Cognitive Decline Risk Stratification in People with Late-Onset Epilepsy of Unknown Etiology: An Electroencephalographic Connectivity and Graph Theory Pilot Study

2021 ◽  
pp. 1-9
Author(s):  
Cinzia Costa ◽  
Fabrizio Vecchio ◽  
Michele Romoli ◽  
Francesca Miraglia ◽  
Elena Nardi Cesarini ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cognitive Decline ◽  
Late Onset ◽  
Neuropsychological Testing ◽  
Small World ◽  
Unknown Etiology ◽  
Dementia Patients ◽  
Normal Cognitive Function ◽  
Epilepsy Diagnosis

Background: Although people with late onset epilepsy of unknown etiology (LOEU) are at higher risk of cognitive decline compared to the general population, we still lack affordable tools to predict and stratify their risk of dementia. Objective: This pilot-study investigates the potential application of electroencephalography (EEG) network small-world (SW) properties in predicting cognitive decline among patients with LOEU. Methods: People diagnosed with LOEU and normal cognitive examination at the time of epilepsy diagnosis were included. Cerebrospinal fluid biomarkers, brain imaging, and neuropsychological assessment were performed at the time of epilepsy diagnosis. Baseline EEG was analyzed for SW properties. Patients were followed-up over time with neuropsychological testing to define the trajectory of cognitive decline. Results: Over 5.1 years of follow-up, among 24 patients diagnosed with LOEU, 62.5% were female, mean age was 65.3 years, thirteen developed mild cognitive impairment (MCI), and four developed dementia. Patients with LOEU developing MCI had lower values of SW coefficients in the delta (p = 0.03) band and higher SW values in the alpha frequency bands (p = 0.02) compared to patients having normal cognition at last follow-up. The two separate ANOVAs, for low and alpha bands, confirmed an interaction between SW and cognitive decline at follow-up. A similar gradient was confirmed for patients developing dementia compared to those with normal cognitive function as well as to those developing MCI. Conclusion: Baseline EEG analysis through SW is worth investigating as an affordable, widely available tool to stratify LOEU patients for their risk of cognitive decline.

Cognitive decline risk stratification in people with late-onset epilepsy of unknown etiology: An electroencephalographic connectivity and graph theory pilot study

2021 ◽  
Vol 429 ◽  
pp. 117686
Author(s):  
Cinzia Costa ◽  
Fabrizio Vecchio ◽  
Michele Romoli ◽  
Francesca Miraglia ◽  
Elena Nardi Cesarini ◽  
...  
Keyword(s):  
Graph Theory ◽  
Pilot Study ◽  
Risk Stratification ◽  
Cognitive Decline ◽  
Late Onset ◽  
Unknown Etiology

Smell identification test as a progression marker in Alzheimer's disease

2011 ◽  
Vol 26 (S2) ◽  
pp. 502-502
Author(s):  
L. Velayudhan ◽  
M. Pritchard ◽  
S. Lovestone
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Decline ◽  
Late Onset ◽  
Linear Regression Analysis ◽  
Rapid Progressors ◽  
Progression Marker ◽  
Identification Test ◽  
Smell Identification

IntroductionFactors influencing or predicting progression in Alzheimer's disease (AD) is not well understood. Olfactory dysfunction, impaired smell identification in particular, is known to occur in AD. Mesial temporal lobe, important for memory function is also critical for the processing of olfactory information. In view of the common anatomical substrate, we hypothesized that olfaction dysfunction worsens faster in people with AD with rapid cognitive decline compared to those with slower cognitive decline.AimsTo test whether smell identification test can be used as a predictor for illness progression in AD patients.MethodsForty one participants with late onset mild to moderate AD were recruited from mental health services for older adults. Subjects were classified as ‘Rapid Progressors’ defined on ‘a-priori’ with a loss of 2 or more points in Mini-Mental State Examination (MMSE) within six months. Assessments included MMSE, Neuropsychiatric Inventory, Bristol Activities of Daily Living, and the University of Pennsylvania Smell Identification Test (UPSIT), at baseline and after 3 months.ResultsTwenty subjects were ‘Rapid Progressors’, and had lower UPSIT scores compared to ‘Non-Rapid Progressors’ both at the baseline (p = 0.02) and at follow up after 3 months (p = 0.05). Baseline UPSIT correlated with follow up UPSIT (r = 0.5, p < 0.01) and MMSE (r = 0.4, p = 0.04). Also it was the baseline UPSIT score that best predicted (p < 0.05) the follow up smell and cognitive function on linear regression analysis.ConclusionsSmell identification function could be useful as a clinical measure to assess and predict progression in AD.

scholarly journals Cognitive performances in patients affected by late-onset epilepsy with unknown etiology: A 12-month follow-up study

