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Perra A, Sancassiani F, Cantone E, Pintus E, D’Oca S, Casula A, Littarru S, Zucca S, Tumolillo D, Pinna I, Primavera D, Cossu G, Nardi AE, Kalcev G, Carta MG. An e-Health Psychoeducation Program for Managing the Mental Health of People with Bipolar Disorder during the COVID-19 Pandemic: A Randomized Controlled Study. J Clin Med 2024; 13:3468. [PMID: 38929997 PMCID: PMC11204713 DOI: 10.3390/jcm13123468] [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: 05/21/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Background: Social rhythm dysregulation has been identified as a determining factor in bipolar disorder (BD) relapses. It directly impacts individuals' quality of life (QoL). This study aims to present preliminary data on the efficacy of an e-health psychoeducational intervention for BD for improving clinical outcomes. Methods: This study used an open-label, crossover, randomized controlled trial design. The inclusion criteria consisted of a BD diagnosis, affiliation with the Consultation Psychiatry and Psychosomatic Center at the University Hospital in Cagliari, Italy, age over 18, and the obtaining of informed consent. Anxiety and depressive symptoms, QoL, and social and biological rhythms were measured using standardized instruments validated in Italian. Results: A total of 36 individuals were included in the experimental group (EG) and 18 in the control group (CG). The final sample consisted of 25 in the EG and 14 in the CG. A statistically significant improvement in QoL was found in the EG post-treatment (p = 0.011). Significant correlations were found between QoL and the dysregulation of biorhythms in the EG at T0 (p = 0.0048) and T1 (p = 0.0014). Conclusions: This study shows that, during extreme distress, an e-health group psychoeducation intervention for people with BD could significantly improve the perception of QoL. The results must be confirmed by studies conducted with larger-sized samples.
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Affiliation(s)
- Alessandra Perra
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Federica Sancassiani
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Cantone
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Elisa Pintus
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Silvia D’Oca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Alessio Casula
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Littarru
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Sara Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Davide Tumolillo
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Irene Pinna
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Diego Primavera
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Antonio Egidio Nardi
- Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Visconde de Piraja 407/702, Rio de Janeiro 21941-972, Brazil;
| | - Goce Kalcev
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria, S.P. Monserrato-Sestu km 0,700, 09042 Cagliari, Italy; (A.P.); (F.S.); (E.C.); (E.P.); (S.D.); (A.C.); (S.L.); (S.Z.); (D.T.); (I.P.); (D.P.); (G.C.); (M.G.C.)
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Kang G, Zhang H, Zhou J, Wan D. The WeChat platform-based health education improves health outcomes among patients with stable coronary artery disease. PATIENT EDUCATION AND COUNSELING 2023; 111:107704. [PMID: 36906932 DOI: 10.1016/j.pec.2023.107704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/03/2023] [Accepted: 03/04/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of the WeChat platform-based health education on patients with stable coronary artery disease (CAD) compared with usual care. METHODS We conducted a randomized controlled trial that included patients with stable CAD who were admitted to the Bin Hai Wan Central Hospital of Dongguan between January 2020 and December 2020. Participants in the control group received a standard regimen of care. In the WeChat group, the patients were provided with the WeChat platform-based health education by multidisciplinary team members in addition to usual care. The coprimary outcome of the study was the blood pressure, lipid profile, fasting blood glucose, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores and Seattle Angina Questionnaire (SAQ) scores at 12 months, relative to baseline levels. RESULTS Between January 2020 and December 2020, 200 eligible CAD patients were randomly assigned to WeChat group (n = 100) or usual care group (n = 100). After 12 months, the number of participants who knew the risk factors, symptoms, diagnostic criteria, management methods and treating target of CAD was significantly larger in the WeChat group than at baseline (P < 0.05) and also larger than the post-intervention level of the control group (P < 0.05). The systolic blood pressure after intervention of the WeChat group significantly decreased compared to those of the control group (132.06 ± 8.87 mmHg vs 140.32 ± 9.42 mmHg; P < 0.05). After intervention, the triglycerides, total cholesterol, and low-density lipoprotein cholesterol of the WeChat group significantly decreased compared to those at baseline and significantly decreased than those in the control group (all P < 0.05). After the intervention, scores of HAMA and HAMD both significantly decreased in the two groups. Moreover, the decreases were more significant in the WeChat group than in the control group (5.78 ± 0.98 vs 8.54 ± 1.24; 6.27 ± 1.03 vs 8.63 ± 1.66; P < 0.05). The SAQ scores of WeChat group were significantly higher than those of the control group in all 5 dimensions at the 1-year follow-up (72.71 ± 10.83 vs 59.32 ± 9.86; 80.01 ± 11.56 vs 61.98 ± 11.02; 76.76 ± 12.64 vs 65.22 ± 10.72; 83.17 ± 13.06 vs 67.01 ± 12.86; 71.82 ± 12.78 vs 55.79 ± 11.90; all P < 0.05). CONCLUSION This study showed the high efficacy of the WeChat platform-based health education in improving health outcomes in patients with CAD. PRACTICE IMPLICATIONS This study highlighted the potential of social media as a helpful tool for health education among patients with CAD.
