Ruchi Singh, N. Rai, Akash Pathak, Jyotsana Rai, Abhijit Pakhare, Priyanka Vikas Kashyap, A. R. Rozatkar, Shweta Mishra, Sofia Mudda
Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients’ daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients. Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep – using the Pittsburgh sleep quality index, QOL by SF-36, pain-visual analog scales (VASs) and global pain scale (GPS), mood-depression, anxiety, stress scale-21, somatic symptoms, anxiety and depression – by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR). The mean pain score was 6.80 ± 1.58 on VAS and 54.10 ± 14.33 on GPS. FIQR score was 50.62 ± 13.68, mean sleep quality was poor (9.30 ± 3.88), and depression, anxiety, and stress scores were increased (10.04 ± 4.59, 8.33 ± 4.48, and 10.75 ± 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 ± 1.92 in mild FMS to 12.0 ± 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity. With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.
{"title":"Impact of fibromyalgia severity on patients mood, sleep quality, and quality of life","authors":"Ruchi Singh, N. Rai, Akash Pathak, Jyotsana Rai, Abhijit Pakhare, Priyanka Vikas Kashyap, A. R. Rozatkar, Shweta Mishra, Sofia Mudda","doi":"10.25259/jnrp_14_2024","DOIUrl":"https://doi.org/10.25259/jnrp_14_2024","url":null,"abstract":"\u0000\u0000Fibromyalgia syndrome (FMS) is characterized by persistent widespread pain which greatly impacts the quality of life (QOL). Pain not only limits patients’ daily activities but also restricts their social activities further leading to depression, anxiety, and stress. The present cross-sectional study elucidated the association of sleep quality and mood with increasing symptom severity of fibromyalgia and its impact on the QOL of fibromyalgia patients.\u0000\u0000\u0000\u0000Hundred adult fibromyalgia patients diagnosed by the American College of Rheumatology 2010 criteria were evaluated for: sleep – using the Pittsburgh sleep quality index, QOL by SF-36, pain-visual analog scales (VASs) and global pain scale (GPS), mood-depression, anxiety, stress scale-21, somatic symptoms, anxiety and depression – by patients health questionnaire somatic, anxiety, and depressive symptom scales (PHQ-SADS), and FMS severity was evaluated using fibromyalgia impact questionnaire (FIQR).\u0000\u0000\u0000\u0000The mean pain score was 6.80 ± 1.58 on VAS and 54.10 ± 14.33 on GPS. FIQR score was 50.62 ± 13.68, mean sleep quality was poor (9.30 ± 3.88), and depression, anxiety, and stress scores were increased (10.04 ± 4.59, 8.33 ± 4.48, and 10.75 ± 4.66). An increasing trend of depression, anxiety, stress, and somatoform symptoms was observed with an increase in the severity of FMS when patients were compared according to FMS severity scores. Sleep also deteriorated with increasing severity of FMS from 5.66 ± 1.92 in mild FMS to 12.0 ± 3.41 in highly severe FMS patients. The QOL too deteriorated in all the domains with increasing severity.\u0000\u0000\u0000\u0000With the increasing severity of fibromyalgia, not only does the pain increase but mood and sleep quality also deteriorate, which further impacts the QOL of FMS patients. Thus, comorbid mood derangements must also be screened and addressed for maximum benefit of the patients.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140687924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amit Jha, R. M. Kiragasur, Harshini Manohar, J. Kommu
Depression is a leading cause of global disease burden and morbidity among adolescents. Studies have reported higher rates of depression and anxiety secondary to the COVID pandemic and the psychosocial impact of social distancing measures. There is a paucity of literature on the subjective experiences of depressed adolescents in such pandemic circumstances. The objective of this study was to explore the lived experiences of adolescents with major depressive disorder (MDD) during the COVID pandemic, and the impact of the pandemic, and pandemic-related circumstances on adolescents’ mental health and coping. In-depth interviews with eight adolescents diagnosed with MDD were analyzed using interpretative phenomenological analysis. The analysis revealed three major themes; “The pandemic was arduous,” “Negativity in family interactions,” and “Effects on depression.” Most adolescents coped using excessive screen time as a distraction, and their families perceived them as indolent. The study found that adolescents’ experience of depression during the pandemic was extremely overwhelming because, on the one hand, they had to deal with immediate COVID infection-related worries and were not able to adjust to the new routine, not able to concentrate during online classes while also dealing with greater interpersonal discord with their parents and limited social resources for coping. The findings expand the clinical understanding of adolescents’ experience of depression during pandemic circumstances and would aid in better management planning.
