Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are early stages of Alzheimer's disease (AD). Neurophysiological markers such as electroencephalography (EEG) and event-related ...potential (ERP) are emerging as alternatives to traditional molecular and imaging markers. This paper aimed to review the literature on EEG and ERP markers in individuals with SCD. We analysed 30 studies that met our criteria, with 17 focusing on resting-state or cognitive task EEG, 11 on ERPs, and two on both EEG and ERP parameters. Typical spectral changes were indicative of EEG rhythm slowing and were associated with faster clinical progression, lower education levels, and abnormal cerebrospinal fluid biomarkers profiles. Some studies found no difference in ERP components between SCD subjects, controls, or MCI, while others reported lower amplitudes in the SCD group compared to controls. Further research is needed to explore the prognostic value of EEG and ERP in relation to molecular markers in individuals with SCD.
People with epilepsy frequently have cognitive impairment. The majority of cognitive problems is influenced by a variety of interlinked factors, including the early onset of epilepsy and the ...frequency, intensity and duration of seizures, along with the anti-epileptic drug treatment. With a systematic review, we investigate significant factors about the cognitive impairment in epilepsy. Most cognitive problems in adult people with epilepsy include memory, attention and executive function deficits. However, which cognitive area is mainly affected highly depends on the location of epileptic activity. Moreover, modifications in signalling pathways and neuronal networks have an essential role in both the pathophysiology of epilepsy and in the mechanism responsible for cognitive impairment. Additionally, studies have shown that the use of polytherapy in the treatment of epilepsy with anti-epileptic drugs (AEDs) heightens the risk for cognitive impairment. It can be challenging to distinguish the contribution of each factor, because they are often closely intertwined.
Background: We assessed the prevalence and risks associated with pain during and after a multiple sclerosis (MS) relapse, and the impact of pain on quality of life (QoL), in MS patients. Methods: 117 ...patients suffering an acute MS relapse were evaluated with clinician- and patient-reported outcomes, including the expanded disability status scale (EDSS), Multiple Sclerosis Impact Scale (MSIS-29), and MS Walking scale-12 (MSWS-12). Relapse-related pain was assessed via the short-form 36 (SF-36) questionnaire upon first visit (relapse onset) and at 6 weeks after treatment with intravenous methylprednisolone (follow-up visit). Results: Pain was present in 80% of patients at relapse onset. Patients with pain were more impaired physically (higher mean scores on MSIS-29phys and MSWS-12 and lower mean scores on SF-36 role physical, physical, and vitality scales) at relapse and six weeks after. In total, 74% of patients with MS relapse reported a poorer QoL due to pain. A lower psychological well-being was correlated with greater pain (MSIS29psy score). An increased number of prior relapses was a predictor of more pain at relapse onset. Conclusions: Pain was common at the time of MS relapse and improved, but was still significant, six weeks after treatment with corticosteroids. Further studies are required to better understand relapse-related pain.
(1) Background: The SARS-CoV-2 pandemic had a significant impact on the management of traumatic brain injury (TBI). We aimed to compare the clinical characteristics and outcomes of TBI patients ...before and during the SARS-CoV-2 pandemic.; (2) Methods: We analyzed depicted data from existing medical records on sex, age, mechanism of injury, clinical performance at admission and discharge, neuroimaging, laboratory values at admission, mortality, duration of hospitalization, and referrals after discharge from the traumatology department for all adult patients during the SARS-CoV-2 pandemic and a year before. Variables were compared using the Chi-square or t-test between both groups.; (3) Results: Most patients had mild (n = 477), followed by moderate (11) and severe (11) TBI. Mild TBI was less frequent during the SARS-CoV-2 period (n = 174 vs. n = 303). The incidence of high falls increased during the SARS-CoV-2 period (14.5% vs. 24.7%; p < 0.05) in the group with mild TBI. Patients had similar mean Glasgow Coma Scales (GCS), Glasgow Outcome Scales-Extended (GOSE), and glucose levels at admission before and during the pandemic. Serum ethanol levels were significantly lower during the SARS-CoV-2 period (1.3 ± 0.7 mmol/L vs. 0.7 ± 1.2 mmol/L; p < 0.001). At discharge, the mean GCS was significantly lower (14.7 ± 1.8 vs. 14.1 ± 0.5; p < 0.05) for patients treated during the SARS-CoV-2 period than before the SARS-CoV-2 period. There were no differences in GOSE; (4) Conclusions: our results demonstrated a significant impact of SARS-CoV-2 pandemic on the frequency, mechanism, and consequences of TBI, and may help improve care for our patients.
