共查询到20条相似文献，搜索用时 312 毫秒
1.
Background
In spite of their extensive use, the ecological relevance of tasks dedicated to assessing real-world decision-making in a laboratory setting remains unclear.Objectives
Our study aimed to evaluate the relationship between decision-making and behavioral competency and awareness of limitations.Methods
A total of 20 patients with Alzheimer's disease (AD), 20 with amnestic mild cognitive impairment (aMCI) and 20 healthy controls (HC) were assessed for decision-making using the Iowa Gambling Task (IGT). Behavioral competency was evaluated by the Patient Competency Rating Scale (PCRS), which requires each participant and a relative to answer the same 30 questions on participant's competency and to rate each item, while awareness of limitations was evaluated by subtracting the self-rated score from the relative-rated score.Results
Using the median-split approach, the proportion of disadvantageous decision-makers was higher in both the MCI and AD groups than in HC (P = 0.02 and P = 0.03, respectively), with no differences between clinical groups. The percentage of participants with poorer behavioral competency was also higher in the MCI and AD than in the HC (self-rated: P = 0.025 and P = 0.01, respectively; relative-rated: P = 0.008 and P = 0.008, respectively), again with no differences between MCI and AD. All groups were comparable in awareness. For all participants, disadvantageous decision-making was associated with both reduced behavioral competency and poor awareness of limitations (OR: 3.47, P = 0.03 and OR: 5.4, P = 0.004, respectively).Conclusion
Our findings support the ecological relevance of the IGT. Behavioral competency integrity and awareness of limitations are both associated with advantageous decision-making profiles. 相似文献2.
E. Hainque A. Blancher V. Mesnage S. Rivaud-Pechoux A. Bertrand S. Dupont V. Navarro E. Roze I. Gourfinkel-An E. Apartis 《Revue neurologique》2018,174(1-2):56-65
Objectives
Unverricht–Lundborg disease (ULD) is the most common form of progressive myoclonus epilepsy. Cerebellar dysfunction may appear over time, contributing along with myoclonus to motor disability. The purpose of the present work was to clarify the motor and neurophysiological characteristics of ULD patients.Methods
Nine patients with genetically proven ULD were evaluated clinically (medical history collected from patient charts, the Scale for the Assessment and Rating of Ataxia and Unified Myoclonus Rating Scale). Neurophysiological investigations included EEG, surface polymyography, long-loop C-reflexes, somatosensory evoked potentials, EEG jerk-locked back-averaging (JLBA) and oculomotor recordings. All patients underwent brain MRI. Non-parametric Mann-Whitney tests were used to compare ULD patients’ oculomotor parameters with those of a matched group of healthy volunteers (HV).Results
Myoclonus was activated by action but was virtually absent at rest and poorly induced by stimuli. Positive myoclonus was multifocal, often rhythmic and of brief duration, with top-down pyramidal temporospatial propagation. Cortical neurophysiology revealed a transient wave preceding myoclonus on EEG JLBA (n = 8), enlarged somatosensory evoked potentials (n = 7) and positive long-loop C-reflexes at rest (n = 5). Compared with HV, ULD patients demonstrated decreased saccadic gain, increased gain dispersion and a higher frequency of hypermetric saccades associated with decreased peak velocity.Conclusion
A homogeneous motor pattern was delineated that may represent a ULD clinical and neurophysiological signature. Clinical and neurophysiological findings confirmed the pure cortical origin of the permanent myoclonus. Also, oculomotor findings shed new light on ULD pathophysiology by evidencing combined midbrain and cerebellar dysfunction. 相似文献3.
