elsevierStyleSup">18</span>F-FBB de cada VOI regional definida&#46; Se calcul&#243; el &#237;ndice de captaci&#243;n estandarizado compuesto del <span class="elsevierStyleSup">18</span>F-FBB &#40;SUVR<span class="elsevierStyleInf">FBB</span>&#41; dividiendo la media de los valores de captaci&#243;n estandarizados de <span class="elsevierStyleSup">18</span>F-FBB del c&#243;rtex frontal&#44; temporal y parietal y del cingulado por el valor del c&#243;rtex cerebeloso como &#225;rea de referencia y como ya se ha descrito previamente<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">20</span></a>&#46; El &#237;ndice compuesto SUVR<span class="elsevierStyleInf">FBB</span> se utiliz&#243; para evaluar la relaci&#243;n existente entre la carga de A&#946; cerebral y el metabolismo de la glucosa&#46; Se consideraron positivos para A&#946; aquellos pacientes con un SUVR compuesto<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>1&#44;39&#44; que ya est&#225; descrito como un valor de corte que refleja una carga de A&#946; cerebral anormalmente elevada&#44; mientras que aquellos pacientes con un SUVR compuesto<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1&#44;39 se consideraron negativos para A&#946;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">20</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Para la cuantificaci&#243;n del metabolismo cerebral de la glucosa&#44; en las im&#225;genes PET con <span class="elsevierStyleSup">18</span>F-FDG se definieron VOIs individualmente en la regi&#243;n central&#59; en el c&#243;rtex frontal lateral&#44; medial y orbitario&#59; en el c&#243;rtex temporal lateral&#59; en el c&#243;rtex parietal lateral y medial&#59; en el c&#243;rtex occipital medial y lateral&#59; y en el l&#243;bulo l&#237;mbico&#46; Se obtuvieron los valores de captaci&#243;n estandarizada de <span class="elsevierStyleSup">18</span>F-FDG a partir de los VOI regionales definidos&#44; as&#237; como tambi&#233;n el &#237;ndice de captaci&#243;n estandarizado regional de <span class="elsevierStyleSup">18</span>F-FDG &#40;SUVR<span class="elsevierStyleInf">FDG</span>&#41;&#44; dividiendo el valor de captaci&#243;n estandarizado de cada regi&#243;n por el global del cerebro&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se compar&#243; el SUVR<span class="elsevierStyleInf">FBB</span> compuesto &#40;carga de A&#946; cerebral&#41; y el SUVR<span class="elsevierStyleInf">FDG</span> regional &#40;metabolismo cerebral de la glucosa&#41; de los 3 grupos utilizando el an&#225;lisis ANOVA unilateral&#46; Se aplic&#243; la correcci&#243;n de Bonferroni al an&#225;lisis post-hoc de comparaciones intergrupo&#46; Se evaluaron las diferencias en el SUVR<span class="elsevierStyleInf">FDG</span> entre los grupos con LSB baja y alta utilizando la prueba de la t para 2 muestras&#46; Los valores de p en las comparaciones m&#250;ltiples se corrigieron mediante una correcci&#243;n del &#237;ndice de falso descubrimiento&#46; Tambi&#233;n evaluamos la relaci&#243;n existente entre el SUVR<span class="elsevierStyleInf">FBB</span> compuesto y el SUVR<span class="elsevierStyleInf">FDG</span> regional&#44; as&#237; como entre el SUVR<span class="elsevierStyleInf">FBB</span> compuesto y la puntuaci&#243;n del MMSE utilizando el an&#225;lisis de correlaci&#243;n de Pearson&#46; Se realizaron an&#225;lisis de correlaci&#243;n de Spearman para evaluar la relaci&#243;n entre la puntuaci&#243;n de la escala de Fazekas con el SUVR<span class="elsevierStyleInf">FDG</span> y la puntuaci&#243;n del MMSE&#46; Se realiz&#243; un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple&#44; ajustado seg&#250;n la edad&#44; el sexo y el SUVR<span class="elsevierStyleInf">FBB</span> compuesto&#44; o bien ajustado seg&#250;n la edad&#44; el sexo y el estadio cognitivo&#44; con el fin de evaluar los efectos de la puntuaci&#243;n en la escala de Fazekas sobre los resultados del SUVR<span class="elsevierStyleInf">FDG</span> regional y la puntuaci&#243;n del MMSE&#46; Se consider&#243; estad&#237;sticamente significativo un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Caracter&#237;sticas de los pacientes</span><p id="par0055" class="elsevierStylePara elsevierViewall">Este estudio incluy&#243; un total de 83 sujetos&#46; De estos&#44; 19 se clasificaron como ADC&#44; 30 como DCL y 34 como demencia tipo EA&#46; La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra el diagrama de flujo de la poblaci&#243;n de estudio&#46; El intervalo de tiempo entre la RM cerebral y la PET con <span class="elsevierStyleSup">18</span>F-FDG fue de 6&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;4 d&#237;as &#40;rango 0-23 d&#237;as&#41;&#44; mientras que entre la PET con <span class="elsevierStyleSup">18</span>F-FBB y la PET con <span class="elsevierStyleSup">18</span>F-FDG fue de 3&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;7 d&#237;as &#40;rango 0-27 d&#237;as&#41;&#46; La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra informaci&#243;n descriptiva sobre las caracter&#237;sticas de los pacientes incluidos en el estudio&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">En relaci&#243;n con la carga cerebral de A&#946;&#44; los SUVR<span class="elsevierStyleInf">FBB</span> regional y compuesto fueron significativamente superiores en el grupo con demencia tipo EA respecto a los grupos con ADC y DCL &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> complementaria&#41;&#46; En