A non-invasive hidden-goal test for spatial orientation deficit detection in subjects with suspected mild cognitive impairment

BACKGROUND

There is a need for highly sensitive and specific tests and biomarkers that would allow preclinical diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD), which would also enable timely intervention.

NEW METHOD

We have developed a new system (ALZENTIA) to help detect early MCI, mainly caused by AD. The system is based on a hidden-goal task (HGT) in which the human subject has to find a target that is not visible; as such, the navigation is based on a previously memorized target position, in relation to the starting position (egocentric variant) and/or other navigational landmarks (allocentric variant of the task). We present our preliminary results obtained in 33 patients with MCI and 91 healthy controls (HC).

RESULTS AND COMPARISON WITH EXISTING METHODS

Between-group differences in the average error measured in allocentric, egocentric, and combined allocentric-egocentric subtests were statistically significant in MCI compared to HC. The high negative predictive values suggested high discriminative capacity and diagnostic potential for the HGT test as a tool to detect subjects in healthy population who will progress to MCI. Considering the low sensitivity of the Mini-Mental Status Examination and Montreal Cognitive Assessment tests, we believe that HGT can improve early identification of MCI patients who will progress to AD.

CONCLUSION

The HGT carried out with the ALZENTIA system proved to be a reliable screening test to identify individuals with MCI from an aging cohort.

Oxidative status and the severity of clinical symptoms in patients with post-traumatic stress disorder

BACKGROUND

The aim of this study was to measure the parameters of oxidative stress in the blood of patients with post-traumatic stress disorder.

METHODS

The study included 80 male war veterans who participated actively in the Homeland war in Croatia. Volunteers were divided into two groups: 50 veterans diagnosed with post-traumatic stress disorder and 30 without diagnosis. The self-assessment Hospital Anxiety and Depression Scale and the Beck Depression Inventory were used to detect the severity of depression and anxiety in the post-traumatic stress disorder patients. Catalytic concentrations of superoxide dismutase and glutathione peroxidase in erythrocytes and the concentration of malondialdehyde in serum were measured spectrophotometrically.

RESULTS

Although the catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase were within the reference range for both groups, the values obtained for the post-traumatic stress disorder group were significantly lower (P<0.001). For serum malondialdehyde concentrations, no statistically significant differences between the groups were found.

CONCLUSIONS

Lower catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase in patients with post-traumatic stress disorder may indicate a weaker response to oxidative stress due to impaired enzyme activity and/or decreased synthesis. Conversely, no significant changes in serum malondialdehyde concentrations suggest a compensated balance and adaptive response to (oxidative) stress.

Eicosapentaenoic acid in serum lipids could be inversely correlated with severity of clinical symptomatology in Croatian war veterans with posttraumatic stress disorder

AIM

To explore the association between plasma fatty acids composition and the severity of clinical symptoms in Croatian war veterans with posttraumatic stress disorder (PTSD).

METHODS

This cross-sectional study included 62 men diagnosed with PTSD caused by combat activities during the War in Croatia 1991-1995. Clinician-Administered PTSD Scale (CAPS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D-17) were used. Plasma fatty acids composition was determined by gas chromatography. Data about life-style habits were collected by a structured interview. To evaluate the association between plasma fatty acid levels and PTSD severity scales, multivariate general linear models (GLM) were applied while controlling for different confounders.

RESULTS

Significant negative correlations were found between plasma eicosapentaenoic acid (EPA, 20:5n-3) level and the scores on psychological scales (τ = -0.326, P<0.001 for CAPS; τ-0.304, P =0 .001 for HAM-A; and τ = -0.345, P<0.001 for HAM-D-17). GLM confirmed that PTSD severity was affected by EPA (Wilks'Λ = 0.763-0.805, P = 0.006-0.018, ηp 0.195-0.237), arachidonic acid (AA)/EPA (Wilks'Λ = 0.699-0.757, P = 0.004, ηp 0.243-0.301), and dairy products consumption (Wilks'Λ = 0.760-0.791, P = 0.045-0.088, ηp 0.128-0.111). No other fatty acid or dietary/lifestyle variable was significant ( P = 0.362-0.633).

CONCLUSION

The study suggests that lower EPA levels are associated with the severity of clinical symptoms in PTSD.

Art therapy may be benefitial for reducing stress--related behaviours in people with dementia--case report

Communication with person with dementia (PWD) is becoming worse and worse during the course of illness, and at the end may be totally lost. Non-pharmacological interventions may be beneficial in increasing the behavioural disturbances which appears frequently during the progression of dementia, and combination of non-pharmacological techniques and drugs is usually more efficacy than psychopharmacs alone. Mr. Zvonko, the PWD diagnosed with Alzheimer's disease of moderate stage, is presented in this case report. Although Mr. Zvonko was treated with antidementia drugs, the behavioural disturbances were present. The introduction of low doses of conventional antipsychotic was accompanied with extrapiramidal side-effects, and atypical antipsychotics were not used due to the FDA warning and non-willingness of caregiver and family to take that risk. After his individual and family status was evaluated, he was advised to attend the daily care centre and to start with art therapy. Despite he was never drawing pictures before developing AD, everybody, including his wife who is also a caregiver, was surprised with his talent and creativity. While drawing the pictures he was calm and satisfied and his behaviour in the daily care centre, but also at home, became much more adequate. There was no need to add psychopharmacs for behavioural disturbances. In this case the art therapy was shown to be an excellent add-on non-pharmacological intervention, beneficial for reducing stress-related behaviours in PWD taking antidementia drugs.

A validation study of appropriate phonological verbal fluency stimulus letters for use with croatian speaking individuals

The aim of this study is to determine the word frequency for all thirty letters of the Croatian alphabet and to collect normative data for the letter fluency task in Croatian speakers. Ninety two healthy participants were given each of the Croatian letters, and asked to generate as many words as possible in 60 seconds for each letter Results suggested that participants generated most frequently words starting with the letters as follows: "K", "P", "S" and "M".