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Baldassarre I, Rotondo R, Piccardi L, Leonardi L, Lanni D, Gaglione M, Stocchi F, Fini M, Goffredo M, Padua E, De Pandis MF. The Effects of Multidisciplinary Intensive Rehabilitation on Cognitive and Executive Functions in Parkinson's Disease: A Clinical Database Analysis. J Clin Med 2024; 13:3884. [PMID: 38999450 PMCID: PMC11242624 DOI: 10.3390/jcm13133884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024] Open
Abstract
Background/Objectives: This study is based on data collected from a medical health record review to assess whether multidisciplinary intensive rehabilitation treatment in Parkinson's disease (PD) patients can improve global cognitive functioning and executive functions. Methods: The data related to PD patients were extrapolated from a clinical database called "NeuroRehab". A total of 104 PD patients (51 males; 53 females) performed 6 weeks of multidisciplinary intensive rehabilitation treatment in clinical practice from January 2019 to May 2023. This training program was characterized by three daily sessions of 60 min of activities (muscle relaxation and stretching exercises, moderate physical aerobic exercise, and occupational therapy). The patients were classified and stratified according to disease severity (according to the Hoehn and Yahr scale), postural instability and gait difficulty (PIGD) or tremor-dominant (TD) subtypes, disease duration (DD), and the presence of dyskinesias. The effect of multidisciplinary intensive rehabilitation treatment on cognitive and executive functions was evaluated through the administration of cognitive tests, such as the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Frontal Assessment Battery (FAB). All the parameters were evaluated at the baseline (T0) and at the end of the rehabilitation program (T1). Results: The multidisciplinary intensive rehabilitation treatment significantly improved cognitive performance. The MMSE, MoCA, and FAB test scores after the rehabilitation program (T1) were significantly higher compared to the scores obtained at the baseline (T0). Moreover, further analyses on subgroups of the patients who scored below the cut-off in the MMSE showed that at least 50% of patients overcame the cut-off score. Interestingly, the same analyses performed for the MoCA and FAB revealed a higher rate of improvement in cognitive functions, with normal scores in both tests after 6 weeks of multidisciplinary intensive rehabilitation treatment. Conclusions: This study revealed the potential effects of a 6-week multidisciplinary rehabilitation program in improving cognitive status in a PD inpatient cohort.
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Affiliation(s)
- Ivana Baldassarre
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
| | - Rossella Rotondo
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
| | - Laura Piccardi
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Lorenza Leonardi
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
| | - Danilo Lanni
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
| | - Maria Gaglione
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
| | - Fabrizio Stocchi
- IRCCS San Raffaele Roma, 00163 Rome, Italy; (F.S.); (M.F.); (M.G.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy;
| | - Massimo Fini
- IRCCS San Raffaele Roma, 00163 Rome, Italy; (F.S.); (M.F.); (M.G.)
| | - Michela Goffredo
- IRCCS San Raffaele Roma, 00163 Rome, Italy; (F.S.); (M.F.); (M.G.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy;
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy;
| | - Maria Francesca De Pandis
- San Raffaele Cassino, 03043 Cassino, Italy; (I.B.); (R.R.); (L.P.); (L.L.); (D.L.); (M.G.)
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy;
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Katerelos A, Alexopoulos P, Economou P, Polychronopoulos P, Chroni E. Cognitive function in amyotrophic lateral sclerosis: a cross-sectional and prospective pragmatic clinical study with review of the literature. Neurol Sci 2024; 45:2075-2085. [PMID: 38105306 PMCID: PMC11021277 DOI: 10.1007/s10072-023-07262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Amyotrophic lateral sclerosis (ALS) can present with either bulbar or spinal symptoms, and in some cases, both types of symptoms may be present. In addition, cognitive impairment has been observed in ALS. The study aimed to evaluate the frontal and general cognitive performance in ALS not only cross-sectionally but also longitudinally. METHODS AND MATERIALS The Frontal Assessment Battery (FAB) and the Montreal Cognitive Assessment (MoCA) were employed to assess cognitive function in 52 adults with ALS and 52 cognitively healthy individuals. The statistical analyses encompassed the Pearson Chi square test, the Skillings-Mack test, the Spearman's rank correlation coefficient, and the Proportional Odds Logistic Regression Model (POLR). RESULTS Cross-sectionally, lower cognitive performance was associated with ALS diagnosis, older age, and motor functional decline. The cognitive impairment of individuals with bulbar and spinal-bulbar symptoms showed faster deterioration compared to those with spinal symptoms. The spinal subgroup consistently performed worst in delayed recall and attention, while the spinal-bulbar and bulbar subgroups exhibited inferior scores in delayed recall, attention, visuospatial skills, orientation, and verbal fluency. CONCLUSION The incorporation of cognitive screening in the diagnostic workup of ALS may be beneficial, as early detection can enhance symptom management and improve the quality of life for both individuals with ALS and their care partners.
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Affiliation(s)
- Adamantios Katerelos
- Department of Medicine, School of Health Sciences, University of Patras, Patras, Greece.
- Department of Neurology, Patras University General Hospital, Rio, Greece.
| | - Panagiotis Alexopoulos
- Department of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Mental Health Services, Patras University General Hospital, Rio, Greece
- Medical School, Trinity College Dublin, Global Brain Health Institute, The University of Dublin, Dublin, Republic of Ireland
- Faculty of Medicine, Klinikum Rechts Der Isar, Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
- Patras Dementia Day Care Centre, Patras, Greece
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Panagiotis Polychronopoulos
- Department of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Department of Neurology, Patras University General Hospital, Rio, Greece
| | - Elisabeth Chroni
- Department of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Department of Neurology, Patras University General Hospital, Rio, Greece
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Zhu X, Gan J, Wu N, Zhang Y, Liu Z. The simultaneous presence of demoralization, apathy, and depression has a detrimental impact on both cognitive function and motor symptoms in Parkinson's disease patients. Front Psychiatry 2024; 15:1345280. [PMID: 38404468 PMCID: PMC10884111 DOI: 10.3389/fpsyt.2024.1345280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/25/2024] [Indexed: 02/27/2024] Open
Abstract
Objective Parkinson's disease (PD) is marked not only by motor symptoms but also by neuropsychiatric manifestations, including demoralization, apathy, and depression. Understanding the clinical distribution and characteristics of these co-occurring symptoms is crucial for improving quality of life of PD patients. Methods This study enrolled 195 Chinese PD patients from Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine. The study involved analyzing the clinical characteristics related to the simultaneous presence of demoralization, apathy, and depression in PD patients. Linear regression was employed to elucidate the linear trend between the quantity of negative neuropsychiatric symptoms and cognitive function, as well as motor symptoms and motor complications. SPSS mediation models were utilized to investigate whether the severity of cognitive function mediated the connection between multiple negative neuropsychiatric symptoms and motor symptoms. Results Among PD patients, a notable 57.5% experience the presence of multiple concurrent negative neuropsychiatric symptoms. Our investigation unveiled a correlation where patients with more negative neuropsychiatric symptoms displayed heightened cognitive impairment (P=0.048) and more severe motor symptoms (P=0.024), following a linear trend with increasing symptom numbers. Additionally, cognitive impairment played a partial mediating role in the impact of multiple negative neuropsychiatric symptoms on motor symptoms (β=0.747; 95% bootstrap confidence interval: 0.195 to 1.532). Conclusions The co-occurrence of these negative neuropsychiatric symptoms has the potential to worsen cognitive function and motor symptoms in PD patients. Moreover, cognitive impairment was identified as playing a partial mediating role in the relationship between multiple negative neuropsychiatric symptoms and motor symptoms.
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Affiliation(s)
- Xiaobo Zhu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Neurology, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Jing Gan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Na Wu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu Zhang
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Madetko-Alster N, Otto-Ślusarczyk D, Struga M, Kutyłowski M, Drzewińska A, Duszyńska-Wąs K, Migda B, Alster P. Glucose Metabolism and Cognitive Decline in Progressive Supranuclear Palsy and Corticobasal Syndrome: A Preliminary Study. J Clin Med 2024; 13:465. [PMID: 38256599 PMCID: PMC10816752 DOI: 10.3390/jcm13020465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/31/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Multiple studies have analyzed the possible correlations between diabetes and Alzheimer's disease. Less is known about the context of cognitive deterioration among patients with atypical Parkinsonian syndromes and glucose metabolism impairment. The aim of this study was to evaluate the association between the impaired glucose metabolism and cognitive decline among patients with progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). The study included 22 patients with PSP and CBS with disease durations varying from 3 to 6 years. The levels of glycated hemoglobin (HbA1C), fasting blood glucose, fasting C-peptide and the presence of microalbuminuria were evaluated, and oral glucose tolerance tests (OGTT) were performed. Based on the OGTT results, the glycemic variability, mean glycemia, glycemia standard deviation (SD) and coefficient of variation (%CV) were calculated. All patients underwent a three-Tesla brain magnetic resonance (MRI) examination and neuropsychological cognitive assessment with the use of standardized scales: Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB). A statistical analysis revealed that poor control of glycemia with high glycemic variability and increased atrophy of the medial temporal lobe among patients with PSP and CBS correlated with worse cognitive performance independent of age or sex, even among patients who did not fulfill the criteria for diabetes. The study results indicate the importance of glucose metabolism control and optimal treatment in the context of cognition maintenance among patients with PSP and CBS. Due to the relatively small number of analyzed patients, the issue requires further assessment. To the best of our knowledge, this is the first study discussing the role of glycemic variability in atypical Parkinsonian syndromes.
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Affiliation(s)
- Natalia Madetko-Alster
- Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland;
| | - Dagmara Otto-Ślusarczyk
- Department of Biochemistry, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland; (D.O.-Ś.); (M.S.)
| | - Marta Struga
- Department of Biochemistry, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland; (D.O.-Ś.); (M.S.)
| | - Michał Kutyłowski
- Department of Radiology, Mazovian Brodno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland;
| | - Agnieszka Drzewińska
- Department of Neurology, Mazovian Brodno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland; (A.D.); (K.D.-W.)
| | - Karolina Duszyńska-Wąs
- Department of Neurology, Mazovian Brodno Hospital, Kondratowicza 8, 03-242 Warsaw, Poland; (A.D.); (K.D.-W.)
| | - Bartosz Migda
- Diagnostic Ultrasound Lab, Department of Pediatric Radiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Piotr Alster
- Department of Neurology, Medical University of Warsaw, Kondratowicza 8, 03-242 Warsaw, Poland;
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Petok JR, Dang L, Hammel B. Impaired executive functioning mediates the association between aging and deterministic sequence learning. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:323-339. [PMID: 36476065 PMCID: PMC10244484 DOI: 10.1080/13825585.2022.2153789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Sensitivity to the fixed ordering of actions and events, or deterministic sequence learning, is an important skill throughout adulthood. Yet, it remains unclear whether age deficits in sequencing exist, and we lack a firm understanding of which factors might contribute to age-related impairments when they arise. Though debated, executive functioning, governed by the frontal lobe, may underlie age-related sequence learning deficits in older adults. The present study asked if age predicts errors in deterministic sequence learning across the older adult lifespan (ages 55-89), and whether executive functioning accounts for any age-related declines. Healthy older adults completed a comprehensive measure of frontal-based executive abilities as well as a deterministic sequence learning task that required the step-by-step acquisition of associations through trial-and-error feedback. Among those who met a performance-based criterion, increasing age was positively correlated with higher sequencing errors; however, this relationship was no longer significant after controlling for executive functioning. Moreover, frontal-based executive abilities mediated the relationship between age and sequence learning performance. These findings suggest that executive or frontal functioning may underlie age deficits in learning judgment-based, deterministic serial operations.
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Affiliation(s)
| | - Layla Dang
- Department of Psychology, Saint Olaf College, Northfield, MN
- Department of Psychological Sciences, Purdue University, West Lafayette, IN
| | - Beatrice Hammel
- Department of Psychology, Saint Olaf College, Northfield, MN
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Pellas J, Damberg M. Assessment of executive functions in older adults: Translation and initial validation of the Swedish version of the Frontal Assessment Battery, FAB-Swe. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:64-68. [PMID: 34672882 DOI: 10.1080/23279095.2021.1990929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The Frontal Assessment Battery (FAB) is a screening test for executive functions. The purpose of this study was to describe the translation process and to make an initial evaluation of the reliability and convergent validity of the Swedish version of the FAB, the FAB-Swe. METHODS The FAB-Swe was translated and adapted to Swedish using a translation and back-translation procedure. Seventy community-dwelling participants aged 65 years or older participated. Participants completed the FAB-Swe, the Mini-Mental State Examination - Swedish Revision (MMSE-SR), three established tests of executive functions (FAS, Trail Making Test-part B [TMT-B] and Stroop), and self-ratings of executive abilities. Reliability of the FAB-Swe was measured using Cronbach's alpha. Convergent validity was measured using Spearman's rank correlation. RESULTS Internal consistency was moderately high (.675). Statistically significant correlations were found between the FAB-Swe and MMSE-SR, FAS, TMT-B, Stroop, and education. No significant correlations were found between the FAB-Swe and age or self-rated executive functioning. CONCLUSIONS This study indicates that the FAB-Swe has acceptable reliability and convergent validity. Further normative studies are needed to further investigate the effect of age and educational level. Studies are also needed to evaluate the diagnostic accuracy in clinical populations.