{"title":"Lived experiences of adolescents with major depressive disorder during the COVID pandemic: A qualitative study from a tertiary care center","authors":"Amit Jha, R. M. Kiragasur, Harshini Manohar, J. Kommu","doi":"10.25259/jnrp_23_2024","DOIUrl":"https://doi.org/10.25259/jnrp_23_2024","url":null,"abstract":"\u0000\u0000Depression is a leading cause of global disease burden and morbidity among adolescents. Studies have reported higher rates of depression and anxiety secondary to the COVID pandemic and the psychosocial impact of social distancing measures. There is a paucity of literature on the subjective experiences of depressed adolescents in such pandemic circumstances. The objective of this study was to explore the lived experiences of adolescents with major depressive disorder (MDD) during the COVID pandemic, and the impact of the pandemic, and pandemic-related circumstances on adolescents’ mental health and coping.\u0000\u0000\u0000\u0000In-depth interviews with eight adolescents diagnosed with MDD were analyzed using interpretative phenomenological analysis.\u0000\u0000\u0000\u0000The analysis revealed three major themes; “The pandemic was arduous,” “Negativity in family interactions,” and “Effects on depression.” Most adolescents coped using excessive screen time as a distraction, and their families perceived them as indolent.\u0000\u0000\u0000\u0000The study found that adolescents’ experience of depression during the pandemic was extremely overwhelming because, on the one hand, they had to deal with immediate COVID infection-related worries and were not able to adjust to the new routine, not able to concentrate during online classes while also dealing with greater interpersonal discord with their parents and limited social resources for coping. The findings expand the clinical understanding of adolescents’ experience of depression during pandemic circumstances and would aid in better management planning.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Varoğlu, Bahadir Hosver, Zeynep Erva Güllüoğlu Torun
We describe two cases with recurrent demyelinating attacks following BioNTech BNT162b2 immunization. No reports of any recurring demyelinating attack cases connected to COVID-19 immunization. Case-1: A 37-year-old male patient was admitted due to diplopia and ptosis. Neurological examination showed isolated oculomotor cranial paralysis on the right side. The second dose of BNT162b2 was given 10 days ago. On T2- and fluid-attenuated inversion recovery (FLAIR)-weighted magnetic resonance imaging (MRI), hyperintense lesions were seen in the pons on T1, with no evidence of contrast enhancement. We diagnosed the patient with central pontine myelinolysis associated with BNT162b2. Six months later after the first attack, a new lesion appeared in the same region. Case-2: He applied to the hospital at the age of 57 years, complaining of numbness in his hands and feet, confusion, and cooperation disorder. During the neurological assessment, apathy, cooperation, and orienting disorders were found. Hyperintense lesions were seen in both hemispheres, with cortico-subcortical localization on MRI. The patient received the BNT162b2 two weeks ago. After the initial attack six months ago, new clinical signs and an increase in demyelinating lesions were found. Despite early corticosteroid treatment, BNT162b2 immunization may be associated with repeated demyelination attacks. In patients with diffusion restriction on MRI, we might suggest using corticosteroid therapy for approximately one year, a lot longer than the literatures suggested.