relaci&#243;n con el metabolismo cerebral de la glucosa&#44; el SUVR<span class="elsevierStyleInf">FDG</span> de la regi&#243;n cortical frontal lateral&#44; temporal lateral y parietal lateral y del l&#243;bulo l&#237;mbico&#44; todo ello bilateral&#44; fue significativamente menor en el grupo con demencia tipo EA respecto a los grupos con ADC y DCL &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Relaci&#243;n entre las LSB y el metabolismo cerebral de la glucosa</span><p id="par0065" class="elsevierStylePara elsevierViewall">En el grupo con LSB elevada&#44; los valores de SUVR<span class="elsevierStyleInf">FDG</span> regional para el c&#243;rtex frontal lateral bilateral&#44; temporal lateral bilateral y parietal lateral izquierdo y del l&#243;bulo l&#237;mbico bilateral fueron significativamente menores respecto al grupo con LSB baja &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Hubo una correlaci&#243;n negativa significativa entre la puntuaci&#243;n de la escala de Fazekas y el SUVR<span class="elsevierStyleInf">FDG</span> regional en los c&#243;rtex frontal lateral bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;389&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;345&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; temporal lateral bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;326&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;343&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41; y parietal lateral izquierdo &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;267&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;015&#41; y en el l&#243;bulo l&#237;mbico bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;355&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;333&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#46; El SUVR<span class="elsevierStyleInf">FBB</span> compuesto y el SUVR<span class="elsevierStyleInf">FDG</span> regional en el c&#243;rtex temporal lateral bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;255&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;020&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;335&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;002&#41;&#44; parietal lateral bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;268&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;014&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;224&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;042&#41; y el l&#243;bulo l&#237;mbico bilateral &#40;izquierdo&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;276&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;012&#59; y derecho&#44; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;239&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;029&#41; tambi&#233;n mostraron una correlaci&#243;n negativa significativa&#46; El an&#225;lisis de regresi&#243;n lineal m&#250;ltiple ajustado seg&#250;n la edad&#44; el sexo y el SUVR<span class="elsevierStyleInf">FBB</span> compuesto mostr&#243; que la puntuaci&#243;n en la escala de Fazekas constitu&#237;a un factor determinante independiente del SUVR<span class="elsevierStyleInf">FDG</span> regional en los l&#243;bulos frontal lateral&#44; temporal lateral&#44; parietal lateral y l&#237;mbico&#44; todos ellos bilateralmente &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; El an&#225;lisis de regresi&#243;n m&#250;ltiple lineal ajustado seg&#250;n la edad&#44; el sexo y el estadio cognitivo mostr&#243; que la puntuaci&#243;n en la escala de Fazekas constitu&#237;a un factor determinante independiente del SUVR<span class="elsevierStyleInf">FDG</span> regional en los c&#243;rtex frontal lateral izquierdo&#44; temporal lateral bilateral y parietal lateral izquierdo&#44; as&#237; como en el l&#243;bulo l&#237;mbico bilateral &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> complementaria&#41;&#46; La <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> muestra im&#225;genes representativas de RM en T2 FLAIR y de la PET con <span class="elsevierStyleSup">18</span>F-FDG&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Hubo una correlaci&#243;n negativa significativa entre las puntuaciones de la escala de Fazekas y del MMSE &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;387&#44; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#44; as&#237; como entre los &#237;ndices de SUVR<span class="elsevierStyleInf">FBB</span> compuesto y la puntuaci&#243;n del MMSE &#40;<span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;327&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; El an&#225;lisis de regresi&#243;n lineal m&#250;ltiple ajustado seg&#250;n la edad&#44; el sexo y el SUVR<span class="elsevierStyleInf">FBB</span> compuesto mostr&#243; que la puntuaci&#243;n en la escala de Fazekas era un factor independiente que influ&#237;a sobre la puntuaci&#243;n del MMSE &#40;<span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> ajustado<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;097&#44; <span class="elsevierStyleItalic">&#946;</span> estandarizada<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#8722;0&#44;318&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Discusi&#243;n</span><p id="par0080" class="elsevierStylePara elsevierViewall">En este estudio hemos observado una correlaci&#243;n negativa entre las LSB y el metabolismo cerebral de la glucosa en pacientes con deterioro cognitivo&#46; Este