Neuro endocrinology letters最新文献

Objective: This study examines the relationship between Glycated hemoglobin A1c (HbA1c) levels and cognitive impairment in elderly patients with complex chronic conditions, a link previously unclear.

Design: This is a cross-sectional study.

Material and methods: The data from 2,366 patients in Catalonia (2013-2017) from the Dryad database. HbA1c levels were taken from clinical records, and cognitive function was assessed with ICD-10 criteria and the Pfeiffer test. We included demographic details, comorbidities, medications, and clinical data as covariates. Multivariate logistic regression was used, with subgroup analyses by age and other factors.

Results: The cohort had an average age of 84.1 ± 10 years; 46.4% were male, with an average HbA1c of 6.5 ± 1.4%. Cognitive impairment was present in 20.2% of participants. The association between HbA1c and cognitive impairment was not significant after adjusting for all variables (OR = 0.99, 95% CI: 0.91-1.08, p > 0.05). Ischemic cardiomyopathy (p = 0.008) and Barthel scores > 40 (p = 0.032) demonstrate an interaction effect on their relationship.

Conclusion: In the population of patients with complex chronic conditions, HbA1c did not show a statistically significant correlation with cognitive impairment, indicating that HbA1c might not be an independent predictor of cognitive decline in this group, though further research is needed to confirm this.

Objective: This article focuses on utilizing therapeutic letters within group schema therapy-an innovative therapeutic approach that integrates elements from various therapeutic disciplines. The primary aim is to explore how therapeutic letters can enhance the therapeutic process and support the treatment of patients.

Methods: To achieve this objective, we conducted a narrative literature review centred on schema therapy and using therapeutic letters as a therapeutic strategy. We systematically searched databases (PubMed, PsycINFO, and Google Scholar) using the keywords "schema therapy," "therapy letters," "group," "therapeutic strategies," and "adult psychotherapy." Additionally, we gathered clinical insights from schema therapists through interviews to gain a practical perspective.

Results: Group schema therapy primarily targets identifying and modifying early maladaptive schemas and maladaptive schema modes that originate during childhood and persist into adulthood. Within this context, therapeutic letters are an effective tool, allowing individuals to process intense emotions stemming from their formative years. Individuals complete these letters as homework assignments and then, divided into small groups, read them aloud while receiving emotional support and encouragement from their peers. This process enables individuals to explore their thoughts and feelings, potentially reframe their life narratives, seek forgiveness, and ultimately progress. Various types of therapeutic letters are discussed, including the "uncensored letter", "letter from the other shore", "letter to an adult child", "business card", and "letter from the future".

Discussion: The article provides an in-depth overview of the techniques and exercises employed in group schema work when using letters. It also addresses potential challenges, such as difficulties with visualization, resistance to change, and trust issues.

Conclusion: Therapeutic letters emerge as a valuable tool in group schema therapy, enhancing the therapeutic process and supporting individual treatment. However, further research is necessary to comprehend and fully maximize their potential.

Background: Multiple sclerosis (MS) is a disease that affects the central nervous system. One of its manifestations is cognitive impairment (CI), which can negatively affect the quality of life in people with MS (pwMS). This study aimed to investigate the nature of CI in MS and its associations with various disease characteristics.

Methods: Symbol Digit Modalities Test and cognitive tests adapted for the Slovak population as part of the NEUROPSY battery were used. For the assessment of depression, the Patient Health Questionnaire-9 was used. To assess the degree of functional disability, the Expanded Disability Status Scale, Timed 25-Foot Walk, and 9-Hole Peg Test were used. Plasma neurofilament light chain level (pNfL, a promising marker of neurodegeneration) was assessed. Variables in the CI vs. non-CI group were compared.

Results: In cognition, we observed statistically significant differences between the CI and the non-CI group in multiple measures. In the degree of functional disability, we found statistically significant differences between the groups in all measures. However, we found no statistically significant differences in depression, pNfL, type of disease-modifying therapy, or education. The Digit Span Forward (longest line) (OR: 0.375, 95%CI: 0.156-0.901, p = 0.028) and Trail Making Test-B (OR: 0.066, 95%CI: 0.013-0.339, p = 0.001) were the only independent variables in a model that predicted CI in binary logistic regression analysis.

Conclusion: Our cross-sectional study design failed to reveal the association of CI with various disease characteristics, or markers of neurodegeneration. For this purpose, longitudinal observation of pwMS, and future prospective studies are highly warranted.

