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Erratum. 勘误表。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 DOI: 10.1159/000531202
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引用次数: 0
Association between Low Vitamin D Status, Serotonin, and Clinico-Biobehavioral Parameters in Alzheimer's Disease. 阿尔茨海默病患者低维生素D状态、血清素与临床生物行为参数之间的关系。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-10-06 DOI: 10.1159/000534492
Anna-Lena Richter, Marlies Diepeveen-de Bruin, Michiel G J Balvers, Lisette C P G M De Groot, Peter Paul De Deyn, Sebastiaan Engelborghs, Renger F Witkamp, Yannick Vermeiren

Introduction: Studies suggest a role of vitamin D in the progression and symptomatology of Alzheimer's disease (AD), with few in vitro studies pointing to effects on serotonergic and amyloidogenic turnover. However, limited data exist in AD patients on the potential association with cognition and behavioral and psychological signs and symptoms of dementia (BPSD). In this retrospective cross-sectional study, we, therefore, explored potential correlations of serum 25-hydroxyvitamin D3 (25(OH)D3) concentrations, indicative of vitamin D status, with serum serotonin (5-hydroxytryptamine, 5-HT) levels, cognitive/BPSD scorings, and cerebrospinal fluid (CSF) biomarker levels.

Methods: Frozen serum samples of 25 well-characterized AD subjects as part of a previous BPSD cohort were analyzed, of which 15 had a neuropathologically confirmed diagnosis. Serum 25(OH)D3 levels were analyzed by means of LC-MS/MS, whereas 5-HT concentrations were quantified by competitive ELISA.

Results: Among AD patients, vitamin D deficiency was highly prevalent, defined as levels below 50 nmol/L. Regression analyses, adjusted for age, gender, and psychotropic medications, revealed that serum 25(OH)D3 and 5-HT levels were positively associated (p = 0.012). Furthermore, serum 25(OH)D3 concentrations correlated inversely with CSF amyloid-beta (Aβ1-42) levels (p = 0.006), and serum 5-HT levels correlated positively with aggressiveness (p = 0.001), frontal behavior (p = 0.001), depression (p = 0.004), and partly with cognitive performance (p < 0.005). Lastly, AD patients on cholinesterase inhibitors had higher serum 25(OH)D3 (p = 0.030) and lower serum 5-HT (p = 0.012) levels.

Conclusions: The molecular associations between low vitamin D status, serum 5-HT, and CSF Aβ1-42 levels are highly remarkable, warranting further mechanistic and intervention studies to disclose potential involvement in the clinico-biobehavioral pathophysiology of AD.

背景:研究表明维生素D在阿尔茨海默病(AD)的进展和症状中发挥作用,很少有体外研究指出维生素D对5-羟色胺能和淀粉样变性的影响。然而,AD患者以及与认知、行为和心理症状以及痴呆症(BPSD)的潜在关联的数据有限。因此,在这项回顾性横断面研究中,我们探讨了表明维生素D状态的血清25-羟基维生素D3(25(OH)D3)浓度与认知/BPSD评分、血清5-羟色胺(5-羟色胺,5-HT)和脑脊液(CSF)生物标志物水平的潜在相关性。方法:分析25例特征良好的AD受试者的冷冻血清样本,其中15例经神经病理学证实。血清25(OH)D3水平采用LC-MS/MS进行分析,而5-HT浓度则采用竞争性ELISA进行定量。结果:在AD患者中,维生素D缺乏症非常普遍,定义为水平低于50nmol/L。经年龄、性别和精神药物调整后的回归分析显示,血清25(OH)D3和5-HT呈正相关(p=0.012)。此外,血清25,抑郁症(p=0.004)和认知能力(p结论:低维生素D状态、血清5-HT和CSF Aβ1-42水平之间的分子相关性非常显著,需要进一步的机制和干预研究来揭示AD临床生物行为病理生理学的潜在参与。
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引用次数: 0
Supervised, Self-Administered Tablet-Based Cognitive Assessment in Neurodegenerative Disorders and Stroke. 基于平板电脑的神经退行性疾病和中风患者认知能力评估。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-03-30 DOI: 10.1159/000527060
Kelly L Sloane, Rachel Fabian, Amy Wright, Sadhvi Saxena, Kevin Kim, Colin M Stein, Zafer Keser, Shenly Glenn, Argye E Hillis

Introduction: As the population ages, the prevalence of cognitive impairment is expanding. Given the recent pandemic, there is a need for remote testing modalities to assess cognitive deficits in individuals with neurological disorders. Self-administered, remote, tablet-based cognitive assessments would be clinically valuable if they can detect and classify cognitive deficits as effectively as traditional in-person neuropsychological testing.