Our trial (ClinicalTrials.gov Identifier: NCT04246619) evaluates the efficacy of two generic medications, pregabalin and duloxetine, for treating pain in PDPN patients.
The patients were randomised ...either into the pregabalin (99) or the duloxetine (102) arm. Pain was evaluated using the DN-4 questionnaire, and visual analogue scales (VASs, 0-100 mm) were used to measure the average pain intensity (API), worst pain intensity (WPI) in the last 24 h and current pain intensity (CPI).
The proportion of patients with a clinically significant improvement in the API at Week 12 was 88.3% CI 81.7%, 94.8% in the pregabalin arm and 86.9% CI 76.7%, 97.1% in the duloxetine arm. After 12 weeks, the CPI, API, and WPI decreased by -35.3 -40.5, -30.0, -37.0 -41.4, -32.6, and -41.6 -46.6, -36.5 in the pregabalin arm, and by -35.0 -39.2, -30.7, -36.9 -41.5, -32.3, and -40.0 -44.8, -35.2 in the duloxetine arm (all in mm, all
< 0.001).
Our results demonstrate that pregabalin and duloxetine are effective medications for treating pain in PDPN in more than 86% of all randomised patients.
Parkinson's disease (PD) is generally associated with abnormally increased beta band oscillations in the cortico-basal ganglia loop during walking. PD patients with freezing of gait (FOG) exhibit a ...more distinct, prolonged narrow band of beta oscillations that are locked to the initiation of movement at ∼18 Hz. Upon initiation of cycling movements, this oscillation has been reported to be weaker and rather brief in duration. Due to the suppression of the overall beta band power during cycling and its continuous nature of the movement, cycling is considered to be less demanding for cortical networks compared to walking, including reduced need for sensorimotor processing, and thus unimpaired continuous cycling motion. Furthermore, cycling has been considered one of the most efficient non-pharmacological therapies with an influence on the subthalamic nucleus (STN) beta rhythms implicative of the deep brain stimulation effects. In the current review, we provide an overview of the currently available studies and discuss the underlying mechanism of preserved cycling ability in relation to the FOG in PD patients. The mechanisms are presented in detail using a graphical scheme comparing cortical oscillations during walking and cycling in PD.
Objective
This study assessed the impact of cancer‐related neuropathic pain (CRNP) on patients and the importance of the patient–healthcare professional (HCP) relationship in diagnosis and ...management.
Methods
A quantitative online survey was conducted involving adult patients from 13 European countries who had been diagnosed with treatable cancer and experienced symptoms of peripheral neuropathy.
Results
Of 24,733 screened respondents, 549 eligible persons met the inclusion criteria and completed the questionnaire. Among individuals still experiencing pain, 75% rated it as ‘severe’ or ‘moderate’. In addition, 61% reported a negative impact on day‐to‐day activities, and 30% said they had stopped working as a result. A third of respondents had received no diagnosis of CRNP despite reporting painful symptoms to an HCP. HCPs spending enough time discussing pain and understanding the impact on patients' lives were each associated with an increased likelihood of a formal CRNP diagnosis. Compared with individuals currently in active cancer treatment, cancer survivors were less likely to have a diagnosis of CRNP or regular pain conversations with HCPs.
Conclusion
CRNP remains under‐recognised despite its substantial impact on patients' lives. Clinical practice may be improved by strengthening patient–HCP relationships around pain discussions and increasing the focus on pain management among cancer survivors.
Background
With the increasing number of elderly, it is necessary to have a brief screening tool for detecting people with cognitive impairment. Our study aimed to standardise and validate the ...Slovenian version of ADAS‐Cog for a cognitive screening of people with MCI or AD.
Method
We included 26 people with MCI, 20 with AD, and 45 healthy controls. All participants completed the Slovenian version of ADAS‐Cog. We calculated the mean age, years of education, and ADAS‐Cog score for each group and compared them ANOVA. In the end, we draw the Receiver operator curve (ROC), calculated sensitivity, specificity, and likelihood ratio.
