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Tee BL, Li‐Ying LK, Chen T, Yan CTY, Tsoh J, Chan AL, Wong A, Lo RY, Lu CJ, Sun Y, Wang P, Lee Y, Chiu M, Allen IE, Battistella G, Bak TH, Chuang Y, García AM, Gorno‐Tempini ML. More than a piece of cake: Noun classifier processing in primary progressive aphasia. Alzheimers Dement 2024; 20:2353-2363. [PMID: 38284802 PMCID: PMC11032580 DOI: 10.1002/alz.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/29/2023] [Accepted: 12/31/2023] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Clinical understanding of primary progressive aphasia (PPA) has been primarily derived from Indo-European languages. Generalizing certain linguistic findings across languages is unfitting due to contrasting linguistic structures. While PPA patients showed noun classes impairments, Chinese languages lack noun classes. Instead, Chinese languages are classifier language, and how PPA patients manipulate classifiers is unknown. METHODS We included 74 native Chinese speakers (22 controls, 52 PPA). For classifier production task, participants were asked to produce the classifiers of high-frequency items. In a classifier recognition task, participants were asked to choose the correct classifier. RESULTS Both semantic variant (sv) PPA and logopenic variant (lv) PPA scored significantly lower in classifier production task. In classifier recognition task, lvPPA patients outperformed svPPA patients. The classifier production scores were correlated to cortical volume over left temporal and visual association cortices. DISCUSSION This study highlights noun classifiers as linguistic markers to discriminate PPA syndromes in Chinese speakers. HIGHLIGHTS Noun classifier processing varies in the different primary progressive aphasia (PPA) variants. Specifically, semantic variant PPA (svPPA) and logopenic variant PPA (lvPPA) patients showed significantly lower ability in producing specific classifiers. Compared to lvPPA, svPPA patients were less able to choose the accurate classifiers when presented with choices. In svPPA, classifier production score was positively correlated with gray matter volume over bilateral temporal and left visual association cortices in svPPA. Conversely, classifier production performance was correlated with volumetric changes over left ventral temporal and bilateral frontal regions in lvPPA. Comparable performance of mass and count classifier were noted in Chinese PPA patients, suggesting a common cognitive process between mass and count classifiers in Chinese languages.
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Affiliation(s)
- Boon Lead Tee
- Memory and Aging CenterUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
- Department of NeurologyDyslexia CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Lorinda Kwan‐Chen Li‐Ying
- Department of Special Education and CounsellingThe Education University of Hong KongHong KongHong Kong
| | - Ta‐Fu Chen
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan R.O.C.
| | - Connie TY Yan
- Department of PsychiatryPrince of Wales Hospital and ShaTin HospitalHong KongHong Kong
- Department of PsychiatryFaculty of MedicineThe Chinese University of Hong KongHong KongHong Kong
| | - Joshua Tsoh
- Department of PsychiatryPrince of Wales Hospital and ShaTin HospitalHong KongHong Kong
- Department of PsychiatryFaculty of MedicineThe Chinese University of Hong KongHong KongHong Kong
| | | | - Adrian Wong
- Division of NeurologyDepartment of Medicine and TherapeuticsChinese University of Hong KongHong KongHong Kong
| | - Raymond Y. Lo
- Department of NeurologyBuddhist Tzu Chi General HospitalHualienTaiwan
| | - Chien Jung Lu
- Department of NeurologyEn Chu Kong HospitalNew Taipei CityTaiwan R.O.C.
| | - Yu Sun
- Department of NeurologyEn Chu Kong HospitalNew Taipei CityTaiwan R.O.C.
| | - Pei‐Ning Wang
- Division of General NeurologyDepartment of Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan R.O.C.
- School of MedicineNational Yang Ming Chiao Tung University College of MedicineTaipeiTaiwan R.O.C.
- Brain Research CenterNational Yang‐Ming Chiao‐Tung UniversityHsinChuTaiwan R.O.C.
| | - YiChen Lee
- Department of NeurologyNational Taiwan University HospitalHsinChuTaiwan R.O.C.
| | - Ming‐Jang Chiu
- Department of NeurologyNational Taiwan University HospitalTaipeiTaiwan R.O.C.
| | - Isabel Elaine Allen
- Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Giovanni Battistella
- Department of Otolaryngology ‐ Head and Neck SurgeryMassachusetts Eye and Ear and Harvard Medical SchoolBostonMassachusettsUSA
| | - Thomas H. Bak
- School of Philosophy, Psychology and Language Sciences (PPLS)University of EdinburghEdinburghUK
| | - Yu‐Chen Chuang
- Division of General NeurologyDepartment of Neurological InstituteTaipei Veterans General HospitalTaipeiTaiwan R.O.C.
| | - Adolfo M. García
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Cognitive Neuroscience CenterUniversidad de San AndrésBuenos AiresArgentina
- Departamento de Lingüística y LiteraturaFacultad de HumanidadesUniversidad de Santiago de ChileSantiagoChile
| | - Maria Luisa Gorno‐Tempini
- Memory and Aging CenterUniversity of California at San FranciscoSan FranciscoCaliforniaUSA
- Department of NeurologyDyslexia CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
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Pan H, Liu TW, Ng SSM, Tsoh J, Wong TWL, Lam SSL, Li CSK, Chan CCC, Lai CYY. Testing the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke in people with chronic stroke. Disabil Rehabil 2024; 46:159-169. [PMID: 36476081 DOI: 10.1080/09638288.2022.2153179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 11/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of SATIS-Stroke (C-SATIS-Stroke) in people with chronic stroke. MATERIALS AND METHODS Forward and backward translations were performed in accordance with available guidelines. We administered the C-SATIS-Stroke to 101 people with stroke and 50 healthy older adults. We assessed the test-retest and internal reliability, measurement error, known-group validity, correlations with other outcome measures, optimal cut-off score and ceiling and floor effects. RESULTS C-SATIS-Stroke demonstrated excellent internal consistency (Cronbach's α = 0.959) and good test-retest reliability (intraclass correlation coefficient3,1 = 0.913). Compared with healthy controls, people with chronic stroke had lower C-SATIS-Stroke scores. The mean C-SATIS-Stroke score was significantly correlated with the mean scores of the Activities-specific Balance Confidence Scale, Stroke Impact Scale, Community Integration Measure and Survey of Activities and Fear of Falling in the Elderly. The cut-off score to distinguish the levels of satisfaction with activity and participation between people with chronic stroke and healthy older adults was 80 out of 108 (sensitivity: 77%; specificity: 72%). C-SATIS-Stroke exhibited ceiling effects but not floor effects. CONCLUSIONS C-SATIS-Stroke is a reliable and valid measure for assessing satisfaction with social participation among Chinese people with chronic stroke.IMPLICATIONS FOR REHABILITATIONSatisfactory semantic, idiomatic, cultural, and conceptual equivalence of the C-SATIS-Stroke are in line with those of the original English version of the SATIS-StrokeExcellent reliability and validity of the C-SATIS-Stroke are also in line with those of the original English version of the SATIS-StrokeThe C-SATIS-Stroke can be used to assess the subjective satisfaction feeling in terms of social participation among Chinese people with chronic stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China (SAR)