hallazgo apunta a que no solamente es la carga de A&#946; cerebral la que contribuye al deterioro cognitivo en el anciano&#44; sino tambi&#233;n las LSB&#44; que son consecuencia de la enfermedad vascular de vaso peque&#241;o&#46; De acuerdo con nuestros hallazgos&#44; estudios previos han descrito un solapamiento considerable entre la enfermedad de vaso peque&#241;o y la EA&#44; con un aumento de la prevalencia de las LSB&#46; Adem&#225;s&#44; est&#225; descrito que las LSB reducen el umbral de la expresi&#243;n cl&#237;nica de la demencia para una determinada carga de la afecci&#243;n de la EA<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">21</span></a>&#46; Las LSB se consideran un factor de riesgo potencial en el deterioro cognitivo y de la memoria<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">22</span></a>&#44; y est&#225; descrita su asociaci&#243;n con una mayor incidencia de demencia<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">3</span></a>&#44; as&#237; como con el desarrollo de cambios microestructurales en la sustancia blanca en el estadio presintom&#225;tico de la EA<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Se ha utilizado la PET con <span class="elsevierStyleSup">18</span>F-FDG para evaluar el metabolismo cerebral de la glucosa en reposo&#44; que constituye un indicador de la actividad neuronal&#46; En los pacientes con EA&#44; la PET con <span class="elsevierStyleSup">18</span>F-FDG muestra un patr&#243;n caracter&#237;stico de hipometabolismo gluc&#237;dico en el hipocampo o c&#243;rtex temporal medial&#44; en el c&#243;rtex cingulado posterior&#44; en el prec&#250;neo y en el c&#243;rtex temporoparietal lateral<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">24</span></a>&#46; En los pacientes con DCL que tienen m&#225;s probabilidad de progresar hacia una EA cl&#237;nica&#44; se observan cambios regionales similares aunque m&#225;s leves&#44; mientras que aquellos pacientes con EA m&#225;s avanzada muestran caracter&#237;sticamente afectaci&#243;n del c&#243;rtex frontal<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a>&#46; Coincidiendo con estudios previos&#44; el presente mostr&#243; una disminuci&#243;n del metabolismo gluc&#237;dico en el c&#243;rtex frontal&#44; temporal y parietal laterales&#44; todo ello bilateral&#44; as&#237; como en el l&#243;bulo l&#237;mbico en los pacientes con demencia tipo EA&#46; Estudios recientes han descrito que el patr&#243;n longitudinal de disminuci&#243;n del metabolismo cerebral sigue anat&#243;micamente el patr&#243;n de dep&#243;sito de la sustancia amiloide con un decalaje temporal&#44; lo cual indica que la disfunci&#243;n neuronal se propaga dentro del patr&#243;n anat&#243;mico de la enfermedad A&#946; cerebral<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a>&#46; De acuerdo con estos estudios&#44; el presente tambi&#233;n mostr&#243; que el metabolismo cerebral de la glucosa era significativamente menor en el c&#243;rtex frontal&#44; temporal y parietal&#44; as&#237; como en el l&#243;bulo l&#237;mbico&#44; todo ello bilateral&#44; del grupo con demencia tipo EA respecto a los grupos con ADC y DCL&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Existen muchos factores que aumentan el riesgo de enfermedad vascular cerebral y que se asocian a un mayor riesgo de EA&#46; Estos factores incluyen el tabaquismo&#44; la obesidad en pacientes de mediana edad y la diabetes<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">3</span></a>&#46; Adem&#225;s&#44; existen varios estudios que han mostrado asociaciones entre las LSB y la afecci&#243;n por EA<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">27&#8211;29</span></a>&#46; Un estudio poblacional extenso describi&#243; que las LSB contribuyen a los patrones de atrofia cerebral en regiones relacionadas con la EA<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">5</span></a>&#44; y otro estudio ha propuesto que la presencia de las LSB duplica el riesgo de EA<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">30</span></a>&#46; Las LSB se representan con frecuencia como &#225;reas de hiperintensidad de la sustancia blanca en las im&#225;genes cerebrales potenciadas en T2 de los ancianos&#44; especialmente en aquellos pacientes con hipertensi&#243;n e ictus<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">31</span></a>&#46; Se sabe que estas lesiones aparecen como consecuencia de la isquemia y que pueden estar producidas por la enfermedad de vaso peque&#241;o<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">32</span></a>&#46; El presente estudio mostr&#243; una correlaci&#243;n leve-moderada entre la carga de la LSB y el hipometabolismo gluc&#237;dico en el c&#243;rtex bilateral frontal&#44; temporal y parietal&#44; todos ellos laterales&#44; as&#237; como tambi&#233;n en el l&#243;bulo l&#237;mbico&#46; Este hallazgo implica que existen otros factores&#44; adem&#225;s de la LSB&#44; como la edad&#44; el sexo o la carga de A&#946;&#44; que pueden afectar al hipometabolismo gluc&#237;dico cerebral&#46; Sin embargo&#44; el presente estudio mostr&#243; que&#44; incluso despu&#233;s del ajuste seg&#250;n la edad&#44; el sexo y la carga de A&#946; cerebral&#44; la carga de la LSB permaneci&#243; como un factor determinante significativo del metabolismo de la glucosa cerebral&#46; Este hallazgo coincide con los resultados de estudios anteriores realizados con otras enfermedades&#44; en