Result
People with AD had the highest total ADAS‐Cog score, followed by MCI and healthy controls (26 SD 12 vs 19 SD 7 vs 8 SD 2 points, p<0.001). There were no statistically significant differences between groups in age or years of education.
The area under the ROC for MCI was 0.97 (CI 0.9 to 1; p<0.0001) and for the AD was 0.98 (CI 0.95 to 1; p<0.0001). Optimal the cut‐off for the ADAS‐Cog for MCI was 11/12 points. Sensitivity was 92% (CI 76% to 99%), specificity 96% (CI 85% to 99%), and likelihood ratio 21. The optimal cut‐off for AD was 14/15 points. Sensitivity was 95% (CI 76% to 100%), specificity 100% (CI 92% to 100%).
Conclusion
The optimal cut‐off score for Slovenian population is 11/12 points for MCI and 14/15 points for people with AD dementia. We may conclude that ADAS‐Cog is a reliable screening tool in our population.
Abstract
Background
The purpose of the study was to determine the eating habits of patients with MCI or AD and to determine their nutritional status.
Methods
patients with MCI or AD were recruited in ...the dementia outpatient clinic. Cognitive status and nutritional status were evaluated. Each patient or his/her caregiver fill out full Mini Nutritional Assessment scale (MNA). Maximal score on MNA was 30, patients at risk of malnutrition scored between 17 and 23.5. Patients with less than 17 were considered malnourished. Descriptive statistic for age, body mass index (BMI), arm/calf circumference and total MNA score was performed. MNA score was compared between MCI, mild and moderate AD group using one‐way Anova, and the correlation between the degree of cognitive impairment and MNA score was performed.
Results
Mean age of all patients was 74 years (10 years SD), mean MNA score was 24.6 (SD 3.2). The results showed that patients do not consume enough of the recommended nutrients, especially proteins, fruits and vegetables, daily. Measurements of the median circumference of the forearm and calf revealed that more than (60%) patients had decreased muscle mass, although the Body Mass Index was in the normal range in more than 90% of patients. Six patients had moderate, 34 had mild AD, and 38 had MCI. Only one patient was malnourished, while 23 (29.5%) were at risk of malnutrition. All patient with MCI had normal MNA score. Patients with moderate AD had significantly lower MNA score than patients with MCI (21.5, SD 4 vs 25.5 SD 3.4). No differences were found between other groups. A significant correlation was found between cognitive impairment and MNA (r=0.31, p<0.001)
Conclusion
Our results suggest that patients with AD need nutritional assessment, especially in the advanced phase. It would be worthwhile to make a nutritional assessment at the first and every subsequent visit of the patient to the outpatient clinic to monitor his or her nutritional status.
Background
The purpose of the study was to determine the eating habits of patients with MCI or AD and to determine their nutritional status.
Methods
patients with MCI or AD were recruited in the ...dementia outpatient clinic. Cognitive status and nutritional status were evaluated. Each patient or his/her caregiver fill out full Mini Nutritional Assessment scale (MNA). Maximal score on MNA was 30, patients at risk of malnutrition scored between 17 and 23.5. Patients with less than 17 were considered malnourished. Descriptive statistic for age, body mass index (BMI), arm/calf circumference and total MNA score was performed. MNA score was compared between MCI, mild and moderate AD group using one‐way Anova, and the correlation between the degree of cognitive impairment and MNA score was performed.
Results
Mean age of all patients was 74 years (10 years SD), mean MNA score was 24.6 (SD 3.2). The results showed that patients do not consume enough of the recommended nutrients, especially proteins, fruits and vegetables, daily. Measurements of the median circumference of the forearm and calf revealed that more than (60%) patients had decreased muscle mass, although the Body Mass Index was in the normal range in more than 90% of patients. Six patients had moderate, 34 had mild AD, and 38 had MCI. Only one patient was malnourished, while 23 (29.5%) were at risk of malnutrition. All patient with MCI had normal MNA score. Patients with moderate AD had significantly lower MNA score than patients with MCI (21.5, SD 4 vs 25.5 SD 3.4). No differences were found between other groups. A significant correlation was found between cognitive impairment and MNA (r=0.31, p<0.001)
Conclusion
Our results suggest that patients with AD need nutritional assessment, especially in the advanced phase. It would be worthwhile to make a nutritional assessment at the first and every subsequent visit of the patient to the outpatient clinic to monitor his or her nutritional status.
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