Does fatigue in Parkinson’s disease correlate with autonomic nervous system dysfunction?

Background

Despite its negative impact on quality of life, fatigue in Parkinson’s disease (PD) remains an under-recognized issue and the underlying pathology is undetermined.

Objective

To contribute at understanding the pathogenesis of fatigue in a naturalistic cohort of cognitively intact PD patients.

Methods

In a Caucasian population of PD patients (n?=?27), we evaluated to what extent fatigue (quantified as PFS-16 score) is associated with PD duration and with autonomic dysfunction, studied by both MIBG scintigraphy and autonomic nervous system testing. The latter included the head-up tilt test, Valsalva maneuver, deep breathing, and handgrip tests.

Results

PFS-16 score correlated with disease duration (R?=?0.57, p?=?0.002). Fatigue showed a clear correlation with deep breathing test (R?=???0.53, p?=?0.004) but not with the MIBG H/M ratios.

Conclusions

Our data are consistent with a multifactorial pathogenesis of fatigue and with effects of dopamine depletion in PD-related fatigue; on the other hand, our findings do not support a role for sympathetic denervation in PD-related fatigue.

     

Single-Session Behavioral Interventions for Sexual Risk Reduction: A Meta-Analysis

Background

Evidence-based, single-session STI/HIV interventions to reduce sexual risk taking are potentially effective options for implementation in resource-limited settings and may solve problems associated with poor participant retention.

Purpose

The purpose of the study is to estimate the efficacy of single-session, behavioral interventions in reducing unprotected sex or increasing condom use.

Methods

Data sources were searched through April 2013 producing 67 single-session interventions (52 unique reports; N?=?20,039) that included outcomes on condom use and/or unprotected sex.

Results

Overall, participants in single-session interventions reduced sexual risk taking relative to control groups (d ₊ ?=?0.19, 95 % CI?=?0.11, 0.27). Within-group effects of the interventions were larger than the between-groups effects when compared to controls.

Conclusions

Brief, targeted single-session sexual risk reduction interventions demonstrate a small but significant effect and should be prioritized.

     

Association between obesity and depressive symptoms in Mexican population

Purpose

Obesity and depression are among the leading causes of disability in Mexico, but their association has not been explored yet. The aim of the current study was to investigate the association between obesity and depression in Mexican population.

Methods

We used data from the health and nutrition survey (ENSANUT 2012), which is representative of the Mexican population. Obesity was determined using the body mass index (BMI) and abdominal obesity by measuring waist circumference. Depressive symptoms were reported using the Center for Epidemiological Studies Depression Scale Short-Form (CES-D-SF, scale 0–21). Regression analyses were performed between obesity and depression, adjusting for gender, age, living with a partner, education, and diabetes history.

Results

Obese women had 1.28 (95% CI 1.07–1.53) times the odds of having depression in comparison with normal-weight women, whereas no association was found for men (OR 0.94; 95% CI 0.74–1.19). A significant association between BMI and depressive symptoms score (β?=?0.05, 95% CI 0.02–0.07) was present in women, but no association was found for men (β?=???0.02, 95% CI ??0.05 to 0.00). There was a statistically significant association between waist circumference and depression scores again for women (β?=?0.03, 95% CI 0.01–0.04) but not for men (β?=?0.00, 95% CI ??0.01 to 0.01). No associations were found between abdominal obesity and depression for both genders. No association was found between different obesity severity levels and depression for both genders.

Conclusion

Obesity was associated with depression in Mexican women, whereas no association was found between obesity and depression in men.

     

Identifying barriers to help-seeking for sexual dysfunction in multiple sclerosis

Background

Sexual dysfunction (SD) is common in multiple sclerosis (MS), however, under-reported.

Objective

The aim of this study was to identify barriers faced by patients with MS and healthcare professionals (HCPs) in discussing SD.

Methods

This was a two-part prospective study carried out at a tertiary care centre. Patients with MS were surveyed using a 29-item questionnaire and SD was assessed using the MSISQ and ASEX questionnaires; depression screened with PHQ-2. HCPs were surveyed using a 23-item questionnaire.