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Affiliation(s)
- GuanYang Kang
- Department of Cardiology, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China.
| | - HuiQing Zhang
- Department of Clinical Pharmacy, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China
| | - Jian Zhou
- Department of Cardiovascular Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200123, China
| | - DeLi Wan
- Department of Cardiology, Bin Hai Wan Central Hospital of Dongguan, The Dongguan Affiliated Hospital of Jinan University (also called The Fifth People's Hospital of Dongguan, Taiping People's Hospital of Dongguan), Dongguan, Guangdong, China
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Wilken J, Traboulsee A, Nelson F, Ionete C, Kolind S, Fratto T, Kane R, Gandhi R, Rawlings AM, Roesch N, Ozog MA, DeLuca J. Longitudinal assessment of neurocognitive function in people with relapsing multiple sclerosis initiating alemtuzumab in routine clinical practice: LEM-COG study results. Mult Scler Relat Disord 2023; 73:104677. [PMID: 37028124 DOI: 10.1016/j.msard.2023.104677] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/21/2023] [Accepted: 03/26/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Alemtuzumab is effective in reducing relapse rate and disability, but limited data exist on its effect on cognitive function in relapsing multiple sclerosis (RMS). The present study assessed neurocognitive function and safety associated with alemtuzumab treatment in RMS. METHODS This longitudinal, single-arm, prospective study included people with RMS (aged 25-55 years) who were treated with alemtuzumab in clinical practice in the United States of America and Canada. The first participant was enrolled in December 2016. The primary endpoint was the change from baseline to post-baseline (month [M] 12/24) in MS-COGnitive (MS-COG) composite score. Secondary endpoints included Paced Auditory Serial Addition Test (PASAT), Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), Selective Reminding Test (SRT), Controlled Oral Word Association Test (COWAT), and Automated Neuropsychological Assessment Metrics (ANAM) scores. Depression and fatigue were assessed using Hamilton Rating Scale-Depression (HAM-D) and Fatigue Severity Scale (FSS)/Modified Fatigue Impact Scale (MFIS), respectively. Magnetic resonance imaging (MRI) parameters were assessed when available. Safety was assessed throughout the study. Descriptive statistics were used for the pre-specified statistical analyses. Since the study was terminated early (November 2019) because of operational and resource difficulties, post hoc analyses for statistical inference were performed among participants who had a baseline value and at least one complete post-baseline assessment for cognitive parameters, fatigue, or depression. RESULTS Of the 112 participants enrolled, 39 were considered as the primary analysis population at M12. At M12, a mean change of 0.25 (95% confidence interval [CI]: 0.04, 0.45; p = 0.0049; effect size [ES]: 0.39) was observed in the MS-COG composite score. Improvements were observed in processing speed (based on PASAT and SDMT; p < 0.0001; ES: 0.62), as well as in individual PASAT, SDMT and COWAT scores. An improvement was also noted in HAM-D (p = 0.0054; ES: -0.44), but not in fatigue scores. Among MRI parameters, decreases in burden of disease volume (BDV; ES: -0.12), new gadolinium-enhancing lesions (ES: -0.41) and newly active lesions (ES: -0.07) were observed at M12. About 92% of participants showed stable or improved cognitive status at M12. There were no new safety signals reported in the study. The most common adverse events (≥10% of participants) were headache, fatigue, nausea, insomnia, urinary tract infection, pain in extremity, chest discomfort, anxiety, dizziness, arthralgia, flushing, and rash. Hypothyroidism (3.7%) was the most frequent adverse event of special interest. CONCLUSION The findings from this study suggest that alemtuzumab has a positive impact on cognitive function with significant improvements in processing speed and depression in people with RMS over a period of 12 months. The safety profile of alemtuzumab was consistent with previous studies.