{"title":"Recurrent demyelination attacks after BNT162b2 vaccination: Two case reports and literature review","authors":"A. Varoğlu, Bahadir Hosver, Zeynep Erva Güllüoğlu Torun","doi":"10.25259/jnrp_496_2023","DOIUrl":"https://doi.org/10.25259/jnrp_496_2023","url":null,"abstract":"We describe two cases with recurrent demyelinating attacks following BioNTech BNT162b2 immunization. No reports of any recurring demyelinating attack cases connected to COVID-19 immunization. Case-1: A 37-year-old male patient was admitted due to diplopia and ptosis. Neurological examination showed isolated oculomotor cranial paralysis on the right side. The second dose of BNT162b2 was given 10 days ago. On T2- and fluid-attenuated inversion recovery (FLAIR)-weighted magnetic resonance imaging (MRI), hyperintense lesions were seen in the pons on T1, with no evidence of contrast enhancement. We diagnosed the patient with central pontine myelinolysis associated with BNT162b2. Six months later after the first attack, a new lesion appeared in the same region. Case-2: He applied to the hospital at the age of 57 years, complaining of numbness in his hands and feet, confusion, and cooperation disorder. During the neurological assessment, apathy, cooperation, and orienting disorders were found. Hyperintense lesions were seen in both hemispheres, with cortico-subcortical localization on MRI. The patient received the BNT162b2 two weeks ago. After the initial attack six months ago, new clinical signs and an increase in demyelinating lesions were found. Despite early corticosteroid treatment, BNT162b2 immunization may be associated with repeated demyelination attacks. In patients with diffusion restriction on MRI, we might suggest using corticosteroid therapy for approximately one year, a lot longer than the literatures suggested.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140698502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Post-operative epidural collection is a commonly encountered complication following cranioplasty (CP) in a patient with a sunken skin flap. While on most occasions, the collection is small and resolves spontaneously, on occasion, it may be large enough to warrant evacuation. Further, such collections may predispose to infection and bone flap resorption. Dural hitch sutures were once used routinely in all craniotomies by tacking up the dura at the margins of the craniotomy to the surrounding pericranium to prevent post-operative epidural collection but now several surgeons use them only when deemed absolutely necessary. We describe a variation (in cases where CP is performed in patients with a sunken flap) where several sutures are passed from the neodura through the center of the bone flap (as opposed to the peripherally placed conventional hitch sutures) to obviate the dead space and prevent any post-operative collection.
{"title":"Pitching for the hitch: Neodural tenting sutures to prevent post-cranioplasty collection in a sunken craniectomy site","authors":"Prasad Krishnan, V. Maurya","doi":"10.25259/jnrp_43_2024","DOIUrl":"https://doi.org/10.25259/jnrp_43_2024","url":null,"abstract":"Post-operative epidural collection is a commonly encountered complication following cranioplasty (CP) in a patient with a sunken skin flap. While on most occasions, the collection is small and resolves spontaneously, on occasion, it may be large enough to warrant evacuation. Further, such collections may predispose to infection and bone flap resorption. Dural hitch sutures were once used routinely in all craniotomies by tacking up the dura at the margins of the craniotomy to the surrounding pericranium to prevent post-operative epidural collection but now several surgeons use them only when deemed absolutely necessary. We describe a variation (in cases where CP is performed in patients with a sunken flap) where several sutures are passed from the neodura through the center of the bone flap (as opposed to the peripherally placed conventional hitch sutures) to obviate the dead space and prevent any post-operative collection.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Migraine is a frequent incapacitating neurovascular illness characterized by severe headache bouts. Individuals suffering from migraine appear to process auditory and visual information differently from those without migraine. The visual-evoked potential (VEP) is a commonly used standardized test to measure excitability in the occipital cortex. Patients with migraine exhibit amplification rather than habituation of stimulus-induced brain responses, between attacks. Our objective is to compare the amplitude of P100 and the latencies of N75, P100, and N145 (N and P represent negative and positive peaks, respectively, with average latency being subscripted with the alphabet) in the fourth block between migraine patients and controls and to determine the various clinical factors associated with the P100 mean amplitude and latency differences between the first and the fourth block in migraine patients. The study compared 20 migraine patients (with or without aura) and 20 apparently healthy subjects with no history of migraines or secondary headaches, focusing on the habituation of the VEP. Four blocks of 200 responses were recorded during the headache-free period, and the latencies and amplitudes of N75, P100, and N145 components were analyzed. There was a statistically significant (P < 0.05) decrement in the P100 amplitude in the fourth block when compared to the first block in both eyes in the controls as well as migraine patients. In addition, there was no statistically significant difference between controls and migraine sufferers in the P100 amplitude of the fourth block in either eye. The N145 latency in the fourth block was shorter in both eyes in migraine patients compared to controls (P < 0.05). The mean P100 amplitude difference between the first and fourth block correlated negatively with age and positively with headache frequency, while there was a moderate negative correlation with headache duration. The mean P100 latency difference between the first and fourth block correlated positively with age and negatively with headache frequency, while there was a moderate positive correlation with headache duration. In our study, VEP habituation was not lacking in migraine patients which means that habituation of the P100 wave was noted in migraineurs. The VEP reveals neurological changes due to ischemia injury or neurotransmitter imbalances. Migraine alters cortical excitability, but it is unclear if these changes are due to altered excitatory connections, damaged inhibitory networks or subcortical pre-activation. Our findings suggest that at least during the interictal period, lack of habituation cannot be employed as a consistent neurophysiological marker of migraine across laboratories.