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Affiliation(s)
- Johnny Pellas
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Mattias Damberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
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Beschin N, MacPherson SE, Barozzi N, Della Sala S. Luria's fist-edge-palm test: A small change makes a big difference. Cortex 2023; 169:191-202. [PMID: 37944207 DOI: 10.1016/j.cortex.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 07/25/2023] [Accepted: 09/01/2023] [Indexed: 11/12/2023]
Abstract
Slight modifications in the instructions or administration of neuropsychological tests could result in noticeable differences in performance. A good example is offered by a test devised by Luria to assess executive functioning in motor planning, the three-step fist-edge-palm (FEP) test, which is still frequently employed in clinical settings and features in several neuropsychological test batteries such as the Frontal Assessment Battery (FAB). While Luria described the orientation of the fist as horizontal to the testing desk (hFEP), recent versions of the task indicate the fist should be vertical to the testing desk (vFEP). The current study examined whether administering the hFEP or the vFEP tests results in different performance in healthy people, and whether one version is better than the other at detecting impairments in a patient population. The hFEP proved more challenging for healthy adults than the vFEP, and people with brain damage committed more errors on the hFEP than the vFEP. Both versions correlated with executive measures but also with several other cognitive variables, indicating that the test is not a specific marker of executive functions. Although performance on the FEP is sensitive to articulatory suppression, faster pace, and the number of sequences performed, none of these conditions fully account for the differences between the hFEP and vFEP. The additional demand of the hFEP appears to be due to the less natural (i.e., automatic) orientation of the horizontal fist. In conclusion, a small change in the administration of the test, eluding Luria's instructions, grossly modified its sensitivity. Clinicians and researchers should be wary of modifying instructions or testing procedures without considering the possible consequences of such modifications.
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Affiliation(s)
- Nicoletta Beschin
- Neuropsychological Service, Rehabilitation Unit, ASST Valle Olona, Somma Lombardo Hospital, Italy
| | - Sarah E MacPherson
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK
| | - Nicole Barozzi
- Neuropsychological Service, Rehabilitation Unit, ASST Valle Olona, Somma Lombardo Hospital, Italy
| | - Sergio Della Sala
- Human Cognitive Neuroscience, Psychology, University of Edinburgh, Edinburgh, UK.
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Silva AR, Santos I, Fernandes C, Silva C, Pereira D, Galego O, Queiroz H, Almeida MDR, Baldeiras I, Santo G. The relevance of the socio-emotional deficits in cerebral small vessels disease (CSVD): An exploratory study with sporadic CSVD and CADASIL patients. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100186. [PMID: 38162294 PMCID: PMC10757198 DOI: 10.1016/j.cccb.2023.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/03/2023] [Accepted: 09/25/2023] [Indexed: 01/03/2024]
Abstract
Background Cerebral Small Vessels Disease (CSVD) is categorized in different forms, the most common being the sporadic form and a genetic variant - Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL). Amongst the most frequent clinical manifestations are the neuropsychological changes of cognitive, behavioral, and emotional nature, whose features are still under debate. Objective This exploratory study aimed to compare the neuropsychological profile of a sporadic CSVD sample and a CADASIL sample with an age, education, and gender matched control group, between the ages of 30-65 YO (total sample mean age=51.16; SD=4.31). Methods 20 patients with sporadic CSVD, 20 patients with CADASIL and 20 matched controls completed a neuropsychological assessment battery. Global cognitive state, processing speed, working memory, attention, executive dysfunction, episodic memory, social cognition, impulsivity, apathy, alexithymia, depression, and anxiety were measured. White matter hyperintensities (WMH) volume were quantified and measured as lesion burden. Results The cognitive differences found between the clinical groups combined (after confirming no differences between the two clinical groups) and matched controls were restricted to speed processing scores (d = 0.32 95 % CI [.12-.47]). The socio-emotional and behavioral profile revealed significantly higher levels of depression (d = 0.21, 95 % CI [.16-.33]). and anxiety (d = 0.25 95 % CI [.19-.32]) in CADASIL and sporadic CSVD groups, and the same for the alexithymia score (d = 0.533 95 % CI [.32-.65]) were the clinical groups revealed impoverished emotional processing compared to controls. WMH only significantly correlated with the cognitive changes and age. Conclusions In our study, CADASIL and sporadic cSVD patients combined, present multiple emotional-behavioral symptoms - alexithymia, anxiety, depression, and in a lower extent apathy and impulsivity - suggesting for the presence of emotion dysregulation behaviors, present independently of age and of the presence of cognitive deficits. Despite of the small sample size that could underpower some findings, this exploratory research supported that these symptoms may have a significant impact in disease monitoring, progression, and prognosis, requiring further investigation regarding their neurophysiological substrates.
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Affiliation(s)
- Ana Rita Silva
- CINEICC – Center for Research in Neuropsychology and Cognitive Behavioral Interventions of the University of Coimbra, Colegio Novo Street, N/A, Coimbra 3000-115, Portugal
| | - Irina Santos
- Neurology Department, Academic and Clinical Centre – Coimbra University Hospitals, Coimbra, Portugal
| | - Carolina Fernandes
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
| | - Cristiana Silva
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
| | - Daniela Pereira
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | - Orlando Galego
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | - Henrique Queiroz
- Neurorradiology Functional Unit, Coimbra University Hospitals, Coimbra, Portugal
| | | | - Inês Baldeiras
- Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Gustavo Santo
- Department of Neurology, Centro Hospitalar e Universitário de Coimbra, CNC-CIBB, Coimbra, Portugal
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Ilardi CR, di Maio G, Villano I, Messina G, Monda V, Messina A, Porro C, Panaro MA, Gamboz N, Iavarone A, La Marra M. The assessment of executive functions to test the integrity of the nigrostriatal network: A pilot study. Front Psychol 2023; 14:1121251. [PMID: 37063521 PMCID: PMC10090354 DOI: 10.3389/fpsyg.2023.1121251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundParkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by motor and non-motor symptoms. The latter mainly include affective, sleep, and cognitive deficits. Non-demented PD patients often demonstrate impairments in several executive domains following neuropsychological evaluation. The current pilot study aims at assessing the discriminatory power of the Frontal Assessment Battery-15 (FAB15) in differentiating (i) non-demented PD patients and healthy controls and (ii) PD patients with more and less pronounced motor symptoms.MethodsThirty-nine non-demented early-stage PD patients in the “on” dopamine state (26 females, mean age = 64.51 years, SD = 6.47, mean disease duration = 5.49 years, SD = 2.28) and 39 healthy participants (24 females, mean age = 62.60 years, SD = 5.51) were included in the study. All participants completed the FAB15. Motor symptoms of PD patients were quantified via the Unified Parkinson’s Disease Rating Scale-Part III (UPDRS-Part III) and Hoehn and Yahr staging scale (H&Y).ResultsThe FAB15 score, adjusted according to normative data for sex, age, and education, proved to be sufficiently able to discriminate PD patients from healthy controls (AUC = 0.69 [95% CI 0.60–0.75], SE = 0.06, p = 0.04, optimal cutoff = 11.29). Conversely, the battery lacked sufficient discriminative capability to differentiate PD patients based on the severity of motor symptoms.ConclusionThe FAB15 may be a valid tool for distinguishing PD patients from healthy controls. However, it might be less sensitive in identifying clinical phenotypes characterized by visuospatial impairments resulting from posteroparietal and/or temporal dysfunctions. In line with previous evidence, the battery demonstrated to be not expendable in the clinical practice for monitoring the severity of PD-related motor symptoms.
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Affiliation(s)
| | - Girolamo di Maio
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ines Villano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
- *Correspondence: Ines Villano,
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, Naples, Italy
| | - Antonietta Messina
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Chiara Porro
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Maria Antonietta Panaro
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari, Bari, Italy
| | - Nadia Gamboz
- Laboratory of Experimental Psychology, Suor Orsola Benincasa University, Naples, Italy
| | | | - Marco La Marra
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Duarte JDS, Alcantara WA, Brito JS, Barbosa LCS, Machado IPR, Furtado VKT, dos Santos-Lobato BL, Pinto DS, Krejcová LV, Bahia CP. Physical activity based on dance movements as complementary therapy for Parkinson's disease: Effects on movement, executive functions, depressive symptoms, and quality of life. PLoS One 2023; 18:e0281204. [PMID: 36730266 PMCID: PMC9894447 DOI: 10.1371/journal.pone.0281204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 09/22/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Parkinson's disease (PD) is a progressive, neurodegenerative disease with motor symptoms that are well understood, but non-motor symptoms may be present and appear at different temporal stages of the disease. Physical activity based on dance movements is emerging as a complementary therapeutic approach to a range of PD symptoms as a multidimensional activity that requires rhythmic synchronization and more neuromuscular functions. OBJECTIVE To evaluate the effects of physical activity based on dance movements on the movement, executive functions, depressive symptoms, quality of life, and severity of PD in individuals diagnosed with PD. METHODS 13 individuals with PD (Hoehn & Yahr I-III, MDS-UPDRS 67.62 ± 20.83), underwent physical activity based on dance movements (2x week for 6 months). Participants were assessed at baseline and after 6 months on movement (POMA, TUG and MDS-UPDRS Part III), executive function (FAB), depressive symptoms (MADRS), quality of life (PDQ-39), and severity of PD (MDS-UPDRS TOTAL). Student's t-test was used to compare pre and post-intervention results. RESULTS We observed a significant improvement in the movement (balance and gait) by the POMA test, p = 0.0207, executive function by the FAB test, p = 0.0074, abstract reasoning and inhibitory control by the FAB, Conceptualization test, p = 0.0062, and Inhibitory Control, p = 0.0064, depressive symptoms assessed by the MADRS test significantly reduced, p = 0.0214, and the quality of life by the PDQ-39 had a significant increase after the intervention, p = 0.0006, showed significant improvements between the pre-and post-intervention periods of physical activity based on dance movements. CONCLUSION Physical activity based on dance movements contributed to significant improvements in movement (balance and gait), executive functions, especially in cognitive flexibility and inhibitory control, and the quality of life too. Sensorimotor integration, most cognitive processing and social skills may have contributed to the results. TRIAL REGISTRATION The study was registered in the Brazilian registry of clinical trials: RBR-3bhbrb5.
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Affiliation(s)
- Juliana dos Santos Duarte
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | | | - Juliana Silva Brito
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | | | | | | | | | - Denise Silva Pinto
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
| | - Lane Viana Krejcová
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- Parkinson Group, Art Science Institute, Federal University of Pará, Belém, Pará, Brazil
| | - Carlomagno Pacheco Bahia
- Laboratory of Neuroplasticity, Institute of Health Sciences, Federal University of Pará, Belém, Pará, Brazil
- * E-mail:
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11
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Home-Based Individualized Cognitive Stimulation (iCS) Therapy in Portuguese Psychiatric Patients: A Randomized Controlled Trial. Brain Sci 2022; 12:brainsci12121655. [PMID: 36552114 PMCID: PMC9775072 DOI: 10.3390/brainsci12121655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Cognitive difficulties are common in people with mental health issues, including psychotic disorders, although this population may have difficulty accessing treatments due to various challenges, including transportation, remembering appointments, or discomfort in crowded or unfamiliar places. Home-based services can be crucial and effective for reaching populations with accessibility issues; one home-based intervention technique is individual cognitive stimulation (iCS), which has been shown to be an effective strategy to target and improve cognitive functioning in various samples. Using a previously established Portuguese iCS protocol, based on an initial brief cognitive assessment and the subsequent administration of cognitive stimulation materials and reflection exercises, the current randomized controlled trial explored the effectiveness of the iCS intervention on participants in Portugal with psychotic disorders. Outcome tools included measures of cognition, depression, quality of life, and functional abilities at baseline, the completion of the intervention, and post-intervention follow-up. With two well-matched groups at baseline, the results revealed significant improvements in the intervention group on cognitive functioning, depression, quality of life, and, more modestly, functional activities. These results offer an important contribution to the field of iCS protocols, in an effort to enhance the lives and well-being of various clinical populations, including those with psychotic disorders.
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12
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Hurtado-Pomares M, Juárez-Leal I, Company-Devesa V, Sánchez-Pérez A, Peral-Gómez P, Espinosa-Sempere C, Valera-Gran D, Navarrete-Muñoz EM. Psychometric properties of the Spanish version of the Frontal Assessment Battery (FAB-E) and normative values in a representative adult population sample. Neurologia 2022:S2173-5808(22)00113-4. [PMID: 36216225 DOI: 10.1016/j.nrleng.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/15/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The Frontal Assessment Battery is a short bedside test used to assess executive functions (EF). The aims of the present study were, first, to evaluate the psychometric proprieties of the Spanish version of the FAB (FAB-E) in a representative sample, and second, to establish cut-off points for impairment in executive function according to age and education level. METHODS A sample of 798 healthy Spanish adult subjects aged 19 to 91 participated in this study. Neuropsychological assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). We examined internal consistency, intraclass correlation, test-retest reliability, and concurrent and divergent validity. In addition, we established a cut-off point for detecting executive function impairment based on the 5th percentile by age group and education level. RESULTS The analysis of the psychometric properties of the FAB-E showed good internal consistency (Cronbach's α = 0.60), intraclass correlation (0.72), test-retest reliability (0.70) and concurrent and divergent validity between the TMT (r = -0.523), MMSE (r = 0.426) and the FAB-E. The cut-off points for each age group were 16 points for the ≤ 29 group, 15 points for the 30-39 group, 14 points for the 40-49 and 50-59 groups, 12 points for the 60-69 group, and 10 points for the ≥ 70 age group. CONCLUSIONS The psychometric analysis showed that the FAB-E has good validity and reliability. Thus, FAB-E may be a helpful tool to evaluate EF in a healthy Spanish population. In addition, this study provides information on reference data that will be very valuable for clinicians and researchers.