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Distinct Neuropsychological Correlates of Apathy Sub-Domains in Multiple Sclerosis. Brain Sci 2023; 13:brainsci13030385. [PMID: 36979195 PMCID: PMC10046638 DOI: 10.3390/brainsci13030385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Background: Apathy is relatively frequent and significantly associated with clinical and cognitive outcomes in Multiple Sclerosis (MS), even if previous research has produced mixed results. This varied picture could be due to most studies treating apathy as a unitary construct, despite the evidence showing that apathy is a multifaceted syndrome including three different sub-domains (i.e., cognitive, affective, and behavioral). This study aims to investigate the neuropsychological correlates of apathy fractionated into its three sub-domains in participants with MS. Methods: Eighty-five participants with MS underwent a comprehensive neuropsychological battery. The severity of apathy symptoms was assessed by the self-report version of the Apathy Evaluation Scale. Results: Correlational analysis showed that cognitive apathy sub-domain scores had a high correlation with the performances obtained at cognitive tests tapping into inhibitory control (i.e., IML and Strop test-interference task), whereas the affective apathy sub-domain scores had a high correlation with the performances obtained at cognitive test tapping into the use of executive functions in visuospatial abilities (i.e., Clock Drawing Test). Moreover, linear regression analysis results showed that the cognitive apathy sub-domain scores predicted executive functioning domain scores and that the cognitive and affective apathy sub-domains scores predicted visuospatial abilities domain scores. Conclusion: These results confirm that apathy is a multidimensional concept with important neuropsychological correlates, visible only when it is fractionated into its sub-domains.
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Mitsikostas D, Bakirtzis C, Nikolaidis I, Tsimourtou V, Kountra P, Matsi S, Papadimitriou A. Quality of life in people with multiple sclerosis receiving glatiramer acetate or interferon in Greek clinical practice. Neurodegener Dis Manag 2022; 12:311-322. [PMID: 36178000 DOI: 10.2217/nmt-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate glatiramer acetate (GA) or IFN-β effects on quality of life (QoL) in people with relapsing/remitting multiple sclerosis (PwRRMS) in Greece. Methods: A prospective, practice-based study. QoL/function/symptoms were assessed by seven questionnaires/scales. Results: Significant increases in Short Form-36 (SF-36) health survey scores occurred with GA in four of the eight domains and three of the eight domains at 6 and 12 months, respectively, versus baseline. Similar and significant SF-36 score improvements occurred with GA in treatment-naive PwRRMS. SF-36 scores were unaffected in GA-treated, IFN-β treatment-experienced PwRRMS, or with IFN-β versus baseline. Slight improvements in fatigue and sexual satisfaction were evident (6 months). No deteriorations were seen in the other four instruments. Conclusion: The findings show that 12-month treatment with GA, but not IFN-β, improved certain QoL parameters in treatment-naive PwRRMS.
