Cardiovascular events in hospitalised patients with schizophrenia: a survival analysis

Objective: To evaluate the occurrence of cardiovascular (CV), cerebrovascular events and mortality rates, and compare the predictive ability of two scores, Framingham Risk Score (FRS) and Atherosclerotic Cardiovascular Disease (ASCVD), of detecting a cardiovascular event in a cohort of schizophrenic patients.

Methods: A cohort of 329 hospitalised schizophrenic patients is being monitored since 1 January 2013. Patients’ file review was performed to detect the CV events of interest.

Results: Out of the 329 patients with schizophrenia, with a mean study follow-up of 41.07?±?12.55?months, 29 cardiovascular events were recorded; of those events, we recorded 4 myocardial infarction, 1 stroke, 6 heart failure and 18 cardiovascular deaths. The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years. The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient). The association between survival curve of patients with high and low CVR according to FRS score tended to significance (RR?=?1.90, p?=?.078). Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival (RR?=?3.35, p?=?.005).

Conclusion: The ASCVD items should be included in the medical assessment in any patient with severe mental illness.

• Key points

• The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years.

• The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient).

• The association between survival curve of patients with high and low CVR according to FRS score tended to significance.

• Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival.

• The ASCVD items should be included in the medical assessment in any patient with severe mental illness.

     

‘I am dead’: Cotard syndrome and dementia

Background: Cotard syndrome is a rare condition whose main feature is a nihilistic delusion ranging from the denial of body parts to that of the existence of one’s own life or even the entire universe.

Objectives: The aim of this article is to review the nosological significance of Cotard syndrome and to explore the disorder among patients with dementia.

Methods: Medline and Google Scholar searches were conducted for relevant articles, chapters and books published before 2018. Search terms used included Cotard delusion, Cotard syndrome and dementia, nihilistic delusion. Publications found through this indexed search were reviewed for further relevant references.

Results and conclusion: In this narrative review we emphasise the fact that cases of Cotard syndrome involving patients with dementia are reported quite infrequently. Published studies are limited to very short series or isolated cases. Clinicians are obliged to treat the disorder. They should be alert to the potential high risk inherent in this condition.

• Keypoints

• Cotard syndrome is a rare condition characterised by nihilistic delusions that may range from negation of existence of parts of the body to delusion of being dead.

• The prevalence and incidence of this rare syndrome are not known.

• Since Cotard’s syndrome is conceptualised as part of an underlying disorder, several psychiatric and somatic diseases have been associated with the syndrome.

• The syndrome may occur in patients suffering from dementia.

     

Problematic internet use and feelings of loneliness

Objectives: Internet addiction or problematic internet use (PIU) has been related to feelings of loneliness and social networking. Research suggests that online communication may cause loneliness. We examined if the association between PIU and loneliness is independent of lack of social support, as indicated by lack of a committed romantic relationship, poor family functioning, and lack of time to interact face-to-face due to time online.

Methods: Portuguese adolescents and young adults (N?=?548: 16–26?years) completed the Generalized Problematic Internet Use Scale-2, the UCLA Loneliness Scale, and the general functioning subscale of the McMaster Family Assessment Device. They also reported if they had a committed romantic relationship, and if being online did not leave them time to be with partner, spend with family and socialise face-to-face with friends.

Results: Social networking was reported as among the main preferences by 90.6% of the females and 88.6% of the males. Perceived loneliness was associated with PIU independently of age and indicators of social support.

Conclusions: Evolution created neurophysiological mechanisms to recognize satisfying social relationships based on sensory information and bodily feedback present in face-to-face interactions. These are greatly absent in online communication. Hence, online communication likely engenders feelings of loneliness.

• Keypoints

• Problematic internet use (PIU) has been related to loneliness and social networking.

• Online communication was shown to increase loneliness.

• Lack of romantic relationships did not explain the association of PIU with loneliness.

• Poorer family environment did not explain the association of PIU with loneliness.

• Lack of face-to-face interactions due to time online also did not explain it.

• Lack of adequate sensory cues and bodily feedback in online contacts might facilitate it.

     

Evaluation of plasma agmatine level and its metabolic pathway in patients with bipolar disorder during manic episode and remission period

Objectives: Agmatine is a cationic amine resulting from the decarboxylation of l-arginine. Agmatine has neuroprotective, anti-inflammatory, anti-stress, and anti-depressant properties. In this study, plasma agmatine, arginine decarboxylase, and agmatinase levels were measured during manic episode and remission period in patients with bipolar disorder.

