scholarly journals Longitudinal Screening Detects Cognitive Stability and Behavioral Deterioration in ALS Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Susan Woolley ◽  
Ray Goetz ◽  
Pam Factor-Litvak ◽  
Jennifer Murphy ◽  
Jonathan Hupf ◽  
...  
Keyword(s):  
Behavioral Problems ◽  
Race And Ethnicity ◽  
Behavioral Change ◽  
Disease Duration ◽  
Rating Scale ◽  
Cognitive Change ◽  
Cognitive Behavioral ◽  
Symptom Duration ◽  
Multicenter Cohort Study

Objective. To evaluate longitudinal cognitive/behavioral change over 12 months in participants enrolled in the ALS Multicenter Cohort Study of Oxidative Stress (ALS COSMOS). Methods. We analyzed data from 294 ALS participants, 134 of whom were studied serially. Change over time was evaluated controlling for age, sex, symptom duration, education, race, and ethnicity. Using multiple regression, we evaluated associations among decline in ALS Functional Rating Scale-Revised (ALSFRS-R) scores, forced vital capacity (FVC), and cognitive/behavioral changes. Change in cognitive/behavioral subgroups was assessed using one-way analyses of covariance. Results. Participants with follow-up data had fewer baseline behavior problems compared to patients without follow-up data. We found significant worsening of behavior (ALS Cognitive Behavioral Screen (ALS CBS) behavioral scale, p<0.001; Frontal Behavioral Inventory-ALS (FBI-ALS) disinhibition subscale, p=0.044). Item analysis suggested change in frustration tolerance, insight, mental rigidity, and interests (p<0.05). Changes in ALSFRS-R correlated with the ALS CBS. Worsening disinhibition (FBI-ALS) did not correlate with ALSFRS-R, FVC, or disease duration. Conclusion. We did not detect cognitive change. Behavioral change was detected, and increased disinhibition was found among patients with abnormal baseline behavioral scores. Disinhibition changes did not correlate with disease duration or progression. Baseline behavioral problems were associated with advanced, rapidly progressive disease and study attrition.

Comparison of the Sensitivity of Three Instruments for the Detection of Cognitive Decline in Elderly Living at Home

1987 ◽  
Vol 150 (6) ◽  
pp. 808-814 ◽  
Author(s):  
A. Little ◽  
D. Hemsley ◽  
K. Bergmann ◽  
J. Volans ◽  
R. Levy
Keyword(s):  
Cognitive Decline ◽  
Rating Scale ◽  
Cognitive Change ◽  
Screening Tools ◽  
Associate Learning ◽  
Mental Test Score ◽  
Learning Test ◽  
Elderly Living ◽  
At Home

We followed up 181 elderly living at home over 2 years. The changes shown on a brief dementia rating scale (the Abbreviated Mental Test Score (AMTS)) were monitored. At follow-up, subjects were classified as organic or non-organic by three potential screening tools-a screening questionnaire (the Psychogeriatric Assessment Schedule), a psychometric test (the Inglis' Paired Associate Learning Test) and a dementia scale (the AMTS). The value of these as screening tools for community samples was considered as a function of their sensitivity to cognitive decline. The classifications made by each were significantly related to previous cognitive change, but all were conservative, missing many subjects who had declined. Of the three, the AMTS appeared the most useful as a predictor of previous change on the AMTS. It remains to be seen whether it is equally useful with different samples and with different measures of outcome.

Platelet-rich plasma for treatment of chronic proximal hamstring tendinopathy

2020 ◽  
Vol 15 (4) ◽  
pp. 1509-1518
Author(s):  
Michael J Auriemma ◽  
Adam S Tenforde ◽  
Adam Harris ◽  
Kelly C McInnis
Keyword(s):  
Functional Outcomes ◽  
Rating Scale ◽  
Platelet Rich Plasma ◽  
Symptom Duration ◽  
Post Intervention ◽  
Reduction Of Pain ◽  
Numeric Pain Rating Scale ◽  
Pain Rating Scale ◽  
Proximal Hamstring