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, China (SAR)
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
| | - Stefanie S L Lam
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Carol S K Li
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Charles C C Chan
- Physiotherapy Department, Shatin Hospital, Hong Kong, China (SAR)
| | - Cynthia Y Y Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China (SAR)
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Pan H, Ng SSM, Liu TW, Tsoh J, Wong TWL. Psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index in people with chronic stroke. Front Neurol 2023; 14:989403. [PMID: 36908608 PMCID: PMC9998711 DOI: 10.3389/fneur.2023.989403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/03/2023] [Indexed: 03/14/2023] Open
Abstract
Objective To culturally adapt and examine the psychometric properties of the Chinese (Cantonese) version of the Upper Extremity Functional Index (C-UEFI) in people with chronic stroke. Design Cross-sectional study. Settings University-affiliated neurorehabilitation research laboratory. Participants The participants (N = 151) were people with chronic stroke (N = 101) and healthy controls (n = 50). Main outcome measures We assessed the C-UEFI, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Wolf Motor Function Test (WMFT), Six-Minute Walk Test (6MWT), Motor Activity Log (MAL), Activity-Specific Balance Confidence (ABC) scale, Lawton Instrumental Activities of Daily Living (IADL) scale, Survey of Activities and Fear of Falling in the Elderly (SAFFE), Stroke Impact Scale (SIS) and Community Integration Measure (CIM) as outcome measures. Results The C-UEFI items demonstrated good test-retest reliability (intraclass correlation coefficient [ICC]3, 1 = 0.872) and excellent internal consistency (Cronbach's α = 0.922). People with chronic stroke had poorer C-UEFI scores than the healthy controls. The overall C-UEFI mean score of 101 people with stroke was significantly correlated with the mean scores of the FMA-UE, WMFT, MAL, ABC scale, IADL scale, SAFFE, SIS and CIM and the distance covered in the 6MWT. The C-UEFI cut-off score to distinguish between people with chronic stroke and healthy older adults according to upper extremity function was 57.5 out of 59 (sensitivity: 88.1%; specificity: 84%). The C-UEFI had good content validity, with an acceptable fit to the two-factor structure model. Conclusions The C-UEFI is reliable and valid for assessing functional recovery of upper extremity activity in Chinese people with chronic stroke.
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Affiliation(s)
- Hong Pan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, Hong Kong SAR, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Ng SSM, Liu TW, Tsoh J. Translation and initial validation of Chinese (Cantonese) version of Modified Fatigue Impact Scale (MFIS-C) in people with stroke. BMC Neurol 2022; 22:300. [PMID: 35971081 PMCID: PMC9377082 DOI: 10.1186/s12883-022-02832-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 08/09/2022] [Indexed: 11/12/2022] Open
Abstract
Purpose To translate and culturally adapt the Modified Fatigue Impact Scale (MFIS) to Chinese version, and to psychometrically test it in stroke population. Methods This study consisted of 2 phases. In phase one, we translated and culturally adopted the original English version of MFIS into Chinese (Cantonese) (MFIS-C). In phase two, the MFIS was psychometrically tested using a cohort of community-dwelling people with stroke (n = 101) and healthy control (n = 50). Among the stroke participants, 52 of them were reassessed after a 1-week interval. Results The MFIS-C demonstrated satisfactory content validity and good to excellent internal consistency. The overall MFIS-C and its subscales have good test-retest reliability. The MDC95 were 14.86, 7.49, and 9.70 for the overall MFIS-C physical, cognitive and psychosocial subscales, respectively. The overall MFIS-C and its 2 subscales have significant weak to moderate negative correlations with the Community Integration Measure and the 12-item Short Form Health Survey Version 2. Our findings revealed that the people with chronic stroke living in Hong Kong were reported to have high level of fatigue. Conclusion The MFIS-C is a reliable and valid measure for assessing the level of fatigue in people with stroke. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-022-02832-w.
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Affiliation(s)
- Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, Special Administrative Region of China.
| | - Tai Wa Liu
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong, Special Administrative Region of China
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital & Shatin Hospital, Shatin, Hong Kong, Special Administrative Region of China
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Chen P, Liu TW, Tse MMY, Lai CKY, Tsoh J, Ng SSM. The Predictive Role of Hand Section of Fugl–Meyer Assessment and Motor Activity Log in Action Research Arm Test in People With Stroke. Front Neurol 2022; 13:926130. [PMID: 35873769 PMCID: PMC9301333 DOI: 10.3389/fneur.2022.926130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background: Recent findings of clinical studies have demonstrated a significant positive relationship between Fugl–Meyer Assessment of upper extremity score and the action research arm test (ARAT) score in people with stroke. Although the motor activity log (MAL) can assess the self-perception of motor performance, which can affect the performance of the upper limb, the relationship between MAL score and ARAT score still remains unclear. The objective of this study is to quantify the independent contribution of MAL score and FMA-hand score on the ARAT score in people with stroke. Methods This is a cross-sectional study. There were a total of 87 subjects (50 males, 37 females; mean age = 61.12 ± 6.88 years, post-stroke duration=6.31 ± 2.84 years) included in this study. Self-perceived performance in using the paretic limb was measured by MAL, including subscale of the amount of usage (MAL-AOU) and quality of movement (MAL-QOM). Functional performance of the upper limb was measured by action research arm test (ARAT). Upper limb motor control of the hand was measured by hand section of Fugl–Meyer assessment (FMA-hand). Results The result showed that MAL-QOM (r = 0.648, p < 0.001), MAL-AOU (r = 0.606, p < 0.001), FMA-hand scores (r = 0.663, p < 0.001), and the use of a walking aid (r = −0.422, p < 0.001) were significantly correlated with the ARAT scores. A total 66.9% of the variance in the ARAT scores was predicted by the final regression model including MAL-QOM, MAL-AOU, FMA-hand scores, and walking aid. The FMA-hand score was the best predictor of ARAT scores, which can predict a 36.4% variance of ARAT scores in people with stroke, which controlled the effect of using a walking aid. After controlling for use of a walking aid and FMA-hand scores, the multiple linear regression modeling showed that MAL-QOM and MAL-AOU scores could also independently predict an additional 10.4% of the variance in ARAT scores. Conclusion In addition to the FMA-hand score, the MAL score was significantly correlated with the ARAT score. Improving self-perceived performance should be one goal of rehabilitation in people with stroke. Further work developing and testing techniques to do so is clearly warranted.