I. López-de-Uralde-Villanueva A. Gil-Martínez P. Candelas-Fernández J. de Andrés-Ares H. Beltrán-Alacreu R. La Touche 《Neurología (Barcelona, Spain)》2018,33(8):505-514
Introduction
The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features.Objective
To assess the validity and reliability of the Spanish-language version of the S-LANSS scale.Methods
Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively.Results
The optimal cut-off point for S-LANSS was ≥ 12 points (AUC = .89; sensitivity = 88.7; specificity = 76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P < .05). The S-LANSS showed a significant correlation with ID-Pain (r = .734, α = .71).Conclusion
The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features. 相似文献4.
Keju Ju Lingling Zhong Xiaoyu Ni Hua Cao Guanliang Cheng Lianshu Ding 《Neurologia i neurochirurgia polska》2018,52(3):374-378
Objective
To investigate the relationship between cerebral vasomotor reactivity (VMR) and acute stroke in patients with internal carotid artery stenosis.Methods
54 patients with internal carotid artery stenosis were enrolled. VMR was calculated by transcranial Doppler monitoring of the velocity of blood flow. 3-Dimensional dynamic contrast enhanced magnetic resonance angiography was used to detect stenosis, and diffusion weighted imaging was used to detect infarction.Results
VMR value was significantly lower in patients with carotid artery stenosis than in control group (T = 3.112, P = 0.002), and significantly lower in patients with aortic atherosclerotic stroke than in non-infarct group (T = 10.930, P = 0.000). However, VMR value was significantly higher in patients with new-onset small-artery occlusion stroke than in non-infarction group (T = ?2.538, P = 0.013). Scatter plots showed that aortic atherosclerotic stroke occurred mainly in patients with severe internal carotid artery stenosis, and VMR value in cerebral artery significantly decreased.Conclusion
Decreased VMR value is an important prognostic factor for the occurrence of aortic atherosclerotic stroke, and can be used as a reference for preoperative hemodynamic evaluation in patients with internal carotid artery stenosis. 相似文献5.
A. Skalli E.H. Ait Ben Haddou R. El Jaoudi R. Razine G.A. Mpandzou H. Tibar E. El Fahime N. Bouslam A. Alami A. Benomar K. Hajjout M. Yahyaoui A. Bouhouche 《Revue neurologique》2018,174(3):150-156
Background
Growing evidence suggests that hypovitaminosis D contributes to the pathogenesis of multiple sclerosis (MS).Objective
This study aimed to evaluate whether vitamin D levels are associated with having MS and some of its characteristics in the Moroccan population.Methods
Using liquid chromatography-tandem mass spectrometry, the 25(OH)D3 metabolite was measured to quantify vitamin D serum levels (DSLs) in 113 patients with MS and 146 healthy controls matched for gender and age. DSLs were then compared between patients and controls, with correlations sought between DSLs and gender, age at onset, disease duration, MS type, degree of disability (EDSS score) and disease severity (MSSS) in patients.Results
Hypovitaminosis D (DSL < 30 ng/mL) was observed in 97.3% of MS patients and in 98.6% of controls. Although the mean DSL was slightly lower in patients (11.69 ± 6.97 ng/mL) than in controls (12.98 ± 6.58 ng/mL), there was no significant association between DSL and MS status (P = 0.131). Similarly, among patients, no apparent association was found between DSL and MS type (P = 0.214), EDSS score (P = 0.076) or MSSS (P = 0.772).Conclusion
Our study suggests that DSL is not associated with having MS nor with MS type, degree of disability or disease severity in the Moroccan population. On the other hand, DSL was lower in women and decreased with age. 相似文献6.