{"title":"Lack of habituation of visual-evoked potential in the interictal period is not a consistent neurophysiological marker of migraine: A cross-sectional analytical study","authors":"Ankita Rani, Ramkumar Sugumaran, Sunil K. Narayan","doi":"10.25259/jnrp_33_2024","DOIUrl":"https://doi.org/10.25259/jnrp_33_2024","url":null,"abstract":"\u0000\u0000Migraine is a frequent incapacitating neurovascular illness characterized by severe headache bouts. Individuals suffering from migraine appear to process auditory and visual information differently from those without migraine. The visual-evoked potential (VEP) is a commonly used standardized test to measure excitability in the occipital cortex. Patients with migraine exhibit amplification rather than habituation of stimulus-induced brain responses, between attacks. Our objective is to compare the amplitude of P100 and the latencies of N75, P100, and N145 (N and P represent negative and positive peaks, respectively, with average latency being subscripted with the alphabet) in the fourth block between migraine patients and controls and to determine the various clinical factors associated with the P100 mean amplitude and latency differences between the first and the fourth block in migraine patients.\u0000\u0000\u0000\u0000The study compared 20 migraine patients (with or without aura) and 20 apparently healthy subjects with no history of migraines or secondary headaches, focusing on the habituation of the VEP. Four blocks of 200 responses were recorded during the headache-free period, and the latencies and amplitudes of N75, P100, and N145 components were analyzed.\u0000\u0000\u0000\u0000There was a statistically significant (P < 0.05) decrement in the P100 amplitude in the fourth block when compared to the first block in both eyes in the controls as well as migraine patients. In addition, there was no statistically significant difference between controls and migraine sufferers in the P100 amplitude of the fourth block in either eye. The N145 latency in the fourth block was shorter in both eyes in migraine patients compared to controls (P < 0.05). The mean P100 amplitude difference between the first and fourth block correlated negatively with age and positively with headache frequency, while there was a moderate negative correlation with headache duration. The mean P100 latency difference between the first and fourth block correlated positively with age and negatively with headache frequency, while there was a moderate positive correlation with headache duration.\u0000\u0000\u0000\u0000In our study, VEP habituation was not lacking in migraine patients which means that habituation of the P100 wave was noted in migraineurs. The VEP reveals neurological changes due to ischemia injury or neurotransmitter imbalances. Migraine alters cortical excitability, but it is unclear if these changes are due to altered excitatory connections, damaged inhibitory networks or subcortical pre-activation. Our findings suggest that at least during the interictal period, lack of habituation cannot be employed as a consistent neurophysiological marker of migraine across laboratories.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140696006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aishwarya Ghosh, Sadhana Singh, Monisha S., Tejaswini Jagtap, T. Issac
Aging is a natural process and is often associated with an increased incidence of cognitive impairment. Physical exercise, diet, and leisure activities (music, dance, and art) are some of the lifestyle factors that contribute to healthy aging. The present study aims to explore the differences in cognitive functioning between aging individuals involved in musical activity throughout their lifetime and the ones who were not. Fifty-one healthy elderly individuals (50–80 years of age) residing in an urban locality were selected for the study from the Tata Longitudinal Study of Aging cohort. Participants were divided into two groups: Active musicians trained in Carnatic music for more than five years (n = 18) and age-matched non-musicians (n = 33). Addenbrooke cognitive examination-III, Hindi mental status examination, and trail-making test-B (TMT-B) were used to assess cognitive functioning. A Generalized Linear Regression Model was performed including covariates such as gender, age, and years of education. We also looked at the available brain magnetic resonance imaging data of a subset of our study population to inspect the volumetric differences between musicians and non-musicians. Our results showed that musicians had significantly better visuospatial abilities as compared to non-musicians (P = 0.043). Musicians (130.89 ± 45.16 s) also took less time to complete the TMT-B task than non-musicians (148.73 ± 39.65 s), although it was not a statistically significant difference (P =0.150). In addition, brain imaging data suggested that musicians had increased gray matter volumes in the right precuneus, right post-central gyrus, right medial and superior frontal gyrus, right orbital gyrus, left middle temporal gyrus, left cuneus, left fusiform gyrus, and bilateral cingulate gyrus. Our findings are indicative of music being an important attribute in improving cognitive reserve and predicting cognitive resilience. These findings pave the way to explore the utility of non-pharmacological interventions, such as Music Therapy (especially Carnatic music in the Indian context), as a potential factor for improving cognitive reserve in elderly individuals.
