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Angelopoulou E, Kontaxopoulou D, Fragkiadaki S, Stanitsa E, Pavlou D, Papatriantafyllou J, Koros C, Dimovski V, Šemrov D, Papageorgiou SG. Perceptions of Patients, Caregivers, and Healthcare Professionals toward Telemedicine Use for Cognitive and Movement Disorders in the Aegean Islands, Greece: A Pilot Study of the SI4CARE European Project. Geriatrics (Basel) 2023; 9:3. [PMID: 38247978 PMCID: PMC10801565 DOI: 10.3390/geriatrics9010003] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Patients with neurodegenerative diseases who live in remote areas often have limited access to specialized healthcare, and telemedicine represents a useful solution. The aim of this study was to investigate the perceptions toward the use of a specialized-tertiary telemedicine service of patients with cognitive and movement disorders, caregivers, and local healthcare professionals (HPs) in the Aegean Islands. METHODS Data were derived from the "Specialized Outpatient Clinic of Memory, Dementia and Parkinson's disease through the National Telemedicine Network", March 2021-March 2023. The survey included 10 questions (5-point Likert scale). RESULTS We received 64 questionnaires (25 patients, 18 caregivers, 21 HPs). Most participants positively perceived all aspects of telemedicine, including comfort (mean ± standard deviation: patients 4.5 ± 0.9, caregivers: 4.8 ± 0.5, HPs: 4.6 ± 0.7), access to specialized care (4.7 ± 0.6, 4.7 ± 0.5, 4.9 ± 0.4), number of transportations (4.6 ± 0.8, 4.6 ± 0.9, 4.8 ± 0.5), adequacy of follow-up (4.6 ± 0.7, 4.4 ± 0.8, 4.2 ± 0.7), future telemedicine selection (4.8 ± 0.4, 4.8 ± 0.4, 4.6 ± 0.6), perceived reliable medical assessment (4.7 ± 0.5, 4.6 ± 0.6, 4.3 ± 0.6), information delivery (4.7 ± 0.6, 4.6 ± 0.5, 4.4 ± 0.9), health status improvement (4.6 ± 0.7, 4.6 ± 0.6, 4.0 ± 0.7), cost (4.6 ± 1, 4.6 ± 1, 5.0 ± 0.2), and general satisfaction (4.8 ± 0.4, 4.7 ± 0.5, 4.5 ± 0.6). The commonest recommendations were more frequent visits, medical specialties, and dissemination of information. CONCLUSIONS The positive perception of participants highlights the value of telemedicine for specialized healthcare for neurodegenerative disorders, especially in remote areas.
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Affiliation(s)
- Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Stella Fragkiadaki
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Evangelia Stanitsa
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Dimosthenis Pavlou
- School of Topography and Geoinformatics, University of West Attica, Ag. Spyridonos Str., 12243 Aigalew, Greece;
| | - John Papatriantafyllou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Christos Koros
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
| | - Vlado Dimovski
- School of Economics and Business, University of Ljubljana, Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Darja Šemrov
- Faculty of Civic and Geodetic Engineering, University of Ljubljana, Jamova Cesta 2, 1000 Ljubljana, Slovenia
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece; (D.K.); (S.F.); (E.S.); (J.P.); (C.K.); (S.G.P.)
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Fragkiadaki S, Kontaxopoulou D, Stanitsa E, Angelopoulou E, Pavlou D, Šemrov D, Colnar S, Lustrek M, Blažica B, Vučica I, Matković R, Vukojevic K, Jelicic A, Guzzi PH, Martinović V, Medina AP, Piccoli G, Menon M, Kozetinac S, Miljković M, Kiskini C, Kokorotsikos T, Zilidou V, Radević I, Papatriantafyllou J, Thireos E, Tsouros A, Dimovski V, Papageorgiou SG. How Well Did the Healthcare System Respond to the Healthcare Needs of Older People with and without Dementia during the COVID-19 Pandemic? The Perception of Healthcare Providers and Older People from the SI4CARE Project in the ADRION Region. Geriatrics (Basel) 2023; 8:geriatrics8010021. [PMID: 36826363 PMCID: PMC9957093 DOI: 10.3390/geriatrics8010021] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 12/20/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the older people with or without cognitive impairment and their caregivers in the Adrion/Ionian region. Data were collected through e-questionnaires regarding the adequacy of the healthcare system and were anonymously administered to older individuals and stakeholder providers in the following countries: Slovenia, Italy (Calabria), Croatia, Bosnia and Herzegovina, Greece, Montenegro, and Serbia. Overall, 722 older people and 267 healthcare stakeholders participated in the study. During the COVID-19 pandemic, both healthcare stakeholders and the older population claimed that the healthcare needs of the older people and their caregivers increased dramatically in all countries, especially in Italy (Calabria), Croatia and BiH. According to our results, countries from the Adrion/Ionian regions faced significant challenges to adjust to the special needs of the older people during the COVID-19 pandemic, which was possibly due to limited accessibility opportunities to healthcare facilities. These results highlight the need for the development of alternative ways of providing medical assistance and supervision when in-person care is not possible.
