scholarly journals Neuropsychiatric Aspects in a Patient Diagnosed with Corticobasal Degeneration: Clinical Case of Low Incidence and Prevalence in Colombia

2020 ◽  
Vol 12 (3) ◽  
pp. 387-401
Author(s):  
Carlos Alberto Hurtado González ◽  
Carolina Piedrahita ◽  
Diana Vivas Álzate ◽  
Juan José García Borrero ◽  
Carlos Steven Marmolejo Escobar ◽  
...  
Keyword(s):  
Verbal Memory ◽  
Neuropsychiatric Symptoms ◽  
Memory Loss ◽  
Corticobasal Degeneration ◽  
Lewy Body Dementia ◽  
Signs And Symptoms ◽  
Neurocognitive Deficits ◽  
Low Incidence ◽  
The Individual ◽  
Gait Disturbances

Corticobasal degeneration (CBD) is a pathology of low incidence and prevalence worldwide; it is accompanied by symptoms such as dystonia, rigid akinetic syndrome (bradykinesia), gait disturbances, neurological deterioration associated with severe cortical subcortical atrophy, and progressive to moderate to severe neurocognitive deficits, especially in immediate verbal memory and dorsolateral or dysexecutive syndrome. We identified neurocognitive impairment and neuropsychiatric symptoms in a patient diagnosed with CBD. Participant was a 70-year-old female patient, single; she presented progressive memory loss of an immediate verbal nature. Initially, she was diagnosed with Alzheimer’s disease and Lewy body dementia, finding that she had no characteristic signs and symptoms of these pathologies. The patient presented conciliation insomnia, gait disturbances, and severe neurocognitive deficit, especially in executive functions, immediate verbal memory, and visuospatial functioning. It was found that the patient presented neurocognitive alterations of the executive type (frontal lobe) such as decision making, planning, inhibition and operative memory, correlated with a severe alteration in her basic, instrumental and advanced activities of daily life, with a high risk factor for developing dementia. It is necessary to diagnose in an assertive and timely manner in order to generate functional neurorehabilitation plans in people diagnosed with CBD, with the main objective of positively impacting quality of life, at the individual, family, and social level.

scholarly journals Neuropsychiatric Aspects in a Patient Diagnosed with Frontotemporal Dementia: Clinical Case of Low Incidence and Prevalence Disease in Colombia

2021 ◽  
pp. 451-463
Author(s):  
Juliana Vergel Hernández ◽  
María Eugenia Barrera Robledo ◽  
Carlos Alberto Hurtado González ◽  
Carlos Steven Marmolejo Escobar ◽  
Sebastián Ospina Otalvaro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Frontotemporal Dementia ◽  
Verbal Memory ◽  
Clinical Case ◽  
Motor Behavior ◽  
Neurocognitive Deficits ◽  
Neurobehavioral Disorders ◽  
Low Incidence ◽  
The Individual

Frontotemporal dementia (FTD) is a neuropsychiatric pathology characterized by dysfunctions in the frontal lobe of the brain, especially in planning, execution, and inhibition tasks, with an inability to make decisions and handle different sequences, also affecting the temporal lobe. The patient presents alterations to store, consolidate, and recall information. These neurocognitive deficits are accompanied by neurobehavioral disorders such as depression, anxiety, and apathy that contribute to the worsening of the quality of life, with a high impact on the individual, social, and family level. To identify the neurobehavioral disorders and neurocognitive deterioration that present a patient diagnosed with FTD: clinical case of low incidence and prevalence disease in Colombia. A 40-year-old man, with progressive deterioration of his immediate verbal memory, low verbal fluency, aberrant motor behavior, sexual impulsivity, alterations in his executive functions, especially in planning tasks, decision-making, and inhibition was found to have a lesser degree of affectation in his visuospatial functioning and visuoconstructive abilities. It was found that the patient presents a severe dysexecutive syndrome associated with a clinical picture of FTD, correlated with an inability to process and recall information, accompanied by disorders such as depression, anxiety, and apathy. It is necessary to generate a functional neurorehabilitation plan that aims to improve the quality of life in these patients. In the same way, it is necessary to create new lines of research and intervention that have the purpose to create a greater field of heuristics or new questions in this type of neurodegenerative pathologies.

scholarly journals The individual course of neuropsychiatric symptoms in people with Alzheimer's and Lewy body dementia: 12-year longitudinal cohort study

2019 ◽  
Vol 216 (1) ◽  
pp. 43-48 ◽  
Author(s):  
Audun Osland Vik-Mo ◽  
Lasse Melvaer Giil ◽  
Miguel Germán Borda ◽  
Clive Ballard ◽  
Dag Aarsland
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neuropsychiatric Symptoms ◽  
Personalised Medicine ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Psychotic Symptoms ◽  
Primary Inclusion ◽  
The Individual