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Affiliation(s)
- M Hurtado-Pomares
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - I Juárez-Leal
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - V Company-Devesa
- Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - A Sánchez-Pérez
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Hospital General Universitario de Alicante Doctor Balmis, Avda Pintor Baeza, 12, 03010 Alicante, Spain
| | - P Peral-Gómez
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - C Espinosa-Sempere
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain
| | - D Valera-Gran
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain.
| | - E-M Navarrete-Muñoz
- Grupo de Investigación en Terapia Ocupacional (InTeO), Department of Pathology and Surgery, Miguel Hernandez University, Ctra. Alicante-Valencia, Km. 8,7, 03550 San Juan de Alicante (Alicante), Spain; Alicante Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Hospital General Universitario de Alicante Doctor Balmis, Avda Pintor Baeza, 12, 03010 Alicante, Spain
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13
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Lima DDD, Cyrino LAR, Ferreira GK, Magro DDD, Calegari CR, Cabral H, Cavichioli N, Ramos SA, Ullmann OM, Mayer Y, Pscheidt LC, Schramm MA, Tomasi MC, Stammerjohann FLS, Delmonego L, Packer MH, Fiamoncini H. Neuroinflammation and neuroprogression produced by oxidative stress in euthymic bipolar patients with different onset disease times. Sci Rep 2022; 12:16742. [PMID: 36202963 PMCID: PMC9537234 DOI: 10.1038/s41598-022-21170-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
Bipolar disorder (BD) is associated with systemic toxicity, represented by changes in biomarkers associated with mood episodes, leading to neurological damage, which may reflect cognitive functions and functionality and the progression of the disease. We aimed to analyze the effect of four biomarkers, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px), and thiobarbituric acid reactive substances (TBA-RS), related to oxidative stress in BD and to correlate them with cognitive functions and functionality. We studied 50 bipolar types I/II patients in the euthymic phase, which was divided into two subgroups with 25 patients each (≤ 3 years and ≥ 10 years of diagnosis, from the first episode of mania) and 25 control patients. To analyze frontal cognitive functions and functionality, we used the Frontal Assessment Battery (FAB) and Functioning Assessment Short Test (FAST) tests, respectively. The scores of the FAST and FAB tests showed an increase and decrease respectively, in both bipolar groups, when compared to the control group, demonstrating impairment in cognitive functions and functionality since the disease onset. In addition, changes occurred in all six domains of the FAST test, and in four domains of the FAB test in bipolar patients when compared to the control group. Regarding oxidative stress biomarkers, we did not find changes in SOD and GSH-Px activities; however, a significant increase in CAT activity and lipid peroxidation was observed in both groups, although the patients were euthymic and medicated. These results allow us to raise the hypothesis that since the beginning of the disease, the euthymic bipolar patient has presented a level of oxidative stress, which gets worse with the evolution of the disease, promoting impairments in the frontal cognitive functions and functionality gradually.
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Affiliation(s)
- Daniela Delwing-de Lima
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil.,Departamento de Medicina, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Luiz Arthur Rangel Cyrino
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil. .,Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil. .,Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil.
| | - Gabriela Kozuchovski Ferreira
- Programa de Pós-Graduação Em Ciência E Engenharia de Materiais, Universidade Sociedade Educacional de Santa Catarina UNISOCIESC, Joinville, Santa Catarina, Brasil
| | - Débora Delwing Dal Magro
- Departamento de Ciências Naturais, Centro de Ciências Exatas E Naturais, Universidade Regional de Blumenau, Rua Antônio da Veiga, 140, Blumenau, SC, CEP 89012-900, Brasil
| | - Claudia Regina Calegari
- Departamento de Psicologia, Universidad Europea del Atlántico, UNEATLANTICO, Calle Isabel Torres, 21, Santander, Spain
| | - Heloisi Cabral
- Departamento de Ciências Biológicas, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC CEP, CEP 89201-972, Brasil
| | - Natalia Cavichioli
- Departamento de Biomedicina, Centro de Ciências da Saúde, Universidade Regional de Blumenau, Rua Antônio da Veiga, 140, Blumenau, SC, CEP 89012-900, Brasil
| | - Silvia Aparecida Ramos
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Oliver Matheus Ullmann
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Yasmin Mayer
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Luana Carla Pscheidt
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Augusta Schramm
- Departamento de Farmácia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Cecília Tomasi
- Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Felipe Luis Schmoller Stammerjohann
- Departamento de Psicologia, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, Joinville, SC, CEP 89201-972, Brasil
| | - Larissa Delmonego
- Departamento de Medicina, Universidade da Região de Joinville UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Maria Helena Packer
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
| | - Heloiza Fiamoncini
- Programa de Pós-Graduação Em Saúde E Meio Ambiente, Universidade da Região de Joinville- UNIVILLE, Rua Paulo Malschitzki, 10 - Zona Industrial Norte, Joinville, SC, CEP 89201-972, Brasil
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Pérez-Sáez E, Justo-Henriques SI, Alves Apóstolo JL. Multicenter randomized controlled trial of the effects of individual reminiscence therapy on cognition, depression and quality of life: Analysis of a sample of older adults with Alzheimer's disease and vascular dementia. Clin Neuropsychol 2022; 36:1975-1996. [PMID: 33467972 DOI: 10.1080/13854046.2021.1871962] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objective: To determine the effectiveness of a 13-week individual reminiscence therapy (RT) intervention on cognition, memory, executive function, mood, and quality of life of people with Alzheimer's disease and vascular dementia. Method: Non-protocolized analysis using data from a larger multicenter, single-blind, randomized, parallel two-arm RCT of RT for people with neurocognitive disorders. A sample of 148 people with probable Alzheimer's disease or vascular dementia attending 23 Portuguese institutions providing care and support services for older adults were selected. Intervention group (n = 74) received 26 individual RT sessions, twice a week for 13 weeks. Control group (n = 74) maintained their treatment as usual. Outcomes were global cognitive function (MMSE), memory (MAT), executive function (FAB), mood (GDS-15), and self-reported quality of life (QoL-AD). All participants were assessed at baseline (T0) and 15 weeks later (T1). Results: The results showed a significant effect of the intervention on global cognition (Group X Time interaction F(1, 128) = 10.542, p = .001, ηp2 = .076), memory (F(1,128) = 9.881, p = .002, ηp2 = .072), and quality of life (F(1,128) = 0.181, p = .671, ηp2 = .001), with medium effect sizes. A small effect on executive function (F(1,127) = 11.118, p = .001, ηp2 = .080) was also found. No effects were found on depressive symptoms (F(1,128) = 0.181, p = .671, ηp2 = .001). Conclusion: Individual RT may have beneficial effects on cognition and quality of life of people with Alzheimer's disease or vascular dementia.
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Affiliation(s)
- Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, Spain
| | | | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Portugal
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15
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Uribe P, Fuentes N, Álvarez-Ruf J, Cornejo I, Mariman JJ. Differentiation of the motor cost associated with cognitive tasks in Parkinson's disease: a dual-task study. Eur J Neurosci 2022; 56:5106-5115. [PMID: 35962541 DOI: 10.1111/ejn.15792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/25/2022] [Accepted: 08/10/2022] [Indexed: 11/28/2022]
Abstract
Parkinson's disease is a neurodegenerative condition associated with motor and cognitive impairments. While the execution of dual cognitive-motor tasks imposes a cost on gait velocity, it has been barely determined if the gait deterioration depends on the specific cognitive domain involved in the dual-task. Twenty-four subjects (twelve patients with Parkinson's disease and twelve healthy subjects) carried out a single task (gait alone) and several dual tasks where the concurrent second task was the Trail Making Test (Part A) and the six tasks of the Frontal Assessment Battery. Gait variables were measured by accelerometry via smartphone. Data analysis included analysis of variance and exploratory factorial analysis. Both groups showed a similar gait performance, except for velocity, where patients exhibited a bradykinetic profile. The dual-task during the Trail Making Test showed the highest motor cost. Frontal Assessment Battery's tasks as conceptualization, mental flexibility, and motor programming showed a higher motor cost than the other tasks (sensibility to interference, inhibitory control, and environmental autonomy). The factorial analysis applied to the motor costs confirmed two profiles, grouping those related to the dorsolateral prefrontal cortex (mental flexibility and motor programming tasks) in an independent factor. Among cognitive functions, attention is critical for gait control in Parkinson's disease and healthy elderly people. The interference posed by several executive operations suggests a specific competition in prefrontal regions that support dual tasks. Moreover, the higher cost for Parkinson's disease patients emphasizes the cognitive decline and compensatory cognitive strategy for gait control related to attention and executive functions.
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Affiliation(s)
- Paula Uribe
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | - Natalia Fuentes
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile
| | - Joel Álvarez-Ruf
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.,Laboratorio de Biomecánica Clínica, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Carrera de Kinesiología, Santiago, Chile
| | - Isabel Cornejo
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.,Liga Chilena contra el Mal de Parkinson, Santiago, Chile
| | - Juan J Mariman
- Laboratorio de Cognición y Comportamiento Sensoriomotor, Departamento de Kinesiología, Facultad de Artes y Educación Física, Universidad Metropolitana de Ciencias de la Educación, Santiago, Chile.,Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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16
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Connectivity Alterations in Vascular Parkinsonism: A Structural Covariance Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12147240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to investigate the structural covariance between the striatum and large-scale brain regions in patients with vascular parkinsonism (VP) compared to Parkinson’s disease (PD) and control subjects, and then explore the relationship between brain connectivity and the clinical features of our patients. Forty subjects (13 VP, 15 PD, and 12 age-and-sex-matched healthy controls) were enrolled in this study. They each underwent a careful clinical and neuropsychological evaluation, DAT-SPECT scintigraphy and 3T MRI scan. While there were no differences between PD and VP in the disease duration and severity, nor in terms of the DAT-SPECT evaluations, VP patients had a reduction in structural covariance between the bilateral corpus striatum (both putamen and caudate) and several brain regions, including the insula, thalamus, hippocampus, anterior cingulate cortex and orbito-frontal cortex compared to PD and controls. VP patients also showed lower scores on several neuropsychological tests. Interestingly, in the VP group, structural connectivity alterations were significantly related to cognitive evaluations exploring executive functions, memory, anxiety and depression. This compelling evidence suggests that structural disconnection in the basal ganglia circuits spreading in critical cortical regions may be involved in the pathophysiology of cognitive impairment in VP.
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17
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DRD2 Taq1A Polymorphism-Related Brain Volume Changes in Parkinson's Disease: Voxel-Based Morphometry. PARKINSON'S DISEASE 2022; 2022:8649195. [PMID: 35386951 PMCID: PMC8979712 DOI: 10.1155/2022/8649195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 01/18/2023]
Abstract
Taq1A polymorphism is a DRD2 gene variant located in an exon of the ANKK1 gene and has an important role in the brain's dopaminergic functions. Some studies have indicated that A1 carriers have an increased risk of developing Parkinson's disease (PD) and show poorer clinical performance than A2 homo carriers. Previous studies have suggested that A1 carriers had fewer dopamine D2 receptors in the caudate and increased cortical activity as a compensatory mechanism. However, there is little information about morphological changes associated with this polymorphism in patients with PD. The study's aim was to investigate the relationship between brain volume and Taq1A polymorphism in PD using voxel-based morphometry (VBM). Based on Taq1A polymorphism, 103 patients with PD were divided into two groups: A1 carriers (A1/A1 and A1/A2) and A2 homo carriers (A2/A2). The volume of the left prefrontal cortex (PFC) was significantly decreased in A2 homo carriers compared to A1 carriers. This finding supports the association between Taq1A polymorphism and brain volume in PD and may explain the compensation of cortical function in A1 carriers with PD.
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18
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Severiano E Sousa C, Fabbri M, Godinho C, Moiron Simões R, Chendo I, Coelho M, Pavão Martins I, Ferreira JJ. Profile of cognitive impairment in late-stage Parkinson's disease. Brain Behav 2022; 12:e2537. [PMID: 35254007 PMCID: PMC9014988 DOI: 10.1002/brb3.2537] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/03/2022] [Accepted: 02/06/2022] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION The profile of cognitive impairment associated with the late stages of Parkinson's disease (LSPD) is rarely reported. Its characterization is necessary to better understand the cognitive changes that occur as the disease progresses and to better contribute to its management. METHODS In this cross-sectional study, we characterized the cognitive profile of LSPD patients using the comprehensive assessment methodology proposed by the International Parkinson and Movement Disorders Society Task Force. The association of clinical and demographic variables with dementia diagnosis was also investigated using binary logistic regression analysis. RESULTS Eighty-four LSPD patients were included (age 75.4 ± 6.9; disease duration 16.9 ± 7.5). Fifty-four (64.3%) were classified as demented and presented a global impairment cognitive profile. In the nondemented group (N = 30), 25 (83.3%) LSPD patients met the diagnostic criteria for mild cognitive impairment, mostly with multiple domain impairment (96.0%) and a heterogeneous profile. Memory was the most frequent and severely impaired cognitive domain in both groups. Disease disability, orientation, complex order comprehension, verbal learning, and visuoconstructive abilities were significantly associated with dementia diagnosis (p < .05). CONCLUSIONS Cognitive impairment in multiple domains was common in LSPD patients. The most frequent and prominent deficits were in the memory domain, with a strong interference from attention impairment. Disease disability, orientation, complex order comprehension, verbal learning, and visuoconstructive abilities proved to be important determinants for dementia diagnosis.