Methods: We tested whether the Miro application, a tablet-based neurocognitive platform, measured the same cognitive domains as traditional pencil-and-paper neuropsychological tests. Seventy-nine patients were recruited and then randomized to either undergo pencil-and-paper or tablet testing first. Twenty-nine age-matched healthy controls completed the tablet-based assessments. We identified Pearson correlations between Miro tablet-based modules and corresponding neuropsychological tests in patients and compared scores of patients with neurological disorders with those of healthy controls using t tests.

Results: Statistically significant Pearson correlations between the neuropsychological tests and their tablet equivalents were found for all domains with moderate (r > 0.3) or strong (r > 0.7) correlations in 16 of 17 tests (p < 0.05). All tablet-based subtests differentiated healthy controls from neurologically impaired patients by t tests except for the spatial span forward and finger tapping modules. Participants reported enjoyment of the tablet-based testing, denied that it provoked anxiety, and noted no preference between modalities.

Conclusions: This tablet-based application was found to be widely acceptable to participants. This study supports the validity of these tablet-based assessments in the differentiation of healthy controls from patients with neurocognitive deficits in a variety of cognitive domains and across multiple neurological disease etiologies.

简介随着人口老龄化的加剧,认知障碍的发病率也在不断上升。鉴于最近的大流行病,有必要采用远程测试模式来评估神经系统疾病患者的认知障碍。如果基于平板电脑的自助式远程认知评估能像传统的面对面神经心理学测试一样有效地检测认知缺陷并对其进行分类,那么这种评估将具有临床价值:我们测试了基于平板电脑的神经认知平台 Miro 应用程序是否能测量与传统纸笔神经心理学测试相同的认知领域。我们招募了 79 名患者,然后随机分配他们先接受纸笔测试或平板电脑测试。29 名年龄匹配的健康对照者完成了基于平板电脑的评估。我们确定了患者的 Miro 平板电脑模块与相应神经心理学测试之间的皮尔逊相关性,并使用 t 检验比较了神经系统疾病患者与健康对照组的得分:在 17 项测试中,有 16 项测试的神经心理学测试与平板电脑测试之间存在统计学意义上的皮尔逊相关性,相关性中等(r > 0.3)或较强(r > 0.7)(p < 0.05)。除空间跨度和手指敲击模块外,所有基于平板电脑的子测试均通过 t 检验将健康对照组与神经受损患者区分开来。受试者表示喜欢平板电脑测试,否认测试会引起焦虑,并且对不同的测试模式没有偏好:结论:这项基于平板电脑的应用被参与者广泛接受。这项研究证明了这些基于平板电脑的评估在区分健康对照组和神经认知缺陷患者方面的有效性,这些患者涉及多个认知领域和多种神经疾病病因。
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引用次数: 0
Non-Pharmacological Treatments in Lewy Body Disease: A Systematic Review. 路易体病的非药物治疗:系统综述。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 DOI: 10.1159/000529256
Lucia Guidi, Stefania Evangelisti, Andrea Siniscalco, Raffaele Lodi, Caterina Tonon, Micaela Mitolo

Introduction: Lewy body disease (LBD) is the second most common neurodegenerative disorder in patients older than 65 years. LBD is characterized by heterogeneous symptoms like fluctuation in attention, visual hallucinations, Parkinsonism, and REM sleep behaviour disorders. Considering the relevant social impact of the disease, identifying effective non-pharmacological treatments is becoming a priority. The aim of this systematic review was to provide an up-to-date literature review of the most effective non-pharmacological treatments in patients with LBD, focussing on evidence-based interventions.

Methods: Following PRISMA criteria, we carried out a systematic search through three databases (PubMed, Cochrane Libraries, and PEDro) including physical therapy (PT), cognitive rehabilitation (CR), light therapy (LT), transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), deep brain stimulation (DBS). All studies were qualitatively assessed using standardized tools (CARE and EPHPP).