IntroductionUnderstanding the natural course of neuropsychiatric symptoms (NPS) in dementia is important for planning patient care and trial design, but few studies have described the long-term course of NPS in individuals.MethodPrimary inclusion of 223 patients with suspected mild dementia from general practice were followed by annual assessment, including the Neuropsychiatric Inventory (NPI), for up to 12 years. Total and item NPI scores were classified as stable, relapsing, single episodic or not present based on 4.96 (s.d. 2.3) observations (98% completeness of longitudinal data) for 113 patients with Alzheimer's disease and 84 patients with LBD (68 dementia with Lewy bodies and 16 Parkinson's disease dementia).ResultsWe found that 80% had stable NPI total ≥1, 50% had stable modest NPI total ≥12 and 25% had stable NPI total ≥24 scores. Very severe NPS (≥48) were mostly single episodes, but 8% of patients with Alzheimer's disease had stable severe NPS. Patients with Alzheimer's disease and the highest 20% NPI total scores had a more stable or relapsing course of four key symptoms: aberrant motor behaviour, aggression/agitation, delusions and irritability (odds ratio 55, P < 0.001). This was not seen in LBD. Finally, 57% of patients with Alzheimer's disease and 84% of patients with LBD had reoccurring psychotic symptoms.ConclusionsWe observed a highly individual course of NPS, with most presenting as a single episode or relapsing; a stable course was less common, especially in LBD. These findings demonstrate the importance of an individualised approach (i.e. personalised medicine) in dementia care.

scholarly journals Shape Profile of Corpus Callosum As a Signature to Phenotype Different Dementia

2020 ◽  
Author(s):  
Sandhya Mangalore ◽  
Shiva Shanker Reddy Mukku ◽  
Sriharish Vankayalapati ◽  
Palanimuthu Thangaraju Sivakumar ◽  
Mathew Varghese
Keyword(s):  
Corpus Callosum ◽  
Frontotemporal Dementia ◽  
Corticobasal Degeneration ◽  
Lewy Body Dementia ◽  
Clinical History ◽  
The Body ◽  
Cortical Atrophy ◽  
Alzheimer Dementia ◽  
Geriatric Clinic ◽  
Cortical Regions

Abstract Background Phenotyping dementia is always a complex task for a clinician. There is a need for more practical biomarkers to aid clinicians. Objective The aim of the study is to investigate the shape profile of corpus callosum (CC) in different phenotypes of dementia. Materials and Methods Our study included patients who underwent neuroimaging in our facility as a part of clinical evaluation for dementia referred from Geriatric Clinic (2017–2018). We have analyzed the shape of CC and interpreted the finding using a seven-segment division. Results The sample included MPRAGE images of Alzheimer’ dementia (AD) (n = 24), posterior cortical atrophy- Alzheimer’ dementia (PCA-AD) (n = 7), behavioral variant of frontotemporal dementia (Bv-FTD) (n = 17), semantic variant frontotemporal dementia (Sv-FTD) (n = 11), progressive nonfluent aphasia (PNFA) (n = 4), Parkinson’s disease dementia (PDD) (n = 5), diffuse Lewy body dementia (n = 7), progressive supranuclear palsy (PSP) (n = 3), and corticobasal degeneration (CBD) (n = 3). We found in posterior dementias such as AD and PCA-AD that there was predominant atrophy of splenium of CC. In Bv-FTD, the genu and anterior half of the body of CC was atrophied, whereas in PNFA, PSP, PDD, and CBD there was atrophy of the body of CC giving a dumbbell like profile. Conclusion Our study findings were in agreement with the anatomical cortical regions involved in different phenotypes of dementia. Our preliminary study highlighted potential usefulness of CC in the clinical setting for phenotyping dementia in addition to clinical history and robust biomarkers.

scholarly journals Biochemical and hematological analysis in acute intermittent porphyria (AIP): a case report

2013 ◽  
Vol 85 (3) ◽  
pp. 1207-1214 ◽  
Author(s):  
ANNA R.R. DOS SANTOS ◽  
RAFAELA R. DE ALBUQUERQUE ◽  
MARIA J.R. DORIQUI ◽  
GRACIOMAR C. COSTA ◽  
ANA PAULA S.A. DOS SANTOS
Keyword(s):  
Biochemical Parameters ◽  
Contraceptive Use ◽  
Aminolevulinic Acid ◽  
Neuropsychiatric Symptoms ◽  
Acute Intermittent Porphyria ◽  
Signs And Symptoms ◽  
Acute Porphyria ◽  
Reactive Protein ◽  
Hematological Analysis ◽  
Hematological And Biochemical Parameters