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Affiliation(s)
- Peiming Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tai-Wa Liu
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong SAR, China
| | - Mimi M. Y. Tse
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong SAR, China
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Claudia K. Y. Lai
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- School of Health Sciences, Yamaguchi University, Yamaguchi, Japan
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital & Shatin Hospital, Shatin, Hong Kong SAR, China
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- *Correspondence: Shamay S. M. Ng
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Tee BL, Lorinda Kwan-Chen LY, Chen TF, Yan CTY, Tsoh J, Lung-Tat Chan A, Wong A, Lo RY, Lu CL, Wang PN, Lee Y, Yang FG, Battistella G, Allen IE, Dronkers NF, Miller BL, Gorno-Tempini ML. Dysgraphia Phenotypes in Native Chinese Speakers With Primary Progressive Aphasia. Neurology 2022; 98:e2245-e2257. [PMID: 35410909 PMCID: PMC9162166 DOI: 10.1212/wnl.0000000000200350] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/21/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Most primary progressive aphasia (PPA) literature is based on English language users. Linguistic features that vary from English, such as logographic writing systems, are underinvestigated. The current study characterized the dysgraphia phenotypes of patients with PPA who write in Chinese and investigated their diagnostic utility in classifying PPA variants. METHODS This study recruited 40 participants with PPA and 20 cognitively normal participants from San Francisco, Hong Kong, and Taiwan. We measured dictation accuracy using the Chinese Language Assessment for PPA (CLAP) 60-character orthographic dictation test and examined the occurrence of various writing errors across the study groups. We also performed voxel-based morphometry analysis to identify the gray matter regions correlated with dictation accuracy and prevalence of writing errors. RESULTS All PPA groups produced significantly less accurate writing responses than the control group and no significant differences in dictation accuracy were noted among the PPA variants. With a cut score of 36 out of 60 in the CLAP orthographic dictation task, the test achieved sensitivity and specificity of 90% and 95% in identifying Chinese participants with PPA vs controls. In addition to a character frequency effect, dictation accuracy was affected by homophone density and the number of strokes in semantic variant PPA and logopenic variant PPA groups. Dictation accuracy was correlated with volumetric changes over left ventral temporal cortices, regions known to be critical for orthographic long-term memory. Individuals with semantic variant PPA frequently presented with phonologically plausible errors at lexical level, patients with logopenic variant PPA showed higher preponderance towards visual and stroke errors, and patients with nonfluent/agrammatic variant PPA commonly exhibited compound word and radical errors. The prevalence of phonologically plausible, visual, and compound word errors was negatively correlated with cortical volume over the bilateral temporal regions, left temporo-occipital area, and bilateral orbitofrontal gyri, respectively. DISCUSSION The findings demonstrate the potential role of the orthographic dictation task as a screening tool and PPA classification indicator in Chinese language users. Each PPA variant had specific Chinese dysgraphia phenotypes that vary from those previously reported in English-speaking patients with PPA, highlighting the importance of language diversity in PPA.
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Affiliation(s)
- Boon Lead Tee
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis.
| | - Li Ying Lorinda Kwan-Chen
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Ta-Fu Chen
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Connie T Y Yan
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Joshua Tsoh
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Andrew Lung-Tat Chan
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Adrian Wong
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Raymond Y Lo
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Chien Long Lu
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Pei-Ning Wang
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - YiChen Lee
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Fanpei G Yang
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Giovanni Battistella
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Isabel Elaine Allen
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Nina F Dronkers
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Bruce L Miller
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
| | - Maria Luisa Gorno-Tempini
- From the Memory and Aging Center (B.L.T., G.B., B.L.M., M.L.G.-T.), Department of Neurology, Dyslexia Center (B.L.T., G.B., M.L.G.-T.), Global Brain Health Institute (B.L.T., M.L.G.-T.), and Department of Epidemiology and Biostatistics (I.E.A.), University of California, San Francisco; Department of Neurology (B.L.T., R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan R.O.C.; Department of Special Education and Counselling (L.Y.L.K.-C.), The Education University of Hong Kong; Department of Neurology (T.-F.C., Y.L.), National Taiwan University Hospital, Taipei, Taiwan R.O.C.; Department of Psychiatry (C.T.Y.Y., J.T.), ShaTin Hospital, Hong Kong; Department of Medicine (C.T.Y.Y., J.T., A.W.), Chinese University of Hong Kong; Department of Medicine (A.L.-T.C.), Queen Elizabeth Hospital, Hong Kong; Department of Neurology (C.L.L.), En Chu Kong Hospital, New Taipei City; Division of General Neurology, Department of Neurological Institute (P.-N.W.), Taipei Veterans General Hospital; School of Medicine (P.-N.W.) and Brain Research Center (P.-N.W.), National Yang-Ming Chiao-Tung University, Taipei, Taiwan R.O.C.; Department of Foreign Languages and Literature (F.G.Y.), National Tsing Hua University, HsinChu, Taiwan R.O.C.; Department of Radiology (F.G.Y.), Graduate School of Dentistry, Osaka University, Japan; Department of Psychology (N.F.D.), University of California, Berkeley; and Department of Neurology (N.F.D.), University of California, Davis
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Ng SSM, Liu TW, Tsoh J, Chen P, Cheng TS, Cheung MCH, Leung AHH, Ng LLY, So KYK, Tse MMY. Psychometric Properties of the Trail Walking Test for People With Stroke. Front Neurol 2022; 13:821670. [PMID: 35309555 PMCID: PMC8929289 DOI: 10.3389/fneur.2022.821670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/13/2022] [Indexed: 12/01/2022] Open
Abstract
Objective To investigate (i) the inter-rater and test–retest reliability of the trail walking test (TWT) and the minimum detectable change in the TWT completion time; (ii) the correlations between the TWT completion time and stroke-specific impairments; and (iii) the cutoff TWT completion time to distinguish between people with stroke and healthy older adults according to dual-tasking ambulation ability. Design Cross-sectional study. Setting University-based rehabilitation center. Participants In total, 104 people with stroke and 53 healthy older adults. Main Outcome Measures The TWT, the Fugl–Meyer Assessment of Lower Extremity (FMA-LE), the ankle muscle strength test, the limit of stability (LOS) test, the Berg Balance Scale (BBS), the Timed Up and Go test (TUG), and the Community Integration Measure (CIM). Results The mean TWT completion time in subjects with stroke was 124.906 s. The TWT demonstrated excellent inter-rater reliability [intraclass correlation (ICC) = 0.999] and good test–retest reliability (ICC = 0.876) in people with stroke. The TWT performance demonstrated significant negative correlations with the FMA-LE scores (r = −0.409), LOS movement velocity (affected and unaffected sides; r = −0.320 and −0.388, respectively), and LOS endpoint excursion (affected and unaffected sides; r = −0.357 and −0.394, respectively); a significant positive correlation with the LOS reaction time (affected side; r = 0.256); a moderate negative correlation with the BBS scores (r = −0.72); and an excellent positive correlation with the TUG completion time (r = 0.944). The receiver operating characteristic curve analysis revealed that an optimal cutoff of 69.61 s for the TWT completion time had an outstanding diagnostic power to distinguish between people with stroke and healthy older adults (area under the curve = 0.919) with high sensitivity (88.5%) and specificity (83.0%). Conclusion Results of our preliminary study demonstrated that the TWT is a reliable, valid, sensitive, and specific clinical test for evaluating dual-tasking ambulation ability in people with stroke aged 45 years or above and without cognitive impairments. It can differentiate the dual-tasking ambulation ability between people with stroke and healthy older adults.