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Affiliation(s)
- Stella Fragkiadaki
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Evangelia Stanitsa
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dimosthenis Pavlou
- School of Topography and Geoinformatics, University of West Attica, Ag. Spyridonos Str., 12243 Aigalew, Greece
| | - Darja Šemrov
- Faculty of Civic and Geodetic Engineering, University of Ljubljana Jamova cesta 2, 1000 Ljubljana, Slovenia
| | - Simon Colnar
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Mitja Lustrek
- Department of Intelligent Systems, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Bojan Blažica
- Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Inga Vučica
- Department of Gerontology, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Roberta Matković
- Department for Research Data Collecting and Analysis, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Katarina Vukojevic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Ana Jelicic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Pietro Hiram Guzzi
- Municipality of Miglierina, Street B. Telesio 88040, Italy and University of Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Vlatka Martinović
- Faculty of Medicine, University Hospital Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Amina Pekmez Medina
- Health Insurance and Reinsurance Fund of Federation of Bosnia and Herzegovina, Trg Heroja 14, 71000 Sarajevo, Bosnia and Herzegovina
| | - Guido Piccoli
- ALOT, SI4CARE-TEAM Street Cipro, 16, 25124 Brescia, Italy
| | | | - Srdjan Kozetinac
- Special Hospital Merkur, Cara Dusana 3, 36210 Vrnjaka Banja, Serbia
| | | | - Chrysanthi Kiskini
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Themis Kokorotsikos
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Vasiliki Zilidou
- Lab of Medical Physics & Digital Innovation, and Thessaloniki Active & Healthy Ageing Living Lab, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ivan Radević
- Faculty of Economics, University of Montenegro, 37 Bulevar Jovana Tomaševića, 81000 Podgorica, Montenegro
| | - John Papatriantafyllou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Eleftherios Thireos
- National Health System, Athens Medical Society, Meandrou 23, 115 28 Athens, Greece
| | - Agis Tsouros
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Vlado Dimovski
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
- Correspondence:
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Sexton C, Solis M, Aharon-Peretz J, Alexopoulos P, Apostolova LG, Bayen E, Birkenhager B, Cappa S, Constantinidou F, Fortea J, Gerritsen DL, Hassanin HI, Ibanez A, Ioannidis P, Karageorgiou E, Korczyn A, Leroi I, Lichtwarck B, Logroscino G, Lynch C, Mecocci P, Molinuevo JL, Papatriantafyllou J, Papegeorgiou S, Politis A, Raman R, Ritchie K, Sanchez-Juan P, Sano M, Scarmeas N, Spiru L, Stathi A, Tsolaki M, Yener G, Zaganas I, Zygouris S, Carrillo M. Alzheimer's disease research progress in the Mediterranean region: The Alzheimer's Association International Conference Satellite Symposium. Alzheimers Dement 2022; 18:1957-1968. [PMID: 35184367 PMCID: PMC11066754 DOI: 10.1002/alz.12588] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 01/28/2023]
Abstract
As research and services in the Mediterranean region continue to increase, so do opportunities for global collaboration. To support such collaborations, the Alzheimer's Association was due to hold its seventh Alzheimer's Association International Conference Satellite Symposium in Athens, Greece in 2021. Due to the COVID-19 pandemic, the meeting was held virtually, which enabled attendees from around the world to hear about research efforts in Greece and the surrounding Mediterranean countries. Research updates spanned understanding the biology of, treatments for, and care of people with Alzheimer's disease (AD_ and other dementias. Researchers in the Mediterranean region have outlined the local epidemiology of AD and dementia, and have identified regional populations that may expedite genetic studies. Development of biomarkers is expected to aid early and accurate diagnosis. Numerous efforts have been made to develop culturally specific interventions to both reduce risk of dementia, and to improve quality of life for people living with dementia.
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Affiliation(s)
- Claire Sexton
- Alzheimer's Association, 225 N Michigan Avenue, 17th Fl, Chicago, Illinois, USA
| | | | | | - Panagiotis Alexopoulos
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | | | - Eléonore Bayen
- Laboratoire d'imagerie biomédicale, Sorbonne Université, department of physical rehabilitation medicine, Pitié-Salpêtrière hospital, AP-HP, Paris, France
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Betty Birkenhager
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Stefano Cappa
- University School for Advanced Studies (IUSS-Pavia) and IRCCS Mondino Foundation, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, PV, Italy
| | - Fofi Constantinidou
- Department of Psychology & Center for Applied Neuroscience, University of Cyprus, Nicosia, Cyprus
| | - Juan Fortea
- Sant Pau Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau - Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Hany I Hassanin
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
- Geriatric Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Agustin Ibanez
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
- Trinity College Dublin, Dublin, Ireland
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
- Universidad de San Andres & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | | | | | | | - Iracema Leroi
- Trinity College Dublin, Global Brain Health Institute, Dublin, Ireland
| | - Bjorn Lichtwarck
- The Centre for Age-related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain Department of Clinical Research in Neurology of the University of Bari at "Pia Fondazione Card G. Panico" Hospital Tricase (Le), Bari, Italy
- Department of Basic Medicine Neuroscience and Sense Organs University Aldo Moro Bari, Bari, Italy
| | - Chris Lynch
- Alzheimer's Disease International, London, UK
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
| | | | - John Papatriantafyllou
- Third Age Center IASIS, Athens-Glyfada, Athens, Greece
- 1st University Neurology Department, Eginitio Hospital, Athens, Greece
- Ana Aslan International Foundation
| | - Sokratis Papegeorgiou
- 1st University Neurology Department, Eginitio Hospital, Athens, Greece
- National and Kapodistrian University of Athens, Athens, Greece
| | - Antonis Politis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
| | - Rema Raman
- Alzheimer's Therapeutic Research Institute, University of Southern California, CA, USA
| | | | - Pascual Sanchez-Juan
- Institute for Research Marqués de Valdecilla (IDIVAL), CIBERNED, University of Cantabria and Department of Neurology, Marqués de Valdecilla University Hospital, Santander, Spain
| | - Mary Sano
- The Mount Sinai Hospital, New York, NY, USA
| | - Nikolas Scarmeas
- National and Kapodistrian University of Athens, Athens, Greece
- Columbia University, New York, NY, USA
| | - Luiza Spiru
- Carol Davila University of Medicine and Pharmacy Bucharest, Bucharest, Romania
- Ana Aslan International Foundation
| | - Afroditi Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Magda Tsolaki
- 1st Department of Neurology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Makedonia, Greece
| | - Görsev Yener
- Faculty of Medicine, Izmir University of Economics, Izmir, Turkey
| | - Ioannis Zaganas
- Neurogenetics Laboratory, Medical School, University of Crete
| | - Stelios Zygouris
- Centre for Research and Technology Hellas/ Information Technologies Institute, Thessaloniki, Greece
| | - Maria Carrillo
- Alzheimer's Association, 225 N Michigan Avenue, 17th Fl, Chicago, Illinois, USA
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Valotassiou V, Sifakis N, Tzavara C, Lykou E, Tsinia N, Kamtsadeli V, Sali D, Angelidis G, Psimadas D, Theodorou E, Tsougos I, Papageorgiou SG, Georgoulias P, Papatriantafyllou J. Anosognosia in Dementia: Evaluation of Perfusion Correlates Using 99mTc-HMPAO SPECT and Automated Brodmann Areas Analysis. Diagnostics (Basel) 2022; 12:diagnostics12051136. [PMID: 35626292 PMCID: PMC9140080 DOI: 10.3390/diagnostics12051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/28/2022] [Accepted: 05/01/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: Considerable inconsistency exists regarding the neural substrates of anosognosia in dementia in previous neuroimaging studies. The purpose of this study was the evaluation of anosognosia perfusion correlates across various types of dementia using automated Brodmann areas (BAs) analysis and comparison with a database of normal subjects. (2) Methods: We studied 72 patients: 32 with Alzheimer’s disease, 26 with frontotemporal dementia—FTD (12 behavioral FTD, 9 semantic FTD, 5 Progressive Non-Fluent Aphasia), 11 with corticobasal syndrome, and 3 with progressive supranuclear palsy. Addenbrook’s Cognitive Examination—Revised (ACE-R) mean(±SD) was 55.6(±22.8). For anosognosia measurement, the Anosognosia Questionnaire—Dementia was used. Total anosognosia score mean(±SD) was 22.1(±17.9), cognitive anosognosia score mean(±SD) was 18.1(±15.1) and behavioral–mood anosognosia score mean(±SD) was 3.3(±4.7). (3) Results: Higher anosognosia total score was associated with hypoperfusion in the inferior temporal, anterior cingulate, and inferior frontal cortices of the right hemisphere (BAs 20R, 24R, 32R, 45R). Higher anosognosia cognitive score was correlated with hypoperfusion in the left middle and anterior temporal cortices, and right dorsal anterior cingulate cortex (BAs 21L, 22L, 32R). No association was found with behavioral–mood anosognosia. (4) Conclusions: Automated analysis of brain perfusion Single Photon Emission Computed Tomography could be useful for the investigation of anosognosia neural correlates in dementia.