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Affiliation(s)
- Catarina Severiano E Sousa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisboa, Portugal
| | - Margherita Fabbri
- Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisboa, Portugal.,Department of Neurosciences, Clinical investigation Center CIC 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Escola Superior de Saúde Egas Moniz, Almada, Portugal
| | - Rita Moiron Simões
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal.,Campus Neurológico, Torres Vedras, Portugal
| | - Inês Chendo
- Clínica Universitária de Psiquiatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal.,Campus Neurológico, Torres Vedras, Portugal
| | - Miguel Coelho
- Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisboa, Portugal.,Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Isabel Pavão Martins
- Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisboa, Portugal.,Laboratório de Estudos de Linguagem, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.,Faculdade de Medicina, Instituto de Medicina Molecular João Lobo Antunes, Universidade de Lisboa, Lisboa, Portugal.,Campus Neurológico, Torres Vedras, Portugal
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Cavanagh JF, Ryman S, Richardson SP. Cognitive control in Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2022; 269:137-152. [PMID: 35248192 DOI: 10.1016/bs.pbr.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Cognitive control is the ability to act according to plan. Problems with cognitive control are a primary symptom and a major decrement of quality of life in Parkinson's disease (PD). Individuals with PD have problems with seemingly different controlled processes (e.g., task switching, impulsivity, gait disturbance, apathetic motivation). We review how these varied processes all rely upon disease-related alteration of common neural substrates, particularly due to dopaminergic imbalance. A comprehensive understanding of the neural systems underlying cognitive control will hopefully lead to more concise and reliable explanations of distributed deficits. However, high levels of clinical heterogeneity and medication-invariant control deficiencies suggest the need for increasingly detailed elaboration of the neural systems underlying control in PD.
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Affiliation(s)
- James F Cavanagh
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States.
| | - Sephira Ryman
- Mind Research Network, Albuquerque, NM, United States
| | - Sarah Pirio Richardson
- Department of Neurology, University of New Mexico Health Sciences Center, Albuquerque, NM, United States; Neurology Service, New Mexico Veterans Affairs Healthcare System, Albuquerque, NM, United States
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20
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Executive functioning and serum lipid fractions in Parkinson's disease-a possible sex-effect: the PACOS study. J Neural Transm (Vienna) 2022; 129:287-293. [PMID: 35024950 PMCID: PMC8930892 DOI: 10.1007/s00702-022-02460-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/05/2022] [Indexed: 12/21/2022]
Abstract
The association between dyslipidemia and cognitive performance in Parkinson's disease (PD) patients still needs to be clarified. Aim of the study was to evaluate the presence of possible associations between serum lipids fractions and executive dysfunction also exploring the sex-specific contribute of lipids level on cognition. Patients from the PACOS cohort, who underwent a complete serum lipid profile measures (total cholesterol-TC, low-density lipoprotein cholesterol-LDL, high-density lipoprotein cholesterol-HDL and triglycerides-TG) were selected. Adult Treatment Panel III guidelines of the National Cholesterol Education Program were used to classify normal/abnormal lipid fractions. Executive functioning was assessed with the Frontal Assessment Battery (FAB). Logistic regression was performed to assess associations between lipids fractions and FAB score. Correlations between lipids fractions and FAB score were explored. Sex-stratified analysis was performed. Three hundred and forty-eight PD patients (148 women; age 66.5 ± 9.5 years; disease duration 3.9 ± 4.9 years) were enrolled. Women presented significantly higher TC, LDL and HDL than men. In the whole sample, any association between lipid profile measures and FAB score was found. Among women, a positive association between hypertriglyceridemia and FAB score under cutoff was found (OR 3.4; 95%CI 1.29-9.03; p value 0.013). A statistically significant negative correlation was found between the FAB score and triglyceride serum levels (r = - 0.226; p value 0.005). Differently, among men, a statistically significant negative association between hypercholesterolemia and FAB score under cutoff (OR 0.4; 95%CI 0.17-0.84; p value 0.018) and between high LDL levels and FAB score under cutoff (OR 0.4; 95%CI 0.18-0.90; p value 0.027) were found. Our data suggest a sex-specific different role of lipids in executive functioning.
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Grandi F, Martínez-Pernía D, Parra M, Olavarria L, Huepe D, Alegria P, Aliaga Á, Lillo P, Delgado C, Tenorio M, Rosas R, López O, Becker J, Slachevsky A. Standardization and diagnostic utility of the Frontal Assessment Battery for healthy people and patients with dementia in the Chilean population. Dement Neuropsychol 2022; 16:69-78. [PMID: 35719260 PMCID: PMC9170265 DOI: 10.1590/1980-5764-dn-2021-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 09/06/2021] [Accepted: 09/17/2021] [Indexed: 11/22/2022] Open
Abstract
The Frontal Assessment Battery (FAB) is a screening test that measures executive functions. Although this instrument has been validated in several countries, its diagnostic utility in a Chilean population has not been studied yet. Objectives This study aimed to (1) adapt FAB in a Chilean population; (2) study the psychometric properties of the FAB in a Chilean population; (3) assess the sociodemographic influence in the performance of the FAB in a sample of healthy controls (HC); and (4) develop normative data for this healthy group. Methods A HC (n=344) and a group of patients with dementia (n=156) were assessed with the Chilean version of FAB. Results FAB showed good internal consistency (Cronbach's alpha=0.79) and acceptable validity based on the relationship with other variables. Factor analysis showed the unidimensionality of the instrument. Significant differences were found in the total FAB value between the HC and dementia groups. With the matched sample, the established cutoff point was 13.5, showing a sensitivity of 80.8% and a specificity of 90.4%. Regression analysis showed that education and age significantly predicted FAB performance in the healthy group. Finally, normative data are provided. Conclusions This study shows that FAB is a useful tool to discriminate between healthy people and people with dementia. However, further studies are needed to explore the capacity of the instrument to characterize the dysexecutive syndrome in people with dementia in the Chilean population.
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Affiliation(s)
- Fabrissio Grandi
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de los Andes, School of Psychology, Santiago, Chile
| | - David Martínez-Pernía
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Mario Parra
- University of Strathclyde, School of Psychological Sciences and Health, Glasgow, Scotland
| | - Loreto Olavarria
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
| | - David Huepe
- Universidad Adolfo Ibañez, School of Psychology, Center for Social and Cognitive Neuroscience, Santiago, Chile
| | - Patricia Alegria
- Clínica Alemana, Physical Medicine and Rehabilitation Service, Santiago, Chile
| | - Álvaro Aliaga
- Diego Portales Universidad, School of Psychology, Santiago, Chile
| | - Patricia Lillo
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, South Neuroscience Department, Santiago, Chile
- Complejo Hospitalario San José, Neurology Unit, Santiago, Chile
| | - Carolina Delgado
- Universidad de Chile, School of Medicine, Department of Neuroscience, Santiago, Chile
- Universidad de Chile, Hospital Clínico, Department of Neurology and Neurosurgery, Healthy Brain Unit, Santiago, Chile
| | - Marcela Tenorio
- Universidad de los Andes, School of Psychology, Santiago, Chile
- Millennium Institute for Caregiving Research, Santiago, Chile
| | - Ricardo Rosas
- Pontificia Universidad Católica de Chile, Center for the Development of Inclusion Technologies, Santiago, Chile
| | - Oscar López
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
| | - James Becker
- University of Pittsburgh, Department of Psychiatry, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Neurology, Pittsburgh, PA, USA
- University of Pittsburgh, Department of Psychology, Pittsburgh, PA, USA
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador, Memory and Neuropsychiatric Clinic, Neurology Department, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Department, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad del Desarrollo, Clínica Alemana, Department of Medicine, Neurology Unit, Santiago, Chile
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22
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Kapur S, Vaughan C, Hawkins J, Stebbins G, Hall D. Varenicline for the Treatment of Postural and Gait Dysfunction in Parkinson Disease. Neurol Clin Pract 2021; 11:457-461. [PMID: 34992953 DOI: 10.1212/cpj.0000000000000958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 08/04/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether varenicline is effective for the balance in Parkinson disease (PD). METHODS This was an investigator-initiated, double-blind, placebo-controlled study. Participants with a clinical diagnosis of PD were randomized to receive varenicline or placebo for 8 weeks. After dose escalation, participants took 1 mg of drug twice daily until the end of the study. Patients with severe tremor were excluded. Primary outcome was a change on the Berg Balance Scale (BBS) from baseline to 8 weeks. The BBS is a 14-item measure consisting of basic balance tasks. The study had a secondary, exploratory outcome of a change in cognition, measured with the Frontal Assessment Battery (FAB) and the Mini-Mental State Exam (MMSE) from baseline to 8 weeks. The FAB is a 6-item measure of executive functioning. RESULTS Thirty-six participants were randomized (82% men, 100% White). Average age was 71.0 years (± 8.1). Average baseline motor Movement Disorder Society Unified Parkinson's Disease Rating Scale was 34.7 (± 11.6). There were no differences between treatment groups on the BBS (F[1,28] = 2.85, p = 0.10) or FAB (d = 0.16, 95% confidence interval [CI] = [-1.39 to 1.53]) or MMSE (d = 0.81, 95% CI = [-0.40 to 1.40]). CONCLUSION The results did not suggest that varenicline had an effect on balance in patients with PD. Furthermore, varenicline did not seem to affect cognition. Perhaps, if an objective measure of balance had been used in place of the BBS, the analysis would show a difference between the groups. However, the authors do not recommend further study. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that in patients with PD with Hoehn and Yahr stages 2, 3, or 4, varenicline does not improve balance as assessed by the BBS.
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Affiliation(s)
- Sachin Kapur
- Department of Neurological Sciences, Rush University, Department of Neurological Sciences, Chicago, IL
| | - Christina Vaughan
- Department of Neurological Sciences, Rush University, Department of Neurological Sciences, Chicago, IL
| | - Jacob Hawkins
- Department of Neurological Sciences, Rush University, Department of Neurological Sciences, Chicago, IL
| | - Glenn Stebbins
- Department of Neurological Sciences, Rush University, Department of Neurological Sciences, Chicago, IL
| | - Deborah Hall
- Department of Neurological Sciences, Rush University, Department of Neurological Sciences, Chicago, IL
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23
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Justo-Henriques SI, Pérez-Sáez E, Apóstolo JLA, Carvalho JO. Effectiveness of a Randomized Controlled Trial of Individual Reminiscence Therapy on Cognition, Mood and Quality of Life in Azorean Older Adults with Neurocognitive Disorders. J Clin Med 2021; 10:5395. [PMID: 34830677 PMCID: PMC8619984 DOI: 10.3390/jcm10225395] [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: 10/18/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
Reminiscence therapy (RT) is a form of cognitive stimulation therapy that incorporates discussion of past activities, events, and experiences to stimulate individual memories; it has had some success in treating persons with neurocognitive disorders. This research aims to evaluate the ability of individual RT, using a simple reminiscence format, to improve the overall cognitive function, memory, executive functions, emotional status, and quality of life in older adults with neurocognitive disorders who received social care and support services. A multicenter randomized controlled trial was completed in the Azores archipelago (an independent region of Portugal) using repeated measures (pre-intervention, post-intervention, and follow-up). The intervention group underwent individual RT sessions, twice weekly for 13 weeks, while the control group completed regular activities administered as part of their program. Results did not reveal any significant differences between the intervention and control groups. While results did not reveal significant effects, a number of historical and contextual factors are considered as possible explanations for the lack of effects-namely, data collection occurring during the COVID-19 global pandemic, participant cohort effects, and therapist heterogeneity.
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Affiliation(s)
- Susana I Justo-Henriques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, 37008 Salamanca, Spain
| | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Janessa O Carvalho
- Psychology Department, Bridgewater State University, Bridgewater, MA 02325, USA
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24
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The Frontal Assessment Battery 20 years later: normative data for a shortened version (FAB15). Neurol Sci 2021; 43:1709-1719. [PMID: 34410549 DOI: 10.1007/s10072-021-05544-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/31/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The Frontal Assessment Battery (FAB) is a neuropsychological tool largely used to assess executive functions. Prior studies found a marked ceiling effect for the prehension behavior subtest (PBT) in healthy and clinical populations. Aims of the present study were (i) to examine the psychometric properties of the FAB without the contribution of PBT and (ii) to provide normative data for a revised version of the FAB after exclusion of PBT (FAB15). METHODS The normative sample included 1,187 healthy participants. PBT had near-zero variance, poor content validity, and no discrimination power. Internal consistency increased when PBT was excluded. We assessed the FAB15 factorial structure, interrater, and test-retest reliabilities. Normative data for the FAB15 were extracted through a regression-based procedure according to sex, age, and education. RESULTS The principal component analysis revealed a single "executive factor" or alternatively a bifactorial solution reflecting the different degree of discriminative capability vs. difficulty of the subtests. The FAB15 demonstrated excellent interrater and test-retest reliabilities. Regression analysis showed that sex (lowly educated women < lowly educated men), higher age, and lower education affected FAB15 score. Accordingly, three grids for adjustment of raw scores (men, women, and both) were constructed. The cut-off was fixed at the non-parametric outer tolerance limit on the fifth centile (9.36, 95% CI). CONCLUSION The observation of a ceiling effect in healthy subjects makes PBT not suitable for inclusion in a neuropsychological battery. The FAB15 may successfully replace the conventional FAB as a more severe and valid short screening tool to assess executive functioning.