Methods: Thirty healthy volunteers and 30 patients who meet Bipolar Disorder Manic Episode diagnostic criteria were included in the study. Additionally, the changes in the patient group between manic episode and remission period were examined. We evaluated the relationship between levels of l-arginine and arginine decarboxylase in the agmatine synthesis pathway, and level of agmatinase that degrades agmatine.

Results: Levels of agmatine and l-arginine were significantly increased than control group during manic episode (p?<?.01). All parameters were increased during manic episode compared to remission period (p?<?.05). Agmatinase was significantly decreased both during manic episode (p?<?.01) and remission period (p?<?.05) in comparison to the control group. Arginine decarboxylase levels did not show a significant difference between the groups (p?>?.05).

Conclusions: This study indicate that there may be a relationship between bipolar disorder and agmatine and its metabolic pathway. Nonetheless, we believe more comprehensive studies are needed in order to reveal the role of agmatine in etiology of bipolar disorder.

• Key points

• Agmantine, agmatinase, l-arginine and arginine decarboxylase levels in BD have not been explored before.

• Various neuro-chemical mechanisms act to increase agmatine in BD; however, agmatine could have elevated to compensate agmatine deficit prior to the manifestation of the disease as in schizophrenia.

• Elevated agmatine degradation resulting from excess expression of agmatinase which is suggested to be effective in pathogenesis of mood disorders was compensated by this way.

• Elevated agmatine may be one of the causes which play a role in mania development.

• Elevated agmatine levels are also suggested to trigger psychosis and be related with the etiology of manic episode and lead to BD.

     

Cystatin C as an index of acute cerebral infraction recurrence: one-year follow-up study

Background and purpose: Cystatin C is associated with acute cerebral infarction (ACI). However, the correlation of serum cystatin C level with recurrence of ACI and different subtypes of ACI had not been fully clarified. The aim of this study was to detect the relationship between serum cystatin C level and recurrent ACI in one-year follow-up and different subtypes of ACI.

Methods: A total of 532 consecutive patients with ACI and 339 healthy controls were included. All ACI patients were followed up for one year, the clinical and biochemical characteristics of ACI and ACI recurrent patients were documented and analyzed.

Results: A total of 477 (89.7%) patients completed one-year follow-up study, 64 (13.4%) patients suffered ACI recurrence. The results showed serum cystatin C was 1.04?±?0.19?mg/L and 1.14?±?0.49?mg/L in control and ACI, respectively (p<?.001). The significant risk factors for ACI recurrence were presence of hypertension (p?=?.009, OR =3.32), diabetes (p?=.03, OR =1.87), coronary heart disease (p?=?.01, OR =2.46), and cystatin C (p?=?.003, OR =2.87). The risk of ACI recurrence increased with serum cystatin C level. Additionally, cystatin C level was associated with different subtypes of ACI; large-artery atherosclerosis (LAA) subtype had the highest level of cystatin C in ACI and recurrent ACI group.

Conclusions: Serum cystatin C level is an independent prediction biomarker for ACI recurrence. LAA subtype of ACI and ACI recurrence was more closely related to elevated cystatin C level.     

High rates of depression anxiety and suicidal ideation among inpatients in general hospital in China

Objective: To investigate the prevalence rates of depression anxiety and suicidal ideation among Chinese general hospital inpatients and to identify the potential associations with sociodemographics.

Method: A cross-sectional survey was applied in a Chinese general hospital. A questionnaire set, including sociodemographic variables, Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder Scale-7 (GAD-7), was completed by the participants. Clinically significant depression (CSD) and clinically significant anxiety (CSA) were defined as a score above 10 on the two scales. CSD and CSA are proxy measures but not specific diagnoses of mental disorders.

Results: Data from 1329 patients were included in the final analysis. 422 (31.8%) reported clinically significant depressive symptoms, 83 (6.3%) reported frequent suicidal ideation, and 204 (15.3%) reported clinically significant anxiety. Household income was negatively associated with CSD. Inpatients with lower household incomes and educational levels had higher rates of CSA. Middle-aged inpatients were more prone to suicidal ideation, and stable marital status was related to less suicidal ideation.