The quality of prenatal care for women during pregnancy, in terms of monitoring somatic development, is generally high. The study aims to evaluate the psychosocial situation (well being) of pregnant women during a physiological pregnancy. The care of psychosocial issues of pregnant women is not systematic and often does not occur at all. Prenatal depression and anxiety are associated with an increased risk of depression even after delivery. To accomplish the goal, the authors chose both the modified Freybergh scale - the Sabbatsberg anxiety - frustration Self-Rating Scale (SDS) and a questionnaire created by the authors of this study. A total of 324 women from various regions were randomly approached, of which 277 were selected for the final evaluation. The scale contains seven categories, each with ten questions. Pregnant women repeatedly took the self-assessment over the duration of their pregnancy. The result is a summary point evaluation. The seven individual groups of questions focused on the evaluation of stress, fear, depression, regression, feelings of guilt, frustration, and aggression. The scale of answers to individual questions offered five options. The questionnaire itself had 14 monitored items and evaluated the difference in symptoms in women with and without psychological distress. The degree of psychological distress was processed using descriptive statistics. Furthermore, it was classified into four equal groups (175 points each), identified as none, mild, moderate and high deprivation. The adjusted effect of the monitored parameters on the psychological distress score was studied using a mixed model. The results of the study draw attention to psychological distress in pregnant women with physiological pregnancies. It is vital to monitor symptoms of psychological distress during physiological pregnancies. In addition, preventive prenatal programs to reduce or prevent psychological distress during pregnancies must be implemented and widely available.

This article describes using imagery approaches during group schema therapy (GST). Imagery approaches are an important tool for identifying and changing maladaptive schema modes and early maladaptive schemas. It summarises the theoretical background of the group imagery method and practical case vignettes. The text describes methods for using imagery in therapeutic groups, building a safe place, imagery rescribing painful experiences, and dialogue between schema modes. It also stresses challenging matters, like problems with imagery, difficulties trusting another person, and resistance to change. Using imagery in GST is a powerful approach to increase patient results during the therapy.

Background: With the increasing use of developmental screening tools, there is a growing need to validate parental screening methods for the early detection of developmental difficulties in children, regarding their psychometric properties.

Methods: This study evaluates the convergent validity of the S-PMV11 parental screening tool by comparing its outcomes with the Bayley Scales of Infant and Toddler Development (Bayley-III), the gold standard for direct assessment.

Results: We analyzed data from 30 children and found significant correlations between S-PMV11 scores and Bayley-III assessments across cognitive, language, and motor skill domains. Notably, expressive communication showed the strongest correlation, indicating that parents are reliable assessors of developmental risks.

Conclusion: Despite limitations related to potential overestimation in Bayley-III, our findings support the S-PMV11 as a valid tool for early identification of developmental challenges, enhancing early intervention strategies in pediatric healthcare.

Background: Major depression is classified into distinct subtypes: simple (SDMD) and major dysmood disorder (MDMD). MDMD patients exhibit elevated atherogenicity and decreased reverse cholesterol transport (RCT). However, comprehensive data regarding lipid metabolism is absent in first episode (FE)-SDMD.

Aims: In this case-control study, plasma lipid levels, lecithin-cholesterol acyltransferase (LCAT), free cholesterol, apolipoprotein (Apo)A1, ApoB, and ApoE are compared between academic students with first episode SDMD (FE-SDMD) (n = 44) or SDMD (n = 64) and control students (n = 44), after excluding those with metabolic syndrome (MetS).

Results: LCAT is decreased, and free cholesterol and ApoE increased in subjects with SDMD and FE-SDMD as compared with controls. There were no significant alterations in high-density lipoprotein cholesterol (HDLc), ApoA1, RCT, ApoB and triglycerides in SDMD. LCAT, free cholesterol and atherogenicity indices are significantly associated with suicidal behaviors and the SDMD phenome. The effects of LCAT on those phenome features is completely mediated by free cholesterol and brooding. SDMD and FE-SDMD patients without signs of subclinical MetS show lowered LCAT and increased free cholesterol as compared with normal controls. There are significant interactions between the SDMD and FE-SDMD diagnosis and subclinical MetS, which result in decreased HDLc and RCT, and an increased ApoB/ApoA ratio.

Discussion: FE-SDMD and SDMD are pre-proatherogenic states, because of decreased LCAT, and increased free cholesterol and ApoE, and their intersections with subclinical MetS. These aberrations may drive atherogenicity, and activation of peripheral and central oxidative, neuro-immune, and degenerative pathways. Individuals with FE-SDMD should be screened and treated for increased atherogenicity risk by measuring free cholesterol and ApoE.