Paweł Daszkiewicz Paweł Kowalczyk Marcin Roszkowski 《Neurologia i neurochirurgia polska》2018,52(1):2-8
Background
Neuronal-glial tumors (ganglioglioma and dysembryoplastic neuroepithelial tumor) are a frequent cause of focal, drug-resistant and epilepsy in children and young adults, that is amenable for surgical treatment.Aim of paper
Assessment of late outcome of surgical treatment and degree of seizure control, as well as prognostic significance of selected clinical factors.Material and method
52 Pediatric patients presenting with epilepsy, lesion of mesio-basal temporal lobe and histologically verified neuronal-glial tumor treated at our facility since 2000–2011.Results
After the mean follow-up of 2.94 years, satisfactory treatment outcome (Engel classes I and II) was obtained in 92% of the patients (n = 48). Poor outcome (Engel class III) was seen in 8% of patients (n = 4). New neurological deficits appeared in 28% of the patients (n = 20) but in most of them resolved over time.Conclusions
In patients with drug-resistant epilepsy and a lesion of mesial-basal part of temporal lobe suggestive of a glial-neuronal tumor, surgical treatment is strongly recommended, aiming at excision of tumor and elimination of seizures. Histological verification of the lesion is a pre-requisite for optimal treatment planning. In most patients, both treatment goals may be reached. Short duration of epilepsy prior to surgery and young age are favorable prognostic factors. Histological diagnosis of GG, co-existence of cortical dysplasia and location of tumor extending beyond mesial-basal temporal structures are associated with a higher risk of postoperative complications. These may out-weight expected benefits of surgery. 相似文献7.
Association of depression,anxiety and post-traumatic stress disorder with migraine: Data from Kosovo
Introduction
Migraine is ranked as the seventh leading cause of disability worldwide, and it is characterized by a manifestation of combined neurological, gastrointestinal, and autonomic symptoms linked with different provoking factors.Aim of the study
This study investigates the association between migraine and PTSD, depression and anxiety in the Kosovo population during the post-war period.Material and methods
273 war survivors with headache were enrolled in the study and were divided into two groups: 153 individuals with confirmed migraine (the study group) and 120 individuals with non-migraine headaches (control group). All individuals were evaluated using the ICHD-II 2004 diagnostic criteria for migraine, as well as the mini-test for PTSD, MMPI (Minnesota Multiphasic Personality Inventory) for psychological evaluation, PAI (Personality Assessment Inventory) and Hamilton Scale for Depression.Results
Among migraine patients, depressive disorders were present in 27.5% of patients, anxiety was found in 60.8%, and PTSD was present in 39.2%. While the prominence of depression was not different between groups, anxiety was significantly more common (p < 0.05) in women from the control group. PTSD was significantly more common (p < 0.001) in migraine patients overall, whereas the difference in PTSD prevalence between women from the migraine and control groups came close to significance (p = 0.05). Females in the migraine group had higher incidences of aura (50% vs. 25.5%), whereas the incidence of aura in males in each group was approximately equal (9.8% vs. 7.84%).Conclusion
Based on our data, we can confirm an association between PTSD and migraine in a sample of patients from Kosovo. 相似文献8.
Fernanda C. Rueda-Lopes Fernanda M.C. Pessôa Gustavo Tukamoto Fabíola Rachid Malfetano Simone Batista Scherpenhuijzen Soniza Alves-Leon Emerson L. Gasparetto 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(4):256-260
Objective
The aim of our study was to detect functional changes in default-mode network of neuromyelitis optica (NMO) patients using resting-state functional magnetic resonance images and the evaluation of subcortical gray-matter structures volumes.Materials and methods
NMO patients (n = 28) and controls patients (n = 19) were enrolled. We used the integrated registration and segmentation tool, part of FMRIB's Software Library (FSL) to segment subcortical structures including the thalamus, caudate nucleus, putamen, hippocampus and amygdalae. Resting-state functional magnetic resonance images were post-processed using the Multivariate Exploratory Linear Optimized Decomposition into Independent Components, also part of FSL. Average Z-values extracted from the default-mode network were compared between patients and controls using t-tests (P values <0.05 were considered statistically significant).Results
There were areas of increased synchronization in the default-mode network of patients compared to controls, notably in the precuneus and right hippocampus (corrected P < 0.01). The frontal area had decreased synchronization in patients compared to controls (corrected P < 0.01). There were no observed differences between patients and controls in subcortical volumes or average Z-values values for default-mode network.Conclusion
The hyperactivity of certain default-mode network areas may reflect cortical compensation for subtle structural damage in NMO patients. 相似文献9.