Conclusion: Depression, anxiety, and suicidal ideation were determined to be common psychological problems in Chinese inpatients. Chinese medical personnel must pay attention to the mental health conditions of inpatients, particularly inpatients with lower income, educational levels, and poor marital status.

• Key Points

• This is one of the first studies focusing on the prevalence of depression and anxiety in Chinese hospitalized inpatients in non-psychiatric departments of a general hospital.

• The PHQ-9 and GAD-7 were determined to be potential screening tools to aid Chinese medical workers in recognizing depression and anxiety in nonpsychiatric departments.

• The prevalence of depression, anxiety and suicidal ideation was observed to be relatively high in inpatients, which requires more attention from Chinese clinicians.

     

Towards the recovery of a sense of self: An interpretative phenomenological analysis of patients’ experience of body-oriented psychotherapy for schizophrenia

Objective: Increasing evidence supports the efficacy of body-oriented psychotherapy (BPT) for schizophrenia. Yet, so far no research has investigated outcome in relation to therapy process: Why and how BPT is effective. In this study, we qualitatively explore participants’ experience of a manualized BPT for schizophrenia to shed light on the process of therapeutic change. Method: We conducted in-depth interviews with 6 participants who completed a 10-week BPT group intervention. Interviews explored participants’ experience of change and helpful aspects of therapy and were analysed using interpretative phenomenological analysis. Findings: We identified six master themes across the interviews: (i) Being a whole: body-mind connection; (ii) Being agentic and being able; (iii) Being unique and worthy: Being accepted for who one is; (iv) Changing interactions: Engaging in authentic interpersonal contact; (v) Being part of a group: Feeling integrated; and (vi) Hope and investing in the future. Conclusion: We discuss the clinical implications for each theme and bring the findings together by describing therapeutic change in schizophrenia as a recovery of sense of self at different but interlocked levels. Moreover, we put forward recommendations for both specific and common factors for schizophrenia therapy.

Clinical or methodological significance of this article: The clinical significance of this study is twofold. On the one hand, the findings of this analysis might inform the theory and practice of BPT and might directly feedback into a further development of the manual guidelines. On the other hand, common helpful factors have been identified thatmight also be relevant for the more general clinical practice concerning patients with schizophrenia.

Here, we summarize our key messages for the clinical practitioner emerging from the findings:

1. The inclusion of bodily aspects and a focus on pre-reflective experience in psychotherapy can help persons with schizophrenia recover the sense of being a body-mind unity.

2. Empowering persons with schizophrenia, instead of instructing them, seems to foster a sense of agency and self-confidence, which are crucial to the recovery process.

3. A twofold therapeutic stance characterized by openness towards the other and authenticity was experienced by patients as facilitating the rapport building. This might help persons with schizophrenia engage in the relation.

4. Social inclusion might enhance therapeutic change and recovery in schizophrenia. Group therapy might be helpful for fostering a feeling of social belonging, but the inclusion in the wider social and community context remains a critical issue.

5. The experience of joyful moments in psychotherapy might positively contribute to therapeutic change in that it fosters a sense of hope for the future.

Overall our paper contributes to the literature aiming at expanding the range of therapeutic modalities, focussing on the creation and use of mixed models of therapy within and beyond talking practices.     

Effect of activity-based mirror therapy on lower limb motor-recovery and gait in stroke: A randomised controlled trial

Objective: To determine the effect of activity-based mirror therapy (MT) on motor recovery and gait in chronic poststroke hemiparetic subjects.

Design: A randomised, controlled, assessor-blinded trial.

Setting: Rehabilitation institute.

Participants: Thirty-six chronic poststroke (15.89?±?9.01 months) hemiparetic subjects (age: 46.44?±?7.89 years, 30 men and functional ambulation classification of median level 3).

Interventions: Activity-based MT comprised movements such as ball-rolling, rocker-board, and pedalling. The activities were provided on the less-affected side in front of the mirror while hiding the affected limb. The movement of the less-affected lower limb was projected as over the affected limb. Conventional motor therapy based on neurophysiological approaches was also provided to the experimental group. The control group received only conventional management.

Main outcome measures: Brunnstrom recovery stages (BRS), Fugl-Meyer assessment lower extremity (FMA-LE), Rivermead visual gait assessment (RVGA), and 10-metre walk test (10-MWT).

