Spatial neglect (SN) is a common cognitive disorder after brain injury. Prism adaptation treatment (PAT) is one of the promising interventions for SN albeit inconsistent results from previous studies. We carried out a comparison intervention (PAT vs. Sham) and aimed to evaluate the efficacy of PAT on visuospatial symptoms of SN in an inpatient rehabilitation setting that offered a highly intensive comprehensive brain injury rehabilitation program. A total of 34 patients with moderate-to-severe SN secondary to stroke or traumatic brain injury were randomized to the PAT group and the Sham group (an active control group). Both groups received 10 sessions of treatment, over two weeks, in addition to the rehabilitation therapies provided by their rehabilitation care teams. Outcomes were measured using an ecological instrument (the Catherine Bergego Scale) and paper-and-pencil tests (the Bells Test, the Line Bisection Test and the Scene Copying Test). Patients were assessed at baseline, immediately after treatment, two weeks after treatment, and four weeks after treatment. 23 (67.6%) patients completed treatment and all the assessment sessions and were included in the final analyses using mixed linear modeling. While SN symptoms reduced in both groups, we found no difference between the two groups in the degree of improvement. In addition, the average SN recovery rates were 39.1% and 28.6% in the PAT and Sham groups, respectively, but this discrepancy did not reach statistical significance. Thus, the present study suggests that PAT may contribute little to SN care in the context of a highly intensive inpatient rehabilitation program. Further large-scale investigation is required to uncover the mechanisms underlying PAT and Sham in order to refine the treatment or create new interventions.
- MeSH
- cévní mozková příhoda komplikace patofyziologie terapie MeSH
- kognitivní poruchy etiologie patofyziologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- pilotní projekty MeSH
- rehabilitace po cévní mozkové příhodě * metody MeSH
- studie proveditelnosti MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
INTRODUCTION: Recent research indicated that cognitive speed of processing training (SPT) improved Useful Field of View (UFOV) among individuals with Parkinson's disease (PD). The effects of SPT in PD have not been further examined. The objectives of the current study were to investigate use, maintenance and dose effects of SPT among individuals with PD. METHODS: Participants who were randomized to SPT or a delayed control group completed the UFOV at a six-month follow-up visit. Use of SPT was monitored across the six-month study period. Regression explored factors affecting SPT use. Mixed effect models were conducted to examine the durability of training gains among those randomized to SPT (n = 44), and training dose effects among the entire sample (n = 87). RESULTS: The majority of participants chose to continue to use SPT (52%). Those randomized to SPT maintained improvements in UFOV performance. A significant dose effect of SPT was evident such that more hours of training were associated with greater UFOV performance improvements. The cognitive benefits derived from SPT in PD may be maintained for up to three months. CONCLUSION: Future research should determine how long gains endure and explore if such training gains transfer.
- Klíčová slova
- Mixed effect models, cognitive training, non-pharmacological intervention,
- MeSH
- činnosti denního života psychologie MeSH
- kognice * MeSH
- kognitivní poruchy komplikace psychologie terapie MeSH
- lidé MeSH
- Parkinsonova nemoc komplikace psychologie terapie MeSH
- praxe (psychologie) * MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
The research is based on comparative analysis of 'Hinting Task', 'Faux Pas', and 'Reading the Mind in the Eyes' tests sensitivity in detection of Theory of Mind deficits. The study included 20 subjects with schizophrenia and schizophrenia spectrum disorders with the first episode of psychosis. Every subject performed the three proposed tests. It was shown that success rate of the three tests differed significantly. The non-verbal test 'Reading the Mind in the Eyes' caused the most difficulties. The success rate percentage of this test performance correlated negatively with the severity of psychopathological symptoms evaluated according to the PANSS scale. Thus, 'Reading the Mind in the Eyes' test is the most sensitive out of the three to Theory of Mind deficits detection, which may be used for diagnostic purposes.