Results: We obtained a total of 1,220 studies of which 23 original articles met eligibility criteria for inclusion. The total number of LBD patients included was 231; mean age was 69.98, predominantly men (68%). Some PT studies highlighted improvements in motor deficits. CR produced significant improvements in mood, cognition, and patient's quality of life and satisfaction. LT outlined a partial trend of improvements in mood and sleep quality. DBS, ECT, and TMS showed some partial improvements mainly on neuropsychiatric symptoms, whereas tDCS provided partial improvements in attention.

Conclusion: This review highlights the efficacy of some evidence-based rehabilitation studies in LBD; however, further randomized controlled trials with larger samples are needed to provide definitive recommendations.

简介:路易体病(LBD)是65岁以上患者中第二常见的神经退行性疾病。LBD的特点是异质性症状,如注意力波动、视觉幻觉、帕金森病和快速眼动睡眠行为障碍。考虑到该疾病的相关社会影响,确定有效的非药物治疗正在成为一个优先事项。本系统综述的目的是为LBD患者最有效的非药物治疗提供最新的文献综述,重点是循证干预。方法:按照PRISMA标准,我们通过PubMed、Cochrane Libraries和PEDro三个数据库进行系统检索,包括物理治疗(PT)、认知康复(CR)、光疗(LT)、经颅直流电刺激(tDCS)、经颅磁刺激(TMS)、电休克治疗(ECT)、深部脑刺激(DBS)。使用标准化工具(CARE和EPHPP)对所有研究进行定性评估。结果:我们共获得1220项研究,其中23篇原创文章符合入选标准。纳入LBD患者总数为231例;平均年龄69.98岁,以男性为主(68%)。一些PT研究强调了运动缺陷的改善。CR显著改善了患者的情绪、认知、生活质量和满意度。LT概述了情绪和睡眠质量改善的部分趋势。DBS、ECT和TMS主要对神经精神症状有部分改善,而tDCS对注意力有部分改善。结论:本综述强调了一些循证康复研究在LBD中的疗效;然而,需要进一步的大样本随机对照试验来提供明确的建议。
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引用次数: 1
Fluctuations in Cognitive Test Scores and Loss to Follow-Up in Community-Dwelling Older Adults: The IRIDE Cohort Study. 居住在社区的老年人认知测试分数的波动和随访损失:IRIDE 队列研究》。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-08-10 DOI: 10.1159/000531764
Takumi Abe, Mari Yamashita, Yoshinori Fujiwara, Hiroyuki Sasai, Shuichi P Obuchi, Tatsuro Ishizaki, Shuichi Awata, Kenji Toba

Introduction: We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores.

Methods: This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1.

Results: The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2.

Conclusion: Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.