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Affiliation(s)
- Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- *Correspondence: Shamay S. M. Ng
| | - Tai-Wa Liu
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Kowloon, Hong Kong SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong, Hong Kong SAR, China
| | - Peiming Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Tony S. Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Marco C. H. Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Anthony H. H. Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Liam L. Y. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ken Y. K. So
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Mimi M. Y. Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Chen P, Liu TW, Kwong PWH, Lai CKY, Chung RCK, Tsoh J, Ng SSM. Bilateral Transcutaneous Electrical Nerve Stimulation Improves Upper Limb Motor Recovery in Stroke: A Randomized Controlled Trial. Stroke 2021; 53:1134-1140. [PMID: 34852645 DOI: 10.1161/strokeaha.121.036895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Recent evidence has shown bilateral transcutaneous electrical nerve stimulation (Bi-TENS) combined with task-oriented training (TOT) to be superior to unilateral transcutaneous electrical nerve stimulation (Uni-TENS)+TOT in improving lower limb motor functioning following stroke. However, no research explored the effect of Bi-TENS+TOT in improving upper limb motor recovery. This study aimed to compare Bi-TENS+TOT with Uni-TENS+TOT, Placebo transcutaneous electrical nerve stimulation (Placebo-TENS)+TOT, and no treatment (Control) groups in upper limb motor recovery. METHODS This is a 4-group parallel design. One hundred and twenty subjects were given either Bi-TENS+TOT, Uni-TENS+TOT, Placebo-TENS+TOT, or Control without treatment in this randomized controlled trial. Twenty 60-minute sessions were administered 3× per week for 7 weeks. The outcome measure was the Fugl-Meyer Assessment of Upper Extremity, which was assessed at baseline, after 10 sessions (mid-intervention) and 20 sessions (post-intervention) of intervention, and at 1- and 3-month follow-up. RESULTS Patients in the Bi-TENS+TOT group showed greater improvement in the Fugl-Meyer Assessment of Upper Extremity scores than Uni-TENS+TOT (mean difference, 2.13; P=0.004), Placebo-TENS+TOT (mean difference, 2.63; P<0.001), and Control groups (mean difference, 3.11; P<0.001) at post-intervention. Both Bi-TENS+TOT (mean difference, 3.39; P<0.001) and Uni-TENS+TOT (mean difference, 1.26; P=0.018) showed significant within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores. Patients in the Bi-TENS+TOT group showed earlier within-group improvement in the Fugl-Meyer Assessment of Upper Extremity scores at mid-intervention than Uni-TENS+TOT. These improvements were maintained at the 3-month follow-up assessment. CONCLUSIONS Bi-TENS combined with TOT is an effective therapy for improving upper limb motor recovery following stroke. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03112473.
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Affiliation(s)
- Peiming Chen
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China. (P.C., P.W.H.K., R.C.K.C., S.S.M.N.)
| | - Tai-Wa Liu
- School of Nursing & Health Studies, Hong Kong Metropolitan University, Ho Man Tin, China (T.-W.L.)
| | - Patrick W H Kwong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China. (P.C., P.W.H.K., R.C.K.C., S.S.M.N.)
| | - Claudia K Y Lai
- School of Nursing, The Hong Kong Polytechnic University, China. (C.K.Y.L.)
| | - Raymond C K Chung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China. (P.C., P.W.H.K., R.C.K.C., S.S.M.N.)
| | - Joshua Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong SAR, China (J.T.)
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, China. (P.C., P.W.H.K., R.C.K.C., S.S.M.N.)
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Tee BL, Tempini MLG, Chen T, Lo RY, Wang P, Chan ALT, Chen LLK, Wong A, Yan CTY, Tsoh J, Lu CJ. Another side of the coin: Primary progressive aphasia in Chinese language. Alzheimers Dement 2021. [DOI: 10.1002/alz.052482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Boon Lead Tee
- University of California, San Francisco San Francisco CA USA
- Buddhist Tzu Chi General Hospital Hualien Taiwan
- Global Brain Health Institute/University of California, San Francisco San Francisco USA
| | - Maria Luisa Gorno Tempini
- University of California, San Francisco San Francisco CA USA
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco San Francisco CA USA
| | - Ta‐Fu Chen
- National Taiwan University Hospital Taipei Taiwan
| | | | | | | | | | - Adrian Wong
- Chinese University of Hong Kong Shatin Hong Kong
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Wong MMC, Pang PF, Chan CF, Lau MS, Tse WY, Lam LCW, Lee SKL, Tsoh J, Yan CTY. Wilson Sims Fall Risk Assessment Tool Versus Morse Fall Scale in Psychogeriatric Inpatients: a Multicentre Study. East Asian Arch Psychiatry 2021; 31:67-70. [PMID: 34588316 DOI: 10.12809/eaap2113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To compare predictive validity of the Wilson Sims Fall Risk Assessment Tool (WSFRAT) with that of the Morse Fall Scale (MFS) in psychogeriatric inpatients. METHODS Psychogeriatric patients from Shatin Hospital, Tai Po Hospital, Castle Peak Hospital, and United Christian Hospital who had fall incident between April 2019 and April 2020 were identified. Their fall risks were assessed by the WSFRAT and the MFS, and their falls incidents during hospitalisation were recorded. Patients were classified as having high fall risk when their MFS score was ≥45 and when their WSFRAT score was ≥7. Sensitivity, specificity, and positive and negative predictive values of the two scales were calculated. RESULTS We identified 183 (90 male and 93 female) psychogeriatric patients aged ≥65 years who had fall incident and were assessed by both the WSFRAT and the MFS during the study period. Among the 183 patients, four sustained a fall during hospital stay, giving a prevalence of 2.19%. All four patients were classified as having high risk of fall by WSFRAT, but only two of them were classified so by MFS. The sensitivity of WSFRAT was 100%, which was higher than the 50% by MFS, but specificity of MFS was higher than that of WSFRAT (45.81% vs 54.75%). CONCLUSION WSFRAT is a better fall risk assessment scale for psychiatric inpatients than MFS, because of higher sensitivity (100% vs 50%). It has items specific to psychiatric patients and should replace MFS in psychiatric settings.