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Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
- Nuclear Medicine Department, Faculty of Medicine, University of Thessaly, Viopolis, 41500 Larissa, Greece
- Correspondence: or ; Tel.: +30-2413502916; Fax: +302413501851
| | - Nikolaos Sifakis
- Nuclear Medicine Department, “Alexandra” General Hospital, 11528 Athens, Greece;
| | - Chara Tzavara
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
| | - Evi Lykou
- 3rd Age Day Care Center, IASIS, 16562 Athens, Greece; (E.L.); (V.K.); (J.P.)
| | - Niki Tsinia
- 1st University Psychiatric Department, Aeginition Hospital, 11528 Athens, Greece;
| | - Vasiliki Kamtsadeli
- 3rd Age Day Care Center, IASIS, 16562 Athens, Greece; (E.L.); (V.K.); (J.P.)
| | - Dimitra Sali
- Neurology Department, Evrokliniki, 11521 Athens, Greece;
| | - George Angelidis
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
| | - Dimitrios Psimadas
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
| | - Eudoxia Theodorou
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
| | - Ioannis Tsougos
- Medical Physics Department, Faculty of Medicine, University of Thessaly, Viopolis, 41500 Larissa, Greece;
| | | | - Panagiotis Georgoulias
- Nuclear Medicine Department, University Hospital of Larissa, 41110 Larissa, Greece; (C.T.); (G.A.); (D.P.); (E.T.); (P.G.)
- Nuclear Medicine Department, Faculty of Medicine, University of Thessaly, Viopolis, 41500 Larissa, Greece
| | - John Papatriantafyllou
- 3rd Age Day Care Center, IASIS, 16562 Athens, Greece; (E.L.); (V.K.); (J.P.)
- Memory Disorders Clinic, Medical Center, 15125 Athens, Greece
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Valotassiou V, Sifakis N, Tzavara C, Lykou E, Tsinia N, Kamtsadeli V, Sali D, Angelidis G, Psimadas D, Tsougos I, Papageorgiou SG, Georgoulias P, Papatriantafyllou J. Differences of apathy perfusion correlates between Alzheimer's disease and frontotemporal dementia. A 99mTc-HMPAO SPECT study with automated Brodmann areas analysis. Int J Psychiatry Clin Pract 2022; 26:14-22. [PMID: 33207961 DOI: 10.1080/13651501.2020.1846752] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To explore differences of apathy perfusion correlates between Alzheimer's disease (AD) and Frontotemporal dementia (FTD) using perfusion SPECT. METHODS We studied 75 FTD and 66 AD patients. We evaluated apathy using Neuropsychiatric Inventory (NPI). We compared perfusion of BAs on left (L) and right (R) hemisphere in AD and FTD. RESULTS Apathy in AD was significantly and negatively correlated with dorsolateral prefrontal cortex bilaterally, right anterior prefrontal cortex, inferior frontal cortex bilaterally, especially on the right, orbital part of inferior frontal gyrus bilaterally, left dorsal anterior cingulate cortex, right primary and secondary visual cortex, and with bilateral anterior and dorsolateral prefrontal cortex, inferior frontal cortex and orbital part of inferior frontal gyrus, bilaterally, bilateral anterior -ventral and dorsal- cingulate cortex, left posterior ventral cingulate cortex, right inferior, middle and anterior temporal gyri, entorhinal and parahippocampal cortex in FTD. CONCLUSIONS Significant overlapping of apathy perfusion correlates between AD and FTD is seen in frontal areas and anterior cingulate. Right occipital cortex is also involved in AD, while right temporal cortex and left posterior cingulate are involved in FTD. Nuclear imaging could be a useful biomarker for revealing apathy underlying mechanisms, resulting in directed treatments.KEYPOINTSUnderlying neural networks and clinical manifestation of apathy may differ between AD and FTD.Apathy in AD is correlated with hypoperfusion in bilateral frontal areas, more prominent on the right, left anterior cingulate and right occipital cortex.Apathy in FTD is correlated with hypoperfusion in bilateral frontal areas, bilateral anterior cingulate, left posterior cingulate and right temporal cortex.Brain perfusion SPECT with automated BAs analysis and comparison with normal healthy subjects may provide significant information for apathy mechanisms in neurodegenerative disorders, affecting patients' treatment.
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Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Nikolaos Sifakis
- Nuclear Medicine Department, "Alexandra" General Hospital, Athens, Greece
| | - Chara Tzavara
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Evi Lykou
- 3rd Age Day Care Center, IASIS, Athens, Greece
| | - Niki Tsinia
- 1st University Psychiatric Department, Aeginition Hospital, Athens, Greece
| | | | - Dimitra Sali
- Neurology Department, Evrokliniki, Athens, Greece
| | - George Angelidis
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Dimitrios Psimadas
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Ioannis Tsougos
- Medical Physics Department, Medical School, University of Thessaly, Thessaly, Greece
| | | | | | - John Papatriantafyllou
- 3rd Age Day Care Center, IASIS, Athens, Greece.,Memory Disorders Clinic, Medical Center, Athens, Greece
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Dimitriou T, Papatriantafyllou J, Konsta A, Kazis D, Athanasiadis L, Ioannidis P, Koutsouraki E, Tegos T, Tsolaki M. Non-Pharmacological Interventions for Wandering/Aberrant Motor Behaviour in Patients with Dementia. Brain Sci 2022; 12:brainsci12020130. [PMID: 35203894 PMCID: PMC8869749 DOI: 10.3390/brainsci12020130] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Aberrant motor behaviour or wandering refers to aimless movement without a specific purpose. Wandering is common in patients with dementia and leads to early institutionalization and caregivers’ burden. Non-pharmacological interventions should be also considered as a first-line solution for the wandering because current pharmacological treatment has serious side-effects. Methods: A cross-over randomised controlled trial (RCT) with 60 participants of all stages and different types of dementia was conducted in Greece. The sample was randomly assigned in 6 different groups of 10 participants each. Every intervention lasted for 5 days, and there were 2 days as a wash-out period. There was no drop-out rate. The measurements used were the Mini Mental State Examination (MMSE), Addenbrooke’s Cognitive Examination Revised (ACE-R), Geriatric Depression Scale (GDS), Functional Rating Scale for Symptoms in Dementia (FRSSD), and Neuropsychiatric Inventory (NPI). The interventions that were evaluated were reminiscence therapy (RT), music therapy (MT), and physical exercise (PE). Results: NPI scores were reduced in the group receiving PE (p = 0.006). When MT (p = 0.018) follows PE, wandering symptoms are reduced further. RT should follow MT in order to reduce wandering more (p = 0.034). The same combination was effective for the caregivers’ burden as well; PE (p = 0.004), MT (p = 0.036), RT (p = 0.039). Conclusions: An effective combination that can reduce wandering symptoms in all stages and types of dementia was found: The best order was PH-MT-RT. The same combination in the same order reduced caregivers’ burden.