简介我们研究了迷你精神状态检查(MMSE)分数之前的波动、MMSE分数未来的变化以及后续调查中的自然减员之间的关系,这有助于更全面地解释重复收集的MMSE分数:这项为期 4 年的纵向研究纳入了日本 2,073 名年龄≥65 岁、居住在社区的老年人。分别在基线(T0)、2 年(T1)和 4 年(T2)随访期间进行了 MMSE 测评。我们进行了多项式逻辑回归分析,因变量为 MMSE 分数从 T1 到 T2 的变化(分为增加、无变化[参考类别]和减少)以及 T2 时的自然减员。自变量包括 MMSE 分数从 T0 到 T1 的变化以及 T0 和 T1 的 MMSE 分数:三个时间点的 MMSE 平均得分均为 29 分。从 T0 到 T1,MMSE 分数每下降一分,T1 到 T2 MMSE 分数上升的几率就会增加 79% (95% 置信区间:1.62, 1.97),T2 时自然减员的几率就会增加 28% (1.17, 1.40)。T0和T1的MMSE得分下降1分也与T1至T2的MMSE得分增加和T2时的减员有关:结论:关注两年内的认知波动,而不是某一时点的认知功能,在关注未来认知功能和自然减员时并无显著优势。我们的研究结果强调了进一步研究的必要性,以确定哪些因素可以区分那些继续参加后续调查并在认知测试分数上有所提高的人和那些辍学的人。
{"title":"Fluctuations in Cognitive Test Scores and Loss to Follow-Up in Community-Dwelling Older Adults: The IRIDE Cohort Study.","authors":"Takumi Abe, Mari Yamashita, Yoshinori Fujiwara, Hiroyuki Sasai, Shuichi P Obuchi, Tatsuro Ishizaki, Shuichi Awata, Kenji Toba","doi":"10.1159/000531764","DOIUrl":"10.1159/000531764","url":null,"abstract":"<p><strong>Introduction: </strong>We examined the relationship between previous fluctuations in Mini-Mental State Examination (MMSE) scores, future changes in MMSE scores, and attrition from follow-up surveys, which helps in a more comprehensive interpretation of repeatedly collected MMSE scores.</p><p><strong>Methods: </strong>This 4-year longitudinal study included 2,073 community-dwelling older adults aged ≥65 years in Japan. The MMSE was administered at baseline (T0), 2 years (T1), and 4 years (T2) follow-up. We performed multinomial logistic regression analysis with the dependent variable, indicating the change in MMSE score from T1 to T2 (categorized as increase, no change [reference category], and decrease) and attrition at T2. The independent variables included the change in MMSE scores from T0 to T1 and MMSE scores at T0 and T1.</p><p><strong>Results: </strong>The mean MMSE score was 29 across the three time points. A one-point decrease in MMSE score from T0 to T1 was associated with 79% (95% confidence interval: 1.62, 1.97) higher odds of an increase in MMSE score from T1 to T2 and 28% (1.17, 1.40) higher odds of attrition at T2. A one-point decrement in the MMSE score at T0 and T1 was also associated with an increase in the MMSE score from T1 to T2 and attrition at T2.</p><p><strong>Conclusion: </strong>Focusing on cognitive fluctuation for 2 years, rather than cognitive function at a point in time, would have no remarkable advantage when focusing on future cognitive function and attrition. Our results emphasize the need for further studies to identify factors that distinguish between those who continue to attend follow-up surveys and show improvements in cognitive test scores and those who drop out.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"296-303"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10028104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Explainable Alzheimer's Disease Detection Using Linguistic Features from Automatic Speech Recognition. 使用自动语音识别的语言特征进行可解释的阿尔茨海默病检测。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-07-11 DOI: 10.1159/000531818
Lijuan Tang, Zhenglin Zhang, Feifan Feng, Li-Zhuang Yang, Hai Li

Introduction: Alzheimer's disease (AD) is the most prevalent type of dementia and can cause abnormal cognitive function and progressive loss of essential life skills. Early screening is thus necessary for the prevention and intervention of AD. Speech dysfunction is an early onset symptom of AD patients. Recent studies have demonstrated the promise of automated acoustic assessment using acoustic or linguistic features extracted from speech. However, most previous studies have relied on manual transcription of text to extract linguistic features, which weakens the efficiency of automated assessment. The present study thus investigates the effectiveness of automatic speech recognition (ASR) in building an end-to-end automated speech analysis model for AD detection.

Methods: We implemented three publicly available ASR engines and compared the classification performance using the ADReSS-IS2020 dataset. Besides, the SHapley Additive exPlanations algorithm was then used to identify critical features that contributed most to model performance.

Results: Three automatic transcription tools obtained mean word error rate texts of 32%, 43%, and 40%, respectively. These automated texts achieved similar or even better results than manual texts in model performance for detecting dementia, achieving classification accuracies of 89.58%, 83.33%, and 81.25%, respectively.

Conclusion: Our best model, using ensemble learning, is comparable to the state-of-the-art manual transcription-based methods, suggesting the possibility of an end-to-end medical assistance system for AD detection with ASR engines. Moreover, the critical linguistic features might provide insight into further studies on the mechanism of AD.