A. Kachouchi M. Sebbani S. Salim I. Adali F. Manoudi M. Amine F. Asri 《L'Encéphale》2018,44(5):409-414
Background
Persons with schizophrenia are thought to be at increased risk of committing violent crime – 4 to 6 times the level of general population individuals without this disorder. The relationship between schizophrenia and homicide is complex and cannot be reduced to a simple causal link.Objectives
The objectives of this study were to describe the characteristics of homicide in Moroccan patients suffering from schizophrenia and to determine the correlated sociodemographic, clinical and toxic variables.Methods
The study included two groups of patients with a DSM IV diagnosis of schizophrenia who attended the “Ibn Nafis” university psychiatric hospital of Marrakech in Morocco. The first group was composed of 30 patients hospitalized for homicide in the forensic unit between 1 January 2005 and 31 August 2015. The second group included 90 patients without any criminal record. These two groups have been matched according to age and gender. Demographic, clinical and therapeutic variables were analyzed and compared between the two groups.Results
Data analysis has objectified the following results: the mean of age in the first group was 37.03 (± 9.09) and in the second group was 31.4 (± 8.76). No significant differences were found between the two groups regarding the different sociodemographic variables and the age of onset of disease. Significant differences were found between the two groups regarding: personal antecedents of attempt of homicide (P = 0.003), personal antecedents of attempt of suicide (P < 0.001), a history of previous violence (P = 0.005), untreated psychosis before the act (P < 0.001), poor medication compliance and a low familial support (P < 0.001), antisocial behavior (P < 0.001) and addictive behavior (P = 0.005).Discussion
Several studies identified some possible predictor factors for violent behavior: poor compliance, lack of insight impulsivity and paranoid–hallucinatory symptoms, systematized delusions and addictive behavior seem to considerably increase the risk of turning to violence. Demographic variables as suggested by other studies are less valuable predictors of homicide in patients with schizophrenia.Conclusion
Awareness of these factors will allow us to provide improved prevention of violence within schizophrenic subjects. Interventions for reducing such behavior should focus on clinical variables and integrate an early diagnosis of the disease and an improvement of medication compliance. 相似文献10.
Marta Skowronska Anna Piorkowska Anna Czlonkowska 《Neurologia i neurochirurgia polska》2018,52(2):162-167
Objectives
There is little data about sex differences in carotid atherosclerosis in the early phase after an ischemic event. The aim of this study was to examine the carotid artery atherosclerosis differences between men and women in early phase after TIA or stroke.Methods
Consecutive patients with recent ischemic event, admitted during the first week after symptom onset were examined with ultrasound. Sex differences in degree of stenosis, number of plaques and plaque morphology were compared. Plaque morphology was assessed by gray-scale median (GSM), according to which lower values were associated with hemorrhagic/necrotic core indicating plaque instability.Results
Of the 316 patients with ischemic events, 196 (50.5% male) entered the study. Men had more often moderate as well as severe ipsilateral carotid stenosis (12.1% vs 7.2% for moderate and 12.1% vs 2.1% for severe; p = 0.024). Men had more often the largest plaque hypoechogenic contralateral (62.6% vs 37.1%, p = 0.0008), but not ipsilateral. Men had 3 or more hypoechogenic plaques (24.2% vs 4.1%, p = 0.0001; 17.2% vs 4.1%, p < 0.0001) both ipsi and contralateral respectively. Male sex was a risk factor for having 3 or more ipsilateral hypoechogenic plaques (p = 0.002, OR = 20 CI 95% [5.5–75].Conclusions
Men had more often carotid stenosis and higher number of hypoechogenic plaques. 相似文献11.