Results

Seventy four patients (mean age 42.4?±?10.7, 54 females) and 98 HCPs (mean age 45.8?±?8.9, 90 females) participated. SD was significant, with primary (36.4%), secondary (27%) and tertiary (29.8%) contributory factors. Commonest barriers reported by patients were dominance of neurological symptoms (N?=?30, 40.5%), presence of family or friends (N?=?28, 37.8%), and not being asked (N?=?25, 33.8%), while HCPs reported presence of family or friends (N?=?34, 34.7%), lack of knowledge about SD (N?=?30, 30.6%), and inadequate time during the consultation (N?=?27, 27.6%).

Conclusions

Barriers to discussing SD are similar between patients and HCPs. The most common barriers are addressable through modifications in the clinic environment, raising awareness and providing training opportunities.

     

Perceptions of free will in obsessive-compulsive disorder: a quantitative analysis

Background

The aim of this study was to explore perceptions of free will in the repetitive behaviors of patients with obsessive-compulsive disorder (OCD) and to explore their relation with core clinical characteristics.

Methods

Experiences of free will were assessed with the Symptomatology And Perceived Free will rating scale (SAPF) in 295 subjects with a lifetime diagnosis of OCD. Patients’ scores on the SAPF were subjected to an explorative principal axis factor analysis (PAF). Factor scores were regressed on five OCD symptom dimensions and on seven clinical variables: illness duration, severity of OCD, insight, anxiety and depression, suicidal ideation and quality of life.

Results

The PAF revealed three factors: the perceived ability to control and change one’s course of action when faced with an obsession or compulsion (the “alternative possibilities” factor); the experience of obsessions or compulsions as intentional (the “intentionality” factor); and the experience of being the source or owner of the obsessions or compulsions (the “ownership” factor). Lower scores on the “alternative possibilities” factor were associated with lower scores on the washing dimension (β?=?0.237, p?=?0.004) and higher scores on the precision dimension (β?=???0.190, p?=?0.025) and independently associated with longer illness duration (β?=???0.134, p?=?0.039), higher illness severity (β?=???0.298, p?<?0.001) and lower quality of life (β?=?0.172, p?=?0.046). Lower scores on the “intentionality” factor were independently associated with lower quality of life (β?=?0.233, p?=?0.027). Higher scores on the “ownership” factor were associated with higher scores on the precision dimension (β?=?0.207, p?=?0.023) and independently associated with poorer insight (β?=?0.170, p?=?0.045).

Conclusions

The most notable finding of this study is that a diminished experience of free will in OCD is associated with core clinical characteristics: illness duration and severity, insight and quality of life.

     

Methylenetetrahydrofolate reductase C677T polymorphism and susceptibility to epilepsy

Background

Methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism was reported as risk factor for multiple diseases due to its role in conversion of homocysteine to methionine. The aim of the present meta-analysis was to find out the validity of association of C677T polymorphism with epilepsy susceptibility.

Methods

Pubmed, Science Direct, Springer Link and Google Scholar, databases were searched for relevant studies up to January, 31, 2018. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were performed using five genetic models. All statistical analysis was done by MetaAnalyst and Mix programs.

Results

Except recessive model, significant association was found between MTHFR C677T polymorphism and epilepsy risk in other four genetic models (T vs C: OR?=?1.29, 95% CI?=?1.08–1.52, p?=?0.004; TT vs CC: OR?=?1.48, 95% CI?=?1.19–1.82, p?=?0.0003; TT + CT vs CC: OR?=?1.20, 95% CI?=?1.05–1.38, p?=?0.008; TT vs CT + CC: OR?=?1.35, 95% CI?=?1.11–1.62, p?=?0.002). Similarly, in the subgroup analysis based on ethnicity, significant association was found in Asian (T vs C: OR?=?1.85; 95% CI?=?1.15–2.99; p?=?0.03) and Caucasian populations (TT vs CC: OR?=?1.38; 95% CI?=?1.10–1.1.73; p?=?0.005). No evidence of heterogeneity and publication bias was detected in present meta-analysis.

Conclusion

In conclusion, results of present meta-analysis suggested that 677T allele of MTHFR is significantly increases the epilepsy susceptibility.