引言:阿尔茨海默病(AD)是最常见的痴呆类型,可导致认知功能异常和基本生活技能的逐渐丧失。因此,早期筛查对AD的预防和干预是必要的。言语功能障碍是AD患者的早期症状。最近的研究已经证明了使用从语音中提取的声学或语言特征进行自动声学评估的前景。然而,以前的大多数研究都依赖于文本的手动转录来提取语言特征,这削弱了自动评估的效率。因此,本研究调查了自动语音识别(ASR)在构建用于AD检测的端到端自动语音分析模型方面的有效性。方法:我们实现了三个公开可用的ASR引擎,并使用ADReSS-IS2020数据集比较了分类性能。此外,还使用SHapley加性exPlanations算法来识别对模型性能贡献最大的关键特征。结果:三个自动转录工具获得的文本平均单词错误率分别为32%、43%和40%。在检测痴呆症的模型性能方面,这些自动化文本取得了与手动文本相似甚至更好的结果,分类准确率分别为89.58%、83.33%和81.25%。结论:我们使用集成学习的最佳模型与最先进的基于手动转录的方法相当,这表明有可能使用ASR引擎建立用于AD检测的端到端医疗辅助系统。此外,批判性语言特征可能为进一步研究AD的机制提供见解。
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引用次数: 1
Antiepileptic Drugs Modulate Alzheimer-Related Tau Aggregation in a Neuronal Activity-Independent Manner. 抗癫痫药物以神经元活动独立的方式调节阿尔茨海默病相关的Tau聚集。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 DOI: 10.1159/000529915
Yuki Ito, Shuko Takeda, Sayaka Moroi, Tsuneo Nakajima, Akane Oyama, Kunihiro Miki, Nanami Sugihara, Yoichi Takami, Yasushi Takeya, Munehisa Shimamura, Hiromi Rakugi, Ryuichi Morishita

Introduction: A rapidly increasing number of patients with dementia present a serious social problem. Recently, the incidence of epilepsy in patients with Alzheimer's disease (AD) is increasing, drawing attention to the pathological relationship between the two conditions. Clinical studies have suggested the protective action of antiepileptic agents on dementia; however, the underlying mechanism remains unknown. We evaluated the effects of multiple antiepileptic drugs using tau aggregation assay systems to determine the effects of antiepileptic agents on tau aggregation, a major neuropathological finding associated with AD.

Methods: We evaluated the effects of seven antiepileptic agents on intracellular tau aggregation using a tau-biosensor cell-based high-throughput assay. Next, we tested these agents in a cell-free tau aggregation assay using thioflavin T (ThT).

Results: The assay results revealed that phenobarbital inhibited tau aggregation, whereas sodium valproate, gabapentin, and piracetam promoted tau aggregation. In the cell-free tau aggregation assay using ThT, we confirmed that phenobarbital significantly inhibited tau aggregation.

Conclusion: Antiepileptic drugs may modify the tau pathology in AD in a neural activity-independent manner. Our finding may provide an important insight into the optimization of antiepileptic drug therapy in older adults with dementia.

导言:痴呆症患者数量的迅速增加是一个严重的社会问题。近年来,阿尔茨海默病(AD)患者癫痫的发病率不断上升,引起了人们对两种疾病之间病理关系的关注。临床研究表明抗癫痫药物对痴呆有保护作用;然而,其潜在机制尚不清楚。我们使用tau聚集测定系统评估了多种抗癫痫药物的作用,以确定抗癫痫药物对tau聚集的影响,tau聚集是与AD相关的主要神经病理发现。方法:我们使用基于tau生物传感器细胞的高通量测定法评估了七种抗癫痫药物对细胞内tau聚集的影响。接下来,我们使用硫黄素T (ThT)在无细胞tau聚集试验中测试这些药物。结果:实验结果显示,苯巴比妥抑制tau聚集,而丙戊酸钠、加巴喷丁和吡拉西坦促进tau聚集。在使用ThT的无细胞tau聚集实验中,我们证实了苯巴比妥显著抑制tau聚集。结论:抗癫痫药物可能以不依赖神经活动的方式改变AD的tau病理。我们的发现可能为老年痴呆患者抗癫痫药物治疗的优化提供了重要的见解。
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引用次数: 0
The Utility of Visual and Spatial Perception Tests in Alzheimer's Disease: A Systematic Review. 视觉和空间感知测试在阿尔茨海默病中的应用:系统综述。
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2023-01-01 Epub Date: 2023-06-02 DOI: 10.1159/000530911
Jonathan P Scott, Donnchadh F Murphy, Rupert F Noad

Introduction: Visual and spatial perception (VSP) are cognitive domains frequently assessed in the screening and neuropsychological assessment of dementia. Evidence suggests that VSP impairment is common in the early stages of Alzheimer's disease (AD). Despite this evidence, the ability of VSP tests to discriminate between healthy older adults and people with AD remains mixed. The purpose of this literature review was to employ a systematic search strategy to identify empirical evidence supporting the diagnostic utility of VSP tests which may be used in the screening and diagnosis of AD.