Acute intermittent porphyria is the most common acute porphyria caused by a decrease in hepatic porphobilinogen deaminase activity, resulting in an accumulation of delta-aminolevulinic acid and porphobilinogen. This disease shows nonspecific signs and symptoms that can be confused with other diseases, thereby making the diagnosis difficult. We report a case of acute intermittent porphyria, reviewing clinical and laboratory aspects, highlighting the hematological and biochemical parameters during and after the crisis. A female patient, aged 28 years, suffered two crises, both presenting gastrointestinal disorders. The second presented neuropsychiatric symptoms. The analysis of hematological and biochemical parameters during the second crisis showed anemia, leukocytosis, hyponatremia, mild hypokalemia, uremia and elevated C-reactive protein. The initial treatment included glucose infusion, a diet rich in carbohydrates and interruption of porphyrinogenic drugs. Subsequently, treatment was maintained with oral contraceptive use. According to the observed data, signs and symptoms of gastrointestinal, neurological and psychiatric disorders, associated with laboratory results presented in this paper can be applied to screen acute porphyria, contributing to early diagnosis.

scholarly journals Does Diabetes Mellitus Alter the Onset and Clinical Course of Vascular Dementia?

2010 ◽  
Vol 23 (3) ◽  
pp. 145-151 ◽  
Author(s):  
Santosh B. Murthy ◽  
Ali Jawaid ◽  
Salah U. Qureshi ◽  
Yogeshwar Kalkonde ◽  
Andrew M. Wilson ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Dementia ◽  
Neuropsychiatric Symptoms ◽  
Disease Onset ◽  
Multiple Risk Factors ◽  
History Of ◽  
Dementing Illness ◽  
Multiple Variables ◽  
Rate Of Decline ◽  
The Individual

Background:Vascular dementia (VaD) is the second most common dementing illness. Multiple risk factors are associated with VaD, but the individual contribution of each to disease onset and progression is unclear. We examined the relationship between diabetes mellitus type 2 (DM) and the clinical variables of VaD.Methods:Data from 593 patients evaluated between June, 2003 and June, 2008 for cognitive impairment were prospectively entered into a database. We retrospectively reviewed the charts of 63 patients who fit the NINDSAIREN criteria for VaD. The patients were divided into those with DM (VaDDM, n = 29) and those without DM(VaD,n= 34). The groups were compared with regard to multiple variables.Results:Patients with DM had a significantly earlier onset of VaD (71.9 ± 6.54 vs. 77.2 ± 6.03,p< 0.001), a faster rate of decline per year on the mini mental state examination (MMSE; 3.60 ± 1.82 vs. 2.54 ± 1.60 points,p= 0.02), and a greater prevalence of neuropsychiatric symptoms at the time of diagnosis (62% vs. 21%,p= 0.02).Conclusions:A history of premorbid DM was associated with an earlier onset and faster cognitive deterioration in VaD. Moreover, DM was associated with neuropsychiatric symptoms in patients with VaD. A larger study is needed to verify these associations. It will be important to investigate whether better glycemic control will mitigate the potential effects of DM on VaD.

scholarly journals Communicating through music: creating accessible songs for Individuals with memory loss

2021 ◽  
Author(s):  
Hallie Anthony
Keyword(s):  
Verbal Memory ◽  
Memory Loss ◽  
Research Process ◽  
Future Research ◽  
Human Communication ◽  
Information Retention ◽  
Scholarly Literature ◽  
Musical Compositions ◽  
Original Musical ◽  
With Memory

This Major Research Paper (MRP) is a research-­creation project that explores the role, impact and influence of music n human communication. More specifically, this MRP investigates the way that music can assist in cognitive comprehension and information retention in individuals with varied forms of memory loss and considers the ways that music can be used to assist in aiding verbal memory and communicating emotion. It also offers insight on methods that could be utilized to further study this area of research. As a research-­creation project, this MRP includes three original musical compositions (Composition A1, Composition B2, and Composition C3) that were developed in response to the scholarly literature on this topic. The three musical compositions that have been produced for this project aim to communicate emotion, create aesthetic satisfaction, and aid in reinforcing the production of memories based on the information presented in the compositions. The composition creation process was informed by information gathered throughout the research process that addresses topics such as: the influence of music on individual listeners, emotion in music, and musical techniques that can be used to successfully communicate ideas. Beyond the scope of this MRP/research-­creation project, these compositions aim to serve as a basis for testing cognitive function in individuals with varied forms of memory loss. Detailed discussion of the design of the musical compositions, including information related to the composition influences, and a breakdown of each composition are included alongside the MRP’s focus on scholarly literature and research. Furthermore, the potential implications of these compositions, including the ways they could assist in future research, is discussed.

scholarly journals Unanticipated memory loss during superselective Wada testing for right cerebral arteriovenous malformation.