     

An emotion recognition subtyping approach to studying the heterogeneity and comorbidity of autism spectrum disorders and attention-deficit/hyperactivity disorder

Background

Emotion recognition dysfunction has been reported in both autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). This suggests that emotion recognition is a cross-disorder trait that may be utilised to understand the heterogeneous psychopathology of ASD and ADHD. We aimed to identify emotion recognition subtypes and to examine their relation with quantitative and diagnostic measures of ASD and ADHD to gain further insight into disorder comorbidity and heterogeneity.

Methods

Factor mixture modelling was used on speed and accuracy measures of auditory and visual emotion recognition tasks. These were administered to children and adolescents with ASD (N?=?89), comorbid ASD?+?ADHD (N?=?64), their unaffected siblings (N?=?122), ADHD (N?=?111), their unaffected siblings (N?=?69), and controls (N?=?220). Identified classes were compared on diagnostic and quantitative symptom measures.

Results

A four-class solution was revealed, with the following emotion recognition abilities: (1) average visual, impulsive auditory; (2) average-strong visual and auditory; (3) impulsive/imprecise visual, average auditory; (4) weak visual and auditory. The weakest performing class (4) contained the highest percentage of patients (66.07%) and the lowest percentage controls (10.09%), scoring the highest on ASD/ADHD measures. The best performing class (2) demonstrated the opposite: 48.98% patients, 15.26% controls with relatively low scores on ASD/ADHD measures.

Conclusions

Subgroups of youths can be identified that differ both in quantitative and qualitative aspects of emotion recognition abilities. Weak emotion recognition abilities across sensory domains are linked to an increased risk for ASD as well as ADHD, although emotion recognition impairments alone are neither necessary nor sufficient parts of these disorders.

     

The Perceived and Built Environment Surrounding Urban Schools and Physical Activity Among Adolescent Girls

Background

Neighborhood perceived/built environment and physical activity (PA) associations have been examined for adolescents around homes, but not surrounding schools.

Purpose

The purpose of this paper is to examine if positive perceptions/built environment in neighborhoods surrounding schools predict PA among low-income, urban adolescent girls.

Methods

Measures include: minutes in moderate-vigorous PA (MVPA, ankle accelerometry), perceptions of the school environment (questionnaire), built environment (neighborhood audit). Analyses include multi-level models.

Results

Two hundred twenty-four sixth and seventh grade girls [mean(sd) age?=?12.1(0.7)?years] from 12 schools serving low-income, primarily African American communities; mean MVPA 35.4 min (mean days assessed?=?5.8). Girls in schools with more positive perceptions of the neighborhood environment surrounding the school were less active (β?=?7.2, p?=?0.043). Having “places to go within walking distance” (perceptions) and number of food stores near school (built environment) positively relate to MVPA (β?=?5.5, p?=?0.042 and β?=?0.59, p?=?0.047).

Conclusions

Among neighborhoods surrounding urban schools, positive perceptions do not predict PA; accessibility, via both perceived and built environment, support PA.

     

Can risk assessment predict suicide in secondary mental healthcare? Findings from the South London and Maudsley NHS Foundation Trust Biomedical Research Centre (SLaM BRC) Case Register

Purpose

The predictive value of suicide risk assessment in secondary mental healthcare remains unclear. This study aimed to investigate the extent to which clinical risk assessment ratings can predict suicide among people receiving secondary mental healthcare.

Methods

Retrospective inception cohort study (n?=?13,758) from the South London and Maudsley NHS Foundation Trust (SLaM) (London, UK) linked with national mortality data (n?=?81 suicides). Cox regression models assessed survival from the last suicide risk assessment and ROC curves evaluated the performance of risk assessment total scores.

Results

Hopelessness (RR?=?2.24, 95% CI 1.05–4.80, p?=?0.037) and having a significant loss (RR?=?1.91, 95% CI 1.03–3.55, p?=?0.041) were significantly associated with suicide in the multivariable Cox regression models. However, screening statistics for the best cut-off point (4–5) of the risk assessment total score were: sensitivity 0.65 (95% CI 0.54–0.76), specificity 0.62 (95% CI 0.62–0.63), positive predictive value 0.01 (95% CI 0.01–0.01) and negative predictive value 0.99 (95% CI 0.99–1.00).