Aim: To determine whether platelet-rich plasma (PRP) can successfully treat symptoms associated with proximal hamstring tendinopathy. Materials & methods: Charts were retrospectively reviewed of patients with a diagnosis of chronic proximal hamstring tendinopathy who underwent an ultrasound-guided leukocyte-rich PRP injection to assess reported outcomes at baseline and final follow-up post-intervention. Results: In 22 patients with a mean age of 48.7 years and mean symptom duration of 26.5 months, mean Numeric Pain Rating Scale and Victorian Institute of Sport Assessment Scale for Proximal Hamstring Tendinopathy subscores demonstrated statistically significant improvements (p < 0.05) at a mean of 7.91 months follow-up. Sixty-eight percent of patients demonstrated ≥50% reduction of pain. Conclusion: Pain and functional outcomes improved following injection of PRP.

scholarly journals Progression and effect of cognitive-behavioral changes in patients with amyotrophic lateral sclerosis

2017 ◽  
Vol 7 (6) ◽  
pp. 488-498 ◽  
Author(s):  
Meredith Bock ◽  
Y.-Nhy Duong ◽  
Anthony Kim ◽  
Isabel Allen ◽  
Jennifer Murphy ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Caregiver Burden ◽  
Rating Scale ◽  
Cognitive Change ◽  
Cognitive Status ◽  
Cognitive Behavioral ◽  
Behavioral Function ◽  
Disease Heterogeneity ◽  
Study Population ◽  
Lateral Sclerosis

AbstractBackground:To prospectively evaluate the progression of cognitive-behavioral function in amyotrophic lateral sclerosis (ALS) and examine the association of cognitive-behavioral deficits with disease progression, patient quality of life (QOL), and caregiver burden.Methods:We evaluated cognitive-behavioral function using the Amyotrophic Lateral Sclerosis Cognitive Behavioral Screen at enrollment and after 7 months in a cohort of patients with ALS. Paired t tests were used to evaluate the change in the 2 assessments. Linear regression and Kruskal-Wallis tests were applied to investigate how initial cognitive or behavioral status related to outcomes.Results:The mean test-retest interval was 6.8 months (SD 1.6). Cognitive status of the study population (n = 49) overall did not change over the study period (p = 0.06) despite progression of motor weakness (p < 0.001), though small subsets of the sample demonstrate cognitive change. Patients initially classified as behaviorally normal showed increased behavioral problems over time (t = −2.8, p = 0.009). Decline in cognitive (β = −1.3, p = 0.03) and behavioral (β = −0.76, p = 0.002) status predicted increasing caregiver burden. Behavioral abnormalities predicted decline in forced vital capacity and ALS Functional Rating Scale–Revised score (p = 0.008, 0.012) in the study population and patient QOL in the most severely affected group (t = 4.3, p = 0.003).Conclusions:Cognitive-behavioral change is a key aspect of disease heterogeneity in ALS. Executive function in ALS overall remains stable over 7 months as detected by an administered screening tool. However, patients may develop caregiver-reported behavioral symptoms in that time period. Screening for caregiver-reported symptoms has a particular utility in predicting future clinical decline, increased caregiver burden, and worsening patient QOL.

scholarly journals The severity progression of non-motor symptoms in Parkinson’s disease: a 6-year longitudinal study in Taiwanese patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yi-Chieh Chen ◽  
Rou-Shayn Chen ◽  
Yi-Hsin Weng ◽  
Ying-Zu Huang ◽  
Chiung Chu Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Longitudinal Study ◽  
Disease Duration ◽  
Rating Scale ◽  
Medical Center ◽  
Motor Symptoms ◽  
Disease Rating ◽  
Non Motor Symptoms

AbstractNonmotor symptoms (NMSs) cause major burden in patients with Parkinson’s disease (PD). Previous NMSs progression studies mostly focused on the prevalence. We conducted a longitudinal study to identify the progression pattern by the severity. PD patients recruited from the outpatient clinics of a tertiary medical center were evaluated by the Unified Parkinson's Disease Rating Scale and Non-Motor Symptoms Scale (NMSS). A retrospective study with three-step analysis was performed. Step 1, the NMSs severity was compared among patients stratified by disease duration every 2 years up to 10 years. Step 2, patients with repeated tests in 2 years were categorized into 4 groups by the diseased duration of every 5 years. Step 3, the NMSS score changes in 6 years follow-up were determined, and the dosage of anti-PD drugs was compared to the NMSs severity changes. 676 patients completed the step 1 analysis, which showed a trend of NMSs worsening but not significant until the disease duration longer than 4–6 years. Furthermore, the severity did not change between repeated evaluations in 2 years in all patients. The progression became apparent after 6 years. Individual symptoms had different progression patterns and the increment of medications was independent to NMSs evolution. We demonstrated the NMSs severity progression in Taiwanese PD patients and the independence of the medications and NMSs progression.

