Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive neuromodulation technique used to treat major depressive disorder (MDD), particularly in patients with treatment resistant depression. More recently, accelerated transcranial magnetic stimulation (aTMS) has shown comparable efficacy while offering a faster treatment option. This review assesses whether aTMS is non-inferior to rTMS. This systematic review compared aTMS and rTMS protocols for MDD treatment. Studies were identified through PubMed, Cochrane Library, and Web of Science (September 2024).Non-MDD populations and non-aTMS techniques were excluded, such as studies that did not qualify as clinical trials, cohort or randomized controlled trial. Inclusion criteria required direct protocol comparisons and a minimum sample of 10 participants. Bias assessment followed the Cochrane Collaboration’s robvis tool. Four studies were included, encompassing a total sample of 219 patients. Results showed symptom improvement across all groups, with accelerated protocols demonstrating faster response in some cases. However, long-term efficacy varied, and no study provided conclusive superiority of one protocol over the other. This study reveals the variability in aTMS protocols and the inconsistency in the depression rating scales selected across studies, noting that the lack of standardised assessment methods limits meta-analytical potential. Short follow-up durations contrast with antidepressant studies, restricting long-term efficacy evaluation. Additionally, improvements in sham methodologies have increased placebo responses, further influencing treatment outcome interpretation. This systematic review highlights the efficacy, tolerability, and cost-effectiveness of aTMS, suggesting its non-inferiority to rTMS and underscoring the need for further research to define the optimal accelerated protocol.

Background: Bone mineral density (BMD) is a key predictor of fracture risk in postmenopausal women. Evidence on the influence of fat and lean mass (LM) on BMD remains contradictory. This study aimed to assess the associations between BMD at different sites (whole-body, upper, and lower limbs) and anthropometric and body composition variables measured by dual energy X-ray absorptiometry (DXA) in postmenopausal women. Methods: A cross-sectional study was conducted on 308 healthy postmenopausal women. Anthropometric data and whole-body DXA scans were used to measure BMD, total fat mass (FM), LM, appendicular LM index (ALMI), and abdominal fat. Pearson or Spearman correlation analyses were used according to variable distribution, and a correlation matrix along with variance inflation factor analyses was used to reduce 18 variables to a final set of 5. Multiple linear regression models were built for BMD at each site. Results: Age was negatively correlated with BMD at all sites. Total LM and ALMI demonstrated positive correlations with BMD, whereas body mass index (BMI) and abdominal fat exhibited weaker positive associations. In multivariable analyses, age was negatively associated with whole-body BMD, while total LM was positively associated. For lower-limb BMD, age and total LM were significant predictors, with BMI showing a positive but weaker association. For upper-limb BMD, total LM, and ALMI were all positively associated. The models demonstrated satisfactory fit (adjusted R², 0.341-0.438; global P<0.0001). Conclusions Age and total LM were independently and consistently associated with BMD in postmenopausal women, whereas FM and BMI had a limited impact.

Objectives: This study aimed to investigate sleep patterns and chronotypes in Spanish women diagnosed with fibromyalgia syndrome (FMS). Methods: A descriptive, cross-sectional observational study following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines was conducted from March 1, 2024, to June 10, 2024, at the Fibromyalgia and Chronic Fatigue Syndrome Association of Tenerife (San Cristóbal de La Laguna, Spain). Results: A total of 73 women, with a mean age of 56.15±6.47 years, diagnosed with FMS were enrolled. Bedtime habits and wake-up times showed significant variability, reflecting individual differences in sleep chronotype preferences among the participants. The Pittsburgh Sleep Quality Index revealed a mean score of 11.62±0.92, indicating substantial challenges in sleep quality among participants with FMS. Sleep efficiency was low, averaging 14.86%±0.34%, and there was a significant discrepancy in sleep duration between workdays and free days, with an average difference of 2.0±0.5 h. The participants reported compensatory sleep through an average of two naps per day, each lasting 40 min. Conclusions Participants with FMS experienced poor sleep quality, characterized by variability in sleep patterns between workdays and free days, along with significant social jet lag. Low sleep efficiency suggests a prevalent sleep debt, which the participants attempted to mitigate through frequent and extended napping.