{"title":"Music and the aging brain – Exploring the role of long-term Carnatic music training on cognition and gray matter volumes","authors":"Aishwarya Ghosh, Sadhana Singh, Monisha S., Tejaswini Jagtap, T. Issac","doi":"10.25259/jnrp_605_2023","DOIUrl":"https://doi.org/10.25259/jnrp_605_2023","url":null,"abstract":"\u0000\u0000Aging is a natural process and is often associated with an increased incidence of cognitive impairment. Physical exercise, diet, and leisure activities (music, dance, and art) are some of the lifestyle factors that contribute to healthy aging. The present study aims to explore the differences in cognitive functioning between aging individuals involved in musical activity throughout their lifetime and the ones who were not.\u0000\u0000\u0000\u0000Fifty-one healthy elderly individuals (50–80 years of age) residing in an urban locality were selected for the study from the Tata Longitudinal Study of Aging cohort. Participants were divided into two groups: Active musicians trained in Carnatic music for more than five years (n = 18) and age-matched non-musicians (n = 33). Addenbrooke cognitive examination-III, Hindi mental status examination, and trail-making test-B (TMT-B) were used to assess cognitive functioning. A Generalized Linear Regression Model was performed including covariates such as gender, age, and years of education. We also looked at the available brain magnetic resonance imaging data of a subset of our study population to inspect the volumetric differences between musicians and non-musicians.\u0000\u0000\u0000\u0000Our results showed that musicians had significantly better visuospatial abilities as compared to non-musicians (P = 0.043). Musicians (130.89 ± 45.16 s) also took less time to complete the TMT-B task than non-musicians (148.73 ± 39.65 s), although it was not a statistically significant difference (P =0.150). In addition, brain imaging data suggested that musicians had increased gray matter volumes in the right precuneus, right post-central gyrus, right medial and superior frontal gyrus, right orbital gyrus, left middle temporal gyrus, left cuneus, left fusiform gyrus, and bilateral cingulate gyrus.\u0000\u0000\u0000\u0000Our findings are indicative of music being an important attribute in improving cognitive reserve and predicting cognitive resilience. These findings pave the way to explore the utility of non-pharmacological interventions, such as Music Therapy (especially Carnatic music in the Indian context), as a potential factor for improving cognitive reserve in elderly individuals.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anuradha Kushwaha, D. Basera, Sangita Kumari, Roshan Sutar, Vijender Singh, Saikat Das, Amit Agrawal
Memory deficits are observed across psychiatric disorders ranging from the prodrome of psychosis to common mental disorders such as anxiety, depression, and dissociative disorders. Memory deficits among patients recovering from psychiatric disorders could be directly related to the primary illness or secondary to the adverse effect of a treatment such as Electroconvulsive Therapy (ECT). The trouble in the meaningful integration of working-memory and episodic memory is the most commonly affected domain that requires routine assessments. An update on the recent trends of methods of assessment of memory deficits is the first step towards understanding and correcting these deficits to target optimum recovery. A systematic literature search was conducted from October 2018 to October 2022 to review the recent methods of assessment of memory deficits in psychiatric disorders. The definition of ‘Memory deficit’ was operationalized as ‘selective processes of memory, commonly required for activities of daily living, and affected among psychiatric disorders resulting in subjective distress and dysfunction’. We included 110 studies, most of them being conducted in western countries on patients with schizophrenia. Other disorders included dementia and mild cognitive impairment. Brief Assessment of Cognition in Schizophrenia, Cambridge Automated Neuropsychological Test Battery, California Verbal Learning Test, Trail Making Test Part A and B, Rey Auditory Verbal Learning Test, Wechsler Memory Scale, Wechsler Adults Intelligence Scale-IV were the most common neuropsychological assessments used. Mini-Mental State Examination and Montreal Cognitive Assessment were the most common bedside assessment tools used while Squire Subjective Memory Questionnaire was commonly used to measure ECT-related memory deficits. The review highlights the recent developments in the field of assessment of memory deficits in psychiatric disorders. Findings recommend and emphasize routine assessment of memory deficits among psychiatric disorders in developing countries especially severe mental illnesses. It remains interesting to see the role of standardized assessments in diagnostic systems given more than a decade of research on memory deficits in psychiatric disorders.
