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de la Rosa T, Scorza FA. Contextualizing stigma in Parkinson's disease research. Clinics (Sao Paulo) 2024; 79:100425. [PMID: 38943705 PMCID: PMC11261289 DOI: 10.1016/j.clinsp.2024.100425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 07/01/2024] Open
Affiliation(s)
- Tomás de la Rosa
- Neuroscience Department, Universidad de Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Cádiz, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
| | - Fúlvio Alexandre Scorza
- Neurology Department, Escola Paulista de Medicina Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Yan F, Wu K, Wan Q, Zhang M, Zhang Y, Li N, Wang X. Assessing the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the influencing factors of disease-related shame. Am J Transl Res 2023; 15:6786-6796. [PMID: 38186976 PMCID: PMC10767525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/24/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To evaluate the effectiveness of biofeedback therapy in the rehabilitation of limb motor dysfunction after stroke and the factors influencing disease-related shame. METHODS Medical records of 118 patients with limb motor dysfunction after stroke, treated in 521 Hospital of the Norinco Group from October 2019 to November 2022, were collected. The 56 patients in control group received conventional rehabilitation training, while the other 62 patients in observation group received electromyographic biofeedback therapy in addition to conventional treatment. The therapeutic effects of both groups were evaluated and compared after 4 weeks of treatment. Changes in FMA (Fugl-Meyer Motor Function Assessment Scale), mRS (Modified Rankin Scale), ADL (Activities of Daily Living Scale), and SSS (Stroke Stigma Scale) were compared before and after treatment. Multivariate logistic regression analysis was used to analyze the factors influencing disease-related shame after treatment. The effectiveness of risk factors in predicting disease-related shame was analyzed using receiver operating characteristic (ROC) curves. RESULTS Upon intervention, significant gains were noted in FMA and ADL scores, with reductions in mRS and SSS (P<0.0001). After 4 weeks, the observation group showed higher FMA and ADL scores and lower mRS and SSS (P<0.0001 for FMA and ADL; P<0.05 for mRS and SSS). Logistic regression identified age ≥60 (OR 8.045, P<0.001), income <4000 yuan (OR 0.187, P=0.002), and pretreatment ADL (OR 0.047, P<0.001) as predictors of disease-related shame. The AUC for age, household monthly income, and pretreatment ADL score were 0.595 (P=0.089), 0.608 (P=0.053), and 0.750 (P<0.001), respectively, demonstrating pretreatment ADL score as the most accurate predictor of disease-related shame. CONCLUSIONS Electromyographic biofeedback therapy has a significant effect on the rehabilitation of stroke patients, especially on motor recovery and activities of daily living. Age, monthly family income and pre-treatment ADL scores are key factors influencing disease-related shame.
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Affiliation(s)
- Fei Yan
- The Third Department of Neurology, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Ke Wu
- Department of Nursing, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Qian Wan
- Department of Operatiaon Anesthesia, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Mingming Zhang
- Department of Medical, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Yuangang Zhang
- Department of Imaging, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Ning Li
- Department of Medical, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
| | - Xin Wang
- The Third Department of Neurology, 521 Hospital of Norinco GroupNo. 12 Zhangba East Road, Yanta District, Xi’an 710065, Shaanxi, China
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Mothersill D, Loughnane G, Grasso G, Hargreaves A. Knowledge, attitudes, and behaviours towards schizophrenia, bipolar disorder, and autism: a pilot study. Ir J Psychol Med 2023; 40:634-640. [PMID: 34857060 DOI: 10.1017/ipm.2021.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Lack of knowledge and discriminatory attitudes and behaviours towards individuals with mental disorders is a worldwide problem but may be particularly damaging for young people. This pilot study examined knowledge, attitudes and behaviours towards schizophrenia, bipolar disorder and autism within a large sample of adults in Ireland, a country with the youngest population in Europe, in order to better understand public views on these groups. METHODS In a correlational, cross-sectional design, 307 adults in Ireland over the age of 18 completed a questionnaire over Google Forms examining knowledge, attitudes and behaviours towards schizophrenia, bipolar disorder and autism. Responses to questions specifically relating to each diagnosis were compared using trimmed mean ANOVA to examine whether responses to questions differed depending on diagnosis. RESULTS Results indicate varied knowledge, attitudes and behaviours towards these groups, but a majority believe it should be a research priority. ANOVA and post hoc tests revealed significant differences in knowledge, attitudes and behaviours towards each of schizophrenia, bipolar disorder, and autism (p < 0.005), and reported attitudes and behaviours towards schizophrenia were more negative than either bipolar disorder or autism. A majority of participants (54.8%) felt not informed enough about mental health by the media. CONCLUSIONS In our Irish sample, type and level of stigma varies according to mental health diagnosis. Our sample also report feeling inadequately informed about mental health by the media. Thus future policy and campaigns could consider targeting individual mental health diagnoses, with a focus on increasing familiarity and knowledge.