Methods: Specified criteria were used to perform a systematic literature search of the PsycINFO and PubMed databases with no date restrictions. Relevant data from the selected studies were extracted, and a published appraisal tool (the Quality Assessment of Diagnostic Accuracy Studies-2) was used to evaluate methodological quality.

Results: Of the 144 articles returned, six studies and 11 VSP tests met review inclusion criteria. Four tests demonstrated both sensitivity and specificity values above 80%. A computerised 3D Visual Task demonstrated the highest sensitivity and specificity values (90% and 95%, respectively). The quality of the identified studies was considered to be satisfactory. Identified limitations and the implications of issues relating to study methodology are discussed, and recommendations for future research are suggested.

Conclusion: The evidence from this review suggests that certain tests of VSP may be a useful addition to the routine screening of AD.

引言:视觉和空间感知(VSP)是痴呆症筛查和神经心理学评估中经常评估的认知领域。有证据表明,VSP损伤在阿尔茨海默病(AD)的早期阶段很常见。尽管有这些证据,VSP测试区分健康老年人和AD患者的能力仍然参差不齐。本文献综述的目的是采用系统的搜索策略来确定支持VSP测试诊断效用的经验证据,VSP测试可用于AD的筛查和诊断。方法:使用指定的标准对PsycINFO和PubMed数据库进行系统的文献搜索,没有日期限制。从所选研究中提取相关数据,并使用已发表的评估工具(诊断准确性研究的质量评估-2)来评估方法学质量。结果:在返回的144篇文章中,6项研究和11项VSP测试符合审查纳入标准。四项测试显示敏感性和特异性均超过80%。计算机化三维视觉任务显示出最高的敏感性和特异性值(分别为90%和95%)。已确定的研究的质量被认为是令人满意的。讨论了与研究方法有关的问题的局限性和影响,并提出了未来研究的建议。结论:本综述的证据表明,VSP的某些测试可能是AD常规筛查的有用补充。
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引用次数: 0
Plasma Oxytocin Is Not Associated with Social Cognition or Behavior in Frontotemporal Dementia and Alzheimer’s Disease Syndromes 额颞叶痴呆和阿尔茨海默病综合征患者血浆催产素与社会认知或行为无关
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-06-15 DOI: 10.1159/000525087
Emma G Johnson, Wytse Kuiper, R. Ahmed, G. Halliday, J. Burrell, J. Hodges, A. Guastella, O. Piguet, F. Kumfor
Introduction: Changes in social behavior and emotion processing are common in frontotemporal dementia (FTD) and semantic dementia (SD), and less so in Alzheimer’s disease (AD). Recent research has investigated oxytocin as a potential treatment for these symptoms; however, whether plasma oxytocin is associated with social-emotional symptoms of dementia remains underexplored. Methods: Thirty behavioral-variant FTD (bvFTD), 28 SD, 39 AD, and 24 controls underwent blood sampling to measure oxytocin. Participants completed an emotion processing battery. Carers completed the Cambridge Behavioral Inventory and the Neuropsychiatric Inventory. Results: Patients with bvFTD were severely impaired in emotion processing and behavioral ratings, with milder impairment in SD and AD. No difference in plasma oxytocin was observed between groups (p = 0.632). No significant associations were found between oxytocin and social behavior or emotion processing (r values between −0.241 and 0.227, all p values >0.099). Conclusion: Our results indicate that plasma oxytocin is not reduced in dementia and is unrelated to social, emotional, and behavioral features. We noted high interindividual variability in our data; hence, future investigations should consider methodological influences such as serum versus saliva and diurnal variation on oxytocin function. These results demonstrate that current measurement measures of plasma oxytocin have limited utility in determining the role of oxytocin in FTD. Alternative oxytocin measures may prove more sensitive and should be considered when conducting clinical trials.