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 337-338
Author(s):  
Ronald M Lazar ◽  
Randolph S Marshall ◽  
J P Mohr ◽  
William L Young ◽  
John Pile-Spellman
Keyword(s):  
Verbal Memory ◽  
Right Hemisphere ◽  
Memory Loss ◽  
Read Aloud ◽  
Maximum Score ◽  
Left Handed ◽  
Unusual Distribution ◽  
The Mean ◽  
Amobarbital Sodium ◽  
Anatomic Locations

120 Background: A major concern in the treatment of cerebral AVMs is whether so-called eloquent regions occupy normal anatomic locations. Recently, we have shown with selective anesthetic injections that language has a wide and unusual distribution in patients with left cerebral AVM. Our Objective here was to determine whether superselective Wada testing in medial right-hemisphere arteries would produce verbal memory loss in patients with right cerebral AVM. Methods: Nine patients, 8 right- and 1 left-handed, had superselective injections of amobarbital sodium plus lidocaine into vessels near or feeding right medial AVMs. Five patients had AVMs supplied by PCA feeders and four had ACA feeders. Memory testing occurred in a no-anesthetic baseline, 1 minute after anesthetic injection, and 12 minutes after injection. A memory test consisted of 5 words presented on a computer screen which the patient had to read aloud. After 3 minutes, recall was tested. A maximum score was 15, with uncued recall of a word = 3 points, prompted recall = 2 points, and multiple choice = 1 point. Based on clinical considerations, various numbers of vessels were tested in each patient. Results: Superselective anesthetic testing in most vessels yielded memory scores no different than baseline, and embolization took place. In each patient, however, there was at least one vessel feeding the AVM in which significant short-term verbal memory loss took place. In these instances, the mean memory score at baseline was 14 (s.d. = 1.5). Following injection of anesthetics, the mean score fell significantly to 7.1 (t-test, p<.00001). Attention was unaltered. After dissipation of the anesthesia at 12 minutes, memory returned to baseline levels in every case. Conclusions: In nine patients, superselective Wada injection into arteries feeding right medial AVMs produced unanticipated verbal memory deficits. Traditional assumptions about eloquent regions would have suggested that such testing would have been unnecessary, but embolization here would have yielded significant morbidity. Our findings also question established notions of verbal memory restricted to the left hemisphere.

Delayed Tuberculosis Diagnosis in a Low Incidence Country and its Effect on Cost of Care

2021 ◽  
Author(s):  
James O'Connell ◽  
Niamh Reidy ◽  
Cora McNally ◽  
Debbi Stanistreet ◽  
Eoghan de Barra ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Care Provider ◽  
Delayed Diagnosis ◽  
Signs And Symptoms ◽  
Cost Of Care ◽  
Global Priority ◽  
Low Incidence ◽  
The Cost ◽  
Health Care Records

Abstract Background Tuberculosis elimination (TB) is a global priority that requires high-quality timely care to be achieved. In low TB incidence countries such as Ireland, delayed diagnosis is common. Despite cost being central to policy making, it is not known if delayed care affects care cost among TB patients in a low-incidence setting. Methods Health care records of patients with signs and symptoms of TB evaluated by a tertiary service in Ireland between July 1st 2018 and December 31st 2019 were reviewed to measure and determine predictors of patient-related delays, health care-provider related delay and the cost of TB care. Benchmarks against which the outcomes were compared were derived from the literature. Results Thirty-seven patients were diagnosed with TB and 51% (19/37) had pulmonary TB (PTB). The median patient-related delay was 60 days among those with PTB, greater than the benchmark derived from the literature (38 days). The median health care provider-related delay among patients with PTB was 16 days and, although similar to the benchmark (median 22 days, minimum 11 days, maximum 36 days) could be improved. The health care-provider related delay among patients with EPTB was 66 days, greater than the benchmark (42 days). The cost of care was €8298, and while similar to that reported in the literature (median €9,319, minimum €6,486, maximum €14,750) could be improved. Patient-related delay among those with PTB predicted care costs. Conclusion Patient-related and health care-related delays in TB diagnosis in Ireland must be reduced. Initiatives to do so should be resourced.

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