Conclusions

Although suicide was linked with hopelessness and having a significant loss, risk assessment performed poorly to predict such an uncommon outcome in a large case register of patients receiving secondary mental healthcare.

     

Community-level social capital,parental psychological distress,and child physical abuse: a multilevel mediation analysis

Purpose

The purpose of this study was to investigate the association between community-level social capital and physical abuse towards children, and the mediating effect of parental psychological distress by multilevel mediation analyses.

Methods

We analyzed data from a population-based study of first-grade elementary school children (6–7 years old) in Adachi City, Tokyo, Japan. The caregivers of first-grade students from all elementary schools in Adachi City (N?=?5355) were asked to respond to a questionnaire assessing parents’ self-reported physical abuse (beating and hitting) and neighborhood social capital. Among them, 4291 parents returned valid responses (response rate 80.1%). We performed multilevel analyses to determine the relationships between community-level parental social capital and physical abuse, and further multilevel mediation analyses were performed to determine whether parental psychological distress mediated the association.

Results

Low community-level social capital was positively associated with physical abuse (both beating and hitting) after adjustment for other individual covariates (beating: middle, OR?=?1.54, 95% CI 1.11–2.13; low, OR?=?1.33, 95% CI 0.94–1.88; and hitting: middle, OR?=?1.35, 95% CI 1.02–1.80; low, OR?=?1.16, 95% CI 0.86–1.57). Multilevel mediation analyses revealed that community-level parental psychological distress did not mediate the association (indirect effect ß?=?0.10, 95% CI ??0.10 to 0.29, p?=?0.34 for beating; ß?=?0.03, 95% CI ??0.16 to 0.23, p?=?0.74 for hitting).

Conclusions

Fostering community-level social capital might be important for developing a strategy to prevent child maltreatment, which may have a direct impact on abusive behavior towards children.

     

Predictors of Moderate-to-Vigorous Physical Activity (MVPA) in African American Young Adolescents

Background

African American adolescents residing in the South are at increased risk for obesity and physical inactivity, yet our understanding of potential influences is limited.

Purpose

Using an ecological framework, this study explored multilevel predictors (individual, family, home, and neighborhood environment) of moderate-to-vigorous physical activity (MVPA) among 116 African American adolescents (ages 12–16).

Methods

Adolescents and their parents completed self-report surveys for hypothesized predictors. Youth physical activity was measured using accelerometry.

Results

In multiple regression models, decreased daily MVPA was associated with female sex (β?=??24.27, p?<?0.0001). Family social support (β?=?1.07, p?=?0.004) and adolescent self efficacy for PA (β?=?6.89, p?=?0.054) were positively associated with daily MVPA.

Conclusions

Adolescent demographics along with family social support and self-efficacy influence younger African American adolescent physical activity. Further exploration of the complex interaction of multiple levels of influence is needed to develop appropriate interventions for this vulnerable group.

     

Primary lateral sclerosis and the amyotrophic lateral sclerosis–frontotemporal dementia spectrum

Aim

To investigate whether primary lateral sclerosis (PLS) represents part of the amyotrophic lateral sclerosis–frontotemporal dementia (ALS–FTD) spectrum of diseases.

Methods

Comprehensive assessment was taken on 21 patients with PLS and results were compared to patients diagnosed with pure motor ALS (n?=?27) and ALS–FTD (n?=?12). Clinical features, Addenbrooke’s Cognitive Examination (ACE) scores, Motor Neuron Disease Behaviour (Mind-B) scores, motor disability on the ALS functional rating scale (ALSFRS) and survival times were documented. Motor cortex excitability was evaluated using transcranial magnetic stimulation (TMS).