los que las LSB se asociaron a un hipometabolismo gluc&#237;dico difuso en el c&#243;rtex cerebral&#46; Un estudio PET con <span class="elsevierStyleSup">18</span>F-FDG mostr&#243; que los pacientes con demencia de origen vascular presentaban un patr&#243;n de hipometabolismo gluc&#237;dico cortical m&#225;s difuso&#44; y una mayor dificultad en mantener una atenci&#243;n continuada respecto a aquellos pacientes con EA probable<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">12</span></a>&#46; Otro estudio de cohorte realizado con pacientes con deterioro cognitivo mostr&#243; una relaci&#243;n significativa entre la disrupci&#243;n de las v&#237;as de la sustancia blanca l&#237;mbica y el hipometabolismo de la glucosa en los c&#243;rtex parietal y temporal&#44; as&#237; como en el c&#237;ngulo posterior<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">33</span></a>&#46; Adem&#225;s&#44; en aquellos pacientes sin deterioro cognitivo&#44; un estudio de RM que utiliz&#243; la escala de modificaci&#243;n de la conectividad tambi&#233;n mostr&#243; que aquella sustancia gris con una mayor alteraci&#243;n de la conectividad secundaria a LSB tambi&#233;n presentaba un hipometabolismo de la glucosa<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">34</span></a>&#46; Estos hallazgos pueden ser atribuidos al hecho de que las LSB representan la desmielinizaci&#243;n y la destrucci&#243;n axonales en la sustancia blanca periventricular y profunda&#46; Los estudios histol&#243;gicos han mostrado que las &#225;reas extensas de LSB se asocian a una disminuci&#243;n en la densidad de la gl&#237;a y a la presencia de vacuolas&#44; mientras que las LSB m&#225;s leves se asocian a una activaci&#243;n microglial y endotelial<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">35</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Las LSB aparecen m&#225;s frecuentemente en los pacientes con EA respecto a los controles ancianos normales&#44; posiblemente como consecuencia de la enfermedad de vaso peque&#241;o<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">1&#44;3</span></a>&#46; Adem&#225;s&#44; las LSB pueden estar relacionadas etiol&#243;gicamente con la demencia o ser un hallazgo simult&#225;neo<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">36</span></a>&#46; Los pacientes con EA y demencia vascular combinadas constituyen un subgrupo importante de los pacientes con demencia<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a>&#46; Un estudio reciente que utiliz&#243; secuencias RM de tensor de difusi&#243;n mostr&#243; un solapamiento significativo en aquellas &#225;reas con disminuci&#243;n regional en la anisotrop&#237;a fraccional&#44; lo que constituye un &#237;ndice de la carga de LSB&#44; en pacientes con DCL y EA<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a>&#46; Ello indic&#243; que las LSB aparec&#237;an en pacientes con DCL antes del desarrollo de la demencia&#46; La demencia vascular pura sin enfermedad A&#946; es infrecuente y muchos de los pacientes que no satisfacen los criterios histol&#243;gicos de EA o de demencia vascular presentan un d&#233;ficit cognitivo secundario a la combinaci&#243;n de ambos procesos<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a>&#46; Un metaan&#225;lisis mostr&#243; que las LSB se asocian a un rendimiento disminuido en aquellas tareas que implican velocidad de procesado&#44; la memoria inmediata y retardada&#44; funciones ejecutivas e &#237;ndices de funcionamiento cognitivo global<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">39</span></a>&#46; De acuerdo con estudios anteriores&#44; este estudio mostr&#243; una correlaci&#243;n entre la carga de LSB y la puntuaci&#243;n del MMSE&#46; Incluso despu&#233;s de efectuar el ajuste por la carga cerebral de A&#946;&#44; la carga de LSB fue un factor determinante independiente de la puntuaci&#243;n del MMSE&#46; Este hallazgo evidencia que las LSB contribuyen al deterioro cognitivo con la acumulaci&#243;n cerebral de A&#946; y que pueden favorecer la aparici&#243;n de signos cl&#237;nicos de demencia en los sujetos con EA confirmada&#44; o hacer que el deterioro relacionado con la EA se manifieste a una edad m&#225;s temprana<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">40</span></a>&#46; Por ello&#44; aquellas estrategias que prevengan la enfermedad cerebral de vaso peque&#241;o&#44; incluyendo la medicaci&#243;n&#44; la rehabilitaci&#243;n y la cirug&#237;a&#44; pueden ayudar a reducir la prevalencia de demencia por EA o impedir su progresi&#243;n&#46; La eliminaci&#243;n de los factores de riesgo tradicionales&#44; as&#237; como la instauraci&#243;n de un estilo de vida saludable&#44; constituyen&#44; en la actualidad&#44; los planteamientos profil&#225;cticos y terap&#233;uticos m&#225;s importantes en el abordaje de la enfermedad cerebral de vaso peque&#241;o<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">41</span></a>&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El presente estudio tiene algunas limitaciones&#46; En primer lugar&#44; la carga de LSB se evalu&#243; visualmente a trav&#233;s de la escala de Fazekas&#46; Ello puede haber influido en nuestros resultados&#46; Sin embargo&#44; incluso con los m&#233;todos actuales de cuantificaci&#243;n autom&#225;tica y semiautom&#225;tica para evaluar la carga de LSB&#44; las mediciones de las lesiones y los par&#225;metros del tejido cerebral pueden verse