Background: Spasticity is a common symptom of multiple sclerosis (MS) which affects mobility. Dry Needling (DN) has shown a reduction in spasticity in neuromuscular conditions such as stroke and spinal cord injury although the mechanism of action is still unclear. In spastic individuals, the Rate-Dependent Depression (RDD) of the H reflex is decreased as compared to controls and analyzing the effects of DN in the RDD may help to understand its mechanism of action. Objective: To evaluate the effect of Dry Needling on spasticity measured by the Rate-dependent Depression (RDD) of the H reflex in an MS patient. Methods: Three time points were evaluated: Pre-intervention (T1), Post-intervention assessments were carried out in the seventh week at two-time points: Before DN (T2) and After DN (T3). Main outcomes included the RDD and latency of the H reflex in the lower limbs at stimulation frequencies of 0.1, 1, 2, and 5 Hz in a five consecutive pulses protocol. Results: An impairment of the RDD of the H reflex at frequencies ≥ 1 Hz was found. Statistically significant differences were found when comparing the mean RDD of the H reflex in Pre-intervention compared to Post-intervention at 1, 2, and 5 Hz stimulation frequencies. Mean latencies were statistically lower when comparing Pre- vs Post-intervention. Conclusion: Results suggest a partial reduction in spasticity represented by decrease of the excitability of the neural elements involved in the RDD of the H reflex following DN. The RDD of the H reflex could be implemented as an objective tool to monitor changes in spasticity in larger DN trials.

Se conoce como disfagia a cualquier alteración en el proceso de la deglución que afecta la capacidad para ingerir alimentos y bebidas, presentándose con una frecuencia del 30 al 40% en pacientes hospitalizados. En el adulto mayor es de gran relevancia por su asociación con el desarrollo de fragilidad, desnutrición y el alto riesgo de morbi-mortalidad. Se ha propuesto un conjunto de factores que contribuyen al desarrollo de la misma como las alteraciones anatómicas y fisiológicas, patologías neurológicas, fármacos y sarcopenia. Es por ello que el soporte nutricional resulta de vital importancia con el fin de evitar el riesgo de broncoaspiración y desnutrición que, a su vez, contribuyen al desarrollo de disfagia.

Peripheral and autonomic neuropathy are common in type 2 diabetes; they are associated with oxidative stress and inflammation. Cocoa, rich in polyphenols, may offer neuroprotective benefits. This study evaluated the effect of cocoa supplementation on the biochemical, clinical, and somatosensory profile of neuropathy in individuals with type 2 diabetes. A 12-week, double-blind controlled trial involved 39 subjects randomized to receive cocoa capsules (50 mg polyphenols) or placebo (methylcellulose). Evaluations included glycemic and lipid profiles, neutrophil/lymphocyte ratio, blood pressure, standardized questionnaires, anthropometric measurements, and the rate-dependent depression of the H-reflex. In the cocoa group, the Toronto score decreased by 2.63 points and the BEST score decreased by 1.45 points. In the placebo group, these reductions were 1.84 and 2.21 points, respectively. Neither difference was statistically significant between groups (p > 0.05). Quality-of-Life questionnaire score decreased by 9.2 points in the cocoa group, but without significant difference to the placebo group (p = 0.501). Fasting glucose and HbA1c levels decreased in the placebo group by 38 mg/dL (0.28%) but were not significantly different from the cocoa group (p > 0.05). No other intra- or inter-group differences were significant (p > 0.05). Cocoa supplementation did not show significant improvements over the placebo in the measured outcomes. Both groups showed persistent abnormalities in spinal somatosensory processing, with an RDD of the H-reflex ≥ 0.5.

Diabetic neuropathy is one of the most common diabetes-related complications but also one of the most complex in terms of diagnosis and management. This complication refers to a heterogeneous group of peripheral nerve disorders resulting from a combination of metabolic, vascular, and neurodegenerative factors, typically triggered by chronic hyperglycemia, which has a significant impact on quality of life. Despite its clinical relevance, the diagnosis of diabetic neuropathy remains challenging due to its diverse clinical manifestations and the lack of a single diagnostic approach capable of identifying all diabetic neuropathy types. Available diagnostic approaches range from clinical assessment and symptom-based scales to neurophysiological and small-fiber-specific techniques, each with distinct diagnostic performance and methodological requirements. Consequently, reported prevalence estimates may vary considerably among populations and studies. In Mexico, this variability is particularly relevant, as the prevalence of diabetic neuropathy has been reported across a wide range, making it difficult to establish a reliable national estimate. Differences in study populations, diagnostic criteria, and assessment methods may substantially contribute to this heterogeneity.