- MeSH
- kognitivní poruchy * diagnóza terapie MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- psychotické poruchy * diagnóza MeSH
- schizofrenie * diagnóza MeSH
- teorie mysli * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Cognitive dysfunction is a common characteristic across a number of psychiatric conditions. With growing technological advances, application based cognitive remediation (cognitive apps) is becoming steadily popular due to its accessibility, ease of use and minimal interference with the activities of daily life. However, despite a number of benefits that application based cognitive training possesses, it is not clear, whether the utilisation of these apps is a reliable approach that can be recommended in clinical psychiatric practice in order to restore cognition. In the present review, we have analysed eleven applications which trained the cognitive domains of memory, attention, language, processing speed, executive function and perception with respect to the structure and function of the applications, duration of use and measuring and monitoring of user progress and assessed them, based on the published data, for efficacy in the general population and clinical subgroups of the population. We conclude that, given that there are differences between the apps, given that there is a difference between the general population using these apps and groups suffering pathological conditions using them, given that cognitive deficits are caused by different pathological processes in different illnesses and that different illnesses present with different ranges of deficits, it is not possible to make blanket recommendations for the use of the apps. Nor is there sufficient published evidence for any of the apps to be specifically recommended for cognitive remediation. More evidence, such as trials of specific apps in different conditions, trials of specific apps against therapist guided techniques and blind trials of different apps against each other are necessary before recommendations of particular apps for particular remedial treatments can be made. Nor can 'brain training' in normal populations be seen as preventing cognitive decline or be seen as proof that cognitive remediation can improve cognition in pathological groups. Our paper serves as a useful reference to what apps are available, how they compare, and what the published evidence is, with a view to planning further research.
BACKGROUND: The organization of long-term care is one of the main challenges of public health and health policies in Europe and worldwide, especially in terms of care concepts for people with dementia. In Austria and the Czech Republic the majority of elderly institutionalized persons with dementia are cared for in nursing homes. It is however unclear, how many persons living in nursing homes in Austria and in the Czech Republic are suffering from cognitive impairment and dementia. In addition, basic information on the nutritional status, the status of mobility and the medication prescription patterns are often missing. To facilitate new effective and evidenced based care concepts, basic epidemiological data are in urgent need. Thus, DEMDATA was initiated to provide important basic data on persons living in nursing homes in Austria and the Czech Republic for future care planning. METHODS: DEMDATA is a multicentre mixed methods cross-sectional study. Stratified and randomly drawn nursing homes in Austria and the Czech Republic are surveyed. The study protocol used in both study centres assesses four different domains: a) Resident, b) Care team, c) Relative and d) Environmental Factors. Resident's data include among others health status, cognition, dementia, mobility, nutrition, behavioural symptoms, pain intensity and quality of life. A minimum of 500 residents per country are included into the study (N = 1000 residents). The care team is asked about the use of the person-centred care and their burden. The relatives are asked about the number of visits and proxy-rate the quality of life of their family member. All staff employed in the nursing homes, all residents and relatives can voluntary take part in the study. The environmental factors include among others the organisational category of the nursing home, number of residents, number of rooms, social activities and the care concept. The project started in March 2016 and will be concluded in February 2018. DISCUSSION: DEMDATA will provide important epidemiological data on four different nursing home domains in Austria and the Czech Republic, with a focus on the prevalence of dementia in this population. Thereby supplying decision and policy makers with important foundation for future care planning.