afectados durante el procesado de las im&#225;genes&#44; en su diferenciaci&#243;n de artefactos y en su corregistro<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">39</span></a>&#46; Debido a que ya est&#225; demostrada la coherencia del sistema de puntuaci&#243;n en la escala de Fazekas<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">42</span></a>&#44; nuestros resultados se ver&#237;an m&#237;nimamente afectados por esta circunstancia&#46; En segundo lugar&#44; el estudio actual no mostr&#243; cambios en el metabolismo gluc&#237;dico con la progresi&#243;n de las LSB debido a su dise&#241;o de estudio transversal&#46; A pesar de estas limitaciones&#44; nuestro estudio mostr&#243; que la enfermedad de vaso peque&#241;o puede influir en el deterioro cognitivo adicionalmente a la acumulaci&#243;n cerebral de A&#946;&#46; Es necesaria la realizaci&#243;n de estudios longitudinales con muestras de tama&#241;o suficiente para poder evaluar la contribuci&#243;n de la enfermedad de vaso peque&#241;o al deterioro cognitivo&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conclusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">Las LSB se asocian a un hipometabolismo gluc&#237;dico cerebral&#46; Nuestros hallazgos demuestran que la enfermedad de vaso peque&#241;o&#44; as&#237; como la enfermedad de la A&#946;&#44; pueden contribuir al deterioro cognitivo de los pacientes con EA&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Aprobaci&#243;n &#233;tica</span><p id="par0120" class="elsevierStylePara elsevierViewall">Todos los procedimientos que involucraban a participantes humanos estaban en consonancia con las normas &#233;ticas del comit&#233; de investigaci&#243;n institucional y con la Declaraci&#243;n de Helsinki de 1964&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Consentimiento informado</span><p id="par0125" class="elsevierStylePara elsevierViewall">La junta de revisi&#243;n institucional aprob&#243; este estudio y se obtuvo el consentimiento informado por escrito de todos los participantes o cuidadores&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financiaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Este estudio fue financiado por la Bumsuk Academic Research Fund en 2016&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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              "titulo" => "Conclusions"
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          "titulo" => "Introducci&#243;n"
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          "titulo" => "Material y m&#233;todos"
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              "titulo" => "RM cerebral"
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "PET con F-FBB y con F-FDG"
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              "identificador" => "sec0030"
              "titulo" => "An&#225;lisis estad&#237;stico"
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          "titulo" => "Resultados"
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              "titulo" => "Caracter&#237;sticas de los pacientes"
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              "titulo" => "Relaci&#243;n entre las LSB y el metabolismo cerebral de la glucosa"
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          "titulo" => "Discusi&#243;n"
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          "titulo" => "Aprobaci&#243;n &#233;tica"
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          "titulo" => "Conflicto de intereses"
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          "titulo" => "Bibliograf&#237;a"
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    "fechaRecibido" => "2018-10-11"
    "fechaAceptado" => "2018-12-08"
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            0 => "Da&#241;os en la sustancia blanca"
            1 => "Enfermedad de peque&#241;os vasos"
            2 => "Enfermedad de Alzheimer"
            3 => "&#946;-Amiloide"
            4 => "PET con <span class="elsevierStyleSup">18</span>F-FDG"
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            0 => "White matter lesion"
            1 => "Small vessel disease"
            2 => "Alzheimer&#39;s disease"
            3 => "&#946;-Amyloid"
            4 => "<span class="elsevierStyleSup">18</span>F-FDG PET"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los da&#241;os en la sustancia blanca &#40;DSB&#41;&#44; detectados como hiperintensidades en las im&#225;genes de RM ponderadas en T2&#44; representan la enfermedad de peque&#241;os vasos cerebrales&#44; y est&#225;n considerados como un factor de riesgo potencial de trastornos de la memoria y disfunci&#243;n cognitiva&#46; No se ha evidenciado suficientemente que la disfunci&#243;n cognitiva en pacientes con enfermedad de Alzheimer est&#233; causada por DSB y la patolog&#237;a &#946;-amiloide &#40;A&#946;&#41;&#46; El objetivo de estudio fue evaluar la relaci&#243;n entre los DSB y el metabolismo de la glucosa cerebral en pacientes con disfunci&#243;n cognitiva&#44; tras el ajuste de la carga cerebral de A&#946;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Materiales y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Incluimos en este estudio transversal a ochenta y tres sujetos con desempe&#241;o cognitivo que oscilaba entre normal y demencia&#44; a quienes se realiz&#243; RM cerebral y PET con Florbetaben &#40;<span class="elsevierStyleSup">18</span>F&#41; y PET con <span class="elsevierStyleSup">18</span>F-FDG&#46; Utilizamos la escala Fazekas para cuantificar los DSB en la RM cerebral ponderada en T2&#46; Estimamos cuantitativamente la carga cerebral de A&#946; y el metabolismo de la glucosa cerebral utilizando el an&#225;lisis del volumen de inter&#233;s&#46; Evaluamos las diferencias del metabolismo de la glucosa cerebral regional entre los grupos de bajo DSB &#40;escala Fazekas<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2&#41; y alto DSB &#40;escala Fazekas<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; Realizamos un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple ajustado por edad&#44; sexo y carga cerebral de A&#946;&#44; para evaluar la relaci&#243;n entre la puntuaci&#243;n de la escala Fazekas y el metabolismo de la glucosa cerebral&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">El metabolismo de la glucosa cerebral regional para los l&#243;bulos bilateral frontal&#44; temporal&#44; c&#243;rtices parietales&#44; y l&#243;bulos l&#237;mbicos en el grupo de alto DSB fueron significativamente menores que los del grupo de bajo DSB&#46; Existieron correlaciones negativas significativas entre la puntuaci&#243;n de la escala Fazekas y el metabolismo de la glucosa cerebral regional en los c&#243;rtices bilateral frontal&#44; bilateral temporal y c&#243;rtices parietales izquierdos&#44; y l&#243;bulos l&#237;mbicos bilaterales&#46; Los an&#225;lisis de regresi&#243;n lineal m&#250;ltiple revelaron que la puntuaci&#243;n de la escala Fazekas era un determinante independiente del metabolismo de la glucosa en los c&#243;rtices bilateral frontal y temporal y los l&#243;bulos l&#237;mbicos&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los DSB est&#225;n asociados a un descenso del metabolismo de la glucosa cerebral&#46; Nuestros hallazgos sugieren que la enfermedad de los peque&#241;os vasos&#44; as&#237; como lo patolog&#237;a de A&#946;&#44; pueden contribuir a la disfunci&#243;n cognitiva en pacientes con enfermedad de Alzheimer&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Materiales y m&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Aim</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">White matter lesions &#40;WMLs&#41;&#44; detected as hyperintensities on T2-weighted MRI&#44; represent small vessel disease in the brain and are considered a potential risk factor for memory and cognitive impairment&#46; It has not been sufficiently evident that cognitive impairment in patients with Alzheimer&#39;s disease is caused by WMLs as well as &#946;-amyloid &#40;A&#946;&#41; pathology&#46; The aim of this study was to evaluate relationship between WMLs and cerebral glucose metabolism in patients with cognitive impairment after adjustment of cerebral A&#946; burden&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materials and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Eighty-three subjects with cognitive performance ranging from normal to dementia&#44; who underwent brain MRI and <span class="elsevierStyleSup">18</span>F-florbetaben positron emission tomography &#40;PET&#41; and <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose PET&#44; were included in this cross-sectional study&#46; The Fazekas scale was used to quantify WMLs on brain T2-weighted MRI&#46; The cerebral A&#946; burden and cerebral glucose metabolism were quantitatively estimated using volume-of-interest analysis&#46; Differences in the regional cerebral glucose metabolism were evaluated between low-WML &#40;Fazekas scale<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>2&#41; and high-WML &#40;Fazekas scale<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>2&#41; groups&#46; Multiple linear regression analysis adjusted for age&#44; sex and cerebral A&#946; burden was performed to evaluate the relationship between the Fazekas scale score and cerebral glucose metabolism&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The regional cerebral glucose metabolism for the bilateral frontal&#44; temporal&#44; and parietal cortices&#44; and limbic lobes in the high-WML group were significantly lower than those in the low-WML group&#46; There were significant negative correlations between the Fazekas scale score and regional cerebral glucose metabolism in the bilateral frontal&#44; bilateral temporal and left parietal cortices&#44; and bilateral limbic lobes&#46; Multiple linear regression analysis revealed that the Fazekas scale score was an independent determinant of the glucose metabolism in the bilateral frontal and temporal cortices and limbic lobes&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">WMLs are associated with decreased cerebral glucose metabolism&#46; Our findings suggest that small vessel disease&#44; as well as A&#946; pathology&#44; may contribute to cognitive impairment in patients with Alzheimer&#39;s disease&#46;</p></span>"