从精神病的前驱症状到焦虑症、抑郁症和分离性障碍等常见精神疾病，都会出现记忆缺陷。精神病康复患者的记忆缺陷可能与原发疾病直接相关，也可能是继发于电休克疗法（ECT）等治疗的不良反应。工作记忆和外显记忆的整合问题是最常见的受影响领域，需要进行常规评估。了解记忆缺陷评估方法的最新趋势，是理解和纠正这些缺陷以达到最佳康复效果的第一步。2018年10月至2022年10月期间，我们进行了一次系统性文献检索，以回顾近期评估精神疾病记忆缺陷的方法。记忆缺陷 "的定义可操作化为 "记忆的选择性过程，通常为日常生活活动所必需，在精神障碍中受到影响，导致主观痛苦和功能障碍"。我们共纳入了 110 项研究，其中大部分是西方国家针对精神分裂症患者进行的研究。其他疾病包括痴呆症和轻度认知障碍。最常用的神经心理学评估方法包括：精神分裂症认知能力简明评估、剑桥自动神经心理学测试电池、加利福尼亚言语学习测试、寻迹测试 A 部分和 B 部分、雷伊听觉言语学习测试、韦氏记忆量表、韦氏成人智能量表-IV。迷你精神状态检查和蒙特利尔认知评估是最常用的床边评估工具，而 Squire 主观记忆问卷则常用于测量与 ECT 相关的记忆缺陷。综述强调了精神疾病记忆缺陷评估领域的最新进展。研究结果建议并强调对发展中国家的精神疾病，尤其是严重精神疾病患者的记忆缺陷进行常规评估。鉴于十多年来对精神疾病记忆缺陷的研究，标准化评估在诊断系统中的作用仍然值得关注。
{"title":"Assessment of memory deficits in psychiatric disorders: A systematic literature review","authors":"Anuradha Kushwaha, D. Basera, Sangita Kumari, Roshan Sutar, Vijender Singh, Saikat Das, Amit Agrawal","doi":"10.25259/jnrp_456_2023","DOIUrl":"https://doi.org/10.25259/jnrp_456_2023","url":null,"abstract":"Memory deficits are observed across psychiatric disorders ranging from the prodrome of psychosis to common mental disorders such as anxiety, depression, and dissociative disorders. Memory deficits among patients recovering from psychiatric disorders could be directly related to the primary illness or secondary to the adverse effect of a treatment such as Electroconvulsive Therapy (ECT). The trouble in the meaningful integration of working-memory and episodic memory is the most commonly affected domain that requires routine assessments. An update on the recent trends of methods of assessment of memory deficits is the first step towards understanding and correcting these deficits to target optimum recovery. A systematic literature search was conducted from October 2018 to October 2022 to review the recent methods of assessment of memory deficits in psychiatric disorders. The definition of ‘Memory deficit’ was operationalized as ‘selective processes of memory, commonly required for activities of daily living, and affected among psychiatric disorders resulting in subjective distress and dysfunction’. We included 110 studies, most of them being conducted in western countries on patients with schizophrenia. Other disorders included dementia and mild cognitive impairment. Brief Assessment of Cognition in Schizophrenia, Cambridge Automated Neuropsychological Test Battery, California Verbal Learning Test, Trail Making Test Part A and B, Rey Auditory Verbal Learning Test, Wechsler Memory Scale, Wechsler Adults Intelligence Scale-IV were the most common neuropsychological assessments used. Mini-Mental State Examination and Montreal Cognitive Assessment were the most common bedside assessment tools used while Squire Subjective Memory Questionnaire was commonly used to measure ECT-related memory deficits. The review highlights the recent developments in the field of assessment of memory deficits in psychiatric disorders. Findings recommend and emphasize routine assessment of memory deficits among psychiatric disorders in developing countries especially severe mental illnesses. It remains interesting to see the role of standardized assessments in diagnostic systems given more than a decade of research on memory deficits in psychiatric disorders.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Viswanadh Kalaparti Sri Venkata Ganesh, HariKishore Kamepalli, DevPrakash Sharma, B. Thomas, C. Kesavadas
The excellent resolution offered by magnetic resonance imaging (MRI) has a trade-off in the form of scan duration. The purpose of the present study was to assess the clinical utility of echo-planar imaging mix (EPIMix), an echo-planar imaging-based MRI sequence for the brain with a short acquisition time. This was a retrospective observational study of 50 patients, who could benefit from faster MRI brain scans. The T1, T2, fluid attenuated inversion recovery, diffusion-weighted imaging (DWI), and T2*/susceptibility-weighted imaging sequences were acquired, conventionally and with EPIMix. Conventional and EPIMix images were assessed by two radiologists for overall quality, motion, and susceptibility artifacts and scored on a Likert scale. The scores given for conventional and EPIMix images were compared. The diagnostic performance of EPIMix was also assessed by the ability to detect clinically relevant findings. The acquisition