Anna Starostka-Tatar Beata Łabuz-Roszak Michał Skrzypek Anetta Lasek-Bal Mariusz Gąsior Marek Gierlotka 《Neurologia i neurochirurgia polska》2018,52(2):252-262
Introduction
The available data on acute stroke (AS) in Poland come mainly from non-representative cohorts or are outdated. Therefore, the current study was done to access the most recent data on AS in the industrial region that covers 12% (4.6 mln) of the country's population.Objective
To evaluate the epidemiological data of AS in the Silesian Province, Poland.Patients and methods
Analysis of the data from stroke questionnaires, obligatory for all patients hospitalized due to AS and administered by the only public health insurer in Poland (the National Health Fund) between 2009 and 2015 (n = 81,193).Results
The annual number of hospitalizations due to AS in the analyzed period was between 239 and 259 per 100,000 inhabitants of the Silesian Province. Haemorrhagic stroke constituted 13.3%, ischaemic stroke – 85.5%, and unspecified stroke – 1.2%. The average age of patients was 71.6 ± 12.2 years (M 68.2 ± 11.9, F 74.8 ± 11.9, P < 0.05). The mean duration of hospitalization was 17 ± 16 days for haemorrhagic stroke, and 14 ± 11 days for ischaemic stroke. Large-artery atherosclerosis (36.1%) and cardioembolism (18.7%) constituted the main causes of ischaemic stroke. Overall hospital mortality for AS was 18% (haemorrhagic – 40.8%, ischaemic – 14.9%). A decreasing trend in mortality was observed in ischaemic but not in haemorrhagic stroke. In-hospital mortality was significantly higher in women than in men (P < 0.05).Conclusions
This comprehensive long-term analysis of the epidemiological situation related to AS in the industrial region of Poland should encourage further development of educational and treatment programmes for improvement in the health status of the population. 相似文献12.
Agnieszka Niemierzycka Krzysztof Tomczuk Mirosław Mikicin Agnieszka Zdrodowska Grzegorz Orzechowski Marek Kowalczyk 《Neurologia i neurochirurgia polska》2018,52(4):505-513
Objective
The article represents the preliminary study, with the aim of the experiment being to examine whether different types of light sources used commonly in building interiors combined with various color temperature have an effect on EEG activity. The effect of frequency pulsation and color temperature on brain activity in EEG examinations in the beta 2 band was assumed.Material/participants
Twenty healthy men aged 19–25 years participated in the experiment.Methods
The research stand was lit by: LED diodes with color temperatures of 3000 K, 4200 K, 6500 K, with the power supplied using the pulse width modulation (PWM) method with the current frequency of 122 Hz, linear fluorescent tubes (3000 K, 6500 K), with the power supplied with the frequency of 50 Hz and 52 kHz from the electromagnetic and electronic ballasts, and the conventional light bulb, with the power supplied directly from the mains electricity, used as a reference light. System Flex 30 apparatus with TrueScan software was used to record the EEG signal. The examination used two factors (speed and accuracy) of the Kraepelin's work curve to describe changes in work performance for various types of lighting.Results
The results demonstrate that the use of different types of emission of light and color temperature of the light have an effect on bioelectrical brain activity and work performance.Conclusions
The highest activity of brain waves concerns the beta band in the frequency range of 21–22 Hz, regardless of the type of the light source (LED, fluorescent tube). The methods used to supply power and color temperature of fluorescent tubes do not significantly affect bioelectrical brain activity during “work”, but previous lighting with fluorescent tubes during work has an essential effect on bioelectrical brain activity during rest. Regardless of the color temperature, LED lighting with PWM power supply leads to the highest bioelectrical activity (mainly in the range of 21–22 Hz) in the brain during work and rest, which might suggests the usefulness of this method of supplying power for everyday work. Incandescent light does not affect the bioelectrical brain activity during work and rest. 相似文献13.