- Klíčová slova
- Database, Health parameters, Nursing homes, dementia,
- MeSH
- behaviorální symptomy psychologie terapie MeSH
- demence epidemiologie psychologie terapie MeSH
- dlouhodobá péče organizace a řízení MeSH
- domovy pro seniory statistika a číselné údaje MeSH
- institucionalizace MeSH
- kognitivní poruchy psychologie terapie MeSH
- kvalita života MeSH
- lékaři statistika a číselné údaje MeSH
- lidé MeSH
- péče orientovaná na pacienta MeSH
- pečovatelské domovy statistika a číselné údaje MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- rodina psychologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Rakousko epidemiologie MeSH
Circadian rhythms are highly important not only for the synchronization of animals and humans with their periodic environment but also for their fitness. Accordingly, the disruption of the circadian system may have adverse consequences. A certain number of animals in our breeding stock of Djungarian hamsters are episodically active throughout the day. Also body temperature and melatonin lack 24-h rhythms. Obviously in these animals, the suprachiasmatic nuclei (SCN) as the central pacemaker do not generate a circadian signal. Moreover, these so-called arrhythmic (AR) hamsters have cognitive deficits. Since motor activity is believed to stabilize circadian rhythms, we investigated the effect of voluntary wheel running. Hamsters were bred and kept under standardized housing conditions with food and water ad libitum and a 14 L/10 D lighting regimen. AR animals were selected according to their activity pattern obtained by means of passive infrared motion detectors. In a first step, the daily activity behavior was investigated for 3 weeks each without and with running wheels. To estimate putative photic masking effects, hamsters were exposed to light (LPs) and DPs and also released into constant darkness for a minimum of 3 weeks. A novel object recognition (NOR) test was performed to evaluate cognitive abilities both before and after 3 weeks of wheel availability. The activity patterns of hamsters with low wheel activity were still AR. With more intense running, daily patterns with higher values in the dark time were obtained. Obviously, this was due to masking as LPs did suppress and DPs induced motor activity. When transferred to constant darkness, in some animals the daily rhythm disappeared. In other hamsters, namely those which used the wheels most actively, the rhythm was preserved and free-ran, what can be taken as indication of a reconstitution of circadian rhythmicity. Also, animals showing a 24-h activity pattern after 3 weeks of extensive wheel running were able to recognize the novel object in the NOR test but not so before. The results show that voluntary exercise may reestablish circadian rhythmicity and improve cognitive performance.
- Klíčová slova
- Djungarian hamster, arrhythmic activity pattern, circadian rhythm, cognitive performance, constant darkness, masking, running wheel,
- MeSH
- chování zvířat * MeSH
- cirkadiánní rytmus * MeSH
- kognice * MeSH
- kognitivní poruchy patofyziologie terapie MeSH
- křečci praví MeSH
- nucleus suprachiasmaticus fyziologie MeSH
- paměť MeSH
- Phodopus MeSH
- pohybová aktivita * MeSH
- světlo MeSH
- zvířata MeSH
- Check Tag
- křečci praví MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) is a promising tool to study and modulate brain plasticity. OBJECTIVE: Our aim was to investigate the effects of rTMS on cognitive functions in patients with mild cognitive impairment and Alzheimer's disease (MCI/AD) and assess the effect of gray matter (GM) atrophy on stimulation outcomes. METHODS: Twenty MCI/AD patients participated in the proof-of-concept controlled study. Each patient received three sessions of 10 Hz rTMS of the right inferior frontal gyrus (IFG), the right superior temporal gyrus (STG), and the vertex (VTX, a control stimulation site) in a randomized order. Cognitive functions were tested prior to and immediately after each session. The GM volumetric data of patients were: 1) compared to healthy controls (HC) using source-based morphometry; 2) correlated with rTMS-induced cognitive improvement. RESULTS: The effect of the stimulated site on the difference in cognitive scores was statistically significant for the Word part of the Stroop test (ST-W, p = 0.012, linear mixed models). As compared to the VTX stimulation, patients significantly improved after both IFG and STG stimulation in this cognitive measure. MCI/AD patients had significant GM atrophy in characteristic brain regions as compared to HC (p = 0.029, Bonferroni corrected). The amount of atrophy correlated with the change in ST-W scores after rTMS of the STG. CONCLUSION: rTMS enhanced cognitive functions in MCI/AD patients. We demonstrated for the first time that distinct pattern of GM atrophy in MCI/AD diminishes the cognitive effects induced by rTMS of the temporal neocortex.
- Klíčová slova
- Alzheimer’s disease, brain atrophy, cognitive functions, noninvasive brain stimulation; source-based morphometry,
- MeSH
- Alzheimerova nemoc komplikace MeSH
- analýza rozptylu MeSH
- kognitivní poruchy * etiologie patologie terapie MeSH
- lidé MeSH
- mozková kůra fyziologie MeSH
- neuropsychologické testy MeSH
- psychiatrické posuzovací škály MeSH
- šedá hmota patologie patofyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- transkraniální magnetická stimulace metody MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: We studied whether 1 session of high-frequency repetitive transcranial magnetic stimulation (rTMS) applied sequentially over both the left and right inferior frontal gyri (IFG) would enhance performance in tests evaluating the ability to inhibit habitual responses (Stroop test, ST; Frontal Assessment Battery, FAB) in patients with Parkinson's disease (PD). METHODS: Ten nondemented PD patients (6 men, 4 women; age, 66 ± 6 years; disease duration, 5.4 ± 2.45 years) entered the randomized, sham stimulation-controlled study with a crossover design. The ST and the FAB were performed prior to and immediately after an appropriate rTMS session. RESULTS: The active but not sham rTMS induced significant improvement in all ST subtests (word, color, color-word). Conversely, the calculated Stroop interference and the FAB scores remained unchanged. CONCLUSIONS: In PD patients, rTMS of the IFG increased the speed of cognitive processing in both the congruent and incongruent conditions of the ST.