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Affiliation(s)
- David Mothersill
- Psychology Department, School of Business, National College of Ireland, Dublin, Ireland
| | - Gerard Loughnane
- School of Business, National College of Ireland, Dublin, Ireland
| | - Gabriela Grasso
- Psychology Department, School of Business, National College of Ireland, Dublin, Ireland
| | - April Hargreaves
- Psychology Department, School of Business, National College of Ireland, Dublin, Ireland
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Mpango RS, Ssembajjwe W, Rukundo GZ, Amanyire P, Birungi C, Kalungi A, Rutakumwa R, Tusiime C, Gadow KD, Patel V, Nyirenda M, Kinyanda E. Physical and sexual victimization of persons with severe mental illness seeking care in central and southwestern Uganda. Front Public Health 2023; 11:1167076. [PMID: 37621606 PMCID: PMC10446879 DOI: 10.3389/fpubh.2023.1167076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/12/2023] [Indexed: 08/26/2023] Open
Abstract
Purpose This study established the prevalence of physical and sexual victimization, associated factors and psychosocial consequences of victimization among 1,201 out-patients with severe mental illness at Butabika and Masaka hospitals in Uganda. Methods Participants completed structured, standardized and locally translated instruments. Physical and sexual victimization was assessed using the modified adverse life events module of the European Para-suicide Interview Schedule. We used logistic regression to determine the association between victimization, the associated factors and psychosocial consequences. Results The prevalence of physical abuse was 34.1% and that of sexual victimization was 21.9%. The age group of > = 50 years (aOR 1.02;95% CI 0.62-1.66; p = 0.048) was more likely to have suffered physical victimization, while living in a rural area was protective against physical (aOR 0.59; 95% CI 0.46-0.76; p = <0.001) and sexual (aOR 0.48, 95% CI 0.35-0.65; p < 0.001) victimization. High socioeconomic status (SES) (aOR 0.56; 95% CI 0.34-0.92; p = <0.001) was protective against physical victimization. Females were more likely to have been sexually victimized (aOR 3.38; 95% CI 2.47-4.64; p = <0.001), while being a Muslim (aOR 0.60; 95% CI 0.39-0.90; p = 0.045) was protective against sexual victimization. Risky sexual behavior was a negative outcome associated with physical (aOR 2.19; 95% CI 1.66-2.90; p = <0.001) and sexual (aOR 3.09; 95% CI 2.25-4.23; p < 0.001) victimization. Mental health stigma was a negative outcome associated with physical (aOR 1.03; 95% CI 1.01-1.05; p < 0.001) and sexual (aOR 1.03; 95% CI 1.01-1.05; p = 0.002) victimization. Poor adherence to oral anti-psychotic medications was a negative outcome associated with physical (aOR 1.51; 95% CI 1.13-2.00; p = 0.006) and sexual (aOR 1.39; 95% CI 0.99-1.94; p = 0.044) victimization. Conclusion There is a high burden of physical and sexual victimization among people with SMI in central Uganda. There is need to put in place and evaluate complex interventions for improving detection and response to abusive experiences within mental health services. Public health practitioners, policymakers, and legislators should act to protect the health and rights of people with SMI in resource poor settings.