Results: Postintervention, the experimental group exhibited significant and favourable changes for FMA-LE (mean difference?=?3.29, 95% CI?=?1.23–5.35, p?=?.003) and RVGA (mean difference?=?5.41, 95% CI?=?1.12–9.71, p?=?.015) in comparison to the control group. No considerable changes were observed on 10-MWT.

Conclusions: Activity-based MT facilitates motor recovery of the lower limb as well as reduces gait deviations among chronic poststroke hemiparetic subjects.     

The role of high high-sensitivity C-reactive protein levels at admission on poor prognosis after acute ischemic stroke

Objective: Plasma high hypersensitive C-reactive protein (hs-CRP) levels are associated with risk and prognosis of vascular diseases. The clinical implications of markedly elevated hs-CRP levels are more discovered in the onset and development of stroke. The aim of this study is to determine the association of plasma hs-CRP levels on the prognosis in patients with acute ischemic stroke.

Methods: Retrospective analysis of a single-center database of consecutive cases for acute cerebral infarction (ACI) from January 1 2012 to December 30 2016 was performed. Significant predictors of the dependent variable variance were identified by standard linear, univariate and multivariate, or binary logistic regression modeling. Multivariate regression analysis was introduced to investigate the relationship between plasma hs-CRP levels at admission and change in National Institutes of Health Stroke Scale (NIHSS) score at discharge.

Results: The percentages of hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, body mass index (BMI) and chronic kidney disease were raised with the increase of hs-CRP plasma concentration at admission among all patients (p?<?0.05). ACI patients with large-artery atherosclerosis had an increasing percentage with the increase of hs-CRP mean value (p?<?0.05). The initial NIHSS scores, the acute infection rate and age advance also increased with the increase of hs-CRP plasma concentration at admission (p?<?0.05). The ratio of neurological improvement increased with the decrease of plasma hs-CRP concentration (p?<?0.05). The neurological deterioration and poor prognosis increased with the increase of plasma hs-CRP concentration (p?<?0.05).

Conclusion: High plasma hs-CRP levels are associated with worse outcomes in the ACI patients. Monitoring plasma hs-CRP levels and cutting down the elevated plasma hs-CRP levels will be beneficial in screening and treatment decisions for the prognosis of acute ischemic stroke.     

Klotho,vitamin D and homocysteine levels during acute episode and remission periods in schizophrenia patients

Aim: Neurodegenerative processes are effective in schizophrenia. However, the underlying causes of the symptoms and associated factors have not yet been fully elucidated. Recent research has focused on the relationship between neurodegeneration and vitamin D, Klotho and homocysteine levels. In this study, we aimed to investigate this relationship in schizophrenia.

Method: This study included 30 schizophrenic inpatients, 30 schizophrenic outpatients in remission and 28 healthy volunteers as the control group. The psychiatric diagnoses of our patients were evaluated according to DSM-IV criteria. The Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF) scale and the Clinical Global Impression (CGI) scale were used for clinical measurements. Serum Klotho, homocysteine, vitamin D, vitamin B12 and folic acid levels were analyzed using ELISA and compared with clinical properties.

Results: The PANSS scores and CGI scores were higher in schizophrenic inpatients than outpatients, and the GAF scores were lower (p?<?0.05). Three groups were compared for Klotho, homocysteine and vitamin D serum levels; Klotho levels were elevated but the difference was not statistically significant (p?>?0.05). However, vitamin B12, folic acid and homocysteine levels were higher in schizophrenic patients than the control group (p?<?0.05).

Conclusions: Higher levels of homocysteine with concomitant higher levels of vitamin B12 and folic acid suggest a relationship of this pathway with schizophrenia. Differences in Klotho levels were elevated but it was not significant. Replication studies to investigate probable associations with larger samples are needed.     

A randomized study on the effect of modified behavioral activation treatment for depressive symptoms in rural left-behind elderly

Objective: To evaluate the effectiveness of a modified behavioral activation treatment (MBAT) intervention on reducing depressive symptoms in rural left-behind elderly.

Method: This is a randomized study registered in Chinese Clinical Trial Registry (ChiCTR-IOR-17011289). Eighty rural left-behind elderly people who had a Geriatric Depression Scale (GDS) score between 11 and 25 were randomly assigned to the intervention (n?=?40) and control group (n?=?40). The intervention group received both MBAT and regular treatment for 8 weeks while the control group received regular treatment. Both groups were assessed with the GDS, Beck Anxiety Inventory (BAI), and Oxford Happiness Questionnaire (OHQ) at baseline, immediately post-intervention, and at 3 months post-intervention.