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Im&#225;genes de RM en T2 FLAIR y de PET con <span class="elsevierStyleSup">18</span>F-FDG en pacientes con deterioro cognitivo&#46; A medida que aumenta la puntuaci&#243;n en la escala de Fazekas&#44; disminuye el metabolismo gluc&#237;dico en los c&#243;rtex parietal y temporal&#46; &#40;A&#41; Hombre de 56 a&#241;os sin deterioro cognitivo y carga A&#946; negativa &#40;SUVR<span class="elsevierStyleInf">FBB</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;34&#41; y grado 0 en la escala de Fazekas&#44; que no mostr&#243; alteraci&#243;n del metabolismo gluc&#237;dico en c&#243;rtex parietal ni temporal bilateral&#46; &#40;B&#41; Mujer de 66 a&#241;os con deterioro cognitivo leve y carga A&#946; positiva &#40;SUVR<span class="elsevierStyleInf">FBB</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;55&#41; y grado 1 en la escala de Fazekas&#44; presenta un leve hipometabolismo en c&#243;rtex parietal y temporal derechos&#46; &#40;C&#41; Mujer de 68 a&#241;os de edad con deterioro cognitivo leve y carga A&#946; positiva &#40;SUVR<span class="elsevierStyleInf">FBB</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;47&#41; y grado 2 en la escala de Fazekas&#44; present&#243; un hipometabolismo gluc&#237;dico moderado en c&#243;rtex parietal y temporal bilateral&#46; &#40;D&#41; Hombre de 72 a&#241;os con demencia y carga A&#946; positiva &#40;SUVR<span class="elsevierStyleInf">FBB</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;71&#41; y grado 3 en la escala de Fazekas&#44; present&#243; un hipometabolismo gluc&#237;dico severamente reducido en c&#243;rtex parietal y temporal bilateral&#46;</p>"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ADC&#58; ausencia de deterioro cognitivo&#59; DCL&#58; deterioro cognitivo leve&#59; EA&#58; enfermedad de Alzheimer&#59; K-BNT&#58; Korean-Boston Naming Test &#40;&#171;Test de Denominaci&#243;n Korean-Boston&#187;&#41;&#59; RCFT&#58; Rey-Osterrieth Complex Figure Test and Recognition Trial &#40;test de la figura compleja de Rey-Osterrieth y ensayo de reconocimiento&#41;&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Educaci&#243;n&#44; a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">APOE4&#43;&#44; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">MMSE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Digit span&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">K-BNT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;EA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">RCFT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Escala de Fazekas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">SUVR<span class="elsevierStyleInf">FBB</span> compuesto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;55 &#40;0&#44;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL&#60;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">A&#946; positivo&#44; &#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;016&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Regi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Lado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ADC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DCL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Demencia EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p corregido&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Resultados post-hoc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Central</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;851&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;079&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;97 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;008&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;884&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;325&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal orbitario</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;91 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Temporal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;07 &#40;0&#44;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;06 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;017&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parietal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;89 &#40;0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;029&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parietal medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;08 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;09 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;269&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;06 &#40;0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;07 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;373&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Occipital lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;97 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;620&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;98 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;594&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Occipital medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;02 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;785&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;729&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L&#237;mbico</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;89 &#40;0&#44;05&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;90 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;83 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;82 &#40;0&#44;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;84 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;77 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADC&#44; DCL<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>EA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2380367.png"
              ]