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Affiliation(s)
- Dimos Mitsikostas
- First Department of Neurology, Aeginition Hospital, National & Kapodistrian University of Athens, Athens, 11528, Greece
| | - Christos Bakirtzis
- Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Ioannis Nikolaidis
- Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, 54636, Greece
| | - Vana Tsimourtou
- Department of Neurology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, 40500, Greece
| | - Persa Kountra
- Department of Neurology, General Hospital of Volos, Volos, 38222, Greece
| | - Stavroula Matsi
- Country Medical Affairs Manager, Teva Pharmaceuticals, Athens, 15135, Greece
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Aiello EN, D’Iorio A, Montemurro S, Maggi G, Giacobbe C, Bari V, Di Tella GS, Pischedda F, Bolognini N, Appollonio I, Arcara G, Santangelo G. Psychometrics, diagnostics and usability of Italian tools assessing behavioural and functional outcomes in neurological, geriatric and psychiatric disorders: a systematic review. Neurol Sci 2022; 43:6189-6214. [PMID: 35932375 PMCID: PMC9616758 DOI: 10.1007/s10072-022-06300-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/18/2022] [Indexed: 11/05/2022]
Abstract
Background Psychometric instruments assessing behavioural and functional outcomes (BFIs) in neurological, geriatric and psychiatric populations are relevant towards diagnostics, prognosis and intervention. However, BFIs often happen not to meet methodological-statistical standards, thus lowering their level of recommendation in clinical practice and research. This work thus aimed at (1) providing an up-to-date compendium on psychometrics, diagnostics and usability of available Italian BFIs and (2) delivering evidence-based information on their level of recommendation. Methods This review was pre-registered (PROSPERO ID: CRD42021295430) and performed according to PRISMA guidelines. Several psychometric, diagnostic and usability measures were addressed as outcomes. Quality assessment was performed via an ad hoc checklist, the Behavioural and Functional Instrument Quality Assessment. Results Out of an initial N = 830 reports, 108 studies were included (N = 102 BFIs). Target constructs included behavioural/psychiatric symptoms, quality of life and physical functioning. BFIs were either self- or caregiver-/clinician-report. Studies in clinical conditions (including neurological, psychiatric and geriatric ones) were the most represented. Validity was investigated for 85 and reliability for 80 BFIs, respectively. Criterion and factorial validity testing were infrequent, whereas content and ecological validity and parallel forms were almost never addressed. Item response theory analyses were seldom carried out. Diagnostics and norms lacked for about one-third of BFIs. Information on administration time, ease of use and ceiling/floor effects were often unreported. Discussion Several available BFIs for the Italian population do not meet adequate statistical-methodological standards, this prompting a greater care from researchers involved in their development. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06300-8.
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Mechanisms of Repetitive Transcranial Magnetic Stimulation on Post-stroke Depression: A Resting-State Functional Magnetic Resonance Imaging Study. Brain Topogr 2022; 35:363-374. [PMID: 35286526 DOI: 10.1007/s10548-022-00894-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
Abstract
We aimed to identify neural mechanisms underlying clinical response to repetitive transcranial magnetic stimulation (rTMS) in post-stroke depression (PSD) by the Resting-state functional magnetic resonance imaging (rs-fMRI). Thirty-two depressed patients after ischemic stroke were randomized in a 1:1 ratio to receive 20 min of 5 Hz rTMS or sham over left dorsolateral prefrontal cortex (DLPFC) in addition to routine supportive treatments. The clinical outcome was measured by the 17-item Hamilton Depression Rating Scale (HDRS-17), while the imaging results were acquired from rs-fMRI, including regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF) and seed-based dynamic functional connection (dFC). HRSD-17 scores were improved in the two groups after treatment (P < 0.01), while greater mood improvement was observed in the rTMS group (P < 0.05). Compared with the sham group, the rTMS group demonstrated regions with higher ReHo and fALFF values locating mainly in the left hemisphere and highly consistent with the default mode network (DMN) (p < 0.05). Using the medial prefrontal cortex (mPFC) and posterior cingulate cortex (PCC) as seeds, significant difference between the two groups in dFC within the DMN was found after treatment, including 10 connections with increased connectivity strength and 2 connections with reduced connectivity strength. The ReHo, fALFF and dFC values within DMN in the rTMS group were negatively correlated with the HDRS scores after treatment (P < 0.05). Our results indicated reductions in depressive symptoms following rTMS in PSD are associated with functional alterations of different depression-related areas within the DMN.