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Affiliation(s)
- M M C Wong
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | - P F Pang
- Department of Psychiatry, United Christian Hospital, Hong Kong
| | | | - M S Lau
- Castle Peak Hospital, Hong Kong
| | - W Y Tse
- Castle Peak Hospital, Hong Kong
| | - L C W Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | | | - J Tsoh
- Department of Psychiatry, Prince of Wales Hospital and Shatin Hospital, Hong Kong
| | - C T Y Yan
- Department of Psychiatry, Shatin Hospital, Hong Kong
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11
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Wong A, Savage S, Yan C, Au L, Tsoh J, Lam B, Ng A, Yuen Y, Law D, Hodges J, Mok V. Adaptation and validation of the Cantonese Sydney Language Battery for assessment of language deficits in patients with primary progressive aphasia in Hong Kong. Front Hum Neurosci 2019. [DOI: 10.3389/conf.fnhum.2019.01.00062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Chiu HFK, Zhong BL, Leung T, Li SW, Chow P, Tsoh J, Yan C, Xiang YT, Wong M. Development and validation of a new cognitive screening test: The Hong Kong Brief Cognitive Test (HKBC). Int J Geriatr Psychiatry 2018; 33:994-999. [PMID: 29642275 DOI: 10.1002/gps.4883] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 01/28/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To develop and examine the validity of a new brief cognitive test with less educational bias for screening cognitive impairment. METHODS A new cognitive test, Hong Kong Brief Cognitive Test (HKBC), was developed based on review of the literature, as well as the views of an expert panel. Three groups of subjects aged 65 or above were recruited after written consent: normal older people recruited in elderly centres, people with mild NCD (neurocognitive disorder), and people with major NCD. The brief cognitive test, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA), were administered to the subjects. The performance of HKBC in differentiating subjects with major NCD, mild NCD, and normal older people were compared with the clinical diagnosis, as well as the MMSE and MoCA scores. RESULTS In total, 359 subjects were recruited, with 99 normal controls, 132 subjects with major NCD, and 128 with mild NCD. The mean MMSE, MoCA, and HKBC scores showed significant differences among the 3 groups of subjects. In the receiving operating characteristic curve analysis of the HKBC in differentiating normal subjects from those with cognitive impairment (mild NCD + major NCD), the area under the curve was 0.955 with an optimal cut-off score of 21/22. The performances of MMSE and MoCA in differentiating normal from cognitively impaired subjects are slightly inferior to the HKBC. CONCLUSIONS The HKBC is a brief instrument useful for screening cognitive impairment in older adults and is also useful in populations with low educational level.
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Affiliation(s)
- Helen F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Bao-Liang Zhong
- Affiliated Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Tony Leung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - S W Li
- Castle Peak Hospital, Hong Kong
| | | | | | | | - Yu-Tao Xiang
- Faculty of Health Sciences, University of Macau, Macau, China
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13
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Fung ACH, Tse G, Cheng HL, Lau ESH, Luk A, Ozaki R, So TTY, Wong RYM, Tsoh J, Chow E, Wing YK, Chan JCN, Kong APS. Depressive Symptoms, Co-Morbidities, and Glycemic Control in Hong Kong Chinese Elderly Patients With Type 2 Diabetes Mellitus. Front Endocrinol (Lausanne) 2018; 9:261. [PMID: 29896155 PMCID: PMC5986894 DOI: 10.3389/fendo.2018.00261] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/07/2018] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Undiagnosed depression is an important comorbidity in type 2 diabetes (T2D) which can be detected using the Geriatric Depression Scale (GDS-15) questionnaire. In this cross-sectional study, we examined the associations of depression using GDS score with control of cardiometabolic risk factors and health status in elderly patients with T2D. SETTING AND PARTICIPANTS Between February and December 2013, patients aged ≥65 years who underwent structured comprehensive assessment as a quality improvement program at the Diabetes Center of a teaching hospital were invited to complete the GDS-15 questionnaire. MAIN OUTCOME MEASURES Depression was defined as a GDS score ≥7. Demographic data, prior history of co-morbidities, frequency of self-reported hypoglycemia, and attainment of treatment targets defined as HbA1c, <7%, blood pressure <130/80 mmHg, and LDL-C <2.6 mmol/L were documented. RESULTS Among 325 participants (65% male, median [interquartile range] age: 69 [8] years), 42 (13%) had depression. Patients with depression had longer disease durations (mean ± SD: 15.1 ± 9.1 vs. 11.6 ± 8.1 years, P = 0.02), more frequent self-reported hypoglycemic events (17 vs. 6%, P = 0.03) and were less likely to attain all three treatment targets (0 vs. 16%, P = 0.004) than those without depression. On multivariable analysis, patients with depression had an odds ratio of 2.84 (95% confidence intervals: 1.35-6.00, P = 0.006) of reporting prior history of co-morbidities. CONCLUSION In elderly patients with T2D, depression was not uncommon especially in those with poor control of risk factors, hypoglycemia, and co-morbidities. Inclusion of GDS-15 questionnaire during structured assessment for complications and risk factors can identify these high-risk patients for more holistic management of their physical and mental health.
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Affiliation(s)
- Annie C. H. Fung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Gary Tse
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hiu Lam Cheng
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Eric S. H. Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Andrea Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Risa Ozaki
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tammy T. Y. So
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Rebecca Y. M. Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Joshua Tsoh
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Elaine Chow
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Yun Kwok Wing
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Juliana C. N. Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Alice P. S. Kong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong
- Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Shatin, Hong Kong
- *Correspondence: Alice P. S. Kong,
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14
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Wong TS, Xiang YT, Tsoh J, Ungvari GS, Ko FWS, Hui DSC, Chiu HFK. Suicidal ideation in Chinese patients with chronic obstructive pulmonary disease: a controlled study. Psychogeriatrics 2016; 16:172-6. [PMID: 26115202 DOI: 10.1111/psyg.12135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 09/29/2013] [Accepted: 04/26/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND No study has been published on the prevalence of suicidal behaviour in older Chinese patients with chronic obstructive pulmonary disease (COPD). This study examined the 1-year prevalence of suicidal ideation in older Chinese COPD patients and explored its demographic and clinical correlates. METHODS A consecutive sample of 143 COPD patients and 211 matched control subjects were recruited and interviewed using structured, standardized instruments. RESULTS The 1-year prevalence of suicidal ideation in COPD patients and controls were 15.4% and 10.9%, respectively. In multivariate analyses, suicidal ideation was significantly associated with the severity of depressive symptoms in COPD patients. CONCLUSION Suicidal ideation was not higher in COPD patients than in controls.
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Affiliation(s)
- Tak-Shun Wong
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China.,Unit of Psychiatry, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Joshua Tsoh
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
| | - Gabor S Ungvari
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia.,The University of Notre Dame Australia/Marian Centre, Perth, Western Australia, Australia
| | - Fanny W S Ko
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - David S C Hui
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China
| | - Helen F K Chiu
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong, China
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15
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Xiang YT, Wong TS, Tsoh J, Ungvari GS, Correll CU, Sareen J, Penner-Goeke K, Ko FWS, Hui DSC, Chiu HFK. Quality of life in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a case-control study. Perspect Psychiatr Care 2015; 51:121-7. [PMID: 24890904 DOI: 10.1111/ppc.12073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 04/01/2014] [Accepted: 04/29/2014] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To date, there have been few studies examining quality of life (QOL) in older patients with chronic obstructive pulmonary disease (COPD) in China. The aim of the study was to assess QOL in Chinese older patients with COPD and explore its demographic and clinical correlates. DESIGN AND METHODS Case-control study of 142 outpatients with COPD and 218 matched control subjects without COPD. COPD patients were recruited from a prospective study sample hospitalized in Hong Kong for acute COPD exacerbation (≥ 2 major COPD symptoms or > 1 major + minor COPD symptoms for ≥ 2 consecutive days). Controls were recruited from social centers in Hong Kong. Activity of daily living was assessed with the Instrumental Activities of Daily Living Scale (IADL), life events were evaluated with the Life Event Scale, depressive disorders were diagnosed using the Geriatric Depression Scale (GDS), and QOL was measured using the Medical Outcomes Study Short Form-12 (SF-12) and St. George's Respiratory Questionnaire (SGRQ). FINDINGS Compared to controls, patients had significantly lower scores in the physical (PCS score), but not in the mental (MCS score) QOL domain. Multivariate analyses showed that more hospitalizations in the past year significantly contributed to higher PCS score (p = .03), while higher GDS total score contributed to lower MCS score (p = .003). Severe and very severe COPD, more physical illnesses, and higher IADL total score each independently contributed to higher SGRQ total score, explaining 40.0% of the variance (p < .001). PRACTICE IMPLICATIONS Our results suggest that therapeutic and psychosocial interventions alleviating depressive symptoms, severe COPD, comorbidities, and improving IADL in Chinese patients with COPD are likely of considerable benefit for improving QOL in patients with COPD.