Min Soo Kim Sung Ho Park Eun Suk Park Jun Bum Park Soon Chan Kwon In Uk Lyo Hong Bo Sim 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(5):310-315
Purpose
The purpose of this study was to verify changes in diffusion tensor imaging (DTI) factors in patients with brain metastases treated with stereotactic radiotherapy (SRT). We also investigated the impact of SRT on peritumoral volumes though the use of DTI.Methods
A total of 28 patients with brain metastases who had undergone SRT between March 2014 and December 2015 were enrolled. Magnetic resonance imaging with DTI factors, such as fractional anisotropy (FA) and apparent diffusion tensor (ADC) value, was performed 1 day before the procedure and 3 months after the procedure. DTI data from tumor lesions, edema volumes, and the volumes that received 12 Gy were measured.Results
Tumor volume (P = 0.001) and ADC values in the volumes that received 12 Gy (P = 0.018) and the edema volumes (P = 0.003) significantly decreased after the procedure. Decreases in tumor volume were only correlated with decreases in edema volumes (P < 0.001). Decreases in edema volumes were correlated with increases in FA values and decreases in ADC values of the volumes that received 12 Gy [P = 0.019 (FA)/0.002 (ADC)] and the edema volumes [P = 0.011 (FA)/0.002 (ADC)].Conclusions
It was possible to quantify changes in peritumoral volumes in patients with brain metastases after SRT by using DTI. ADC values of peritumoral volumes decreased significantly after SRT. Therefore, it was confirmed through DTI that performing SRT on tumor lesions has a positive effect on the structure and function of peritumoral volumes. 相似文献14.
Les facteurs de rémission du trouble de l’adaptation : la parole aux patients. Une étude qualitative
Gerrit Weber Laurent Michaud Orest Weber Friedrich Stiefel Sonia Krenz 《Annales médico-psychologiques》2018,176(10):948-953
Background
Adjustment disorder (AD) is a frequent clinical diagnosis defined by the patient's reaction to an external factor and reversibility. While it is known that the prevalence of AD varies depending on setting and diagnostic tools utilized, the literature is rather scarce when it comes to AD's investigation or remission factors. Unlike other psychiatric disorders, the fact that there is a factor triggering AD makes it especially suitable to learn more about triggering elements, reversibility and factors of remission.Objectives
To study the evolution of AD, to identify and categorize AD remission factors from the patient's perspective.Methods
We interviewed by means of semi-structured approach patients (n = 11) who consulted the emergency and crisis psychiatric unit of Lausanne University Hospital (CHUV) for an AD and who presented a positive evolution in the following four months. Interviews were transcribed and then analyzed to identify and categorize the remission factors evoked by the patients; categorization was then confirmed by a consensus within the research group.Results
We identified three main categories of remission factors (aggregated from 11 subcategories and 101 items) based on the interviews: (i) relational factors (5 subcategories, 46 items), (ii) personal factors (5 subcategories, 36 items) and (iii) factors related to life events (3 subcategories, 19 items). No patient explained his remission by factors of one single category. On the contrary, our study reveals that a variety of remission factors exists, with 4 to 14 different factors having been reported to play a crucial role in remission of AD.Conclusions
Relationships play an important role in remission of AD, but personal and life events also contribute in a complex way. According to the patients, mental health professionals are part of a favorable evolution of AD, especially by means of their containing presence, their neutrality and their invitation to “think with the patient”. Our observations call for a therapeutic intervention with a particular focus on the therapeutic relationship – therapeutic alliance – in which the clinician is aware that remission of AD is multifactorial and dynamic. 相似文献15.