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Di Tella M, Perutelli V, Miele G, Lavorgna L, Bonavita S, De Mercanti SF, Streito LM, Clerico M, Castelli L. Family Functioning and Multiple Sclerosis: Study Protocol of a Multicentric Italian Project. Front Psychol 2021; 12:668010. [PMID: 34177727 PMCID: PMC8219871 DOI: 10.3389/fpsyg.2021.668010] [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: 02/15/2021] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
Multiple Sclerosis (MS) is a chronic inflammatory and neurodegenerative disease, which not only affects physical functioning, but is also associated with cognitive impairments and great psychological distress. The combination of those symptoms may have negative consequences on the family functioning of patients with MS, with detrimental effects on both marital relationships and parental bonding. Furthermore, the presence of individual characteristics and of an adequate social support may also contribute to the quality and endurance of family relationships. Particularly, high levels of alexithymia, a personality trait that affects the recognition of a person's own emotions, have been associated with reduced interpersonal communication skills and enhanced anxiety/depressive symptoms. Therefore, the main aim of the present study is to provide an in-depth evaluation of family functioning and related factors in patients with MS and their families. In order to reach this goal, the perceived quality of family functioning, dyadic relationships, and parental bonding will be first investigated. Secondly, the possible associations between the quality of family relationships and the presence of alexithymia, psychological distress, and perceived social support will be examined. Patients with MS and their families who will consent to take part in the study will be asked to provide sociodemographic and clinical information, and to complete a series of questionnaires, presented and uploaded on an online dedicated platform. The final sample will be made up of 300 families, consecutively recruited from the Italian medical centers involved in the project. The results of the present study will shed light on the family functioning of patients with MS, through a comprehensive assessment of the main factors that are associated with family dynamics. A holistic evaluation of those aspects can help clinicians and researchers understand family dynamics in MS population better.
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Affiliation(s)
| | - Virginia Perutelli
- Department of Clinical and Biological Sciences, School of Medicine, University of Turin, Azienda Ospedaliera Universitaria San Luigi Gonzaga, Turin, Italy
| | - Giuseppina Miele
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Luigi Lavorgna
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Simona Bonavita
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefania Federica De Mercanti
- Department of Clinical and Biological Sciences, School of Medicine, University of Turin, Azienda Ospedaliera Universitaria San Luigi Gonzaga, Turin, Italy
| | - Lidia Mislin Streito
- Department of Clinical and Biological Sciences, School of Medicine, University of Turin, Azienda Ospedaliera Universitaria San Luigi Gonzaga, Turin, Italy
| | - Marinella Clerico
- Department of Clinical and Biological Sciences, School of Medicine, University of Turin, Azienda Ospedaliera Universitaria San Luigi Gonzaga, Turin, Italy
| | - Lorys Castelli
- Department of Psychology, University of Turin, Turin, Italy
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Lin X, Zhang X, Liu Q, Zhao P, Zhong J, Pan P, Wang G, Yi Z. Social cognition in multiple sclerosis and its subtypes: A meta-analysis. Mult Scler Relat Disord 2021; 52:102973. [PMID: 33962135 DOI: 10.1016/j.msard.2021.102973] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 04/12/2021] [Accepted: 04/17/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is an immune-mediated demyelinating disease that disrupts several social cognitive abilities, including the theory of mind (ToM) and facial emotion recognition (FER). It is unclear how specific ToM subcomponents, including cognitive and affective ToM, are affected in patients with MS and the social cognitive abilities in MS subtypes. METHODS A search of PubMed, Web of Science, and Embase databases was conducted until June 2020. Effect sizes were calculated using Hedges g with a random-effects model. RESULTS A total of 45 studies were included. Relative to health controls (HCs), patients with MS and its subtypes (including relapsing-remitting MS [RRMS] and progressive MS) exhibited impairments in ToM (g = -0.77, g = -0.70, g = -0.75, respectively), cognitive ToM (g = -0.72, g = -0.83, g = -0.73, respectively), affective ToM (g = -0.84, g = -0.63, g = -0. 50, respectively), and FER (g = -0.62, g = -0.53, g = -1.07, respectively). In addition, there was no difference between progressive primary MS and secondary progressive MS in overall ToM, cognitive ToM, affective ToM, and FER. Compared to patients with RRMS, patients with progressive MS showed no difference in overall ToM, cognitive ToM, and affective ToM but had more serious defects in FER (g = -0.57). CONCLUSIONS These quantitative results indicate that patients with MS and its subtypes have a differential impairment of the core aspects of social cognitive processing (including ToM and FER), which may help develop the structured social cognitive interventions in MS.
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Affiliation(s)
- XiaoGuang Lin
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - XueLing Zhang
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - QinQin Liu
- Department of Neurology, Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, PR China
| | - PanWen Zhao
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - JianGuo Zhong
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - PingLei Pan
- Department of Neurology and Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - GenDi Wang
- Department of Neurology, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China
| | - ZhongQuan Yi
- Department of Central Laboratory, Affiliated Yancheng School of Clinical Medicine of Nanjing Medical University, PR China.