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25
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Moura BM, van Rooijen G, Schirmbeck F, Wigman JTW, Madeira L, van Harten P, van Os J, Bakker PR, Marcelis M. A Network of Psychopathological, Cognitive, and Motor Symptoms in Schizophrenia Spectrum Disorders. Schizophr Bull 2021; 47:915-926. [PMID: 33533401 PMCID: PMC8266645 DOI: 10.1093/schbul/sbab002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Schizophrenia spectrum disorders (SSDs) are complex syndromes involving psychopathological, cognitive, and also motor symptoms as core features. A better understanding of how these symptoms mutually impact each other could translate into diagnostic, prognostic, and, eventually, treatment advancements. The present study aimed to: (1) estimate a network model of psychopathological, cognitive, and motor symptoms in SSD; (2) detect communities and explore the connectivity and relative importance of variables within the network; and (3) explore differences in subsample networks according to remission status. A sample of 1007 patients from a multisite cohort study was included in the analysis. We estimated a network of 43 nodes, including all the items from the Positive and Negative Syndrome Scale, a cognitive assessment battery and clinical ratings of extrapyramidal symptoms. Methodologies specific to network analysis were employed to address the study's aims. The estimated network for the total sample was densely interconnected and organized into 7 communities. Nodes related to insight, abstraction capacity, attention, and suspiciousness were the main bridges between network communities. The estimated network for the subgroup of patients in remission showed a sparser density and a different structure compared to the network of nonremitted patients. In conclusion, the present study conveys a detailed characterization of the interrelations between a set of core clinical elements of SSD. These results provide potential novel clues for clinical assessment and intervention.
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Affiliation(s)
- Bernardo Melo Moura
- Department of Psychiatry, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
- Department of Psychiatry and Mental Health, North Lisbon University Hospital Centre, Avenida Professor Egas Moniz, 1649-028 Lisbon, Portugal
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Geeske van Rooijen
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Arkin Institute for Mental Health, 1033 NN Amsterdam, The Netherlands
| | - Johanna T W Wigman
- Rob Giel Onderzoekscentrum, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Luís Madeira
- Department of Psychiatry, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
- Department of Psychiatry and Mental Health, North Lisbon University Hospital Centre, Avenida Professor Egas Moniz, 1649-028 Lisbon, Portugal
| | - Peter van Harten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, 6200 MD Maastricht, The Netherlands
- GGz Centraal, Innova Medical Centre, 3800 DB Amersfoort, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, 6200 MD Maastricht, The Netherlands
- Brain Center Rudolf Magnus University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, The Netherlands
| | - P Roberto Bakker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, 6200 MD Maastricht, The Netherlands
- Arkin Institute for Mental Health, 1033 NN Amsterdam, The Netherlands
- Brain Center Rudolf Magnus University Medical Center Utrecht, Utrecht University, 3508 AB Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht University, 6200 MD Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), 5600 AX Eindhoven, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
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26
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Severiano E Sousa C, Fabbri M, Godinho C, Simões R, Chendo I, Coelho M, Martins IP, Ferreira JJ. Clinical Diagnostic Criteria Have a High Impact on the Frequency of Dementia in Late-Stage Parkinson's Disease. Front Neurol 2021; 12:652424. [PMID: 34093399 PMCID: PMC8172803 DOI: 10.3389/fneur.2021.652424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Cognitive impairment is a potential late feature of Parkinson's disease (PD). However, studies in patients with late-stage PD are lacking due to the particular characteristics of this population. Objectives: To evaluate the frequency of dementia in late-stage PD patients and to assess the impact of using different diagnostic criteria. Methods: We conducted a cross-sectional study to estimate the frequency of dementia in late-stage PD patients using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria as the primary outcome. We also applied other diagnostic criteria [MDS (Level I), DSM-IV, and DSM-5 criteria] to determine their applicability and impact on dementia frequency. Results: 93 participants with a mean age of 75.8 years (SD 6.8) and 16.5 years (SD 7.5) of disease duration were included. 64.3% were classified as demented using the International Parkinson and Movement Disorders Society (MDS) (Level II) clinical diagnostic criteria. We observed a high discrepancy on the frequency of dementia depending on the criteria applied [6.2% with MDS (Level I), 58.8% with DSM-IV, and 72.0% with DSM-5 criteria]. Conclusions: We found a frequency of dementia below what was observed in similar populations. The particular characteristics of our sample may have contributed as protective factors for late-stage dementia. Dementia frequency varied depending on the criteria used mainly due to the presence of major depression.
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Affiliation(s)
- Catarina Severiano E Sousa
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Margherita Fabbri
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Department of Neurosciences, Clinical Investigation Center 1436, Parkinson Toulouse Expert Center, NS-Park/FCRIN Network and NeuroToul COEN Center, Toulouse University Hospital, INSERM, University of Toulouse 3, Toulouse, France
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico do Centro de Investigação Interdisciplinar Egas Moniz, Escola Superior de Saúde Egas Moniz, Almada, Portugal
| | - Rita Simões
- Neurology Department, Hospital Beatriz Ângelo, Loures, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
| | - Inês Chendo
- Campus Neurológico Sénior, Torres Vedras, Portugal.,Psychiatry Department, Department of Neurosciences, Hospital de Santa Maria, Lisbon, Portugal.,Clínica Universitária de Psiquiatria, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Miguel Coelho
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Neurology Service, Department of Neurosciences, Hospital Santa Maria, Lisbon, Portugal
| | - Isabel Pavão Martins
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Laboratório de Estudos da Linguagem, Instituto de Medicina Molecular de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Joaquim J Ferreira
- Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.,Campus Neurológico Sénior, Torres Vedras, Portugal
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Virtual Reality-Based Cognitive Stimulation on People with Mild to Moderate Dementia due to Alzheimer's Disease: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105290. [PMID: 34065698 PMCID: PMC8156930 DOI: 10.3390/ijerph18105290] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/02/2022]
Abstract
The use of ecologically oriented approaches with virtual reality (VR) depicting instrumental activities of daily living (IADL) is a promising approach for interventions on acquired brain injuries. However, the results of such an approach on dementia caused by Alzheimer’s disease (AD) are still lacking. This research reports on a pilot randomized controlled trial that aimed to explore the effect of a cognitive stimulation reproducing several IADL in VR on people with mild-to-moderate dementia caused by AD. Patients were recruited from residential care homes of Santa Casa da Misericórdia da Amadora (SCMA), which is a relevant nonprofit social and healthcare provider in Portugal. This intervention lasted two months, with a total of 10 sessions (two sessions/week). A neuropsychological assessment was carried out at the baseline and follow-up using established neuropsychological instruments for assessing memory, attention, and executive functions. The sample consisted of 17 patients of both genders randomly assigned to the experimental and control groups. The preliminary results suggested an improvement in overall cognitive function in the experimental group, with an effect size corresponding to a large effect in global cognition, which suggests that this approach is effective for neurocognitive stimulation in older adults with dementia, contributing to maintaining cognitive function in AD.
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28
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Justo-Henriques SI, Pérez-Sáez E, Alves Apóstolo JL. Multicentre randomised controlled trial about the effect of individual reminiscence therapy in older adults with neurocognitive disorders. Int J Geriatr Psychiatry 2021; 36:704-712. [PMID: 33176394 DOI: 10.1002/gps.5469] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/01/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of a 13-week individual reminiscence therapy (RT) intervention to improve the overall cognitive function, memory, executive function, mood and quality of life (QoL) of people with neurocognitive disorders. METHODS A single-blind, multicentre, randomised parallel two-arm controlled trial recruited 251 people with neurocognitive disorders attending 24 institutions providing care and support services for older adults in Portugal. The primary outcome measure was cognitive function (Mini-Mental State Examination [MMSE]). Secondary outcomes were memory (Memory Alteration Test [MAT]), executive function (Frontal Assessment Battery [FAB]), mood (Geriatric Depression Scale-15 [GDS-15]) and self-reported QoL-Alzheimer's disease AD). Participants in the intervention group (n = 131) received 26 individual RT sessions, twice a week, over the course of 13 weeks. Participants in the control group (n = 120) maintained their treatment as usual. RESULTS Intention-to-treat analysis showed that, at endpoint assessment, the intervention group had significantly improved in relation to the control group in MMSE (mean difference 1.84, 95% CI [0.80, 2.89], p = .001, d = .44), MAT (mean difference 2.82, 95% CI [0.72, 4.91], p = .009, d = .34) and QoL-AD (mean difference 1.78, 95% CI [0.17, 3.39], p = .031, d = .28). Non-significant improvements were found on FAB (mean difference 0.74, 95% CI [-0.04, 1.52], p = .062, d = .24) and GDS-15 (mean difference -0.63, 95% CI [-1.45, 0.19], p = .130, d = .19). CONCLUSIONS For people with neurocognitive disorders attending social care and support services, the individual RT designed for this trial should be considered an intervention with the potential to improve cognition, memory and QoL.
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Affiliation(s)
| | - Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, Salamanca, Spain
| | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal
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Fernández-Fleites Z, Jiménez-Puig E, Broche-Pérez Y, Morales-Ortiz S, Luzardo DAR, Crespo-Rodríguez LR. Evaluation of sensitivity and specificity of the INECO Frontal Screening and the Frontal Assessment Battery in mild cognitive impairment. Dement Neuropsychol 2021; 15:98-104. [PMID: 33907602 PMCID: PMC8049576 DOI: 10.1590/1980-57642021dn15-010010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The Frontal Assessment Battery (FAB) and the INECO Frontal Screening (IFS) are
two instruments frequently used to explore cognitive deficits in different
diseases. However, studies reporting their use in patients with mild cognitive
impairment (MCI) are limited.
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Affiliation(s)
- Zoylen Fernández-Fleites
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas - Santa Clara, Cuba.,CognitiON (Cuban Inicative on Cognitive Health) - Santa Clara, Cuba
| | - Elizabeth Jiménez-Puig
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas - Santa Clara, Cuba.,CognitiON (Cuban Inicative on Cognitive Health) - Santa Clara, Cuba
| | - Yunier Broche-Pérez
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas - Santa Clara, Cuba.,CognitiON (Cuban Inicative on Cognitive Health) - Santa Clara, Cuba
| | - Sheyla Morales-Ortiz
- Psychology Department, Universidad Central "Marta Abreu" de Las Villas - Santa Clara, Cuba.,CognitiON (Cuban Inicative on Cognitive Health) - Santa Clara, Cuba
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Gamito P, Oliveira J, Matias M, Cunha E, Brito R, Lopes PF, Deus A. Virtual Reality Cognitive Training Among Individuals With Alcohol Use Disorder Undergoing Residential Treatment: Pilot Randomized Controlled Trial. J Med Internet Res 2021; 23:e18482. [PMID: 33512329 PMCID: PMC7880813 DOI: 10.2196/18482] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 08/10/2020] [Accepted: 11/11/2020] [Indexed: 01/16/2023] Open
Abstract
Background Alcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce. Objective The aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs. Methods This study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility. Results In order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies. Conclusions Overall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD. Trial Registration ClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345
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Affiliation(s)
- Pedro Gamito
- School of Psychology and Life Sciences, Lusófona University, Lisboa, Portugal.,Digital Human-Environment Interaction Lab, Lusófona University, Lisboa, Portugal
| | - Jorge Oliveira
- School of Psychology and Life Sciences, Lusófona University, Lisboa, Portugal.,Digital Human-Environment Interaction Lab, Lusófona University, Lisboa, Portugal
| | - Marcelo Matias
- School of Psychology and Life Sciences, Lusófona University, Lisboa, Portugal
| | - Elsa Cunha
- School of Psychology and Life Sciences, Lusófona University, Lisboa, Portugal
| | - Rodrigo Brito
- Digital Human-Environment Interaction Lab, Lusófona University, Lisboa, Portugal
| | - Paulo Ferreira Lopes
- School of Psychology and Life Sciences, Lusófona University, Lisboa, Portugal.,Digital Human-Environment Interaction Lab, Lusófona University, Lisboa, Portugal
| | - Alberto Deus
- Casa de Saúde do Telhal, Instituto São João de Deus, Sintra, Portugal
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31
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van Nuland AJ, Helmich RC, Dirkx MF, Zach H, Toni I, Cools R, den Ouden HEM. Effects of dopamine on reinforcement learning in Parkinson's disease depend on motor phenotype. Brain 2020; 143:3422-3434. [PMID: 33147621 PMCID: PMC7719026 DOI: 10.1093/brain/awaa335] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 07/10/2020] [Accepted: 08/06/2020] [Indexed: 01/16/2023] Open
Abstract
Parkinson's disease is clinically defined by bradykinesia, along with rigidity and tremor. However, the severity of these motor signs is greatly variable between individuals, particularly the presence or absence of tremor. This variability in tremor relates to variation in cognitive/motivational impairment, as well as the spatial distribution of neurodegeneration in the midbrain and dopamine depletion in the striatum. Here we ask whether interindividual heterogeneity in tremor symptoms could account for the puzzlingly large variability in the effects of dopaminergic medication on reinforcement learning, a fundamental cognitive function known to rely on dopamine. Given that tremor-dominant and non-tremor Parkinson's disease patients have different dopaminergic phenotypes, we hypothesized that effects of dopaminergic medication on reinforcement learning differ between tremor-dominant and non-tremor patients. Forty-three tremor-dominant and 20 non-tremor patients with Parkinson's disease were recruited to be tested both OFF and ON dopaminergic medication (200/50 mg levodopa-benserazide), while 22 age-matched control subjects were recruited to be tested twice OFF medication. Participants performed a reinforcement learning task designed to dissociate effects on learning rate from effects on motivational choice (i.e. the tendency to 'Go/NoGo' in the face of reward/threat of punishment). In non-tremor patients, dopaminergic medication improved reward-based choice, replicating previous studies. In contrast, in tremor-dominant patients, dopaminergic medication improved learning from punishment. Formal modelling showed divergent computational effects of dopaminergic medication as a function of Parkinson's disease motor phenotype, with a modulation of motivational choice bias and learning rate in non-tremor and tremor patients, respectively. This finding establishes a novel cognitive/motivational difference between tremor and non-tremor Parkinson's disease patients, and highlights the importance of considering motor phenotype in future work.