time for conventional MRI was 11 min and 45 s and for EPIMix 1 min and 15 s. All EPIMix images were sufficient for diagnostic use. On assessment of the diagnostic performance, it was excellent for ischemic and hemorrhagic strokes. Smaller lesions, lesions adjacent to bone, and post-operative tumors were difficult to identify. Moderate to perfect agreement (Kappa values 0.41–1) was seen between radiologists for all categories except skull base, calvarial, and orbital lesions. Image quality, artifact assessment showed excellent interobserver agreement (>90%) for the scores. All EPIMix images showed reduced motion artifacts. The EPIMix-DWI was comparable to conventional-DWI in terms of quality and artifacts. The remaining sequences showed reduced quality and increased susceptibility. The EPIMix has a significantly reduced acquisition time than conventional MRI and could be used instead of conventional MRI in situations demanding faster scans such as suspected acute ischemic or hemorrhagic stroke. In other clinical scenarios, it could help tailor the MRI examination for each patient.
{"title":"Multi-contrast echo-planar imaging sequence (Echo-planar imaging mix) in clinical situations demanding faster MRI-brain scans","authors":"Viswanadh Kalaparti Sri Venkata Ganesh, HariKishore Kamepalli, DevPrakash Sharma, B. Thomas, C. Kesavadas","doi":"10.25259/jnrp_508_2023","DOIUrl":"https://doi.org/10.25259/jnrp_508_2023","url":null,"abstract":"\u0000\u0000The excellent resolution offered by magnetic resonance imaging (MRI) has a trade-off in the form of scan duration. The purpose of the present study was to assess the clinical utility of echo-planar imaging mix (EPIMix), an echo-planar imaging-based MRI sequence for the brain with a short acquisition time.\u0000\u0000\u0000\u0000This was a retrospective observational study of 50 patients, who could benefit from faster MRI brain scans. The T1, T2, fluid attenuated inversion recovery, diffusion-weighted imaging (DWI), and T2*/susceptibility-weighted imaging sequences were acquired, conventionally and with EPIMix. Conventional and EPIMix images were assessed by two radiologists for overall quality, motion, and susceptibility artifacts and scored on a Likert scale. The scores given for conventional and EPIMix images were compared. The diagnostic performance of EPIMix was also assessed by the ability to detect clinically relevant findings.\u0000\u0000\u0000\u0000The acquisition time for conventional MRI was 11 min and 45 s and for EPIMix 1 min and 15 s. All EPIMix images were sufficient for diagnostic use. On assessment of the diagnostic performance, it was excellent for ischemic and hemorrhagic strokes. Smaller lesions, lesions adjacent to bone, and post-operative tumors were difficult to identify. Moderate to perfect agreement (Kappa values 0.41–1) was seen between radiologists for all categories except skull base, calvarial, and orbital lesions. Image quality, artifact assessment showed excellent interobserver agreement (>90%) for the scores. All EPIMix images showed reduced motion artifacts. The EPIMix-DWI was comparable to conventional-DWI in terms of quality and artifacts. The remaining sequences showed reduced quality and increased susceptibility.\u0000\u0000\u0000\u0000The EPIMix has a significantly reduced acquisition time than conventional MRI and could be used instead of conventional MRI in situations demanding faster scans such as suspected acute ischemic or hemorrhagic stroke. In other clinical scenarios, it could help tailor the MRI examination for each patient.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vincentius Diamantino Supit, Yudhi Adrianto, Sita Setyowatie
Primary or secondary hemifacial spasm (HFS) can be caused by a variety of conditions, one of which is caused by neurovascular contact with a vertebrobasilar dolichoectasia (VBD). Microvascular decompression (MVD) had been known for the treatment of neurovascular contact that gives best outcome, however there were still limitations which surgery cannot be performed. In that case, conservative treatment plays essential role. Our case reported A 69-year-old man with chief complaint right HFS for four years that getting better with conservative treatment (blood pressure management and clonazepam oral).