Objectives: This study aimed to investigate sleep patterns and chronotypes in Spanish women diagnosed with fibromyalgia syndrome (FMS). Methods: A descriptive, cross-sectional observational study following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines was conducted from March 1, 2024, to June 10, 2024, at the Fibromyalgia and Chronic Fatigue Syndrome Association of Tenerife (San Cristóbal de La Laguna, Spain). Results: A total of 73 women, with a mean age of 56.15±6.47 years, diagnosed with FMS were enrolled. Bedtime habits and wake-up times showed significant variability, reflecting individual differences in sleep chronotype preferences among the participants. The Pittsburgh Sleep Quality Index revealed a mean score of 11.62±0.92, indicating substantial challenges in sleep quality among participants with FMS. Sleep efficiency was low, averaging 14.86%±0.34%, and there was a significant discrepancy in sleep duration between workdays and free days, with an average difference of 2.0±0.5 h. The participants reported compensatory sleep through an average of two naps per day, each lasting 40 min. Conclusions Participants with FMS experienced poor sleep quality, characterized by variability in sleep patterns between workdays and free days, along with significant social jet lag. Low sleep efficiency suggests a prevalent sleep debt, which the participants attempted to mitigate through frequent and extended napping.

Objectives: This study aimed to investigate sleep patterns and chronotypes in Spanish women diagnosed with fibromyalgia syndrome (FMS). Methods: A descriptive, cross-sectional observational study following the Strengthening the Reporting of Observational Studies in Epidemiology guidelines was conducted from March 1, 2024, to June 10, 2024, at the Fibromyalgia and Chronic Fatigue Syndrome Association of Tenerife (San Cristóbal de La Laguna, Spain). Results: A total of 73 women, with a mean age of 56.15±6.47 years, diagnosed with FMS were enrolled. Bedtime habits and wake-up times showed significant variability, reflecting individual differences in sleep chronotype preferences among the participants. The Pittsburgh Sleep Quality Index revealed a mean score of 11.62±0.92, indicating substantial challenges in sleep quality among participants with FMS. Sleep efficiency was low, averaging 14.86%±0.34%, and there was a significant discrepancy in sleep duration between workdays and free days, with an average difference of 2.0±0.5 h. The participants reported compensatory sleep through an average of two naps per day, each lasting 40 min. Conclusions Participants with FMS experienced poor sleep quality, characterized by variability in sleep patterns between workdays and free days, along with significant social jet lag. Low sleep efficiency suggests a prevalent sleep debt, which the participants attempted to mitigate through frequent and extended napping.

BACKGROUND: Lipoid proteinosis (LP) is a rare autosomal recessive disorder characterized by a hoarse voice, variable scarring, and infiltration of the skin and mucosa. This disease is associated with mutations of the gene encoding extracellular matrix protein 1 (ECM1). CASE REPORT: This was a clinical and molecular study of a new case of LP with a severe phenotype. A 35-year-old female born to nonconsanguineous parents developed dermatological and extracutaneous symptoms in her 9th month of life. The neurological abnormalities of the disease began to appear at the age of 19 years. Computed tomography revealed cranial calcifications. CONCLUSIONS: The diagnosis of LP was confirmed by histopathological findings and direct sequencing of ECM1. A new homozygous nonsense mutation was identified in exon 7 of ECM1, c.1076G>A (p.Trp359*). This mutation was not detected in 106 chromosomes of healthy individuals with a similar demographic origin. Microsatellite markers around ECM1 were used to construct the haplotype in both the parents and the patient. Reports on genotype-phenotype correlations in LP point to a milder phenotype in carriers of missense mutations in the Ecm1a isoform, whereas mutations in the Ecm1b isoform are thought to be associated with more severe phenotypes. The present findings in a Spanish patient carrying a truncating mutation in exon 7 revealed complete dermatological and neurological manifestations.
Adult ; Cicatrix ; Codon, Nonsense ; Diagnosis ; Exons ; Extracellular Matrix* ; Female ; Genetic Association Studies ; Haplotypes ; Humans ; Microsatellite Repeats ; Mucous Membrane ; Mutation, Missense ; Neurologic Manifestations ; Parents ; Phenotype ; Skin ; Voice