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Affiliation(s)
- Tatiana Dimitriou
- 1st Department of Neurology, Aristotle University of Thessaloniki, 44 Salaminos Street, Halandri, 15232 Athens, Greece
- Correspondence: ; Tel.: +30-6978-113357
| | - John Papatriantafyllou
- 3rd Age Center IASIS, 2nd Neurology Department, University of Athens, ‘Attikon’ Hospital, 73 Krimeas str., Glyfada, 16562 Athens, Greece;
| | - Anastasia Konsta
- 1st Department of Psychiatry, “Papageorgiou” General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (L.A.)
| | - Dimitrios Kazis
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Loukas Athanasiadis
- 1st Department of Psychiatry, “Papageorgiou” General Hospital of Thessaloniki, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (A.K.); (L.A.)
| | - Panagiotis Ioannidis
- 2nd Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Efrosini Koutsouraki
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Thomas Tegos
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
| | - Magda Tsolaki
- 3rd Neurology Department, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.K.); (E.K.); (T.T.); (M.T.)
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Valotassiou V, Sifakis N, Tzavara C, Lykou E, Tsinia N, Kamtsadeli V, Sali D, Angelidis G, Psimadas D, Tsougos I, Papageorgiou SG, Georgoulias P, Papatriantafyllou J. Correlation of Neuropsychiatric Symptoms in Dementia with Brain Perfusion: A 99mTc-SPECT-HMPAO Study with Brodmann Areas Analysis. Curr Alzheimer Res 2021; 18:970-983. [PMID: 34931963 DOI: 10.2174/1567205019666211220130505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPSs) are common in dementia. Their evaluation is based on Neuropsychiatric Inventory (NPI). Neuroimaging studies have tried to elucidate the underlying neural circuits either in isolated NPSs or in specific forms of dementia. OBJECTIVE The objective of this study is to evaluate the correlation of NPS in the NPI with Brodmann areas (BAs) perfusion, for revealing BAs involved in the pathogenesis of NPSs in dementia of various etiologies. METHOD We studied 201 patients (82 with Alzheimer's disease, 75 with Frontotemporal dementia, 27 with Corticobasal Syndrome, 17 with Parkinson Disease/Lewy Body Dementia). Exploratory factor analysis was carried out to evaluate underlying groups of BAs, and Principal Component analysis was chosen as extraction method using Varimax rotation. Partial correlation coefficients were computed to explore the association of factors obtained from analysis and NPI items controlling for age, educational yeas, and ACE-R. RESULTS We found 6 BAs Factors(F); F1 (BAs 8,9,10,11,24,32,44,45,46,47, bilaterally), F2 (Bas 4,5,6,7,23,31, bilaterally), F3 (BAs 19,21,22,37,39,40, bilaterally), F4 (BAs 20,28,36,38, bilaterally), F5 (BAs 25, bilaterally) and F6 (BAs 17,18, bilaterally). Significant and negative correlation was found between NPI1 (delusions) and F3,F6, NPI2 (hallucinations) and F6, NPI7 (apathy) and F1,F4,F5, NPI3 (agitation) - NPI10 (aberrant motor behavior) - NPI12 (eating disorders) and F1. We did not find any significant correlation for NPI4,5,6,8,9,11 (depression, anxiety, euphoria, disinhibition, irritability, sleep disorders, respectively). CONCLUSION Several NPSs share the same BAs among different types of dementia, while the manifestation of the rest may be attributed to different neural networks. These findings may have an impact on patients' treatment.
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Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Nikolaos Sifakis
- Nuclear Medicine Department, "Alexandra" General Hospital, Athens, Greece
| | - Chara Tzavara
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Evi Lykou
- 3rd Age Day Care Center, IASIS, Athens, Greece
| | - Niki Tsinia
- 1st University Psychiatric Department, Aeginition Hospital, Athens, Greece
| | | | - Dimitra Sali
- Neurology Department, Evrokliniki, Athens, Greece
| | - George Angelidis
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Dimitrios Psimadas
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Ioannis Tsougos
- Medical Physics Department, Medical School, University of Thessaly, Greece
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Stanitsa E, Economou A, Beratis I, Kontaxopoulou D, Fragkiadaki S, Papastefanopoulou V, Pavlou D, Papantoniou P, Kroupis C, Papatriantafyllou J, Stefanis L, Yannis G, Papageorgiou SG. Effect of Apolipoprotein E4 on the Driving Behavior of Patients with Amnestic Mild Cognitive Impairment or Mild Alzheimer's Disease Dementia. J Alzheimers Dis 2021; 84:1005-1014. [PMID: 34602476 DOI: 10.3233/jad-210622] [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: 11/15/2022]
Abstract
BACKGROUND The driving behavior of patients with mild Alzheimer's disease dementia (ADD) and patients with mild cognitive impairment (MCI) is frequently characterized by errors. A genetic factor affecting cognition is apolipoprotein E4 (APOE4), with carriers of APOE4 showing greater episodic memory impairment than non-carriers. However, differences in the driving performance of the two groups have not been investigated. OBJECTIVE To compare driving performance in APOE4 carriers and matched non-carriers. METHODS Fourteen APOE4 carriers and 14 non-carriers with amnestic MCI or mild ADD underwent detailed medical and neuropsychological assessment and participated in a driving simulation experiment, involving driving in moderate and high traffic volume in a rural environment. Driving measures were speed, lateral position, headway distance and their SDs, and reaction time. APOE was genotyped through plasma samples. RESULTS Mixed two-way ANOVAs examining traffic volume and APOE4 status showed a significant effect of traffic volume on all driving variables, but a significant effect of APOE4 on speed variability only. APOE4 carriers were less variable in their speed than non-carriers; this remained significant after a Bonferroni correction. To further examine variability in the driving performance, coefficients of variation (COV) were computed. Larger headway distance COV and smaller lateral position COV were observed in high compared to moderate traffic. APOE4 carriers had smaller speed COV compared to non-carriers. CONCLUSION The lower speed variability of APOE4 carriers in the absence of neuropsychological test differences indicates reduced speed adaptations, possibly as a compensatory strategy. Simulated driving may be a sensitive method for detecting performance differences in the absence of cognitive differences.