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10
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Raimo S, Santangelo G, Trojano L. The emotional disorders associated with multiple sclerosis. HANDBOOK OF CLINICAL NEUROLOGY 2021; 183:197-220. [PMID: 34389118 DOI: 10.1016/b978-0-12-822290-4.00009-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Multiple sclerosis (MS) is associated with a high prevalence of emotional and mood disorders. Emotional disorders may worsen during illness progression and affect the quality of life of patients and their families. MS is often associated with depression, with an increased risk of suicide, poor adherence to treatment, decreased functional status, and quality of life. The diagnosis and treatment of emotional and mood disorders in these patients is often challenging since several symptoms of these disorders overlap with those of MS. Other prevalent emotional disorders in MS include bipolar disorder, anxiety disorders, emotional blunting (apathy), and pseudobulbar affect. Early recognition and treatment of these comorbidities could contribute to the reduction of disability and even to decreased mortality. The aim of this chapter is to provide an up-to-date review of mood and emotional disorders that are often associated with MS, focusing on their epidemiology, clinical features, pathogenesis, assessment, and treatment. The interplay between the psychosocial impact of the chronic disability and the demyelinating structural lesions of the brain in precipitating emotional and mood disorders is discussed, as well as its implications for diagnosis and treatment.
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Affiliation(s)
- Simona Raimo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
| | - Gabriella Santangelo
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Luigi Trojano
- Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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11
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Neamtu MC, Neamtu OM, Rusu MR, Marin MI, Rusu L. Functional muscle balance assessment in multiple sclerosis. J Back Musculoskelet Rehabil 2020; 33:607-612. [PMID: 31743986 DOI: 10.3233/bmr-191518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Chronic demyelinisation in multiple sclerosis (MS) involves changes in the muscle structure and development of motor disorders. OBJECTIVE The aim of this research is to assess the muscle balance of thigh muscle in MS using a noninvasive method, to have information about the muscle status prior to the rehabilitation and to prevent muscle damage. METHODS The studied group consisted of 20 patients: 9 men and 11 women, with a mean age of 42 years. The patients were diagnosed with MS in different stages. The clinical evaluation included clinical examination, neurological examination, functional evaluation by using the Hamilton score, the activity daily living (ADL) scale and the Kurtze (EDSS) scale. For the muscle assessment we used tensiomyography (TMG), an evaluation method for the functional potential of the muscle, depending on the muscle composition. The TMG parameters are displacement (Dm), contraction time (Tc) and sustain time (Ts) for biceps femoris (mBF) and rectus femoris (mRF). RESULTS The value of Dm shows low values for both studied muscle groups, but closer to the normal value for mBF. The average normal Tc values for mBF are 30.25 ± 3.5 ms and 32.83 ± 4.5 for mRF. The values are low values for mRF and high for mBF. The normal values of Ts are not standard values and can be compared healthy individuals' values. These parameters could monitor the evolution and in our research have lower values for mRF. In the thigh, there was a significant difference in the Dm values, with higher values in mBF and also with higher values in the right lower limb. Analyzing the Ts results, we noticed a difference between the two muscle groups with a significant reduction in mRF, showing the inability to achieve anterior-posterior symmetry and the tendency to develop type I fibers at mBF level. CONCLUSIONS Our study showed the presence of a structural and functional asymmetry explained by the tendency of increasing the tonus at mRF level in order to compensate the knee stability. We noticed a decrease in Tc value at the mRF level, but close to the value of the two lower limbs. TMG analysis revealed the asymmetry of the muscle composition at the level of the antagonist muscle groups of the thigh, with an increase in the percentage of type II fibers in the previous group, which became hyperton, and a decrease in the percentage of type I fibers in the posterior group.