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Affiliation(s)
- Yu-Tao Xiang
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China; Faculty of Health Sciences, University of Macau, Macao SAR, China
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16
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Wing YK, Lam SP, Zhang J, Leung E, Ho CL, Chen S, Cheung MK, Li SX, Chan JWY, Mok V, Tsoh J, Chan A, Ho CKW. Reduced striatal dopamine transmission in REM sleep behavior disorder comorbid with depression. Neurology 2015; 84:516-22. [PMID: 25568298 DOI: 10.1212/wnl.0000000000001215] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate dopamine transmission in patients with comorbid REM sleep behavior disorder (RBD) and major depressive disorder (MDD). METHODS This is a case-control study including 11 medicated patients with comorbid RBD and MDD (mean age 47.5 ± 8.2), 8 medicated patients with MDD only (mean age 47.9 ± 8.4), and 10 healthy participants (mean age 46.5 ± 10.6 years). They underwent clinical assessment, video-polysomnography, olfactory tests, and neuroimaging studies ((18)F-DOPA, (11)C-raclopride, and (18)F-FDG PET neuroimaging). RESULTS Compared with the 2 control groups, patients with comorbid RBD and MDD had significantly lower (18)F-DOPA uptake at 60 minutes in the putamen and caudate after controlling for age and sex effect (p < 0.05). There were no significant differences for the (11)C-raclopride and (18)F-FDG-PET. The (18)F-DOPA uptake in putamens had significant inverse correlation with severity of RBD symptoms (p < 0.01) and REM-related tonic muscle activity (p < 0.01). The comorbid RBD and MDD group had more impairment in olfactory function. CONCLUSION Patients with comorbid RBD and MDD had presynaptic dopamine dysfunction and impaired olfactory function. There is a distinct possibility that the development of RBD symptoms among patients with MDD may represent an early phase of α-synucleinopathy neurodegeneration instead of a merely antidepressant-induced condition.
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Affiliation(s)
- Yun Kwok Wing
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital.
| | - Siu Ping Lam
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Jihui Zhang
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Eric Leung
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Chi Lai Ho
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Sirong Chen
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Man Ki Cheung
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Shirley Xin Li
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Joey Wing Yan Chan
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Vincent Mok
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Joshua Tsoh
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Anne Chan
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
| | - Crover Kwok Wah Ho
- From the Department of Psychiatry (Y.K.W., S.P.L., J.Z., S.X.L., J.W.Y.C., J.T., C.K.W.H.) and the Department of Medicine and Therapeutics (V.M., A.C.), Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR; and Nuclear Medicine & PET (E.L., C.L.H., S.C., M.K.C.), Hong Kong Sanatorium & Hospital
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Wong TS, Xiang YT, Tsoh J, Ungvari GS, Ko FWS, Hui DSC, Chiu HFK. Depressive disorders in older patients with chronic obstructive pulmonary disease (COPD) in Hong Kong: a controlled study. Aging Ment Health 2014; 18:588-92. [PMID: 24261630 DOI: 10.1080/13607863.2013.856862] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE There have been few studies examining the relationship between chronic obstructive pulmonary disease (COPD) and psychiatric morbidity in Hong Kong. This study aimed to examine the prevalence of depressive disorders (major depression, dysthymia and adjustment disorder with depressed mood) in Chinese patients with COPD and explore their demographic and clinical correlates. METHOD A total of 146 patients aged 50 years and above with COPD and 220 age and gender matched control subjects without COPD formed the study sample. Data of demographic and clinical characteristics were collected by a form designed for this study. Activity of daily living was assessed by the Instrumental Activities of Daily Living Scale and life events were evaluated by the Life Event Scale. Depressive disorders were determined using the Chinese version of the Structured Clinical Interview for DSM-IV. RESULTS The point prevalence of DSM-IV depressive disorders in patients with COPD and controls were 15.1% and 3.6%, respectively. Multivariate analyses revealed that female sex and severe impairment in daily activity functioning were independently associated with depressive disorders. Only 22.7% of the depressed COPD patients had consulted psychiatrists in the past three months. CONCLUSION Depressive disorders are significantly higher in COPD patients than controls. The low percentage of depressed patients with COPD seeking psychiatric treatment suggests that there is an unmet need in the psychiatric care of COPD patients.
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Affiliation(s)
- Tak-Shun Wong
- a Department of Psychiatry , Chinese University of Hong Kong , Hong Kong , China
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18
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Xiang YT, Wong TS, Tsoh J, Ungvari GS, Correll CU, Ko FW, Hui DS, Chiu HF. Insomnia in Older Adults with Chronic Obstructive Pulmonary Disease (COPD) in Hong Kong: A Case-Control Study. COPD 2013; 11:319-24. [DOI: 10.3109/15412555.2013.858314] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lam SP, Li SX, Chan JW, Mok V, Tsoh J, Chan A, Yu MWM, Lau CY, Zhang J, Lam V, Ho CK, Wing YK. Does rapid eye movement sleep behavior disorder exist in psychiatric populations? A clinical and polysomnographic case-control study. Sleep Med 2012; 14:788-94. [PMID: 22841026 DOI: 10.1016/j.sleep.2012.05.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 05/18/2012] [Accepted: 05/23/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Rapid eye movement (REM) sleep behavior disorder (RBD) has been increasingly reported in patients with psychiatric disorders (pRBD). Although a close association with the usage of psychotropics has been postulated, it remains elusive whether psychotropics are the only causative factor of RBD symptoms in psychiatric populations. Moreover, there is limited literature documenting and quantifying the clinical and polysomnographic features in this population. METHODS A case-control study comparing the clinical and polysomnographic features of 31 pRBD patients with: (1) Age-, sex-, and psychiatric diagnoses-matched controls; and (2) Typical idiopathic RBD (tRBD) patients. RESULTS Despite being prescribed with similar psychotropics, pRBD patients had more dream-enacting behaviors (p<0.01), sleep-related injuries (p<0.01), and nightmares (p<0.01) than the psychiatric controls. pRBD patients were younger with more females, but they had comparable sleep-related injuries to tRBD. Both tRBD and pRBD had more REM-related muscle activity than controls (p<0.01) and the effect remained significant after adjusting for age, gender, and use of antidepressants. CONCLUSIONS Our study suggests that pRBD had comparable clinical features and consequences to those of tRBD. The occurrence of RBD symptoms in these patients may be related to a constellation of factors, including individual predisposition, depressive illness, antidepressants, and other clinical factors. Given the association of RBD and neurodegeneration in tRBD, further prospective follow-up of these patients is warranted.