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Affiliation(s)
- Evangelia Stanitsa
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Alexandra Economou
- Department of Psychology, National and Kapodistrian University of Athens, Athens, Greece
| | - Ion Beratis
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Stella Fragkiadaki
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Vicky Papastefanopoulou
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimosthenis Pavlou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Panagiotis Papantoniou
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Christos Kroupis
- Department of Clinical Biochemistry, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - John Papatriantafyllou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginiteio University Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - George Yannis
- Department of Transportation Planning and Engineering, School of Civil Engineering, National Technical University of Athens, Athens, Greece
| | - Sokratis G Papageorgiou
- 1st Department of Neurology, Memory, Cognitive Disorders and Rare Dementias Outpatient Unit, Eginition University Hospital, Athens, Greece
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Valotassiou V, Sifakis N, Tzavara C, Lykou E, Tsinia N, Kamtsadeli V, Sali D, Angelidis G, Psimadas D, Tsougos I, Papageorgiou SG, Georgoulias P, Papatriantafyllou J. Eating Disorders in Frontotemporal Dementia and Alzheimer's Disease: Evaluation of Brain Perfusion Correlates Using 99mTc-HMPAO SPECT with Brodmann Areas Analysis. J Alzheimers Dis 2021; 80:1657-1667. [PMID: 33720894 DOI: 10.3233/jad-201434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/15/2022]
Abstract
BACKGROUND Eating disorders (ED) in dementia represent a significant impairment affecting patients' and caregivers' lives. In frontotemporal dementia (FTD), ED include overeating, sweet food preference, stereotypical eating, and hyperorality, while in Alzheimer's disease (AD), anorexia and appetite loss are the most common ED. OBJECTIVE The aim of our study was to highlight Brodmann areas (BAs) implicated specifically in the appearance of ED in FTD and AD. METHODS We studied 141 patients, 75 with FTD and 66 with AD. We used the NeuroGamTM software on the reconstructed single photon emission computed tomography-SPECT data for the automated comparison of BAs perfusion on the left (L) and right (R) hemisphere with perfusion in corresponding BAs of a normal database. RESULTS The FTD group included 27 men and 48 women, age (mean±SD) 65.8±8.5 years, duration of disease 3.4±3.3 years, Mini-Mental State Examination (MMSE) 17.9±8.6, ED score on Neuropsychiatric Inventory (NPI) 4.7±8.5. ED in FTD were correlated with hypoperfusion in right anterior and dorsolateral prefrontal cortices (BAs 10R, 46R), left orbitofrontal cortex (BA 12L), orbital part of the right inferior frontal gyrus (BA 47R), and left parahippocampal gyrus (BA 36L). The AD group included 21 men and 45 women, age (mean±SD) 70.2±8.0 years, duration of disease 3.3±2.4 years, MMSE 20.2±6, ED-NPI score 2.7±3.9. ED in AD were correlated with hypoperfusion in left inferior temporal cortex (BA 20L). CONCLUSION SPECT imaging with automated mapping of brain cortex could contribute to the understanding of the neural networks involved in the manifestation of ED in dementia.
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Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Nikolaos Sifakis
- Nuclear Medicine Department, "Alexandra" General Hospital, Athens, Greece
| | - Chara Tzavara
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Evi Lykou
- 3rd Age Day Care Center, IASIS, Athens, Greece
| | - Niki Tsinia
- 1st University Psychiatric Department, Aeginition Hospital, Athens, Greece
| | | | - Dimitra Sali
- Neurology Department, Evrokliniki, Athens, Greece
| | - George Angelidis
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Dimitrios Psimadas
- Nuclear Medicine Department, University Hospital of Larissa, Thessaly, Greece
| | - Ioannis Tsougos
- Medical Physics Department, Medical School, University of Thessaly, Greece
| | | | | | - John Papatriantafyllou
- 3rd Age Day Care Center, IASIS, Athens, Greece.,Memory Disorders Clinic, Medical Center, Athens, Greece
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Dimitriou TD, Verykouki E, Papatriantafyllou J, Konsta A, Kazis D, Tsolaki M. Non-Pharmacological interventions for the anxiety in patients with dementia. A cross-over randomised controlled trial. Behav Brain Res 2020; 390:112617. [PMID: 32428636 DOI: 10.1016/j.bbr.2020.112617] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Behavioural and Psychiatric Symptoms in dementia (BPSD) tend to be a crucial and big problem in dementia. Anxiety several times remains under-diagnosed because it is often considered to be a psychological response to cognitive decline. As only the 10 % of patients were correctly treated, the pharmacological treatment should be well- considered. The aim of this study was to evaluate three non-pharmacological interventions for the treatment of anxiety in dementia. METHODS A cross-over randomised controlled trial with 60 participants (different types and stages of dementia) conducted in Greece. The sample was randomly assigned to 6 different groups of 10 participants each. The non-pharmacological interventions that have been evaluated are: a) Music Therapy b) Exercise and c) Aromatherapy & Massage. The measurements that were used are: MMSE, ACE-R, GDS, FRSSD and NPI questionnaire. The interventions lasted 5 days and there was two days off as a wash-out period. There was no drop-out rate. RESULTS The study showed that the most effective intervention is Music therapy. The second most effective intervention is Exercise and the third one is Aromatherapy and Massage. In the parenthesis p results indicate that Music Therapy's p is less than 0.05 in comparison with Exercise and Aromatherapy and Massage and therefore the sequence of the interventions does not interfere with the results. (p = <0.05, p = 0.55, accordingly). Caregivers' burden also reduced with MT. In the parenthesis p results indicate Music Therapy's p is less than 0.05 in comparison with the two other interventions and therefore the sequence of the interventions does not interfere with the results, as well (p = <0.05, p = 0.19). CONCLUSIONS Our results are in accordance with the current literature. Music Therapy is a promising alternative intervention for the treatment of anxiety in PwD. Music Therapy is an effective non-pharmacological treatment for the reduction of the caregivers' burden, because of the anxiety symptoms in PwD, such as lack of sleep, lack of personal time, unhealthy lifestyle, lack of solutions on what to do with their patients etc. The type of music, the duration of the intervention and the long-term benefits remain unclear. There is a big need of further research with stronger possible evaluation methods.
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Affiliation(s)
| | - Eleni Verykouki
- Department of Hygiene, Social Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, University Campus, 54124, Thessaloniki, Makedonia, Greece.
| | - John Papatriantafyllou
- 3rd Age Center IASIS, 2nd Neurology Dpt., University of Athens, 'Attikon' Hospital, 73 Krimeas Str., Glyfada, Athens, Greece.
| | - Anastasia Konsta
- 1st Department of Psychiatry, "Papageorgiou" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Greece.
| | - Dimitrios Kazis
- 3rd Neurology Department, Aristotle University of Thessaloníki, Greece.
| | - Magda Tsolaki
- 1st Department of Neurology, Aristotle University of Thessaloniki, Makedonia, 3 Despere Street, Thessaloniki, Greece.