{"title":"Conservative treatment in hemifacial spasm due to vertebrobasilar dolichoectasia","authors":"Vincentius Diamantino Supit, Yudhi Adrianto, Sita Setyowatie","doi":"10.25259/jnrp_41_2024","DOIUrl":"https://doi.org/10.25259/jnrp_41_2024","url":null,"abstract":"Primary or secondary hemifacial spasm (HFS) can be caused by a variety of conditions, one of which is caused by neurovascular contact with a vertebrobasilar dolichoectasia (VBD). Microvascular decompression (MVD) had been known for the treatment of neurovascular contact that gives best outcome, however there were still limitations which surgery cannot be performed. In that case, conservative treatment plays essential role. Our case reported A 69-year-old man with chief complaint right HFS for four years that getting better with conservative treatment (blood pressure management and clonazepam oral).","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140719233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Panicker, Thomas Iype, Ramana Appireddy, Ayana Ajithan, A. S. Lijimol, A. Sasikumar, R. Dileep, Nirmala Vijaya, Chris Booth, M. R. Rajagopal
Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India. Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months. Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up. There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.
脑卒中幸存者在多个领域都有姑息治疗需求，但这些需求都被忽视了。准确估计这些需求对于确保适当的康复和规划干预措施以提高生活质量（QoL）至关重要。我们招募了 75 名连续就诊 6 个月的脑卒中患者，对他们进行了不同领域的评估，包括症状负担、身体领域、日常生活活动 (ADL)、精神/心理领域以及基线时的 QoL 和 1 个月和 3 个月的随访。尽管中风幸存者的常规中风损伤测量指标有所改善，但在各个领域仍有大量需求未得到满足；在三个月的随访中，98%的幸存者严重或完全依赖日常生活活动；疼痛和失眠是最常见的困扰症状（发生率为 33%）。与精神健康相关的问题也很多。采用的 QoL 测量工具是中风影响评估问卷（SIAQ）和世界卫生组织生活质量简易版（WHO-QOL-BREF）。一个月的 SIAQ 评分显示，19 名患者（42.22%）的 QoL 受到严重影响，36 名患者（80%）在三个月的随访中显示出同样的趋势。WHO-BREF 评分显示，27 名患者（62%）的 QoL 不佳，32 名患者（73%）在一个月的随访中对自己的健康状况不满意。
{"title":"Palliative care needs of stroke patients at a tertiary care center in South India","authors":"P. Panicker, Thomas Iype, Ramana Appireddy, Ayana Ajithan, A. S. Lijimol, A. Sasikumar, R. Dileep, Nirmala Vijaya, Chris Booth, M. R. Rajagopal","doi":"10.25259/jnrp_7_2024","DOIUrl":"https://doi.org/10.25259/jnrp_7_2024","url":null,"abstract":"\u0000\u0000Stroke survivors have palliative care needs in multiple domains, which are overlooked. Accurate estimation of these is pivotal in ensuring proper rehabilitation and planning interventions to improve quality of life (QoL). We aimed to assess the palliative care needs of stroke patients in various domains in a structured manner at the neurology service of a tertiary care center in South India.\u0000\u0000\u0000\u0000Seventy-five consecutive stroke patients presenting to the neurology service were recruited over six months with assessment across various domains including symptom burden, physical domain, activities of daily living (ADL), psychiatric/psychological domain, and QoL at baseline and with follow-up at one month and three months.\u0000\u0000\u0000\u0000Despite improvement in the conventional stroke impairment measures among stroke survivors, there were significant unmet needs across various domains; 98% were severely or entirely dependent on ADL at three-month follow-up; and pain and insomnia were the most frequent (33% incidence) troubling symptoms encountered. There were substantial mental health related issues. The QoL measurement tools employed were the stroke impact assessment questionnaire (SIAQ), a novel tool and the World Health Organization Quality Of Life Brief Version (WHO-QOL-BREF). SIAQ scores at one month showed that 19 patients (42.22%) had their QoL severely affected, and 36 patients (80%) showed the same trend at the three-month follow-up. WHO-BREF scores showed that 27 (62%) did not report good QoL, and 32 (73%) were found not to be satisfied with their health at a one-month follow-up.\u0000\u0000\u0000\u0000There is a significant burden of unmet palliative care needs among stroke survivors in India across various domains.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140746203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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