Ho Cheol Choi Sung Eun Park Dae Seob Choi Hwa Seon Shin Ji Eun Kim Hye Young Choi Mi Jung Park Eun Ha Koh 《Journal of neuroradiology. Journal de neuroradiologie》2018,45(4):217-223
Background and purpose
Rupture of the extracranial carotid artery is a rare, but potentially disastrous event. We aimed to review the clinical presentations and radiologic findings of this entity and to evaluate the efficacy of endovascular treatment with covered stent graft.Materials and methods
Since January 2009, eight patients with extracranial carotid artery rupture received endovascular treatment with covered stent graft. We retrospectively reviewed their medical records and radiologic findings.Results
The ruptured sites were in the common carotid artery (n = 5), cervical ICA (n = 2) and petrous ICA (n = 1), respectively. The causes of injury included spontaneous (n = 2), carotid blowout syndrome (CBS) (n = 2), iatrogenic (n = 2) and traumatic (n = 2). Technical success and immediate hemostasis were achieved in all cases. Procedure-related complications occurred in 3 patients (37.5%). In a patient, the ipsilateral angular branch of the MCA was occluded during the procedure and it was completely reopened via mechanical thrombectomy without any neurologic deficit. Minor cerebral infarction was developed in 2 patients (25%). During a mean follow-up of 334 days (range 3–2053 days), two patients died: one from recurrent CBS and the other from aspiration pneumonia.Conclusions
The covered stent grafting is an effective method for the treatment of extracranial carotid artery rupture. 相似文献16.
J.A. Crespo-Burillo D. Rivero-Celada A. Saenz-de Cabezón J. Casado-Pellejero J. Alberdi-Viñas R. Alarcia-Alejos 《Neurología (Barcelona, Spain)》2018,33(3):154-159
Introduction
Our aim is to assess the burden on caregivers of patients with Parkinson's disease treated with deep brain stimulation (DBS) compared to those caring for patients at advanced stages and undergoing other treatments. We have also assessed the variables associated with presence of caregiver overload.Material and methods
We included consecutive patients with Parkinson's disease treated with DBS. Our control group included patients in advanced stages of Parkinson's disease undergoing other treatments. Patients were assessed with the following scales: UPDRS-II, UPDRS-III, UPDRS-IV, Hoehn and Yahr, Schwab & England, Barthel, PDQ-39, MoCA, Apathy Evaluation Scale, HADS, and the abbreviated QUIP. Caregiver burden was evaluated with the Zarit caregiver burden interview and their moods were assessed with the HADS scale.Results
We included 11 patients treated with DBS and 11 with other treatments. For patients treated with DBS, we observed a better quality of life according to the PDQ-39 questionnaire (P = .028), and a lower score on the HADS anxiety subscale (P = .010). Caregiver overload was observed in 54.5% of the caregivers of patients in both groups (P = 1.000); Zarit scores were similar (P = .835). Caregiver overload was associated with higher scores on the caregiver's Apathy Evaluation Scale (P = .048) and on the HADS anxiety subscale (P = .006).Conclusion
According to our results, treatment with DBS is not associated with lower caregiver burden. Apathy in patients and anxiety in caregivers are factors associated with the appearance of overload. 相似文献17.
Joanna Wzorek Marek Karpiński Ewa Wypasek Michał Michalski Andrzej Szczudlik Krzysztof Piotr Malinowski Anetta Undas 《Neurologia i neurochirurgia polska》2018,52(3):352-358
Objective
Genetic background of cryptogenic ischemic stroke (IS) and transient ischemic attack (TIA) remains uncertain. Alpha-2-antiplasmin (α2AP) Arg407Lys polymorphism has been shown to be less common in patients with abdominal aortic aneurysm (AAA) compared with healthy controls. We investigated associations of α2AP Arg407Lys polymorphism with cryptogenic IS and TIA.Methods
We studied 165 consecutive Caucasian patients who experienced cryptogenic IS (n = 123) or TIA (n = 42). Neurological outcomes were assessed using the modified Rankin Scale (mRS) in the acute phase of cerebral ischemia and 8 (6–12) months after the index episode. Patients were genotyped for α2AP Arg407Lys polymorphism (rs1057335) using real time PCR technique.Results
The allele frequency of Arg407Lys polymorphism was: 0.82/0.18. The 407Lys allele was more frequent in TIA patients compared to the IS group (0.29 vs. 0.14, p = 0.003). In the whole group, as well as in IS and TIA patients analyzed separately, possession of the 407Lys allele was associated with excellent outcome (mRS 0–1) during follow-up (p < 0.05) but not in the acute phase of ischemic events both in thrombolyzed and nonthrombolyzed IS patients.The multivariate logistic regression model showed that the excellent outcome (mRS 0–1) assessed after 8 (6–12) months since the index cerebral ischemia was predicted by the occurrence of Lys407 allele (OR 6.18, 95% CI, 2.01–18.98, p = 0.001).Conclusion
The presence of 407Lys allele is associated with better prognosis in cryptogenic cerebrovascular events. Our findings suggest that the α2AP Arg407Lys polymorphism could be involved in the pathogenesis of cerebral ischemia and its outcomes. 相似文献18.