Results: There were a total of 73 participants that completed the intervention. The scores of GDS and BAI decreased significantly, but the scores of OHQ increased significantly in the intervention group after 8 sessions of MBAT (P?<?.01). The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up. Significant differences in GDS, BAI, and OHQ scores were observed between the intervention group and the control group (P?<?.01).

Conclusion: MBAT produced a significantly greater reduction in depressive symptoms than regular care in rural left-behind elderly.

Clinical or methodological significance of this article: A modified behavioral activation (BA) psychotherapy can significantly reduce the recurrence and seriousness of depression symptoms in the left-behind elderly with mild to moderate depression. This study also suggests that further study of the MBAT as an intervention will provide a direction for the management of mental health in rural left-behind elders.     

Exploring dimensions of social support and resilience when providing care at the end of life: a qualitative study

Background: Research shows that formal and informal social support can facilitate resilience in carers. There is a paucity of research exploring social support and resilience amongst recently bereaved informal carers.

Aim: To examine how the presence or absence of distinct dimensions of social support facilitate or hinder resilience in recently bereaved informal carers.

Participants: 44 bereaved carers, who had been identified by GP as ‘main carer’ of someone recently deceased (3–12 months), aged between 38 and 87 years old (mean= 67).

Methods: Thematic analysis then the Ecological Framework of Resilience as an organisational tool to develop overarching themes in the data. We used the Sherbourne and Stewart model to identify social support that was lacking as well as social support that was present.

Results: A range of social support types were identified. There was an emphasis on the importance of relationships with both health professionals and family members, including the care recipient. However, social support was not necessary for resilience if the participant had other resources.

Conclusions: Social support for carers providing end of life care is almost exclusively based around end of life care ‘work’. In comparison to other research our study suggests that relationships with family and health professionals are paramount. Multidimensional support is needed for carers to enhance their resilience.     

Cognitive functions and psychological symptoms in migraine: a study on patients with and without aura

Aim: Migraine is neurological disorder with a complex pathophysiology. We described the neuropsychological profile of 100 migraineurs (50 with visual aura and 50 without aura), in interictal phase, compared to 50 matched healthy controls.

Materials and methods: A battery of standardized neuropsychological tests was used to assess attention, memory and executive functions. Beck Depression Inventory and Hamilton Rating Scale for Anxiety were used to evaluate anxiety and depressive symptoms. Severity of disability during daily activities was assessed by Migraine Disability Assessment.

Results: Migraine without aura showed a significant difference in comparison to healthy controls in semantic verbal fluency (p?=?0.02), delayed memory (p?<?0.001) and set-shifting (p?<?0.001). Migraine with aura showed a significant difference in delayed memory (p?=?0.001) and set-shifting (p?=?0.005) if compared to healthy controls. No significant correlation between cognitive functions and mood was found (HAM-A p?=?0.67) (BDI-II p?=?0.42).

Conclusions: Our data showed isolate and specific cognitive deficit during interictal phase in migraine patients. Future studies are need to identify if specific migraine characteristics may affect cognitive functions.     

Pharmacogenetics and levodopa induced motor complications

Aim: L-dopa remains the most effective symptomatic therapy for Parkinson's disease (PD) but unfortunately, its chronic use is often associated with motor complications. This review highlights the importance of pharmacogenetics in an individualised PD therapeutic approach.

Material and Methods: review of the literature was done.

Results: PD patients show remarkable heterogeneity in their response to L-dopa and this profound interindividual heterogeneity suggests that there is a genetic predisposition.

Conclusions: The impact of the genetic makeup of every individual on PD treatment appears to be of great importance in order to achieve not only the optimum therapeutic effect, but also with minimal side effects.     

A case-control study of paternal and maternal age as risk factors in mood disorders

Objective: Advanced parental age might constitute a risk factor for various disorders. We tested whether this concerns also mood disorder patients.

Methods: The study included 314 subjects (42 bipolar-BD patients; 21 manics and 21 depressives, 68 unipolar-UD, and 204 normal controls-NC). Analysis of Covariance (ANCOVA) and the calculation of the Relative Risk (RR) and the Odds Ratio (OR) were used for the analysis.