Results

Global cognition was impaired in PLS (mean total ACE score 82.5?±?13.6), similar to ALS–FTD (mean total ACE score 76.3?±?7.7, p?>?0.05) while behavioural impairments were not prominent. TMS revealed that resting motor threshold (RMT) was significantly higher in PLS (75.5?±?6.2) compared ALS–FTD (50.1?±?7.2, p?<?0.001) and ALS (62.3?±?12.6, p?=?0.046). Average short-interval intracortical inhibition (SICI) was similar in all three patient groups. The mean survival time was longest in PLS (217.4?±?22.4 months) and shortest in ALS–FTD (38.5?±?4.5 months, p?=?0.002). Bulbar onset disease (β?=???0.45, p?=?0.007) and RMT (β?=?0.54, p?=?0.001) were independent predictors of global cognition while motor scores (β?=?0.47, p?=?0.036) and SICI (β?=?0.58, p?=?0.006) were significantly associated with ALSFRS.

Conclusion

The cognitive profile in PLS resembles ALS–FTD, without prominent behavioural disturbances. A higher RMT in PLS than ALS and ALS–FTD is consistent with differential cortical motor neuronal abnormalities and more severe involvement of corticospinal axons while SICI, indicative of inhibitory interneuronal dysfunction was comparable with ALS and ALS–FTD. Overall, while these findings support the notion that PLS lies on the ALS–FTD spectrum, the mechanisms underlying slow disease progression are likely to be distinct in PLS.

     

Bone mineral density in pediatric patients with meningomyelocele

Purpose

The aim of this study was to determine the bone mineral density (BMD) and the factors leading to reduction in BMD in children diagnosed with meningomyelocele.

Methods

A total of 31 patients with meningomyelocele (mean (SD) age, 8.5 (3.9) years; 51.6 % were females) and 22 healthy children were included. BMD of femoral neck and spinal L1–L4 levels and markers for bone metabolism were recorded.

Results

BMD of femoral neck (p?=?0.001) and spinal L1–L4 (p?=?0.01), serum calcium (p?=?0.031), and urinary deoxypyridinoline (p?=?0.015) levels were significantly lower in patients than in controls. Mobilization was significantly reduced in lumbar (p?=?0.001) and thoracic (p?=?0.002) level meningomyelocele compared to controls, while a significant positive correlation was noted between BMD of spinal L1–L4 and mobility (r?=?0.58, p?=?0.015).

Conclusions

Our findings suggest a decrease in BMD in meningomyelocele patients being associated with osteoporosis rather than nutritional and hormonal factors and the negative impact of higher levels of lesion on the mobility.

     

Depression literacy and health-seeking attitudes in the Western Pacific region: a mixed-methods study

Purpose

Depression literacy refers to the ability to recognize depression and make informed decisions about its treatment. To date, relatively little research has been done to examine depression literacy in the Western Pacific region. Given the pervasiveness of depression and the need to enhance mental health care in this region, it is important to gain a better understanding of depression literacy and health-seeking behaviors in this part of the world.

Methods

This mixed-methods study utilized a convergent parallel design to examine depression literacy and the associated health-seeking attitudes among urban adults from three countries—Cambodia, Philippines, and Fiji. A total of 455 adults completed a quantitative survey on depression knowledge, attitudes, and professional help seeking. Separately, 56 interviewees from 6 focus groups provided qualitative data on their impression and knowledge of depression and mental illness within the context of their local communities.

Results

Overall, results showed that depression knowledge was comparatively lower in this region. Controlling for differences across countries, higher knowledge was significantly associated with more positive attitudes towards mental illness (B?=???0.28, p?=?0.025) and professional help seeking (B?=?0.20, p?<?0.001). Financial stability, such as employment, was also a salient factor for help seeking.

Conclusions

This study was the first to provide a baseline understanding on depression literacy and highlights the need to increase public knowledge on depression in the Western Pacific. Culturally congruent recommendations on enhancing depression literacy in this region, such as anti-stigma campaigns, use of financial incentives, and family-based approach in health education, are discussed.

     

Correlation of occupational stress with depression,anxiety, and sleep in Korean dentists: cross-sectional study

Background

This study aimed to investigate the degree of occupational stress and the clinical mental state of dentists. In addition, we investigated the correlation of occupational stress with depression, anxiety, and sleep among dentists in Korea.

Methods

A cross-sectional survey on 231 dentists was conducted using the Doctor Job Stress Scale, Center for Epidemiologic Studies Depression Scale (CES-D), State-Trait Anxiety Index (STAI), and Pittsburgh Sleep Quality Index (PSQI). Correlation of occupational stress with mental health was investigated by adjusted multiple regression analysis.