Objectives
The Hamilton Depression Rating Scale (HDRS) is the most commonly used scale for the evaluation of patients’ treatments for depression. Since the HDRS has never been validated in Lebanon to our knowledge, our primary objective, therefore, is to investigate the correlation, sensitivity, specificity, as well as the reliability and the validity of the Hamilton Depression Rating Scale (HDRS) among Lebanese depressed patients. The secondary objective is to identify sociodemographic factors that would be correlated to depression among our sample.Methods
This case-control study, performed between January till May 2017, included 400 patients (200 patients, 200 controls).Results
The HDRS scale items converged over a solution of four factors, explaining a total of 58.88% of the variance. A high Cronbach's alpha was found for the full scale (0.862). A stepwise linear regression, using the total HDRS score as continuous variable, showed that a low socioeconomic level, divorced participants and a family history of mental disorders would significantly increase the HDRS total score (Beta = 4.278; Beta = 5.405; and Beta = 3.922) respectively. However, having a university level of education would significantly decrease the HDRS total score (Beta = ?4.248, P < 0.001).Conclusion
This study shows that the Arabic version of the HDRS has promising psychometric properties, making it a good tool to use for the diagnosis of patients with depression. Depression recognition and treatment in general practice with the aim of improving patient outcome and reducing health care expenditure, is definitely warranted. 相似文献19.
Asli Bolayir Seyda Figul Gokce Burhanettin Cigdem Hasan Ata Bolayir Ozlem Kayim Yildiz Ertugrul Bolayir Suat Ahmet Topaktas 《Neurologia i neurochirurgia polska》2018,52(2):150-155
Objective
The inflammatory process is a very important stage in the development and prognosis of acute ischemic stroke (AIS). The monocyte to high-density lipoprotein (HDL) ratio (MHR) is accepted as a novel marker for demonstrating inflammation. However, the role of MHR as a predictor of mortality in patients with AIS remains unclear.Methods
We retrospectively enrolled 466 patients who were referred to our clinic within the first 24 hours of symptom presentation and who were diagnosed with AIS between January 2008 and June 2016. Four hundred and eight controls of similar age and gender were also included. The patient group was classified into two groups according to 30-day mortality. The groups were compared in terms of monocyte counts, HDL, and MHR values.Results
The patient group had significantly higher monocyte counts and lower HDL levels; therefore, this group had higher values of MHR compared to controls. Additionally, the monocyte count and MHR value were higher, and the HDL level was lower in non-surviving patients (p < 0.001). The MHR value was also observed as a significant independent variable of 30-day mortality in patients with AIS (p < 0.001). The optimum cut-off value of MHR in predicting the 30-day mortality for patients with AIS was 17.52 (95% CI 0.95–0.98).Conclusion
Our study demonstrated that a high MHR value is an independent predictor of 30-day mortality in patients with AIS. 相似文献20.
P. Koskas C. Pons-Peyneau N. Houenou-Quenum M. Romdhani M. Gasmi S. Galleron O. Drunat 《Revue neurologique》2018,174(1-2):36-43