Results: Paternal age differed between NC and UD patients (29.42?±?6.07 vs. 32.12?±?5.54; p?=?.01) and manics (29.42?±?6.07 vs. 35.00?±?5.75; p?=?.001) and maternal age between NC and manics (25.46?±?4.52 vs. 31.43?±?4.75; p?<?.001) and manic and UD (31.43?±?4.75 vs. 26.75?±?6.03; p?=?.002). The RR and OR values suggested that advanced parental age constitutes a risk factor for the development of mood disorders.

Conclusions: In a non-dose dependent and gender-independent, advanced parental age constitutes a risk factor for the development of BD with index episode of mania (probably manic predominant polarity); only advanced paternal age constitutes a risk factor for the development of UD and BD with index episode of depression (probably depressive predominant polarity). This is the first study suggesting differential effect of advanced parental age depending on predominant polarity of BD.     

A how-to guide to aphasia services: celebrating Professor Linda Worrall’s contribution to the field

Background: This article recognises Professor Linda Worrall’s contribution to aphasiology and discusses research themes which have grown from her work.

Aims: To review, summarise, and discuss literature relating to four themes which have emerged from the work of Professor Worrall: (1) Research capacity building; (2) Implementation of research evidence in clinical practice; (3) Meaningful outcome measurement; and (4) Improvement of psychological and emotional outcomes.

Main contribution: A review of the literature, with examples of practical applications.

Conclusions: The work of Professor Worrall has greatly influenced the field of aphasia; her legacy is the research capacity she has built in Australia and around the world.     

Therapeutic effects of aerobic exercise on EEG parameters and higher cognitive functions in mild cognitive impairment patients

Background: Mild cognitive impairment (MCI) is becoming an emerging problem for developing countries where there is an increase in expected age. There is no specific curative therapeutic treatment available for these patients.

Objective: The objective of this study was to evaluate short and long-term changes in the electroencephalogram (EEG) parameters and cognition of MCI patients with aerobic exercises.

Methods: A randomized controlled trial was conducted on 40 patients which were randomly divided into two groups, ‘aerobic exercise treatment group (n?=?21)’ and ‘no-aerobic control group (n?=?19)’. Short-term effects of exercise were measured after single session of exercise and long-term effects were measured after an 18 sessions (6?weeks) treatment. The outcomes which were measured were, electroenphelogram paramaters (slowness and complexity of the EEG) and cognitive functions (using mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA), and trail making test (TMT) A and B).

Results: After one session of aerobic exercise there were significant improvements in slowness (delta waves; 0.678?±?0.035 vs 0.791?±?0.033; p?=?.015) and complexity (0.601?±?0.051 vs 0.470?±?0.042; p?=?.027) of the EEG in aerobic exercise treated group as compared to no-aerobic exercise group. After six weeks there were significant improvements in slowness (delta waves; 0.581?±?0.036 vs 0.815?±?0.025; p?=?.005) and complexity (0.751?±?0.045 vs 0.533?±?0.046; p?=?.001) of the EEG in the aerobic group as compared to no-aerobic group. Moreover, significant improvements were observed in the MMSE (p?=?.032), MoCA (p?=?.036), TMT-A (p?=?.005), and TMT-B (p?=?.007) in aerobic exercise group as compared to no-aerobic group.

Conclusion: Aerobic exercise showed improvement in cognition after short and long-term treatment in MCI subjects and can be used as potential therapeutic candidate.     

Estimation of skeletal muscle mass in patients with spinocerebellar ataxia type 3 and 10

Background: Neurodegenerative diseases may progress to a level in which patients present spontaneous weight loss, resulting in increased falls and functional disabilities when the disease is associated with muscle mass depletion.

Objective: Evaluate the muscle compartment in patients presenting spinocerebellar ataxia (SCA) type 3 and 10.

Methods: Forty-six patients presenting SCA type 3 and 10 were assessed and 76 volunteers were selected to the control group. In order to evaluate the muscle compartment, muscle mass anthropometric measurements were assessed and total skeletal muscle mass calculated through a predictive equation.

Results: Women with SCA3 presented greater weight loss and muscle mass reduction compared to those with SCA10 and the control group. Among the predictive measurements, calf muscle circumference showed a more significant correlation with total skeletal muscle mass (p = 0.718).

Conclusion: Patients presenting both types of ataxia did not show severe depletion in their nutritional status; however, those with SCA3 displayed greater weight loss and muscle mass reduction compared to the SCA10 group.