Results

The scores of CES-D, STAI, and PSQI revealed a significant correlation with the Doctor Job Stress Scale (t?=?3.93, P?<?0.0001; t?=?4.05, P?<?0.0001; t?=?4.18, P?<?0.0001, respectively). In particular, patient factors and clinical responsibility/judgment factors were significantly associated with depression (t?=?2.80, P?=?0.0056; t?=?4.93, P?<?0.0001, respectively), anxiety (t?=?2.35, P?=?0.0195; t?=?5.11, P?<?0.0001, respectively), and sleep (t?=?3.78, P?=?0.0002; t?=?4.30, P?<?0.0001, respectively), whereas work factors were not associated with any mental health state.

Conclusions

This study confirms that dentists as professions experience more severe mental states. For successful mental health care among dentists, stress management focusing on interpersonal relationship with patients and responsibility as an expert rather than the intensity of work should be considered.

     

The efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine: a meta-analysis

Objective

This meta-analysis was performed to evaluate the efficacy and safety of monoclonal antibodies against calcitonin gene-related peptide (CGRP) for episodic migraine prevention.

Methods

MEDLINE, EMBASE, Web of Science, and the Cochrane Library were searched from inception to April 2018. Studies considered to be eligible were randomized controlled trials about efficacy and safety of calcitonin gene-related peptide monoclonal antibody for episodic migraine prevention.

Results

Eight randomized controlled trials involving 2292 patients were included. The outcomes of this meta-analysis presented that CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly reduced the monthly migraine days from baseline [weighted mean difference (WMD)?=???1.52; 95%CI, ??1.92 to ??1.11; Z?=?7.40; P?<?0.001] and monthly acute migraine-specific medication consumption from baseline [WMD?=???1.45; 95%CI, ??2.17 to ??0.72; Z?=?3.93; P?<?0.001], as compared with placebo group. CGRP monoclonal antibodies for preventive treatment of episodic migraine significantly increased the ≥?50% reduction from baseline in migraine days per month [RR?=?1.54; 95%CI, 1.38 to1.71; Z?=?7.88; P?<?0.001]. The adverse events were similar between the CGRP monoclonal antibody group and placebo group (P?=?0.998). The outcomes of subgroup analysis showed that erenumab, galcanezumab, and fremanezumab significantly reduced the monthly migraine days from baseline and increased the ≥?50% reduction from baseline in migraine days per month. Both erenumab and fremanezumab significantly reduced from baseline.

Conclusions

Based on the results of this meta-analysis, CGRP monoclonal antibodies significantly reduced the monthly migraine days and acute migraine-specific medication. CGRP monoclonal antibodies were effective and safe for preventive treatment of episodic migraine.

     

Blood Pressure and Fibrinogen Responses to Mental Stress as Predictors of Incident Hypertension over an 8-Year Period

Background

Heightened blood pressure (BP) responses to mental stress predict raised BP levels over subsequent years, but evidence for associations with incident hypertension is limited, and the significance of inflammatory responses is uncertain.

Purpose

We investigated the relationship between BP and plasma fibrinogen responses to stress and incident hypertension over an average 8-year follow-up.

Method

Participants were 636 men and women (mean age 59.1 years) from the Whitehall II epidemiological cohort with no history of cardiovascular disease and hypertension. They performed standardized behavioral tasks (color/word conflict and mirror tracing), and hypertension was defined by clinic measures and medication status.

Results

Of participants in the highest systolic BP reactivity tertile, 29.3 % became hypertensive over the follow-up period compared with 16.5 % of those in the lowest tertile, with an odds ratio of 2.02 (95 % CI 1.17–3.88, p?=?0.012) after adjustment for age, sex, grade of employment, body mass index, smoking, alcohol consumption, physical activity, follow-up time, subjective stress response, perceived task difficulty, perceived task engagement, and baseline BP. Similar associations were observed for diastolic BP reactivity (odds ratio 2.05, 95 % CI 1.23–3.40, p?=?0.006) and for impaired systolic BP post-stress recovery (odds ratio 2.06, 95 % CI 1.19–3.57, p?=?0.010). Fibrinogen reactions to tasks also predicted future hypertension in women (odds ratio 2.64, 95 % CI 1.11–6.30, p?=?0.029) but not men.