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Affiliation(s)
- Siu-Ping Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
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Wing YK, Li SX, Mok V, Lam SP, Tsoh J, Chan A, Yu MWM, Lau CYK, Zhang J, Ho CKW. Prospective outcome of rapid eye movement sleep behaviour disorder: psychiatric disorders as a potential early marker of Parkinson's disease. J Neurol Neurosurg Psychiatry 2012; 83:470-2. [PMID: 22250185 DOI: 10.1136/jnnp-2011-301232] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Tong EK, Gildengorin G, Nguyen T, Tsoh J, Modayil M, Wong C, McPhee SJ. Smoking prevalence and factors associated with smoking status among Vietnamese in California. Nicotine Tob Res 2010; 12:613-21. [PMID: 20488931 PMCID: PMC2878729 DOI: 10.1093/ntr/ntq056] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 03/17/2010] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Vietnamese American men have smoking prevalence rates higher than the general population. We analyzed Vietnamese American smoking behavior by demographic and health-related factors, including some specific to Vietnamese, in the largest tobacco-specific survey yet targeting the Vietnamese population. METHODS Using a statewide surname probability sample and computer-assisted telephone interviewing, we surveyed 1,101 Vietnamese men and 1,078 Vietnamese women in California (63.5% participation among successfully contacted eligible individuals) in 2007-2008. We conducted multivariate regression models to analyze the association between Vietnamese male smoking status and demographic and health-related factors. RESULTS Among women, <1% were current smokers and <2% were former smokers. Among men, 25% were current and 24% were former smokers. Regression models for Vietnamese men delineated factors associated with both current and former smoking (vs. never smoking): being married, being employed, having lower educational attainment, and consuming alcohol. Other factors associated with current smoking (vs. never smoking) were having no health insurance, having seen a Vietnamese doctor or no doctor visit in the past year, having Vietnamese military or Vietnamese reeducation camp experience, having less knowledge about the harms of smoking, and reporting higher depression symptoms. Increasing age and not being Buddhist were associated with former (vs. never) smoking. DISCUSSION Smoking patterns of Vietnamese women and Vietnamese men are significantly different from the general California population. Tobacco control efforts targeting Vietnamese men should include community outreach since current smokers have low health care access, utilization, and knowledge.
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Affiliation(s)
- E K Tong
- Division of General Internal Medicine, University of California, Davis, Sacramento, CA 95817, USA.
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Li SX, Wing YK, Lam SP, Zhang J, Yu MWM, Ho CKW, Tsoh J, Mok V. Validation of a new REM sleep behavior disorder questionnaire (RBDQ-HK). Sleep Med 2009; 11:43-8. [PMID: 19945912 DOI: 10.1016/j.sleep.2009.06.008] [Citation(s) in RCA: 174] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 05/20/2009] [Accepted: 06/30/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES There are limited screening instruments for diagnosis of REM sleep behavior disorder (RBD) and none for quantifying the severity of disease. We aimed to validate a 13-item self-reported RBD questionnaire (RBDQ-HK) for diagnostic and monitoring purposes. METHODS Based on ICSD-II and our previous clinical and empirical work, the RBDQ-HK questionnaire was designed and administered in patients attending university-affiliated sleep clinic and psychiatric out-patient clinic, and subjects from the general population. ROC curve and exploratory factor analysis were employed to evaluate the scale, which had a score ranging from 0 to 100. RESULTS One hundred and seven RBD patients [mean age 62.6 (15.5) years; male 70.1%] and 107 control subjects [mean age 55.3 (9.0) years, male 57.9%] completed the questionnaire. The diagnoses of all the study subjects were independently ascertained by clinical interview and PSG. RBD patients had a significantly higher total RBDQ-HK score [mean (s.d.): 32.1 (16.1), range 3-71] than the control group [9.5 (10.2), range 0-55] (p<0.005). The RBDQ-HK demonstrated robust psychometric properties with moderate sensitivity (82.2%), specificity (86.9%), positive predictive value (PPV; 86.3%), and negative predictive value (NPV; 83.0%), high internal consistency and test-retest reliability. Exploratory factor analysis revealed two components (dream-related and behavioral factors) that corresponded to the essential clinical features of RBD. The best cut-off for total score (range 0-100) was at 18/19 and the best cut-off for factor 2 (behavioral factors including sleep talking, shouting, limb movements and sleep-related injuries, range 0-70) was at 7/8. CONCLUSIONS The RBDQ-HK has satisfactory validity and reliability as a measure of clinical RBD symptoms and severity. It may serve as an effective tool for diagnosis and evaluation of the disease course to facilitate future clinical and research studies.
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Affiliation(s)
- S X Li
- Department of Psychiatry, Sleep Assessment Unit, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, Hong Kong
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Affiliation(s)
- Helen Chiu
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong (CUHK)
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Zhang J, Lam SP, Ho CKW, Li AM, Tsoh J, Mok V, Wing YK. Diagnosis of REM sleep behavior disorder by video-polysomnographic study: is one night enough? Sleep 2008; 31:1179-85. [PMID: 18714790 PMCID: PMC2542964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
STUDY OBJECTIVES Clinical features of RBD were typically episodic with limited data on the night-to-night reliability of the diagnostic video-PSGs. We aimed to assess on whether a single night study was adequate. DESIGN Retrospective review. SETTING Sleep laboratory. PARTICIPANTS 55 RBD patients with at least 2 consecutive video-PSGs. INTERVENTIONS N/A. METHODS We analyzed 2 consecutive video-PSGs using REM-related EMG activity (REMREEA), REM sleep without atonia (RSWA), and video analysis of motor events. MEASUREMENTS AND RESULTS A weak first night effect with increased REM sleep latency, increased stage 1 sleep, and increased arousal index were found. No differences were found in phasic and tonic EMG activity scores between night 1 and night 2. The presence of OSAS, use of CPAP, and clonazepam treatment did not affect the night-to-night variability and diagnostic accuracy. The kappas were 0.64, 0.51, and 0.31 between night 1 and night 2 for 10% REMREEA, RSWA, and video analysis respectively. Over 80% of patients could be diagnosed by various criteria in the first night, but the diagnostic ability could be enhanced to nearly 95% when combining PSG with video analysis. While both of the EMG criteria as well as the combination criteria had good reliability, video-analysis had poorer night-to-night reliability. CONCLUSIONS A single night of video-PSG was adequate in the diagnosis of RBD in most clinical patients and the combination of PSG and video analysis could enhance the detection rate further. Our findings have important resource implications.