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Affiliation(s)
- Richard Stephen Mpango
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Brown School, Washington University in St. Louis, St. Louis, MO, United States
- Department of Mental Health, School of Health Sciences, Soroti University, Soroti, Uganda
| | - Wilber Ssembajjwe
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Statistical Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Philip Amanyire
- Department of Nursing, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Carol Birungi
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Allan Kalungi
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Rwamahe Rutakumwa
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | | | - Kenneth D. Gadow
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States
| | - Moffat Nyirenda
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Global Non-Communicable Diseases (NCD) Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
| | - Eugene Kinyanda
- Mental Health Section, MRC/UVRI and LSHTM Uganda Research Unit, Entebbe, Uganda
- Department of Psychiatry, College of Health Sciences, Makerere University, Kampala, Uganda
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Kibria MG, Islam T, Islam MT, Kabir R, Ahmed S, Sultana P. Stigma and its associated factors among patients with COVID-19 in Dhaka City: evidence from a cross-sectional investigation. PeerJ 2022; 10:e14092. [PMID: 36221262 PMCID: PMC9548314 DOI: 10.7717/peerj.14092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 08/30/2022] [Indexed: 01/20/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) has become a significant disease pandemic. Dhaka City alone has contributed about one-third to the total COVID-19 cases in Bangladesh. Globally, patients with infectious diseases, including COVID-19, experience stigma. There was no quantitative estimate of stigma experienced by patients with COVID-19 in the country. Therefore, this study aimed to assess the prevalence of stigma and its associated factors among patients with COVID-19 in Dhaka. Methods A cross-sectional study was conducted among 384 respondents aged 18 years or older who had been hospitalized or had stayed at home and were tested negative 15 days to 6 months before the day of data collection. Data collection was done through in-person and telephone interviews using a semi-structured survey questionnaire. A 15-item COVID-19-related stigma scale questionnaire was used to assess stigma. Binary logistic regression analysis was performed to identify the predictors of stigma. Results More than half (53.1%) of the respondents experienced stigma when they were COVID-19 positive. Females were at a 3.24 times higher risk of experiencing stigma than their male counterparts. Respondents from the 60+ age group and 40-59 age group were 63.0% and 48.0% less likely to experience stigma than those from the 18-39 age group. Non-hospitalised patients had 1.67 times higher odds of facing stigma than those hospitalised. Conclusions This study reported a high prevalence of stigma among the patients with COVID-19 in Dhaka City. The current evidence base of stigma experience among patients with COVID-19 offers a solid foundation for creating effective strategies and policies and designing appropriate interventions to counter stigma, which will improve the psychological well-being of patients with COVID-19 in Bangladesh.