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Affiliation(s)
- Marius Cristian Neamtu
- Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Oana Maria Neamtu
- Department of Sports Medicine and Kinesiology, University of Craiova, Craiova, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Mihai Robert Rusu
- Department of Sports Medicine and Kinesiology, University of Craiova, Craiova, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Mihnea Ion Marin
- Mechanic Department, University of Craiova, Craiova, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Ligia Rusu
- Department of Sports Medicine and Kinesiology, University of Craiova, Craiova, Romania.,Department of Physiology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
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12
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Cognitive predictors of depression and anxiety in individuals with newly diagnosed Multiple Sclerosis. EUROPEAN JOURNAL OF PSYCHIATRY 2020. [DOI: 10.1016/j.ejpsy.2020.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Psychiatric disorders in multiple sclerosis. J Neurol 2019; 268:45-60. [PMID: 31197511 DOI: 10.1007/s00415-019-09426-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by a large spectrum of symptoms, involving all functional systems. Psychiatric symptoms are common in people with MS (pwMS) having an important impact on quality of life and on some features of MS (fatigue, sleep, disability, adherence to disease-modifying drugs). The main psychiatric disturbances in MS are depressive, bipolar, anxiety, schizophrenic and obsessive-compulsive syndromes. METHODS Literature search for original articles and review in the databases, including PubMed and Scopus from 1959 to 2019. RESULTS AND CONCLUSION Studies answering the aim of this review were selected and reported. Epidemiological and clinical aspects of psychiatric syndromes (PS) in MS as well as self-report diagnostic scales and radiological correlates of PS in MS are described. Moreover, some radiological studies about primary psychiatric disorders (PD) are reported to underline how gray matter atrophy, white matter abnormalities and corpus callosum involvement in these diseases, as features in common with MS, may explain the more frequent occurrence of PD in MS than in the general population.
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14
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Roeh A, Kirchner SK, Malchow B, Maurus I, Schmitt A, Falkai P, Hasan A. Depression in Somatic Disorders: Is There a Beneficial Effect of Exercise? Front Psychiatry 2019; 10:141. [PMID: 30949079 PMCID: PMC6435577 DOI: 10.3389/fpsyt.2019.00141] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 02/26/2019] [Indexed: 12/13/2022] Open
Abstract
Background: The beneficial effects of exercise training on depressive symptoms are well-established. In the past years, more research attention has been drawn to the specific effects of exercise training on depressive symptoms in somatically ill patients. This reviews aims at providing a comprehensive overview of the current findings and evidence of exercise interventions in somatic disorders to improve depressive symptoms. Methods: We systematically searched PubMed and Cochrane databases and extracted meta-analyses from somatically ill patients that underwent exercise interventions and provided information about the outcome of depressive symptoms. Results: Of the 4123 detected publications, 39 were selected for final analysis. Various diseases were included (breast-cancer, prostate cancer, mixed-cancer, cardiovascular disease, coronary heart disease, hemodialysis, fibromyalgia syndrome, acute leukemia, other hematological malignancies, heart failure, HIV, multiple sclerosis, mixed neurological disorders, Parkinson's disease, stroke, ankylosing spondylitis, traumatic brain injury, lupus erythematodes). Most meta-analyses (33/39) found beneficial effects on depressive symptoms, but quality of the included studies as well as duration, intensity, frequency, and type of exercise varied widely. Conclusion: Exercise training has the potential to improve depressive symptoms in patients with somatic disorders. For specific training recommendations, more high quality studies with structured exercise programs and better comparability are needed.
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Affiliation(s)
- Astrid Roeh
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sophie K Kirchner
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Berend Malchow
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Jena, Jena, Germany
| | - Isabel Maurus
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
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15
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Sacco R, Santangelo G, Stamenova S, Bisecco A, Bonavita S, Lavorgna L, Trojano L, D'Ambrosio A, Tedeschi G, Gallo A. Psychometric properties and validity of Beck Depression Inventory II in multiple sclerosis. Eur J Neurol 2016; 23:744-50. [DOI: 10.1111/ene.12932] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2015] [Accepted: 11/04/2015] [Indexed: 01/03/2023]
Affiliation(s)
- R. Sacco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Santangelo
- Department of Psychology; Second University of Naples; Caserta Italy
| | - S. Stamenova
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- Multiprofile Hospital for Active Treatment in Neurology and Psychiatry ‘St. Naum’; Sofia Bulgaria
| | - A. Bisecco
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - S. Bonavita
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Lavorgna
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - L. Trojano
- Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; Scientific Institute of Telese; Telese Terme (BN) Italy
| | - A. D'Ambrosio
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
| | - G. Tedeschi
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
- Neurological Institute for Diagnosis and Care ‘Hermitage Capodimonte’; Naples Italy
| | - A. Gallo
- Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences; Second University of Naples; Naples Italy
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