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Valotassiou V, Malamitsi J, Papatriantafyllou J, Dardiotis E, Tsougos I, Psimadas D, Alexiou S, Hadjigeorgiou G, Georgoulias P. SPECT and PET imaging in Alzheimer’s disease. Ann Nucl Med 2018; 32:583-593. [PMID: 30128693 DOI: 10.1007/s12149-018-1292-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 08/14/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Varvara Valotassiou
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece.
| | - Julia Malamitsi
- Medical Physics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Ioannis Tsougos
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - Dimitrios Psimadas
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - Sotiria Alexiou
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
| | - George Hadjigeorgiou
- Neurology Department, University Hospital of Larissa, Thessaly, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Greece
| | - Panagiotis Georgoulias
- Nuclear Medicine Department, University Hospital of Larissa, Mezourlo, 41110, Larissa, Thessaly, Greece
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Dimitriou TD, Verykouki E, Papatriantafyllou J, Konsta A, Kazis D, Tsolaki M. Non-pharmacological interventions for agitation/aggressive behaviour in patients with dementia: a randomized controlled crossover trial. Funct Neurol 2018; 33:143-147. [PMID: 30457967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Agitation/aggressive behaviour is a common behavioural and psychological symptom in people with dementia (PwD), occurring with a frequency of between 13-50.4% according to recent studies, and the rate increases as the severity of cognitive decline increases. The burden on caregivers is considerable. This trial is a randomized controlled crossover trial conducted in Greece. The following measures were used: the Mini-Mental State Examination, Addenbrooke's Cognitive Examination Revised, Geriatric Depression Scale, Functional Rating Scale for Symptoms in Dementia and Neuropsychiatric Inventory. According to the results the most effective nonpharmacological intervention for reducing agitation/aggressive behaviour in PwD was music therapy, followed by aromatherapy and massage, and finally physical exercise.
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Beratis IN, Andronas N, Kontaxopoulou D, Fragkiadaki S, Pavlou D, Papatriantafyllou J, Economou A, Yannis G, Papageorgiou SG. Driving in mild cognitive impairment: The role of depressive symptoms. Traffic Inj Prev 2017; 18:470-476. [PMID: 27936937 DOI: 10.1080/15389588.2016.1265648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 11/22/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVES Previous studies indicate a negative association between depression and driving fitness in the general population. Our goal was to cover a gap in the literature and to explore the link between depressive symptoms and driving behavior in individuals with mild cognitive impairment (MCI) through the use of a driving simulator experiment. METHODS Twenty-four individuals with MCI (mean age = 67.42, SD = 7.13) and 23 cognitively healthy individuals (mean age = 65.13, SD = 7.21) were introduced in the study. A valid driving license and regular car use served as main inclusion criteria. Data collection included a neurological/neuropsychological assessment and a driving simulator evaluation. Depressive symptomatology was assessed with the Patient Health Questionnaire (PHQ-9). RESULTS Significant interaction effects indicating a greater negative impact of depressive symptoms in drivers with MCI than in cognitively healthy drivers were observed in the case of various driving indexes, namely, average speed, accident risk, side bar hits, headway distance, headway distance variation, and lateral position variation. The associations between depressive symptoms and driving behavior remained significant after controlling for daytime sleepiness and cognition. CONCLUSIONS Depressive symptoms could be a factor explaining why certain patients with MCI present altered driving skills. Therefore, interventions for treating the depressive symptoms of individuals with MCI could prove to be beneficial regarding their driving performance.
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Affiliation(s)
- Ion N Beratis
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Nikos Andronas
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Dionysia Kontaxopoulou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Stella Fragkiadaki
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Dimosthenis Pavlou
- b Department of Transportation Planning and Engineering , School of Civil Engineering, National Technical University of Athens , Zografou , Athens , Greece
| | - John Papatriantafyllou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
| | - Alexandra Economou
- c Department of Psychology , National and Kapodistrian University of Athens , Panepistimiopolis, Ilissia, Athens , Greece
| | - George Yannis
- b Department of Transportation Planning and Engineering , School of Civil Engineering, National Technical University of Athens , Zografou , Athens , Greece
| | - Sokratis G Papageorgiou
- a Cognitive Disorders/Dementia Unit, 2nd Department of Neurology , National and Kapodistrian University of Athens, "Attikon" University General Hospital , Athens , Greece
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Karpathiou N, Kambanaros M, Papatriantafyllou J, Potamianou D, Kartsaklis L, Sakka P. Spelling in a case of logopenic variant of primary progressive aphasia. Front Hum Neurosci 2017. [DOI: 10.3389/conf.fnhum.2017.223.00006] [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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Valotassiou V, Papatriantafyllou J, Sifakis N, Tzavara C, Tsougos I, Psimadas D, Fezoulidis I, Kapsalaki E, Hadjigeorgiou G, Georgoulias P. Clinical Evaluation of Brain Perfusion SPECT with Brodmann Areas Mapping in Early Diagnosis of Alzheimer's Disease. J Alzheimers Dis 2016; 47:773-85. [PMID: 26401711 DOI: 10.3233/jad-150068] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 11/15/2022]
Abstract
Early diagnosis of Alzheimer's disease (AD) based on clinical criteria alone may be problematic, while current and future treatments should be administered earlier in order to be more effective. Thus, various disease biomarkers could be used for early detection of AD. We evaluated brain perfusion with 99mTc-HMPAO single photon emission computed tomography (SPECT) and Brodmann areas (BAs) mapping in mild AD using an automated software (NeuroGam) for the semi-quantitative evaluation of perfusion in BAs and the comparison with the software's normal database. We studied 34 consecutive patients with mild AD: 9 men, 25 women, mean age 70.9 ± 8.1 years, mean Mini-Mental State Examination 22.6 ± 2.5. BAs 25L, 25R, 38L, 38R, 28L, 28R, 36L, and 36R had the lower mean perfusion values, while BAs 31L, 31R, 19R, 18L, 18R, 17L, and 17R had the higher mean values. Compared with healthy subjects of the same age, perfusion values in BAs 25L, 25R, 28R, 28L, 36L, and 36R had the greatest deviations from the healthy sample, while the lowest deviations were found in BAs 32L, 32R, 19R, 24L, 17L, 17R, 18L, and 18R. A percentage of ≥94% of patients had perfusion values more than -2SDs below the mean of healthy subjects in BAs 38R, 38L, 36L, 36R, 23L, 23R, 22L, 44L, 28L, 28R, 25L, and 25R. The corresponding proportion was less than 38% for BAs 11L, 19R, 32L, 32R, 18L, 18R, 24L, and 17R. In conclusion, brain SPECT studies with automated perfusion mapping could be useful as an ancillary tool in daily practice, revealing perfusion impairments in early AD.