- MeSH
- čelní lalok fyziologie MeSH
- dvojitá slepá metoda MeSH
- inhibice (psychologie) MeSH
- klinické křížové studie MeSH
- kognitivní poruchy etiologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- neuropsychologické testy MeSH
- Parkinsonova nemoc komplikace MeSH
- pilotní projekty MeSH
- senioři MeSH
- slovní zásoba MeSH
- transkraniální magnetická stimulace * MeSH
- vnímání barev MeSH
- záznam o duševním stavu MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
OBJECTIVES: To determine modifiable factors related to abusive behaviors in nursing home residents with dementia. DESIGN: Analysis of Minimum Data Set (MDS) of the Resident Assessment Instrument (RAI) information. SETTING: We used MDS-RAI data from 8 Dutch nursing homes and 10 residential homes that volunteered to collect data for care planning. We included the data of residents within a 12-month time window for each facility separately, resulting in a range from April 4, 2007, to December 1, 2008. PARTICIPANTS: We selected 929 residents older than 65 with Alzheimer's disease or other dementia who were dependent in decision making and not comatose. MEASUREMENTS: Cognitive Performance Scale, MDS Depression Scale and several individual items from the MDS-RAI (ability to understand others, verbally and physically abusive behavioral symptoms, resist care, diagnosis of Alzheimer's disease and of dementia other than Alzheimer's disease, diagnosis of depression, presence of delusions, hallucinations, pain frequency and constipation, and number of days receiving medications). RESULTS: Resistiveness to care, related to lack of understanding, depression, hallucinations and delusions, was strongly related to abusive behaviors. Presence of depressive symptoms and delusions was also related to abusive behaviors independent of resistiveness to care. Only very few residents who understood others and were not depressed were abusive. CONCLUSION: Abusive behaviors may develop from lack of understanding leading to resistiveness to care. Behavioral interventions preventing escalation of resistiveness to care into combative behavior and the treatment of depression can be expected to decrease or prevent abusive behavior of most nursing home residents with dementia.
- MeSH
- agrese psychologie MeSH
- Alzheimerova nemoc komplikace psychologie MeSH
- databáze faktografické MeSH
- demence komplikace psychologie terapie MeSH
- domovy pro seniory * MeSH
- incidence MeSH
- kognitivní poruchy komplikace psychologie terapie MeSH
- kohortové studie MeSH
- lidé MeSH
- logistické modely MeSH
- multivariační analýza MeSH
- odmítnutí terapie pacientem MeSH
- pečovatelské domovy * MeSH
- pravděpodobnost MeSH
- psychiatrické posuzovací škály MeSH
- psychomotorický neklid epidemiologie etiologie MeSH
- rizikové faktory MeSH
- rozložení podle pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- věkové rozložení MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: The monitoring of the late effects of childhood cancer treatments was established approximately in the 1970s. With an increasing number of children cancer survivors the identification of the short-term or late effects becomes more detailed. The psychosocial and cognitive problems are of the most frequent sequelae of the cancer treatment and their prevalence is nearly 20% in survivors of childhood cancer. These problems can have an adverse impact on further professional career or private life in the childhood cancer survivors. The most threatened group of patients are children treated for brain tumors and acute lymphoblastic leukemia. DESIGN: The object of this paper is to review the present information in the area of the neuropsychological sequelae in the childhood cancer survivors. CONCLUSIONS: Identification of the specific cognitive problems in childhood cancer survivors can have the profound impact on improvement of the support delivered to the children and adolescents by their families, in the school and further career. Tailored interventions can have the positive impact on the quality of life of this subgroup of children. Multidisciplinary approach including routine psychological screening is necessary for addressed follow-up care concerning this vulnerable at-risk population.