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Affiliation(s)
- Annelies J van Nuland
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
| | - Rick C Helmich
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, 6500 HB Nijmegen, The Netherlands
| | - Michiel F Dirkx
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, 6500 HB Nijmegen, The Netherlands
| | - Heidemarie Zach
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, 6500 HB Nijmegen, The Netherlands
- Department of Neurology, Medical University Vienna, Vienna, Austria
| | - Ivan Toni
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Psychiatry, Nijmegen, The Netherlands
| | - Hanneke E M den Ouden
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, 6500 HB Nijmegen, The Netherlands
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Shen D, Cui B, Liu M, Gao J, Liu C, Li X, Cui L. Strategy for screening cognitive impairment in Chinese patients with amyotrophic lateral sclerosis. J Clin Neurosci 2020; 81:105-110. [PMID: 33222896 DOI: 10.1016/j.jocn.2020.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/31/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND It is an economical strategy to design a screening method to decide which patients with amyotrophic lateral sclerosis/ motor neuron disease (ALS/MND) should enter into the stage for further comprehensive neuropsychological investigation. METHODS 59 patients (including 8 with frank dementia) were recruited. They underwent the extensive neuropsychological evaluation and short screening batteries, namely the Mini-Mental State Examination (MMSE), the Peking Union Medical College Hospital version of Montreal Cognitive Assessment (MoCA-P) and the Frontal Assessment Battery (FAB). Results of the extensive neuropsychological evaluation were set as the gold standard to diagnose cognitive impairment, and the effectiveness of screening tests were measured against them. RESULTS By comparing the sensitivity and specificity, we found that the combination of FAB plus both or either of the other 2 short batteries provided a satisfactorily high sensitivity, but none of these screening batteries was significantly associated with quantitative behavioral measurements among non-demented subjects, the Frontal Behavioral Inventory-ALS version (FBI-ALS). CONCLUSIONS The combination of the FBI-ALS, the FAB, and the MMSE or the MoCA-P or both could effectively screen comorbid dementia, cognitive and behavioral impairment in ALS but this implicates a limited specificity. And the FAB needed to be validated in large Chinese sample.
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Affiliation(s)
- Dongchao Shen
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Bo Cui
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Mingsheng Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Jing Gao
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Caiyan Liu
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Xiaoguang Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Liying Cui
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China; Neurosciences Center, Chinese Academy of Medical Sciences, Beijing 100730, China.
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33
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Ribeiro A, Rosa B, Oliveira J, Lopes P. Depression, social support, executive functioning, functionality, and quality of life in institutionalized elderly people. PSYCHOLOGY, COMMUNITY & HEALTH 2020. [DOI: 10.5964/pch.v8i1.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim
Our aim was to study the executive functioning, functionality, and quality of life of institutionalized old aged persons and to determine the potential roles of self-reported depression and satisfaction with social support on these domains.
Method
The sample comprised 36 volunteers (13 males and 23 females) aged between 71 and 94 years. The measures used consisted of well-established battery of neuropsychological tests. A comparative study was performed.
Results
Participants with depressive symptoms shown impaired executive functioning. Cognitive flexibility, functionality in instrumental activities of daily living, and quality of life are more affected in participants with higher levels of depression that also report higher levels of satisfaction with social support.
Conclusion
This result is intriguing and may highlight the relevance of considering not only depression, but also factors related to social isolation and loneliness in the explanation of cognitive performance, functionality, and quality of life.
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34
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Han M, Kim DY, Leigh JH, Kim MW. Value of the Frontal Assessment Battery Tool for Assessing the Frontal Lobe Function in Stroke Patients. Ann Rehabil Med 2020; 44:261-272. [PMID: 32721991 PMCID: PMC7463112 DOI: 10.5535/arm.19111] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/21/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To examine the correlation between the Frontal Assessment Battery (FAB) test, which is used to assess the frontal lobe function, and anatomical lesions as well as the ability of the test to detect frontal lobe dysfunction. METHODS Records of stroke patients undergoing a FAB test and Mini-Mental State Examination (MMSE) were retrospectively reviewed. The patients were divided into three groups according to the lesions determined by an imaging study: frontal lobe cortex lesions, frontal subcortical circuit lesions, and other lesions. The FAB scores of the three groups were compared using the Kruskal-Wallis test. The validity of the FAB test to detect frontal lobe dysfunction was assessed by a comparison with the Computerized Neuropsychological Function Test (CNT) using the Spearman correlation coefficient. The correlation coefficients between the FAB test and MMSE were analyzed further based on the MMSE cutoff score. RESULTS Patients with frontal cortex lesions had significantly lower total and subtest scores according to the FAB test than the other patients. The FAB test correlated better with the CNT than the MMSE, particularly in the executive function and memory domains. A high MMSE score (r=0.435) indicated a lower correlation with the FAB test score than a low MMSE score (r=0.714). CONCLUSION The FAB test could differentiate frontal lobe lesions from others in stroke patients and showed a good correlation with the CNT. Moreover, the FAB test can be used in patients with high MMSE scores to detect frontal lobe dysfunction and determine the treatment strategies for stroke patients.
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Affiliation(s)
- Mihyang Han
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.,Department of Rehabilitation Medicine, Incheon Hospital of Korea Workers' Compensation and Welfare Service, Incheon, Korea
| | - Da-Ye Kim
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Incheon Hospital of Korea Workers' Compensation and Welfare Service, Incheon, Korea
| | - Min-Wook Kim
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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35
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Vicente SG, Rivera D, Barbosa F, Gaspar N, Dores AR, Mascialino G, Arango-Lasprilla JC. Normative data for tests of attention and executive functions in a sample of European Portuguese adult population. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:418-437. [PMID: 32654600 DOI: 10.1080/13825585.2020.1781768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The main goal of this study was to produce normative data for the Portuguese population on five neuropsychological tests frequently used to assess executive functions and attention: the Modified Wisconsin Card Sorting Test (M-WCST), the Stroop Color and Word Test, the Trail Making Test (TMT), the Brief Test of Attention (BTA), and the Symbol Digit Modalities Test (SDMT). METHOD The study included 300 individuals aged between 18 and 93 years, who had educational backgrounds ranging from 3 to 25 years. RESULTS The influence of age, education, and sex was explored for each measure, as well as their contribution to explain the performance variance. CONCLUSIONS The normative data are presented as regression-based algorithms to adjust direct and derived test scores for sex, age, and education. This study provides a calculator of normative data, derived from the results of the regression models.
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Affiliation(s)
- Selene G Vicente
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal
| | - Diego Rivera
- Departamento De Ciencias De La Salud, Universidad Pública De Navarra , Navarra, España
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto , Porto Portugal
| | - Nuno Gaspar
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto , Porto, Portugal
| | - Artemisa R Dores
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto , Porto Portugal.,School of Health, Polytechnic of Porto , Porto, Portugal
| | - Guido Mascialino
- School of Psychology, Universidad De Las Américas , Quito, Ecuador
| | - Juan Carlos Arango-Lasprilla
- IKERBASQUE. Basque Foundation for Science , Bilbao, Spain.,Biocruces Bizkaia Health Research Institute , Barakaldo, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU) , Leioa, Spain
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36
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Moon S, Sarmento CVM, Steinbacher M, Smirnova IV, Colgrove Y, Lai SM, Lyons KE, Liu W. Can Qigong improve non-motor symptoms in people with Parkinson's disease - A pilot randomized controlled trial? Complement Ther Clin Pract 2020; 39:101169. [PMID: 32379638 PMCID: PMC7607921 DOI: 10.1016/j.ctcp.2020.101169] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/14/2020] [Accepted: 03/31/2020] [Indexed: 01/27/2023]
Abstract
Non-motor symptoms (NMS) including sleep disorders, anxiety, depression, fatigue, and cognitive decline can significantly impact quality of life in people with PD. Qigong exercise is a mind-body exercise that shows a wide range of benefits in various medical conditions. The purpose of this study was to investigate the effect of Qigong exercise on NMS with a focus on sleep quality. Seventeen participants completed a 12-week intervention of Qigong (n = 8) or sham Qigong (n = 9). Disease severity, anxiety and depression levels, fatigue, cognition, quality of life, and other NMS of the participants were evaluated prior to the intervention and at the end of the 12-week intervention. After the intervention, both Qigong and sham-Qigong group showed significant improvement in sleep quality (p < 0.05) and overall NMS (p < 0.05). No significant difference was found between groups. Qigong exercise has the potential as a rehabilitation method for people with PD, specifically alleviating NMS in PD. However, this finding needs to be carefully considered due to the small sample size and potentially low intervention fidelity of this study.
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Affiliation(s)
- Sanghee Moon
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Caio V M Sarmento
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA; Department of Physical Therapy, Department of Physical Therapy, California State University, Fresno, CA, USA.
| | - Michael Steinbacher
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Irina V Smirnova
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Yvonne Colgrove
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Sue-Min Lai
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Kelly E Lyons
- Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Wen Liu
- Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA.
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Abrahámová M, Smolejová E, Dančík D, Pribišová K, Heretik A, Hajdúk M. Normative data for the Slovak version of the Frontal Assessment Battery (FAB). APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:273-278. [PMID: 32297814 DOI: 10.1080/23279095.2020.1748031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The Frontal Assessment Battery (FAB) is a well-established screening measure of frontal lobe pathology. The aim of this study is the development of normative data for healthy Slovak adults. The final sample consisted of 487 healthy adults (54% of them female). The mean age in our sample was M = 55.29 (SD = 19.96). For the whole sample, the mean score on the FAB was 16.46 and the SD was 1.64. The mean score on the MMSE for the whole sample was 28.39 and the SD was 1.43. All participants underwent a complex neuropsychological examination spanning the relevant cognitive domains. FAB scores were found to be negatively associated with age (rs = -0.464, p < 0.001) and positively associated with years of education (rs = 0.199, p < 0.001). FAB scores positively correlated with the performance in MMSE (rs = 0.266, p < 0.001). Statistically significant and theoretically meaningful associations to other neuropsychological tests used in this study suggested the adequate convergent validity of the Slovak version of the FAB. The present study provided accurate normative FAB data, which can be used for clinical and research purposes.
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Affiliation(s)
- Miroslava Abrahámová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Eva Smolejová
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Karin Pribišová
- Neurological Clinic of SHU, University Hospital Bratislava, Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia.,Psychiatric Clinic, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Center for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
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38
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Oliveira J, Gamito P, Lopes B, Silva AR, Galhordas J, Pereira E, Ramos E, Silva AP, Jorge Á, Fantasia A. Computerized cognitive training using virtual reality on everyday life activities for patients recovering from stroke. Disabil Rehabil Assist Technol 2020; 17:298-303. [PMID: 32255695 DOI: 10.1080/17483107.2020.1749891] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: Recent studies argue that the use of virtual reality tasks depicting activities daily living may be effective means for cognitive rehabilitation. The aim of this study was to test an ecologically oriented approach in virtual reality resembling the demands of everyday life activities for cognitive rehabilitation following stroke. Materials and Methods: The sample comprised 30 sub-acute stroke patients recovering from stroke in a rehabilitation hospital. They were assessed in a single-arm pre-post intervention study on global cognition, executive functions, memory and attention abilities. The intervention consisted of virtual reality in a multidomain cognitive training approach depicting everyday life tasks (preparing food, choosing clothes, shopping, etc.). Results: Improvements were found in the assessed cognitive domains at 6 to 10 post-treatment sessions. In-depth analysis through reliable change scores has suggested larger treatment effects on global cognition. Conclusions: Overall results suggest that the use of virtual reality-based exercises on everyday life activities may be a useful cognitive rehabilitation approach to provide short-term gains in cognition following stroke.Implications for rehabilitationVirtual reality-based cognitive rehabilitation resembling everyday life activities may provide short-term gains in cognition of stroke patients;Consistent improvements in executive functions may require higher treatment dosage than for improvements in global cognition.