Our review study addresses the issue of tooth loss, which is caused by loss of masticatory function and its impact on cognitive functions, dementia, and Alzheimer's disease. Numerous studies have confirmed a positive correlation between premature tooth loss, reduction in masticatory function and significant cognitive decline observed through learning disabilities, including overcoming ordinary life problems to early and advanced forms of dementia. Reduced numbers of teeth in the main food processing area, i.e., loss of large molars, have been implicated as a possible cause of cognitive impairment. In research in this area, some groups of major etiopathogenetic causes of this issue have also been established. A significant etiopathogenetic cause of tooth loss is the disappearance of their mechanoreceptors in the periodontium, causing the disappearance of sensorimotor excitation via the cranial nerve V and the associated atrophic changes in the trigeminal brain nuclei and their branching in the Locus Coeruleus area. It may cause further neurodegenerative involvement in this area, one of the centers of the adrenergic system involved in cognitive function. Relatively well-studied factors are the lack of blood supply to the cerebral area during inadequate mastication caused by loss of molars and the consequent hypoxia of brain and nerve structures. In the research and development of Alzheimer's disease, there have been many recent references to the fact that the primary bacterium causing periodontitis, Porphyromonas gingivalis, can infect the neurons of the cranial nerve V ending close to the Locus Coeruleus and thus tau proteins, after tooth extractions, can spread to other subcortical nuclei in the brain. These findings are of great relevance to clinical practice in dentistry as we strive to prevent tooth loss in the distal compartment, which is made possible by the tremendous expansion of endodontic techniques and technologies to save de facto every tooth and its periodontium with the mechanoreceptors necessary to preserve sensorimotor nerve excitability and sensorimotor nerve networks. We uncompromisingly eliminate every periodontal infection in the subgingival region as part of our preventive-therapeutical procedures.

Background: Severe or recurring major depression is associated with increased adverse childhood experiences (ACEs), heightened atherogenicity, and immune-linked neurotoxicity (INT). Nevertheless, the interconnections among these variables in outpatient major depression (OMDD) have yet to be determined. We aim to determine the correlations among INT, atherogenicity, and ACEs in OMDD patients compared to normal controls.

Methods: This study includes 66 OMDD patients (of whom 33 had metabolic syndrome, MetS) and 67 controls (31 of whom had MetS) and used Multiplex Immunoassay to assess serum levels of forty eight cytokines/chemokines/growth factors.

Results: The free cholesterol/reverse cholesterol transport ratio, apolipoprotein (Apo) B and E, and a comprehensive atherogenicity index were all significantly associated with increased INT in subjects without MetS. ACEs were substantially correlated with INT in individuals with MetS. INT (only in MetS) and atherogenicity indices (only in people without MetS) were significantly associated with the clinical phenome features of OMDD, including the recurrence of illness (ROI, including lifetime suicidal behaviors), the lifetime phenome (neuroticism, lifetime anxiety disorders and dysthymia), and the current phenome (including current suicidal behaviors). A significant proportion of the variability (58.3%) in the lifetime + current phenome could be accounted for by INT, interactions between INT and atherogenicity (labeled "atherommune index"), ApoE, three ACE subtypes (all positively correlated), and age (inversely correlated). A common latent construct could be extracted from ROI, lifetime phenome, current phenome, INT, and atherommune index. 36.1% of this factor's variance was accounted for by three ACE subtypes.

Conclusion: We have developed a novel OMDD model, namely a pathway phenotype, labeled the "atherommune-phenome," which demonstrates that the interplay between INT and atherogenicity is essential to OMDD.

Objectives: Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neurostimulation technique that uses magnetic field to comprehensively influence events in the brain. Its use in patients after stroke focuses mainly on influencing brain neuroplasticity and therefore has the potential to improve motor functions in these patients. This study investigates the effect of rTMS on motor function recovery in patients in the acute stage of ischemic stroke.

Design: This study was designed as a randomized double-blind placebo-controlled trial.

Materials and methods: A total of 26 patients with motor impairment in the acute stage of ischemic stroke were enrolled. Participants were randomly assigned to receive 5 sessions of 10 Hz ipsilesional rTMS or placebo rTMS, in addition to standard pharmacotherapy and rehabilitation. Clinical evaluations of motor impairment and activity were performed, along with electrophysiological parameters of motor evoked potential (MEP), at baseline (1 -6 days after stroke) and after the completion of the 5 rTMS sessions (10 -14 days after stroke).

Results: The 10 Hz rTMS group demonstrated significantly greater improvements in most clinical motor function assessments compared to the placebo group. However, no significant changes in the electrophysiological parameters of MEPs were observed.

Conclusion: The application of 10 Hz rTMS to the ipsilesional hemisphere shows promise in improving motor functions in patients in the acute stage of ischemic stroke. Although the results suggest potential therapeutic benefit, more research with larger sample sizes and comprehensive outcome measures is required to optimize rTMS protocols and fully understand its effects on motor recovery.