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Affiliation(s)
- Varvara Valotassiou
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - John Papatriantafyllou
- Memory & Cognitive Disorders Clinic, Department of Neurology, "G.Gennimatas" Hospital, Athens, Greece
| | - Nikolaos Sifakis
- Department of Nuclear Medicine, "Alexandra" University Hospital, Athens, Greece
| | - Chara Tzavara
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Tsougos
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Dimitrios Psimadas
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Ioannis Fezoulidis
- Department of Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Eftychia Kapsalaki
- Department of Radiology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - George Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Panagiotis Georgoulias
- Department of Nuclear Medicine, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
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Bamidis PD, Fissler P, Papageorgiou SG, Zilidou V, Konstantinidis EI, Billis AS, Romanopoulou E, Karagianni M, Beratis I, Tsapanou A, Tsilikopoulou G, Grigoriadou E, Ladas A, Kyrillidou A, Tsolaki A, Frantzidis C, Sidiropoulos E, Siountas A, Matsi S, Papatriantafyllou J, Margioti E, Nika A, Schlee W, Elbert T, Tsolaki M, Vivas AB, Kolassa IT. Gains in cognition through combined cognitive and physical training: the role of training dosage and severity of neurocognitive disorder. Front Aging Neurosci 2015; 7:152. [PMID: 26300772 PMCID: PMC4528297 DOI: 10.3389/fnagi.2015.00152] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/24/2015] [Indexed: 01/06/2023] Open
Abstract
Physical as well as cognitive training interventions improve specific cognitive functions but effects barely generalize on global cognition. Combined physical and cognitive training may overcome this shortcoming as physical training may facilitate the neuroplastic potential which, in turn, may be guided by cognitive training. This study aimed at investigating the benefits of combined training on global cognition while assessing the effect of training dosage and exploring the role of several potential effect modifiers. In this multi-center study, 322 older adults with or without neurocognitive disorders (NCDs) were allocated to a computerized, game-based, combined physical and cognitive training group (n = 237) or a passive control group (n = 85). Training group participants were allocated to different training dosages ranging from 24 to 110 potential sessions. In a pre-post-test design, global cognition was assessed by averaging standardized performance in working memory, episodic memory and executive function tests. The intervention group increased in global cognition compared to the control group, p = 0.002, Cohen’s d = 0.31. Exploratory analysis revealed a trend for less benefits in participants with more severe NCD, p = 0.08 (cognitively healthy: d = 0.54; mild cognitive impairment: d = 0.19; dementia: d = 0.04). In participants without dementia, we found a dose-response effect of the potential number and of the completed number of training sessions on global cognition, p = 0.008 and p = 0.04, respectively. The results indicate that combined physical and cognitive training improves global cognition in a dose-responsive manner but these benefits may be less pronounced in older adults with more severe NCD. The long-lasting impact of combined training on the incidence and trajectory of NCDs in relation to its severity should be assessed in future long-term trials.
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Affiliation(s)
- Panagiotis D Bamidis
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Patrick Fissler
- Institute of Psychology and Pedagogy, Clinical and Biological Psychology, Ulm University, Ulm Germany
| | - Sokratis G Papageorgiou
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Vasiliki Zilidou
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Evdokimos I Konstantinidis
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Antonis S Billis
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Evangelia Romanopoulou
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Maria Karagianni
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece ; Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | - Ion Beratis
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Angeliki Tsapanou
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Georgia Tsilikopoulou
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Eirini Grigoriadou
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece ; Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | - Aristea Ladas
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece ; Cognitive Psychology and Neuropsychology Lab, Department of Psychology, City College, The University of Sheffield International Faculty, Thessaloniki Greece
| | - Athina Kyrillidou
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece ; Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | - Anthoula Tsolaki
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece ; Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki Greece
| | - Christos Frantzidis
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Efstathios Sidiropoulos
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Anastasios Siountas
- Laboratory of Medical Physics, Faculty of Health Sciences, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Stavroula Matsi
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - John Papatriantafyllou
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Eleni Margioti
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Aspasia Nika
- Behavioral Neurology and Neuropsychology Unit, 1st and 2nd Department of Neurology, Medical School, National Kapodistrian University of Athens Athens, Greece
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | - Thomas Elbert
- Clinical Psychology and Clinical Neuropsychology, University of Konstanz Konstanz, Germany
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki Greece ; 3rd Department of Neurology, Medical School, Aristotle University of Thessaloniki Thessaloniki, Greece
| | - Ana B Vivas
- Cognitive Psychology and Neuropsychology Lab, Department of Psychology, City College, The University of Sheffield International Faculty, Thessaloniki Greece
| | - Iris-Tatjana Kolassa
- Institute of Psychology and Pedagogy, Clinical and Biological Psychology, Ulm University, Ulm Germany
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Valotassiou V, Papatriantafyllou J, Sifakis N, Tzavara C, Tsougos I, Psimadas D, Kapsalaki E, Fezoulidis I, Hadjigeorgiou G, Georgoulias P. Brain Perfusion SPECT with Brodmann Areas Analysis in Differentiating Frontotemporal Dementia Subtypes. Curr Alzheimer Res 2014; 11:941-54. [DOI: 10.2174/1567205011666141107125104] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 07/29/2014] [Accepted: 08/16/2014] [Indexed: 11/22/2022]
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Dalagdi A, Arvaniti A, Papatriantafyllou J, Xenitidis K, Samakouri M, Livaditis M. Psychosocial support and cognitive deficits in adults with schizophrenia. Int J Soc Psychiatry 2014; 60:417-25. [PMID: 23828764 DOI: 10.1177/0020764013491899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 11/17/2022]
Abstract
BACKGROUND In recent decades there has been an increasing interest in cognitive deficits in schizophrenia. However, only a few studies have examined the impact of psychosocial support on the prevention of cognitive deterioration in patients who suffer from schizophrenia. AIM The aims of the present study are: (1) to confirm the presence of cognitive deficits among patients with schizophrenia; (2) to explore any correlations between such deficits and a range of clinical and/or demographic characteristics of the patients; and (3) to investigate any association between cognitive deficits and psychosocial support. METHOD A total of 118 patients with schizophrenia (the patient group) and 102 healthy volunteers (the control group) had a cognitive assessment using a battery of neuropsychological tests. The patients were allocated to one of the following groups: (1) patients under routine outpatient follow-up; or (2) patients receiving or having recently received intensive psychosocial support, in addition to follow-up. This included daily participation in vocational and recreational activities provided by dedicated mental health day centers. The findings of the neuropsychological testing of individuals in all groups were compared, after controlling for clinical or demographic factors. RESULTS The scores in the neuropsychological tests were lower overall in the patients group compared to healthy volunteers. Within the patients group, those receiving/having received psychosocial support had higher scores compared to those on routine follow-up alone. There were no significant differences between patients currently receiving psychosocial support and those having received it in the past. Lower education, age and illness duration (but not severity of positive or negative symptoms) were factors associated with lower test scores. CONCLUSIONS The study provides some evidence that psychosocial support may be beneficial for the cognitive functioning of patients with schizophrenia and this benefit may be a lasting one.