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Affiliation(s)
- Jorge Oliveira
- EPCV, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal.,HEI-Lab, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal
| | - Pedro Gamito
- EPCV, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal.,HEI-Lab, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal
| | - Beatriz Lopes
- EPCV, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal
| | - Ana Rute Silva
- EPCV, Universidade Lusófona de Humanidades e Tecnologias (ULHT), Lisbon, Portugal
| | - João Galhordas
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
| | - Eduarda Pereira
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
| | - Elisabete Ramos
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
| | - Ana Paula Silva
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
| | - Áurea Jorge
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
| | - António Fantasia
- Serviço de Psicologia, Centro de Medicina de Reabilitação de Alcoitão (CMRA), Alcabideche, Portugal
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Gamito P, Oliveira J, Alves C, Santos N, Coelho C, Brito R. Virtual Reality-Based Cognitive Stimulation to Improve Cognitive Functioning in Community Elderly: A Controlled Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:150-156. [PMID: 32031888 DOI: 10.1089/cyber.2019.0271] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The advantages of using naturalistic virtual reality (VR) environments based on everyday life tasks for cognitive intervention in the elderly are not yet well understood. The literature suggests that the similarity of such exercises with real life activities may improve generalizability by extending the transfer of gains of training to everyday living. This study aimed to investigate the gains associated with this ecologically-oriented virtual reality cognitive stimulation (VR-CS) versus standard cognitive stimulation in the elderly. Forty-three healthy older adults were divided into two groups: an experimental group underwent a VR-based cognitive stimulation and an active control group underwent a paper-and-pencil cognitive stimulation. The outcomes assessed at the pre-treatment and posttreatment assessment consisted in well-established tests for cognitive and executive functioning, depression, subjective well-being, and functionality. The results showed positive outcomes on dimensions of general cognition, executive functioning, attention, and visual memory in the group that underwent VR-CS. Improvements in executive functioning in this group was supported by consistent evidence of increases in attention abilities but little evidence of increases in memory abilities. Both effects may have contributed to improvements in general cognition. Further studies are needed to test whether these effects may extend to well-being and functionality in cognitively impaired older adults.
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Affiliation(s)
- Pedro Gamito
- HEI-Lab: Digital Human-Environment Interaction Lab, University Lusophone of Humanities and Technologies, Lisboa, Portugal
| | - Jorge Oliveira
- HEI-Lab: Digital Human-Environment Interaction Lab, University Lusophone of Humanities and Technologies, Lisboa, Portugal
| | | | - Nuno Santos
- Junta de Freguesia de Benfica, Lisboa, Portugal
| | | | - Rodrigo Brito
- HEI-Lab: Digital Human-Environment Interaction Lab, University Lusophone of Humanities and Technologies, Lisboa, Portugal
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Hulzinga F, Nieuwboer A, Dijkstra BW, Mancini M, Strouwen C, Bloem BR, Ginis P. The New Freezing of Gait Questionnaire: Unsuitable as an Outcome in Clinical Trials? Mov Disord Clin Pract 2020; 7:199-205. [PMID: 32071940 PMCID: PMC7011794 DOI: 10.1002/mdc3.12893] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/13/2019] [Accepted: 12/30/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Freezing of gait (FOG) is a common gait deficit in Parkinson's disease. The New Freezing of Gait Questionnaire (NFOG-Q) is a widely used and valid tool to quantify freezing of gait severity. However, its test-retest reliability and minimal detectable change remain unknown. OBJECTIVE To determine the test-retest reliability and responsiveness of the NFOG-Q. METHODS Two groups of freezers, involved in 2 previous rehabilitation trials, completed the NFOG-Q at 2 time points (T1 and T2), separated by a 6-week control period without active intervention. Sample 1 (N = 57) was measured in ON and sample 2 (N = 14) in OFF. We calculated various reliability statistics for the NFOG-Q scores between T1 and T2 as well as correlation coefficients with clinical descriptors to explain the variability between time points. RESULTS In sample 1 the NFOG-Q showed modest reliability (intraclass correlation coefficient = 0.68 [0.52-0.80]) without differences between T1 and T2. However, a minimal detectable change of 9.95 (7.90-12.27) points emerged for the total score (range 28 points, relative minimal detectable change of 35.5%). Sample 2 showed largely similar results. We found no associations between cognitive-related or disease severity-related outcomes and variability in NFOG-Q scores. CONCLUSIONS We conclude that the NFOG-Q is insufficiently reliable or responsive to detect small effect sizes, as changes need to go beyond 35% to surpass measurement error. Therefore, we warrant caution in using the NFOG-Q as a primary outcome in clinical trials. These results emphasize the need for robust and objective freezing of gait outcome measures.
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Affiliation(s)
- Femke Hulzinga
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research GroupLeuvenBelgium
| | - Alice Nieuwboer
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research GroupLeuvenBelgium
| | - Bauke W. Dijkstra
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research GroupLeuvenBelgium
| | - Martina Mancini
- Department of NeurologyOregon Health & Science UniversityPortlandOregonUSA
| | - Carolien Strouwen
- UHasselt, Faculty of Rehabilitation Sciences, Rehabilitation Research CenterHasseltBelgium
| | - Bastiaan R. Bloem
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of NeurologyCentre of Expertise for Parkinson & Movement DisordersNijmegenthe Netherlands
| | - Pieter Ginis
- KU Leuven, Department of Rehabilitation Sciences, Neurorehabilitation Research GroupLeuvenBelgium
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van Nuland AJM, den Ouden HEM, Zach H, Dirkx MFM, van Asten JJA, Scheenen TWJ, Toni I, Cools R, Helmich RC. GABAergic changes in the thalamocortical circuit in Parkinson's disease. Hum Brain Mapp 2019; 41:1017-1029. [PMID: 31721369 PMCID: PMC7267977 DOI: 10.1002/hbm.24857] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/31/2019] [Accepted: 10/22/2019] [Indexed: 12/29/2022] Open
Abstract
Parkinson's disease is characterized by bradykinesia, rigidity, and tremor. These symptoms have been related to an increased gamma‐aminobutyric acid (GABA)ergic inhibitory drive from globus pallidus onto the thalamus. However, in vivo empirical evidence for the role of GABA in Parkinson's disease is limited. Some discrepancies in the literature may be explained by the presence or absence of tremor. Specifically, recent functional magnetic resonance imaging (fMRI) findings suggest that Parkinson's tremor is associated with reduced, dopamine‐dependent thalamic inhibition. Here, we tested the hypothesis that GABA in the thalamocortical motor circuit is increased in Parkinson's disease, and we explored differences between clinical phenotypes. We included 60 Parkinson patients with dopamine‐resistant tremor (n = 17), dopamine‐responsive tremor (n = 23), or no tremor (n = 20), and healthy controls (n = 22). Using magnetic resonance spectroscopy, we measured GABA‐to‐total‐creatine ratio in motor cortex, thalamus, and a control region (visual cortex) on two separate days (ON and OFF dopaminergic medication). GABA levels were unaltered by Parkinson's disease, clinical phenotype, or medication. However, motor cortex GABA levels were inversely correlated with disease severity, particularly rigidity and tremor, both ON and OFF medication. We conclude that cortical GABA plays a beneficial rather than a detrimental role in Parkinson's disease, and that GABA depletion may contribute to increased motor symptom expression.
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Affiliation(s)
- Annelies J M van Nuland
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Hanneke E M den Ouden
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Heidemarie Zach
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.,Medical University of Vienna, Department of Neurology, Vienna, Austria
| | - Michiel F M Dirkx
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Jack J A van Asten
- Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - Tom W J Scheenen
- Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - Ivan Toni
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Roshan Cools
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands
| | - Rick C Helmich
- Radboud University Nijmegen, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Nijmegen, The Netherlands.,Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
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42
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Influencia de variables sociodemográficas en el rendimiento de la Frontal Assessment Battery en adultos mayores Argentinos. REVISTA IBEROAMERICANA DE PSICOLOGÍA 2019. [DOI: 10.33881/2027-1786.rip.12211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Introducción. La Frontal Assesment Battery (FAB) es una herramienta de screening de valoración rápida de las funciones ejecutivas. Estudios previos evidencian que variables sociodemográficas como la edad, el sexo y el nivel educativo podrían influir en el rendimiento de la FAB. El objetivo del estudio es analizar, en adultos mayores argentinos provenientes de la población general y sin deterioro cognitivo (evaluados según el Minimental, pruebas de fluidez verbal semántica y fonológica y el Test del Reloj) si existe diferencia en la FAB a partir de dichas variables. Metodología. Se analizó el rendimiento de 145 adultos mayores provenientes de la población general y sin deterioro cognitivo entre 60 y 90 años. Se realizaron estudios de diferencias de medias (t de Student y ANOVA), análisis univariante de la varianza, correlaciones (r de Pearson) y regresiones lineales simples para analizar la influencia de la edad, el sexo, el nivel educativo y el rendimiento cognitivo en la FAB. Resultados. Se observaron diferencias estadísticamente significativas en el puntaje total de la FAB en función del nivel educativo, pero no en función de la edad, ni el sexo. Asimismo, se encontró que el puntaje de la FAB se correlacionó con otras pruebas de screening cognitivo, como el Minimental, el Test del Reloj y fluidez verbal (fonológica y semántica). Conclusiones. El presente estudio presenta resultados que señalan la importancia de considerar el nivel educativo en la valoración de la FAB
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de Melo Cerqueira TM, de Moura JA, de Lira JO, Leal JC, D'Amelio M, do Santos Mendes FA. Cognitive and motor effects of Kinect-based games training in people with and without Parkinson disease: A preliminary study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1807. [PMID: 31468656 DOI: 10.1002/pri.1807] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 07/19/2019] [Accepted: 07/22/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Purpose of this study is to evaluate the effects of training with six commercial Xbox KinectTM games on cognitive and motor aspects in Parkinson's disease (PD) patients and to compare the effects with a group of paired healthy subjects. METHODS This study was a quasi-experimental, controlled trial. Eight individuals with PD (mean age 68.9 ± 7.9) and eight older adults without PD, matched by age (mean age 67.6 ± 7.3) were enrolled in the study. Ten sessions of six Xbox 360 KinectTM commercial games were performed for 5 weeks. Subjects were evaluated before and 7 and 30 days after intervention. They were assessed using Montreal Cognitive Assessment, Frontal Assessment Battery (FAB), Timed Up and Go test, Ten Meters Walking test, and Balance Berg Scale. The Freezing of Gait Questionnaire, the Movement Disorder Society Unified Parkinson Disease Rating Scale, and the Parkinson's disease Questionnaire were also applied to PD group. RESULTS Significant improvement was found for cognitive aspects measured by Montreal Cognitive Assessment and FAB in both groups but without retention on FAB in PD group. No significant improvements were found for motor aspects in none group. CONCLUSION Motor-cognitive training using Xbox KinectTM games is a feasible resource to improve executive functions in PD patients and in older healthy people.
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Affiliation(s)
| | - Júlia Araújo de Moura
- Faculty of Ceilândia, Post-graduation program in Rehabilitation Sciences, Univeristy of Brasília, Brasília, Brazil
| | - Juliana Onofre de Lira
- Faculty of Ceilândia, Department of Phonoaudiology, University of Brasília, Brasília, Brazil
| | - Josevan Cerqueira Leal
- Faculty of Ceilândia, Department of Phonoaudiology, University of Brasília, Brasília, Brazil
| | - Marco D'Amelio
- Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata (BiND), Università degli Studi di Palermo, Italy
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Faustino B, Oliveira J, Lopes P. Diagnostic precision of the Wisconsin Card Sorting Test in assessing cognitive deficits in substance use disorders. APPLIED NEUROPSYCHOLOGY-ADULT 2019; 28:165-172. [PMID: 31060391 DOI: 10.1080/23279095.2019.1607737] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Wisconsin Card Sorting Test (WCST) is a widely used neuropsychological instrument to assess executive functions related to cognitive flexibility and abstract reasoning. However, there is a lack of studies investigating the diagnostic precision of this instrument in substance use disorders. In this study, we aimed at assessing the sensitivity and specificity of the WCST in discriminating the performance of participants with substance use disorder with cognitive deficits and participants from the general population without cognitive deficits. The sample comprised three groups of participants with substance use disorders (opioid use disorder in harm reduction with methadone maintenance; opioid use disorder in treatment in a therapeutic community; alcohol use disorder in a therapeutic community) and a normative group of healthy adults. The total sample consisted of 587 participants that were assessed with cognitive tests for executive functions, general cognitive functioning, and self-reported depression. The results showed differences between groups in most WCST variables, providing evidence of discriminant validity for this test. Convergent validity was also established by weak to moderate correlations with general cognitive functioning. Cutoff points based on receiver operating characteristic (ROC) curves were calculated for the WCST variables. Overall, the WCST was sensitive to changes in cognitive flexibility and abstract reasoning that are key features of substance use disorders.