scholarly journals SENSORY INTEGRATION VERSUS COGNITIVEBEHAVIORAL THERAPY ON BEHAVIORAL ISSUES IN LEARNING-DISABLED CHILDREN

2020 ◽  
Vol 9 (2) ◽  
pp. 11-17
Author(s):  
Syeda Iffat Nasir
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Problems ◽  
Sensory Integration ◽  
Rating Scale ◽  
Behavioral Therapy ◽  
Learning Disabled ◽  
Cognitive Behavioral ◽  
Disabled Children ◽  
Behavioral Issues ◽  
Group A

BACKGROUND AND AIMS Number of studies demonstrated that children with learning disabilities suffers from emotional-behavioral problems, however neurophysiologic approaches are efficient to produce better health-related outcomes thus this study aimed to investigate the effectiveness of sensory integration versus cognitive-behavioral therapy on behavioral issues of learning-disabled children. METHODOLOGY A Randomized Controlled Trial included 30 learning disabled-children, diagnosed by Psychologist on the standardized criteria, divided into Group-A (n=15) and B (n=15) where Group-A performed Sensory Integration while B performed Cognitive-Behavioral Therapy for 4 weeks. Data was collected at baseline and post the intervention on Behavioral Problem Scale and Conner’s Teacher Rating Scale respectively. RESULTS Both the groups showed significant results (p<0.05), however Group-A showed marked reduction in BPS in comparison to B while CTRS was observed with slight greater improvement in Group-B than A. CONCLUSION It was concluded that sensory integration is as effective as cognitive behavioral therapy in improving behavioral problems of learning-disabled children. KEYWORDS Learning, Behavior, Children, Cognitive-Function, Disability Evaluation, Rehabilitation.

scholarly journals Telephone-based cognitive behavioral therapy for depression in Parkinson disease

Neurology ◽  
2020 ◽  
Vol 94 (16) ◽  
pp. e1764-e1773 ◽  
Author(s):  
Roseanne D. Dobkin ◽  
Sarah L. Mann ◽  
Michael A. Gara ◽  
Alejandro Interian ◽  
Kailyn M. Rodriguez ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Parkinson Disease ◽  
Behavioral Treatment ◽  
Rating Scale ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Cognitive Behavioral Treatment ◽  
Treatment As Usual ◽  
Negative Thoughts

ObjectiveTo determine whether, for patients with depression and Parkinson disease (PD), telephone-based cognitive-behavioral treatment (T-CBT) alleviates depressive symptoms significantly more than treatment as usual (TAU), we conducted a randomized controlled trial to evaluate the efficacy of a 10-session T-CBT intervention for depression in PD, compared to TAU.MethodsSeventy-two people with PD (PWP) were randomized to T-CBT + TAU or TAU only. T-CBT tailored to PWPs’ unique needs was provided weekly for 3 months, then monthly during 6-month follow-up. CBT targeted negative thoughts (e.g., “I have no control”; “I am helpless”) and behaviors (e.g., social withdrawal, excessive worry). It also trained care partners to help PWP practice healthy habits. Blind raters assessed outcomes at baseline, midtreatment, treatment end, and 1 and 6 months post-treatment. Analyses were intent to treat.ResultsT-CBT outperformed TAU on all depression, anxiety, and quality of life measures. The primary outcome (Hamilton Depression Rating Scale score) improved significantly in T-CBT compared to TAU by treatment end. Mean improvement from baseline was 6.53 points for T-CBT and −0.27 points for TAU (p < 0.0001); gains persisted over 6-month follow-up (p < 0.0001). Improvements were moderated by a reduction in negative thoughts in the T-CBT group only, reflecting treatment target engagement.ConclusionsT-CBT may be an effective depression intervention that addresses a significant unmet PD treatment need and bypasses access barriers to multidisciplinary, evidence-based care.Clinicaltrials.gov identifierNCT02505737.Classification of evidenceThis study provides Class I evidence that for patients with depression and PD, T-CBT significantly alleviated depressive symptoms compared to usual care.