Conclusions

These data suggest that heightened cardiovascular and inflammatory reactivity to mental stress is associated with hypertension risk, and may be a mechanism through which psychosocial factors impact on the development of hypertension.

     

Adult normative values for the PATA Rate Test

Background

During neurological evaluation, dysarthria is not rated using quantitative measures, but rather using a qualitative approach.

Objective

Aim of our study was to validate and acquire normative values for the PATA Rate Task (PRT), a quantitative test used to measure the severity of dysarthria.

Methods

For the PRT probands are invited to repeat the syllables “PA-TA” as quickly as possible during a 10-s interval. The score consists in the number of correct repetition of both syllables.

Results

We enrolled 232 healthy controls (118 males, 114 females), mean and standard deviation of the PRT was 28.84?±?6.6 (range 14–52). The PRT showed good inter-rater reliability (R?=?0.783; p?<?0.001), as well as test–retest reliability (R?=?0.927; p?<?0.001), and intra-rater reliability (R?=?0.888; p?<?0.001). Higher age correlated with lower scores (R?=?? 0.368; p?<?0.001).

Conclusions

The PRT showed good reliability and could be easily added to the evaluation of movement disorders where a speech evaluation is essential.

     

Hyperhomocysteinemia influenced malnutrition in Parkinson’s disease patients

Introduction

Parkinson’s disease (PD) is a neurodegenerative disease with many motor and non-motor symptoms. Hyperhomocysteinemia is reported in many PD patients. Homocysteine (Hcy) is reported to be a risk factor for some PD non-motor symptoms.

Aim

The aim was to analyze Hcy level and its correlation with physical activity and motor and some non-motor symptoms (depression and cognition) in PD patients.

Patients and methods

Patients were surveyed for physical activity and demographic data. Blood samples were obtained for Hcy, vitamin B12, and folic acid determination. The Mini Nutritional Assessment (MNA), Unified Parkinson’s Disease Rating Scale (UPDRS) parts III and IV, Hoehn and Yahr (H&Y) Scale, Beck Depression Inventory (BDI), and Mini Mental State Examination (MMSE) were used to assess nutritional status, disease stage, and motor and some non-motor symptoms (depression and cognition) of PD in study patients.

Results

We analyzed 34 PD patients. Elevated Hcy level was found in 70.6% of these patients. Patients reporting regular exercise had lower Hcy level (p?<?0.025). Hcy level yielded a statistically significant correlation with MNA score (rs?=???0.510; p?<?0.003), UPDRS part III (rs?=?0.372; p?<?0.030), vitamin B12 (rs?=???0.519; p?<?0.002), and folic acid (rs?=???0.502; p?<?0.003) but not with cognition and depression. There were no statistically significant differences in Hcy level for disease stage either for dyskinesia or “off” periods.

Conclusion

PD patients are at a risk of hyperhomocysteinemia. Regular physical activity decreases Hcy level, whereas poor motor function increases it. There is correlation between Hcy level and malnutrition in PD patients.

     

Daily Interpersonal Experience Partially Explains the Association Between Social Rank and Physical Health

Background

Socioeconomic position is a well-established risk factor for poor physical health.

Purpose

This study examines whether the effects of lower social rank on physical health may be accounted for by differences in daily social experience.

Methods

In a large community sample (N?=?475), we examined whether subjective social rank is associated with self-rated health, in part, through positive and negative perceptions of daily interpersonal interactions, assessed using ecological momentary assessment.

Results

Higher social rank was associated with higher average perceived positivity of social interactions in daily life (e.g., B?=?.18, p?<?.001), but not with perceived negativity of social interactions. Further, the association between social rank and self-rated physical health was partially accounted for by differences in perceived positivity of social interactions. This effect was independent of well-characterized objective markers of SES and personality traits.

Conclusions

Differences in the quality of day-to-day social interactions is a viable pathway linking lower social rank to poorer physical health.