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Affiliation(s)
- Aikaterini Dalagdi
- Department of Psychiatry, Medical School, Democritus University of Thrace, University Campus, Dragana, Alexandroupolis, Greece
| | - Aikaterini Arvaniti
- Department of Psychiatry, Medical School, Democritus University of Thrace, University Campus, Dragana, Alexandroupolis, Greece
| | | | - Kiriakos Xenitidis
- South London and Maudsley NHS Foundation Trust, The Maudsley Hospital, London, UK
| | - Maria Samakouri
- Department of Psychiatry, Medical School, Democritus University of Thrace, University Campus, Dragana, Alexandroupolis, Greece
| | - Miltos Livaditis
- Department of Psychiatry, Medical School, Democritus University of Thrace, University Campus, Dragana, Alexandroupolis, Greece
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Papatriantafyllou J, Ghika A, Kontaxis T, Tsinia N, Lykou E, Chatziantoniou E, Agiomyrgiannakis D, Kyrozis A, Papageorgiou S. Neuropsychiatric Inventory Profile in Frontal Dementias (P07.170). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.170] [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: 11/15/2022] Open
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Tsapanou A, Margioti L, Beratis I, Papatriantafyllou J, Kamtsadeli V, Nika A, Tsilikopoulou G, Kalfakis N, Sakka P, Bamidis P, Papageorgiou S. Cognitive and physical training for the prevention of cognitive decline in the elderly: Preliminary data of the Long Lasting Memories European project. Neurosci Lett 2011. [DOI: 10.1016/j.neulet.2011.05.078] [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: 11/17/2022]
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Valotassiou V, Archimandritis S, Sifakis N, Papatriantafyllou J, Georgoulias P. Alzheimers Disease: SPECT and PET Tracers for Beta-Amyloid Imaging. Curr Alzheimer Res 2010; 7:477-86. [DOI: 10.2174/156720510792231757] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2009] [Accepted: 03/24/2010] [Indexed: 11/22/2022]
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Valotassiou V, Archimandritis S, Sifakis N, Papatriantafyllou J, Georgoulias P. Alzheimer's Disease: SPECT and PET Tracers for Beta-Amyloid Imaging. Curr Alzheimer Res 2010. [DOI: 10.2174/1567210204558602050] [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: 11/22/2022]
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Abstract
BACKGROUND Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is an uncommon autosomal dominant genetic disease due to mutations in the Notch3 gene on chromosome 19. The major clinical characteristics of CADASIL are migraine, recurrent ischaemic strokes and dementia. CASE REPORT We describe the case of a 58-year old man who presented with a minor stroke that occurred in the absence of significant vascular risk factors. His family history included stroke, dementia and early death. An MRI brain scan demonstrated hyperintensities in the white matter on FLAIR images with prominent involvement of the area of the external capsule bilaterally. Based on the family history and the MRI findings, CADASIL was suspected. Mutational analysis of the Notch3 gene disclosed a novel mutation substituting cysteine for glycine at codon 251 in exon 5, confirming the diagnosis of CADASIL. CONCLUSION This case suggests that CADASIL should be suspected in patients with stroke that arises in the absence of known vascular risk factors, especially if there are typical MRI findings. A strong family history of stroke and dementia are also supportive.
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Affiliation(s)
- Michail Vikelis
- Department of Neurology, Athens General Hospital G. Gennimatas, Athens, Greece.
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Vikelis M, Papatriantafyllou J, Karageorgiou CE. A novel CADASIL-causing mutation in a stroke patient. Swiss Med Wkly 2007; 137:323-5. [PMID: 17629811 DOI: 10.4414/smw.2007.11816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy (CADASIL) is an uncommon autosomal dominant genetic disease due to mutations in the Notch3 gene on chromosome 19. The major clinical characteristics of CADASIL are migraine, recurrent ischaemic strokes and dementia. CASE REPORT We describe the case of a 58-year old man who presented with a minor stroke that occurred in the absence of significant vascular risk factors. His family history included stroke, dementia and early death. An MRI brain scan demonstrated hyperintensities in the white matter on FLAIR images with prominent involvement of the area of the external capsule bilaterally. Based on the family history and the MRI findings, CADASIL was suspected. Mutational analysis of the Notch3 gene disclosed a novel mutation substituting cysteine for glycine at codon 251 in exon 5, confirming the diagnosis of CADASIL. CONCLUSION This case suggests that CADASIL should be suspected in patients with stroke that arises in the absence of known vascular risk factors, especially if there are typical MRI findings. A strong family history of stroke and dementia are also supportive.
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Affiliation(s)
- Michail Vikelis
- Department of Neurology, Athens General Hospital G. Gennimatas, Athens, Greece.
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Papatriantafyllou J, Zikos P, Kartsaklis L, Vikelis M, Kapsalakis J, Salli D, Boulas C, Santa Z, Kontoyianni V, Visviki T, Karpathiou N, Tsinia N, Orfanou P, Karageorgiou C. P3–077: Neuropsychological profile of mild cognitive impairment(MCI) subgroups from an outpatient memory clinic. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1344] [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: 10/24/2022]
Affiliation(s)
| | - P. Zikos
- General Hospital of AthensAthensGreece
| | | | | | | | - D. Salli
- General Hospital of AthensAthensGreece
| | - C. Boulas
- General Hospital of AthensAthensGreece
| | - Z. Santa
- General Hospital of AthensAthensGreece
| | | | | | | | - N. Tsinia
- General Hospital of AthensAthensGreece
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Papatriantafyllou J, Papatriantafyllou J, Tsinia N, Orfanou P, Zikos P, Kartsaklis L, Vikelis M, Kapsalakis J, Salli D, Boulas C, Santa Z, Kontoyianni V, Visviki T, Lykou E, Karpathiou N, Karageorgiou C. P2–237: Neuro–psychiatric profile of mild cognitive impairment(MCI) subgroups from an outpatient clinic. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1076] [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: 11/16/2022]
Affiliation(s)
| | | | - N. Tsinia
- General Hospital of AthensAthensGreece
| | | | - P. Zikos
- General Hospital of AthensAthensGreece
| | | | | | | | - D. Salli
- General Hospital of AthensAthensGreece
| | - C. Boulas
- General Hospital of AthensAthensGreece
| | - Z. Santa
- General Hospital of AthensAthensGreece
| | | | | | - E. Lykou
- General Hospital of AthensAthensGreece
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