引言:社交行为和情绪处理的变化在额颞叶痴呆(FTD)和语义痴呆(SD)中很常见,在阿尔茨海默病(AD)中则不那么常见。最近的研究已经调查了催产素作为这些症状的潜在治疗方法;然而,血浆催产素是否与痴呆症的社会情绪症状有关仍有待深入研究。方法:对30例行为变异型FTD(bvFTD)、28例SD、39例AD和24例对照组进行了抽血测定催产素。参与者完成了情绪处理电池。Carers完成了剑桥行为量表和神经精神量表。结果:bvFTD患者的情绪处理和行为评分严重受损,SD和AD受损较轻。两组之间的血浆催产素没有差异(p=0.632)。催产素与社会行为或情绪处理之间没有发现显著关联(r值在-0.241和0.227之间,所有p值均>0.099)。结论:我们的研究结果表明,痴呆症患者的血浆缩宫素没有减少,与社会、情绪和行为特征无关。我们注意到我们的数据中存在较高的个体间变异性;因此,未来的研究应该考虑血清与唾液以及催产素功能的昼夜变化等方法学影响。这些结果表明,目前血浆催产素的测量方法在确定催产素在FTD中的作用方面的效用有限。替代性催产素措施可能更敏感,在进行临床试验时应予以考虑。
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引用次数: 2
Mental Health of Caregivers Working in Nursing Homes during the COVID-19 Pandemic 新冠肺炎大流行期间在疗养院工作的护理人员的心理健康
IF 2.4 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-06-09 DOI: 10.1159/000524953
Takumi Takahashi, Saori Ekoyama, H. Tachikawa, Haruhiko Midorikawa, Y. Shiratori, Miho Ota, Sho Takahashi, T. Arai
Introduction: There have been numerous reports of cluster outbreaks of coronavirus disease 2019 (COVID-19) in hospitals and nursing homes. Healthcare workers fighting COVID-19 experience mental health issues. Caregivers in nursing homes experienced increased psychological distress and concern about deterioration of their mental health. We conducted a large-scale web-based survey exploring mental health among caregivers working in nursing homes during the COVID-19 pandemic with the aim of identifying their support needs. Methods: Survey participants were caregivers working at 284 nursing homes in Ibaraki prefecture, Japan. The survey period was from September 2020 to March 2021. Participants responded to a questionnaire covering gender, age, occupation, infections at facilities, infection protection, changes in nursing home users, cooperation with other medical institutions, and prejudice/discrimination. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate participants’ depression and anxiety. Results: In total, 676 participants completed the survey; 350 (52.5%) were with anxiety symptoms and 378 (56.7%) were with depressive symptoms (scores exceeding the HADS cut-off points). The risk for anxiety was associated with being care worker or social worker. The risk of anxiety or depression was high when family caregivers’ mental state changed. Discussion/Conclusion: This study found that caregivers working in nursing homes were exposed to high levels of stress during the COVID-19 pandemic and were at high risk for developing depression and anxiety.
简介:有大量关于2019冠状病毒病(新冠肺炎)在医院和养老院暴发的报告。抗击新冠肺炎的医护人员经历了心理健康问题。疗养院的护理人员经历了越来越多的心理困扰和对心理健康恶化的担忧。我们进行了一项大规模的网络调查,探讨新冠肺炎大流行期间在养老院工作的护理人员的心理健康状况,目的是确定他们的支持需求。方法:调查参与者是在日本茨城县284家养老院工作的护理人员。调查期间为2020年9月至2021年3月。参与者回答了一份问卷,内容包括性别、年龄、职业、设施感染、感染保护、疗养院用户的变化、与其他医疗机构的合作以及偏见/歧视。医院焦虑和抑郁量表(HADS)用于评估参与者的抑郁和焦虑。结果:共有676名参与者完成了调查;350人(52.5%)有焦虑症状,378人(56.7%)有抑郁症状(得分超过HADS临界点)。焦虑的风险与护理人员或社会工作者有关。当家庭照顾者的精神状态发生变化时,焦虑或抑郁的风险很高。讨论/结论:这项研究发现,在新冠肺炎大流行期间,在养老院工作的护理人员面临着高水平的压力,并有很高的风险患上抑郁症和焦虑症。
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引用次数: 2
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Dementia and Geriatric Cognitive Disorders
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