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Affiliation(s)
- Md. Golam Kibria
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Taslima Islam
- Department of Research, Centre for Development Action, Dhaka, Bangladesh
| | - Md. Tajul Islam
- Department of Research, Centre for Development Action, Dhaka, Bangladesh,Department of Public Health, North South University, Dhaka, Bangladesh
| | - Russell Kabir
- Department of Research, Centre for Development Action, Dhaka, Bangladesh,School of Allied Health, Anglia Ruskin University, Chelmsford, Essex, UK
| | - Shakil Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Papia Sultana
- Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh
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Abstract
BACKGROUND Stigmatized attitudes towards people with mental illness may influence treatment choice for oneself and others. AIM To gauge the attitudes of the UK general public towards treatment at home for mental illness and to assess the extent to which non-acceptability was related to stigmatized attitudes. METHODS Two hundred and two (101 female) people living in the UK completed an online (vignette) questionnaire in which we asked demographic details and personal experience of mental illness. To measure stigma, we used an adapted version of the Attitudes to Mental Illness Questionnaire (AMIQ) with vignettes asking about treatment at home and using scales for social distance and poor expectations; participants also filled in the Mental Health Knowledge Schedule (MAKS). RESULTS Participants did not evidence overall agreement with treatment at home for mental illness (i.e. >0; range = -16-to-+16, Mean (M) = 0.86, 95% confidence interval (CI) = -0.08, 1.80, p = .073), although they showed significant agreement with treatment at home should they experience mental illness themselves (range = -8-to-+8, M = 1.36, CI = 0.82, 1.89, p < .001). Acceptability for treatment at home differed according to specific mental illness considered (range = -4-to-+4); depression (M = 0.47, CI = 0.13, 0.81, p = .006) and alcohol abuse (M = 1.46, CI = 1.14,1.77, p < .001) were considered suitable for being treated at home but schizophrenia was not (M = -0.78, CI = -1.13,-0.43, p < .001). Multivariate analyses revealed that older age and attitudes indicating comfort with less social distance from people with mental illness were independently associated with treatment at home agreeability. CONCLUSIONS Public acceptability of home treatment for mental illness remains ambivalent in the UK, most obviously when considering treatment approaches for individuals other than themselves and for people with schizophrenia. Disagreement with home treatment is particularly evident in younger people and those who prefer less social contact with people with mental illness.
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Affiliation(s)
- Allerdiena A Hubbeling
- Wandsworth Home Treatment Team, South West London and St George's Mental Health NHS Trust, Springfield University Hospital, London, UK
| | - Jared G Smith
- Population Health Research Institute, St George's, University of London, UK
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Doyle I, Catling JC. The Influence of Perfectionism, Self-Esteem and Resilience on Young People's Mental Health. THE JOURNAL OF PSYCHOLOGY 2022; 156:224-240. [PMID: 35201966 DOI: 10.1080/00223980.2022.2027854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The current study explored whether maladaptive perfectionism and low self-esteem constituted reliable risk factors of student mental illness, as well as determining whether resilience moderates these predictive relationships. 434 University undergraduate students were recruited. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Assessment (GAD-7). Perfectionism, self-esteem and resilience were analyzed in relation to the PHQ9 and GAD-7 scores via a regression analysis. Perfectionism discrepancy, self-esteem and resilience all significantly predicted depression and anxiety. Hierarchical regression analysis revealed a statistically significant amount of additional variance to be explained by resilience for depression and anxiety, than for perfectionism and self-esteem alone. Maladaptive perfectionism and low self-esteem predispose an individual to depression and anxiety, though resilience may act as a protective factor against development of mental illness.
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Getnet A, Sintayehu Bitew M, Iyasu AS, Afenigus AD, Haile D, Amha H. Stigma and determinant factors among patients with mental disorders: Institution-based cross-sectional study. SAGE Open Med 2022; 10:20503121221136400. [DOI: 10.1177/20503121221136400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 10/14/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: To assess prevalence and its associated factors of perceived stigma among patients with mental disorders who had appointment for treatment at Debre Markos, Finote Selam, and Felege Hiwot Hospitals, Ethiopia, 2019. Methods: At selected hospitals in the Amhara Region, an institution-based cross-sectional study was conducted from 1 February to 1 March 2019. Participants were selected using systematic random sampling technique and data were collected using a standardized questionnaire. The Internalized Stigma Scale was designed to examine the stigma associated with mental disorders. The data were coded and enter into Epi data version 4.4.2.1 before being exported to SPSS version 20 for analysis. Odds ratios and 95% confidence interval were used to show the strength of the association. Results: A total of 610 participants were participated, with a response rate of 98.6%, and 215 (35.2%) of them reported a high level of perceived stigma. Being single (adjusted odds ratio = 1.84, 95% confidence interval: 1.12, 3.02), accessing their medication freely (adjusted odds ratio = 1.70, 95% confidence interval: 1.08, 2.67), having suicidal thoughts (adjusted odds ratio = 1.95, 95% confidence interval: 1.25, 3.03), having low social support (adjusted odds ratio = 5.09, 95% confidence interval: 2.95, 8.76), age 25–34 years (adjusted odds ratio = 1.94, 95% confidence interval: 1.11, 3.40), age 35–44 years (adjusted odds ratio = 2.10, 95% confidence interval: 1.06–4.18), and age > 44 years (adjusted odds ratio = 3.48, 95% confidence interval: 1.67, 7.24) were revealed to be significantly associated with high perceived stigma after multivariable logistic regression analysis ( p < 0.05). Conclusion: The prevalence of high perceived stigma was 35.2%, which is found to be high among people who have mental disorders in this study. Being single, accessing their medication freely, having suicidal thoughts, having low social support, and being within the age of (25–34), (35–44), > 44 were all found to be significantly associated with high perceived stigma ( p < 0.05). But married, access medication by fee, have no suicidal thought, having moderate and strong social support, and young age were significantly associated with low perceived stigma.