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Affiliation(s)
| | | | | | | | | | - Vincent Mok
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR
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Tsoh J, Chiu HFK, Duberstein PR, Chan SSM, Chi I, Yip PSF, Conwell Y. Attempted suicide in elderly Chinese persons: a multi-group, controlled study. Am J Geriatr Psychiatry 2005; 13:562-71. [PMID: 16009732 DOI: 10.1176/appi.ajgp.13.7.562] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Attempted suicide in later life is under-researched despite its public health significance. In this study, the authors delineated the characteristics of elderly suicide attempters in a representative Chinese sample by comparing them with suicide completers and comparison subjects age 65 years or over who were randomly selected from the community. METHODS There were 224 subjects in this study: 66 suicide attempters, 67 suicide completers, and 91 comparison subjects from the community. Using a case-control design and standardized measuring instruments, authors examined the risk and protective factors associated with attempted suicide, making direct comparisons with the community-comparison subjects and suicide completers. RESULTS A current diagnosis of major depression was associated with a nearly 60-fold increased risk for attempted suicide, and a population attributable risk (PAR) of 67%. Other risk factors included past suicide attempts, poorer function of self-care, arthritis, and specific personality dispositions, particularly low Conscientiousness. Co-residence with children decreased risk. Although the profiles of suicide attempters and completers were similar, they could be distinguished by suicide intent, recent life events (particularly hospitalization), functional competence, religious denomination, and personality characteristics. CONCLUSIONS A high degree of clinical vigilance and multidisciplinary collaboration are required in the management of elderly suicide attempters. The treatment of depression should form a crucial part of the prevention program. Features that distinguish suicide completers from suicide attempters may also carry implications for the secondary prevention of suicide in elderly persons.
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Affiliation(s)
- Joshua Tsoh
- Dept. of Psychiatry, Faculty of Medicine, The Chinese Univ. of Hong Kong, N.T., Hong Kong, China.
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Abstract
OBJECTIVE To examine some of the risk factors for late life suicide in Hong Kong Chinese using a case-controlled psychological autopsy approach. METHOD Informants of 70 subjects aged 60 or above who had committed suicide as well as a community sample of 100 elderly controls were interviewed. Subjects and controls were assessed for the presence of mental illness, history of suicide attempt and data on health care utilization. RESULTS Eighty-six per cent of suicide subjects suffered from a psychiatric problem before committing suicide, compared with 9% of control subjects. Among the psychiatric problems, major depression was the commonest diagnosis. Seventy-seven per cent of suicide subjects had consulted a doctor within 1 month of suicide. One-third of suicide subjects had a history of suicide attempt. Rates of current psychiatric diagnosis, rates of medical consultation and history of suicide attempt are all significantly higher in suicide subjects than controls. CONCLUSION Our findings support the view that depressive disorders and a past history of suicide attempt are risk factors of late-life suicide in the Chinese population of Hong Kong, similar to findings in western studies.
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Affiliation(s)
- H F K Chiu
- Department of Psychiatry, The Chinese University of Hong Kong, and Tai Po Hospital, Tai Po, Hong Kong, P.R. China.
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Bahk WM, Pae CU, Chae JH, Kim KS, Jun TY, Tsoh J, Kim DJ, Lee CT, Lee C, Han SI, Choi BM, Han JH, Go HJ. A naturalistic study of risperidone treatment in seven affiliated university hospitals in Korea. Psychiatry Clin Neurosci 2003; 57:83-9. [PMID: 12519459 DOI: 10.1046/j.1440-1819.2003.01083.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This retrospective naturalistic study, conducted on patients with schizophrenia, was undertaken to examine the differences in the clinical characteristics of subjects who were treated with risperidone, but who were discontinued soon after administration, and those who were maintained on the drug for a long-term period. Data on 210 of 580 inpatients with schizophrenia who were treated with risperidone and whose complete medical records were available, were analyzed. Patients maintained on risperidone for at least 2 years were assigned to a 'long-term maintenance' (LTM) group and those who were discontinued within 6 months of risperidone administration were assigned to an 'early drop-out' (ED) group. The parameters used for comparisons included the patients' demographic characteristics, the presence/absence of physical or psychiatric comorbidities, the severity of the psychopathology, the typology of the schizophrenia, the nature and subjects' responses to previous antipsychotic treatments (if any) and dosages of risperidone treatment. Of the 210 subjects, 67 (31.9%) belonged to the ED group, whereas 143 (68.1%) were maintained on risperidone at 2 years. There were no significant differences in the demographics, nor in the severity of the psychopathology, nor were there significant differences in the starting or maximal dosages of risperidone administered between the two groups. Exposure to any previous antipsychotic and the longest maintained final dosage of risperidone were significantly different in the two groups. We believed that a multicenter-based retrospective naturalistic study would provide useful information about the efficacy and other practical aspects of antipsychotic administration.
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Affiliation(s)
- Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, St Mary's Hospital, Seoul, Korea
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Abstract
This study was aimed at testing the efficacy and tolerability of mirtazapine in the treatment of Korean patients with chronic post-traumatic stress disorder (PTSD). Mirtazapine was administered for 8 weeks using a flexible-dose regime in 15 Korean patients with PTSD based on the DSM-IV criteria. We evaluated the patients at baseline and at weeks 4 and 8 after treatment with the interviewer-administered structured interview for PTSD (SIP), short PTSD rating interview (SPRINT), impact of event scale-revised (IES-R) and the Montgomery Asberg depression rating scale (MADRS). Scores on the SIP, SPRINT, IES-R and MADRS had significantly reduced after 8 weeks treatment. In this pilot study, mirtazapine was found to be effective and well tolerated in the treatment of patients with PTSD. This calls for further evaluation of the effect of this drug on subjects with PTSD with randomized placebo-controlled studies.
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Affiliation(s)
- Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, St Mary' Hospital, 62 Youido-Dong, Youngdeungpo-Gu, Seoul 150-713, Korea
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Abstract
Smoking is the primary preventable cause of mortality and morbidity in our society, killing more than 430,000 people each year--more than 1,000 a day. Despite this deadly record, the treatment of nicotine dependence has not been integrated into routine medical care. Although professionals from many healthcare fields can be effective providers of smoking cessation treatment, relatively few actually advise patients to quit smoking; and even fewer assist their patients in quitting. Systematic changes in healthcare policies are needed to rectify these problems and improve the provision of smoking cessation services. In this article, the issues of who should be providing cessation treatment, why more providers do not offer this service, and what changes should be made to ensure more widespread inclusion of smoking cessation treatment in future healthcare practice are examined.
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Affiliation(s)
- J B McClure
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, USA
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Skaar K, Tsoh J, Cinciripini P, Wetter D, Prokhorov A, Gritz E. Current approaches in smoking cessation. Curr Opin Oncol 1996; 8:434-40. [PMID: 8914811 DOI: 10.1097/00001622-199609000-00017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This review highlights the necessity of smoking cessation as a cornerstone of cancer prevention. We briefly review the literature linking smoking to various forms of cancer, the benefits of smoking cessation for cancer patients, and the Agency for Health Care Policy and Research Smoking Cessation Clinical Practice Guideline. Also provided is an update on controlled smoking cessation studies published between March 1995 and February 1996.
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Affiliation(s)
- K Skaar
- University of Texas, M.D. Anderson Cancer Center, Houston 77030, USA
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