scholarly journals Natural history of motor symptoms in Parkinson’s disease and the long-duration response to levodopa

Brain ◽  
2020 ◽  
Vol 143 (8) ◽  
pp. 2490-2501 ◽  
Author(s):  
Roberto Cilia ◽  
Emanuele Cereda ◽  
Albert Akpalu ◽  
Fred Stephen Sarfo ◽  
Momodou Cham ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Duration ◽  
Rating Scale ◽  
Natural Course ◽  
Sub Saharan Africa ◽  
Motor Symptoms ◽  
Motor Disability ◽  
Long Duration

Abstract The natural pattern of progression of Parkinson’s disease is largely unknown because patients are conventionally followed on treatment. As Parkinson’s disease progresses, the true magnitude of the long-duration response to levodopa remains unknown, because it can only be estimated indirectly in treated patients. We aimed to describe the natural course of motor symptoms by assessing the natural OFF in consecutive Parkinson’s disease patients never exposed to treatment (drug-naïve), and to investigate the effects of daily levodopa on the progression of motor disability in the OFF medication state over a 2-year period. In this prospective naturalistic study in sub-Saharan Africa, 30 Parkinson’s disease patients (age at onset 58 ± 14 years, disease duration 7 ± 4 years) began levodopa monotherapy and were prospectively assessed using the Unified Parkinson’s disease Rating Scale (UPDRS). Data were collected at baseline, at 1-year and 2-years follow-up. First-ever levodopa intake induced a significant improvement in motor symptoms (natural OFF versus ON state UPDRS-III 41.9 ± 15.9 versus 26.8 ± 15.1, respectively; P &lt; 0.001). At 1-year follow-up, OFF state UPDRS-III score after overnight withdrawal of levodopa was considerably lower than natural OFF (26.5 ± 14.9; P &lt; 0 .001). This effect was not modified by disease duration. At the 2-year follow-up, motor signs after overnight OFF (30.2 ± 14.2) were still 30% milder than natural OFF (P = 0.001). The ON state UPDRS-III at the first-ever levodopa challenge was similar to the overnight OFF score at 1-year follow-up and the two conditions were correlated (r = 0.72, P &lt; 0.001). Compared to the natural progression of motor disability, levodopa treatment resulted in a 31% lower annual decline in UPDRS-III scores in the OFF state (3.33 versus 2.30 points/year) with a lower model’s variance explained by disease duration (67% versus 36%). Using the equation regressed on pretreatment data, we predicted the natural OFF at 1-year and 2-year follow-up visits and estimated that the magnitude of the long-duration response to levodopa ranged between 60% and 65% of total motor benefit provided by levodopa, independently of disease duration (P = 0.13). Although levodopa therapy was associated with motor fluctuations, overnight OFF disability during levodopa was invariably less severe than the natural course of the disease, independently of disease duration. The same applies to the yearly decline in UPDRS-III scores in the OFF state. Further research is needed to clarify the mechanisms underlying the long-duration response to levodopa in Parkinson’s disease. Understanding the natural course of Parkinson’s disease and the long-duration response to levodopa may help to develop therapeutic strategies increasing its magnitude to improve patient quality of life and to better interpret the outcome of randomized clinical trials on disease-modifying therapies that still rely on the overnight OFF to define Parkinson’s disease progression.

Neuropsychiatric symptoms in Parkinson’s disease: association with caregiver distress and disease severity

2019 ◽  
Vol 32 (6) ◽  
pp. 733-739
Author(s):  
Wan-Chen Tsai ◽  
Hui-Chen Lin ◽  
Chiung-Chih Chang ◽  
Wen-Neng Chang ◽  
Chih-Cheng Huang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Disease Duration ◽  
Rating Scale ◽  
Neuropsychiatric Symptoms ◽  
Linear Regression Analysis ◽  
Caregiver Distress ◽  
Neuropsychiatric Inventory ◽  
Distress Scale