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Affiliation(s)
- B Faustino
- School of Psychology and Life Sciences, ULHT, Lisbon, Portugal.,Faculty of Psychology, Universidade de Lisboa, Lisbon, Portugal
| | - J Oliveira
- School of Psychology and Life Sciences, ULHT, Lisbon, Portugal
| | - P Lopes
- School of Psychology and Life Sciences, ULHT, Lisbon, Portugal
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45
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Madden DL, Sale MV, O'Sullivan J, Robinson GA. Improved language production with transcranial direct current stimulation in progressive supranuclear palsy. Neuropsychologia 2019; 127:148-157. [PMID: 30836131 DOI: 10.1016/j.neuropsychologia.2019.02.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 12/19/2018] [Accepted: 02/28/2019] [Indexed: 01/05/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical parkinsonian disorder that can present with language production deficits in addition to the characteristic progressive parkinsonian motor symptoms. Although typical parkinsonism treatments such as pharmacotherapy are not effective in PSP, non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have shown promise for treating cognitive deficits relating to this disorder. We report the case of KN, who presented with reduced verbal fluency and connected speech production in the context of PSP. KN completed a set of language tasks, followed by an alternate version of the tasks in conjunction with either sham or active tDCS over the left dorsolateral prefrontal cortex (DLPFC) across four sessions. Results showed improved performance with active stimulation compared to sham stimulation for phonemic fluency and action naming, as well as mixed results suggesting possible benefits for connected speech production. There were no benefits of active stimulation for control tasks, indicating that tDCS can produce specific benefits for phonemic fluency, action naming, and connected speech production in PSP. These promising, preliminary findings warrant further investigation into whether these benefits of tDCS can be a useful therapeutic tool for PSP patients to maintain language.
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Affiliation(s)
- Daniel L Madden
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - Martin V Sale
- School of Health and Rehabilitation Sciences, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Queensland Brain Institute, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia
| | - John O'Sullivan
- Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia; Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Queensland Brain Institute, The University of Queensland, St. Lucia, Brisbane, QLD, 4072, Australia; Neurology Department, Royal Brisbane and Women's Hospital, Herston, Brisbane, Australia.
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46
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Moon S, Sarmento CVM, Smirnova IV, Colgrove Y, Lyons KE, Lai SM, Liu W. Effects of Qigong Exercise on Non-Motor Symptoms and Inflammatory Status in Parkinson's Disease: A Protocol for a Randomized Controlled Trial. MEDICINES (BASEL, SWITZERLAND) 2019; 6:E13. [PMID: 30669324 PMCID: PMC6473798 DOI: 10.3390/medicines6010013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/04/2019] [Accepted: 01/16/2019] [Indexed: 12/26/2022]
Abstract
Background: Non-motor symptoms such as sleep disturbance, cognitive decline, fatigue, anxiety, and depression in Parkinson's disease (PD) impact quality of life. Increased levels of pro-inflammatory cytokines in individuals with PD have been reported, which may contribute to non-motor symptoms. A mind-body exercise, Qigong, has demonstrated benefits across different medical conditions. However, a lack of evidence causes clinicians and patients to be uncertain about the effects of Qigong in individuals with PD. This study will examine the effects of Qigong on non-motor symptoms and inflammatory status in individuals with PD. Methods: Sixty individuals with PD will be recruited. Qigong and sham Qigong group (n = 30 for each) will receive a 12-week intervention. Participants will practice their assigned exercise at home (2×/day) and attend routinely group exercise meetings. Results: Clinical questionnaires and neuropsychological tests will measure non-motor symptoms including sleep quality (primary outcome). Biomarker assays will measure inflammatory status. A two-way mixed-design analysis of variance (ANOVA) will be utilized. Conclusions: This study may generate evidence for the benefits of Qigong on non-motor symptoms of PD and the effect on inflammatory status. Findings may lead to the development of a novel, safe, and cost-effective rehabilitation approach for individuals with PD.
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Affiliation(s)
- Sanghee Moon
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center; 3901 Rainbow Blvd., MailStop 2002, Kansas City, KS 66160, USA.
| | - Caio V M Sarmento
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center; 3901 Rainbow Blvd., MailStop 2002, Kansas City, KS 66160, USA.
| | - Irina V Smirnova
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center; 3901 Rainbow Blvd., MailStop 2002, Kansas City, KS 66160, USA.
| | - Yvonne Colgrove
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center; 3901 Rainbow Blvd., MailStop 2002, Kansas City, KS 66160, USA.
| | - Kelly E Lyons
- Department of Neurology, School of Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd., MailStop 2012, Kansas City, KS 66160, USA.
| | - Sue M Lai
- Department of Preventive Medicine and Public Health, School of Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd., MailStop 1008, Kansas City, KS 66160, USA.
| | - Wen Liu
- Department of Physical Therapy and Rehabilitation Science, School of Health Professions, University of Kansas Medical Center; 3901 Rainbow Blvd., MailStop 2002, Kansas City, KS 66160, USA.
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Gamito P, Oliveira J, Morais D, Coelho C, Santos N, Alves C, Galamba A, Soeiro M, Yerra M, French H, Talmers L, Gomes T, Brito R. Cognitive Stimulation of Elderly Individuals with Instrumental Virtual Reality-Based Activities of Daily Life: Pre-Post Treatment Study. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2019; 22:69-75. [DOI: 10.1089/cyber.2017.0679] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Pedro Gamito
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Jorge Oliveira
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Diogo Morais
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Cátia Coelho
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Nuno Santos
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Catarina Alves
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Ana Galamba
- Junta de Freguesia de Benfica, Gabinete de Psicologia do Pelouro dos Direitos Sociais e Saúde, Lisbon, Portugal
| | - Miguel Soeiro
- Department of Informatics, Universidade de Lisboa Instituto Superior Tecnico
| | - Madhurrima Yerra
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Hannan French
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Lily Talmers
- University of Michigan College of Literature Science and the Arts, Ann Arbor, Michigan, Lisbon, Portugal
| | - Tiago Gomes
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
| | - Rodrigo Brito
- School of Psychology and Life Sciences, Lusophone University of Humanities and Technologies, Lisbon, Portugal
- HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
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Hurtado-Pomares M, Terol-Cantero MC, Sánchez-Pérez A, Leiva-Santana C, Peral-Gómez P, Valera-Gran D, Navarrete-Muñoz EM. Measuring executive dysfunction in Parkinson's disease: Reliability and validity of the Spanish version of Frontal Assessment Battery (FAB-E). PLoS One 2018; 13:e0207698. [PMID: 30452476 PMCID: PMC6242688 DOI: 10.1371/journal.pone.0207698] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/05/2018] [Indexed: 11/29/2022] Open
Abstract
Background Deficits in executive functions (EFs) are frequently detected in patients with Parkinson’s disease (PD). The Frontal Assessment Battery (FAB) is a screening test for assessing EFs although it has not been so far adapted and validated in Spain. We evaluated the reliability and validity of the Spanish version of the FAB (FAB-E) in PD patients. Materials and methods Our study included 54 healthy subjects and 67 PD patients. Cognitive assessment of participants was conducted using the FAB-E, Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Revised-Barcelona Test (RBT) and Executive Interview (EXIT-25). Internal consistency, intra- and test-retest reliabilities, concurrent and discriminant validity of the FAB-E were examined. To evaluate the influence of cognitive dysfunction in PD on the performance of the FAB-E, we also classified the PD patients into groups according to their cognitive status as measured by the MMSE using published criteria to identify cognitive deficits in PD. Results The FAB-E showed good internal consistency (α = 0.751). The intraclass correlation coefficients (ranging from 0.559 to 0.891) and Spearman correlations (from 0.494 to 0.864) of the FAB-E subtests indicated a good-strong reliability. The total and subtest scores generally showed a good concurrent validity, except for the prehension behaviour item of the FAB-E and the Interference and Go/no-go tasks of the EXIT-25 that presented low estimates. Excluding the prehension behaviour subtest, the performance of the FAB-E was higher in the control group than in PD patients. Cognitive dysfunction in PD patients also indicated significant poorer FAB-E scores excepting the motor and prehension behaviour subtests. Discriminant analysis determined a cut-off of 14.5 was optimal to differentiate healthy subjects from PD patients. Moreover, a cut-off <12.5 allocated satisfactorily those PD patients with cognitive impairment (MMSE<26) and scores <11.5 classified suitably those PD patients with dementia (MMSE<24). Conclusion The FAB-E is an accurate tool for evaluating EFs in patients with PD and can provide useful information for distinguishing PD patients with and without cognitive dysfunction at a bedside assessment.
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Affiliation(s)
- Miriam Hurtado-Pomares
- Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain
| | | | - Alicia Sánchez-Pérez
- Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Carlos Leiva-Santana
- Department of Clinical Medicine, Miguel Hernandez University, San Juan de Alicante, Spain
- Department of Neurology, General University Hospital of Alicante, Alicante, Spain
| | - Paula Peral-Gómez
- Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain
| | - Desirée Valera-Gran
- Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- * E-mail:
| | - Eva María Navarrete-Muñoz
- Department of Pathology and Surgery, Miguel Hernandez University, San Juan de Alicante, Spain
- Institute for Health and Biomedical Research (ISABIAL-FISABIO Foundation), Alicante, Spain
- Department of Public Health, History of Medicine and Gynecology, Miguel Hernandez University, San Juan de Alicante, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid, Spain
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Cammisuli DM, Crowe S. Spatial disorientation and executive dysfunction in elderly nondemented patients with Parkinson's disease. Neuropsychiatr Dis Treat 2018; 14:2531-2539. [PMID: 30323601 PMCID: PMC6174307 DOI: 10.2147/ndt.s173820] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Patients with Parkinson's disease (PD) present with a wide range of cognitive deficits. Cognitive impairment is recognized as an independent nonmotor aspect of the disorder and has a critical role in functional outcome and conversion into PD dementia. To date, everyday memory impairment in elderly patients with PD is underinvestigated and its relationship with executive dysfunction was not clearly explained. Our study aims at clarifying the neuropsychological pattern of everyday memory and executive deterioration in elderly patients with PD. METHODS Forty nondemented PD patients (mean age 71.2 years; M:F = 29:11) and 30 well-matched controls (mean age 70.7 years; M:F = 15:15) were assessed on everyday memory (Rivermead Behavioral Memory Test [RBMT]) and executive functioning (Frontal Assessment Battery [FAB]) measures. Mann-Whitney U-tests (Bonferroni corrected) were used to compare groups on these measures and Spearman's rank correlations were performed to highlight their associations. RESULTS PD patients performed worse than controls on recall for novel tasks and geographic recall (RMBT) as well as lexical fluency and mental flexibility (FAB). Particularly, spatial orientation depending on egocentric navigation seems to be altered in PD patients. The clinical group showed poorer performances than controls in mental flexibility, sensitivity to interference, and inhibitory control. Such measures were associated with immediate and delayed recall, picture recognition, prospective memory, and orientation tasks of everyday memory. CONCLUSION Executive-type difficulties and memory-type difficulties have an impact on cognitive performances of elderly patients with PD. We recommend using the RBMT and the FAB as part of routinely neuropsychological battery for assessing PD patients.
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Affiliation(s)
- Davide M Cammisuli
- Department of Surgical, Medical, Molecular and Critical Area Pathology, Pisa University Medical School, Pisa, Italy,
| | - Simon Crowe
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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50
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Loss of glutamate signaling from the thalamus to dorsal striatum impairs motor function and slows the execution of learned behaviors. NPJ PARKINSONS DISEASE 2018; 4:23. [PMID: 30083593 PMCID: PMC6072777 DOI: 10.1038/s41531-018-0060-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/19/2018] [Accepted: 06/27/2018] [Indexed: 01/15/2023]
Abstract
Parkinson’s disease (PD) is primarily associated with the degeneration of midbrain dopamine neurons, but it is now appreciated that pathological processes like Lewy-body inclusions and cell loss affect several other brain regions, including the central lateral (CL) and centromedian/parafascicular (CM/PF) thalamic regions. These thalamic glutamatergic neurons provide a non-cortical excitatory input to the dorsal striatum, a major projection field of dopamine neurons. To determine how thalamostriatal signaling may contribute to cognitive and motor abnormalities found in PD, we used a viral vector approach to generate mice with loss of thalamostriatal glutamate signaling specifically restricted to the dorsal striatum (CAV2Cre-Slc17a6lox/lox mice). We measured motor function and behaviors corresponding to cognitive domains (visuospatial function, attention, executive function, and working memory) affected in PD. CAV2Cre-Slc17a6lox/lox mice were impaired in motor coordination tasks such as the rotarod and beam-walk tests compared with controls (CAV2Cre-Slc17a6+/+ mice). They did not demonstrate much cognitive impairment in the Morris water maze or a water U-maze, but had slower processing reaction times in those tests and in a two-way active avoidance task. These mice could model an aspect of bradyphrenia, the slowness of thought that is often seen in patients with PD and other neurological disorders. Mice in which glutamate signaling from the thalamus to dorsal striatum has been genetically inactivated mimic the slowness of thought that is often observed in patients with Parkinson’s disease (PD). The midbrain and striatum are the brain regions that are most affected in PD, however, it is increasingly recognized that cell loss in other areas of the brain also contribute to disease symptoms. Martin Darvas at the University of Washington, Seattle, USA, and colleagues found that disrupting the excitatory input from thalamic projection neurons into the dorsal striatum affected motor coordination and balance in mice. Although these mice did not have significant impairments in spatial learning and memory, they were slower at reacting to cues and executing learned behaviors suggesting that they could be used to test new approaches for treating this specific cognitive symptom of PD.
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