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Affiliation(s)
- Asmamaw Getnet
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mezinew Sintayehu Bitew
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Ashagrie Sharew Iyasu
- Department of Statistics, College of Natural and Computational Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Abebe Dilie Afenigus
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Dessalegn Haile
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Haile Amha
- Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Yangyuen S, Kanato M, Somdee T. Relationship between psychological factors and perceived stigma of addiction among women with substance use disorders, Thailand. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:16. [PMID: 35281408 PMCID: PMC8893069 DOI: 10.4103/jehp.jehp_572_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/20/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Substance use disorders (SUDs) are one of the most stigmatized health conditions that impact drug user's treatment engagement. However, to date, little is known about perceived stigma and its correlates with psychological factors among high-risk groups such as people with SUDs in the criminal justice system. This study aimed to determine the association of psychological factors and perceived stigma of addiction among women with SUDs. MATERIALS AND METHODS This cross-sectional design was conducted on 652 women with SUDs who were treated in all 7 compulsory drug detention centers in Thailand with consecutive sampling technique. The data were collected by standardized interviewers with interviewing questionnaire. Multiple logistic regression was applied to examine the effect of psychological factors and perceived stigma. RESULTS More than half of SUD patients (57.2%) were methamphetamine abuse or dependence, approximately 69.9% reported high level of perceived stigma, 56.7% had mild depression, 34.8% had low level of perceived social support, and the average perceived stress score was 19.2 (standard deviation, 7.5). The perceived stigma was positively related to depressive symptom and perceived stress while was inversely related to perceived social support. CONCLUSION The psychological factors were strongly associated with perceived stigma of addiction. Thus, the detection of psychological problems among SUD patients may be benefit clinicians for identifying which patients are most at risk of perceived stigma and are the potential targets of intervention to reduce stigma in clinical practice.
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Affiliation(s)
- Suneerat Yangyuen
- Department of Public Health, Faculty of Public Health, Mahasarakham University, Mahasarakham, Thailand
- Address for correspondence: Dr. Suneerat Yangyuen, Faculty of Public Health, Mahasarakham University, 41/20, Khamriang Sub-District, Kantarawichai District, Mahasarakham 44150, Thailand. E-mail:
| | - Manop Kanato
- Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thidarat Somdee
- Department of Public Health, Faculty of Public Health, Mahasarakham University, Mahasarakham, Thailand
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Rosa TDL, Scorza FA. Stigma in Parkinson's disease: Placing it outside the body. Clinics (Sao Paulo) 2022; 77:100008. [PMID: 35172270 PMCID: PMC8903808 DOI: 10.1016/j.clinsp.2022.100008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/08/2021] [Indexed: 11/22/2022] Open
Affiliation(s)
- Tomás de la Rosa
- Neurology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
| | - Fúlvio Alexandre Scorza
- Neurology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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