            ]
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Los valores se presentan como media &#40;DE&#41;&#46;</p>"
            ]
          ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Comparativa del SUVR<span class="elsevierStyleInf">FDG</span> entre los grupos sin deterioro cognitivo&#44; deterioro cognitivo leve y enfermedad de Alzheimer<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a></p>"
        ]
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      4 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">LSB&#58; lesi&#243;n de la sustancia blanca&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Regi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Lado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Carga de LSB</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Valor de la p corregido&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Baja&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Central</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;02 &#40;0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;503&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;03&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;04&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;035&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;97 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;141&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal orbitario</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;009&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;91 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;439&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;90 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;095&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Temporal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;06 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;01 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;05 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;99 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;002&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parietal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;00 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;94 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;93 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;90 &#40;0&#44;09&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;170&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Parietal medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;07 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;08 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;793&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;08 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;592&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Occipital lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;95 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#40;0&#44;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;663&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#40;0&#44;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;890&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Occipital medial</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;03 &#40;0&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;02 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;606&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;764&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">L&#237;mbico</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;89 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;84 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;82 &#40;0&#44;06&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;78 &#40;0&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;004&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2380369.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Los valores se expresan como medias &#40;DE&#41;&#46;</p>"
            ]
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Comparaciones entre el SUVR<span class="elsevierStyleInf">FDG</span> de los grupos con lesi&#243;n de la sustancia blanca baja y alta<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a></p>"
        ]
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      5 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
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        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Regi&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Lado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">R</span><span class="elsevierStyleSup">2</span> ajustada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">&#946;</span> estandarizada<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Valor de p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Frontal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;145&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;394&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;084&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;308&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;005&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Temporal lateral</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;371&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;161&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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