ABSTRACTObjectives:The condition of caregivers is important to the quality of care received by people with Parkinson’s disease (PD), especially at the late disease stages. This study addresses the distress placed on caregivers by participants’ neuropsychiatric symptoms at different stages of PD in TaiwanMethods:This prospective study enrolled 108 people with PD. All participants were examined with the Unified Parkinson’s Disease Rating Scale (UPDRS), Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), and Clinical Dementia Rating (CDR) scale. Caregiver distress was measured using the Neuropsychiatric Inventory Caregiver Distress Scale (NPI-D). Statistical analysis was used to explore the PD-related factors that contribute to caregiver distress.Results:The mean follow-up interval in the 108 PD participants were 24.0 ± 10.2 months with no participant lost to follow-up due to death. NPI-distress (the sum of NPI caregiver distress scale across the 12 domains of the NPI) was positively correlated with NPI-sum (the total score across the 12 domains of the NPI) (r = 0.787, p < 0.001), CDR (r = 0.403, p < 0.001), UPRDS (r = 0.276, p = 0.004), and disease duration (r = 0.246, p = 0.002), but negatively correlated with CASI (r = −0.237, p = 0.043) and MMSE (r = −0.281, p < 0.001). Multiple linear regression analysis showed that only NPI-sum and disease duration were independently correlated with NPI-distress.Conclusion:The disease duration and NPI-sum are independent predictors of caregiver distress in Taiwanese populations with PD. Early detection and reduction of neuropsychiatric symptoms in people with PD can help decrease caregiver distress.

A Partial Component Analysis of Beck’s Cognitive Therapy for the Treatment of General Anger

2000 ◽  
Vol 14 (1) ◽  
pp. 77-95 ◽  
Author(s):  
Eric R. Dahlen ◽  
Jerry L. Deffenbacher
Keyword(s):  
Cognitive Therapy ◽  
Behavioral Change ◽  
Cognitive Change ◽  
Reliable Change Index ◽  
Trait Anger ◽  
Anxiety And Depression ◽  
Treatment Protocols ◽  
Treatment Groups ◽  
Anger Reduction

Eighty-six high-anger undergraduates were assigned to eight group sessions of Beck’s full cognitive therapy (FCT) focusing on both cognitive and behavioral change, cognitive restructuring only (CRO) focusing only on cognitive change, or a no-treatment control. Analyses suggested treatments were delivered in an equivalent, high-quality manner and that therapists adhered to treatment protocols. By 5-week follow-up, treatment groups, while not differing from each other, showed reductions in trait anger, cognitive, emotional, and behavioral components of anger, the individual’s greatest ongoing source of anger, and anger-related physiological arousal. Treatments lowered anger suppression and outward negative expression and enhanced controlled expression. Compared to controls, CRO also reduced trait anxiety and depression. Treatment effect sizes were medium (η2 = .06 to .13) to large (η2 > .13), and more treatment participants met a clinically reliable change index on trait anger. Findings support FCT and CRO for general anger reduction.

scholarly journals Modeling the Cognitive Trajectory in CADASIL

2020 ◽  
Vol 77 (1) ◽  
pp. 291-300
Author(s):  
Sandrine Brice ◽  
Aude Jabouley ◽  
Sonia Reyes ◽  
Carla Machado ◽  
Christina Rogan ◽  
...  
Keyword(s):  
Mixed Model ◽  
Rating Scale ◽  
Time Frame ◽  
Cognitive Change ◽  
Or Education ◽  
Mattis Dementia Rating Scale ◽  
Cognitive Trajectory ◽  
Latent Process ◽  
Global Trajectory

Background: For developing future clinical trials in Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), it seems crucial to study the long-term changes of cognition. Objective: We aimed to study the global trajectory of cognition, measured by the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS), along the course of CADASIL. Methods: Follow-up data of 185 CADASIL patients, investigated at the French National Referral center CERVCO from 2003, were considered for analysis based on strict inclusion criteria. Assuming that the MMSE and the MDRS provide imprecise measures of cognition, the trajectory of a common cognitive latent process during follow-up was delineated using a multivariate latent process mixed model. After adjustment of this model for sex and education, the sensitivities of the two scales to cognitive change were compared. Results: Analysis of the cognitive trajectory over a time frame of 60 years of age showed a decrease of performances with aging, especially after age of 50 years. This decline was not altered by sex or education but patients who graduated from high school had a higher mean cognitive level at baseline. The sensitivities of MMSE and MDRS scales were similar and the two scales suffered from a ceiling effect and curvilinearity. Conclusion: These data support that cognitive decline is not linear and mainly occurs after the age of 50 years during the course of CADASIL. They also showed that MMSE and MDRS scales are hampered by major limitations for longitudinal studies.

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