2019 ◽  
Vol 101 ◽  
pp. 106592 ◽  
Author(s):  
Claudio Liguori ◽  
Cinzia Costa ◽  
Flaminia Franchini ◽  
Francesca Izzi ◽  
Matteo Spanetta ◽  
...  
Keyword(s):  
Late Onset ◽  
Unknown Etiology ◽  
Follow Up Study

scholarly journals Saccadic Eye Movements in Mild Traumatic Brain Injury: A Pilot Study OPEN ACCESS

2014 ◽  
Vol 41 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Sarah J. Mullen ◽  
Yeni H. Yücel ◽  
Michael Cusimano ◽  
Tom A. Schweizer ◽  
Anton Oentoro ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Eye Movements ◽  
Brain Injury ◽  
Pilot Study ◽  
Mild Traumatic Brain Injury ◽  
Neuropsychological Testing ◽  
Saccadic Eye Movements ◽  
Post Injury ◽  
Persistent Symptoms

Objective:To investigate whether repeat saccadic reaction time (SRT) measurements using a portable saccadometer is useful to monitor patients with mild traumatic brain injury (mTBI).Methods:Seven patients with newly-diagnosed mTBI and five agematched controls were prospectively recruited from an emergency Department. Saccadic eye movements, symptom self-reporting and neuropsychological tests were performed within one week of injury and again at follow-up three weeks post-injury. Control patients underwent saccade recordings at similar intervals.Results:Median saccade reaction times were significantly prolonged within one week post-injury in mTBI compared to controls. At follow-up assessment there was no significant between-groups difference. Changes in median SRT between the two assessments were not statistically significant. Four of the seven mTBI patients showed significantly increased SRT at follow-up; three of the mTBI patients and all controls showed no significant change. Among the three mTBI patients with persistent decreased SRT, two experienced loss of consciousness and reported the greatest symptoms, while the third was the only subject with significant decrease in neuropsychological testing scores at both assessments.Conclusion:In three of seven mTBI patients, saccadic eye movements remained delayed within three weeks post-injury. These three patients also showed persistent symptoms or no improvement on neuropsychological testing. This pilot study using a portable saccadometer suggests that comparing SRT from three weeks post-injury to that within one week of injury may be useful for early detection of a subpopulation at risk of persistent disability from mTBI. This finding suggests that further investigation in a large study population is warranted.

scholarly journals Immunoadsorption for Treatment of Patients with Suspected Alzheimer Dementia and Agonistic Autoantibodies against Alpha1a-Adrenoceptor—Rationale and Design of the IMAD Pilot Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1919 ◽  
Author(s):  
Sylvia Stracke ◽  
Sandra Lange ◽  
Sarah Bornmann ◽  
Holger Kock ◽  
Lara Schulze ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Pilot Study ◽  
Clinical Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Alzheimer Dementia ◽  
Dementia Patients ◽  
Confirmation Test ◽  
One Year ◽  
Agonistic Autoantibodies

Background: agonistic autoantibodies (agAABs) against G protein-coupled receptors (GPCR) have been linked to cardiovascular disease. In dementia patients, GPCR-agAABs against the α1- and ß2-adrenoceptors (α1AR- and ß2AR) were found at a prevalence of 50%. Elimination of agAABs by immunoadsorption (IA) was successfully applied in cardiovascular disease. The IMAD trial (Efficacy of immunoadsorption for treatment of persons with Alzheimer dementia and agonistic autoantibodies against alpha1A-adrenoceptor) investigates whether the removal of α1AR-AABs by a 5-day IA procedure has a positive effect (improvement or non-deterioration) on changes of hemodynamic, cognitive, vascular and metabolic parameters in patients with suspected Alzheimer’s clinical syndrome within a one-year follow-up period. Methods: the IMAD trial is designed as an exploratory monocentric interventional trial corresponding to a proof-of-concept phase-IIa study. If cognition capacity of eligible patients scores 19–26 in the Mini Mental State Examination (MMSE), patients are tested for the presence of agAABs by an enzyme-linked immunosorbent assay (ELISA)-based method, followed by a bioassay-based confirmation test, further screening and treatment with IA and intravenous immunoglobulin G (IgG) replacement. We aim to include 15 patients with IA/IgG and to complete follow-up data from at least 12 patients. The primary outcome parameter of the study is uncorrected mean cerebral perfusion measured in mL/min/100 gr of brain tissue determined by magnetic resonance imaging with arterial spin labeling after 12 months. Conclusion: IMAD is an important pilot study that will analyze whether the removal of α1AR-agAABs by immunoadsorption in α1AR-agAAB-positive patients with suspected Alzheimer’s clinical syndrome may slow the progression of dementia and/or may improve vascular functional parameters.

Effect of enzyme replacement therapy in late onset Pompe disease: open pilot study of 48 weeks follow-up

2014 ◽  
Vol 36 (4) ◽  
pp. 599-605 ◽  
Author(s):  
Jin-Sung Park ◽  
Hye-Gyung Kim ◽  
Jin-Hong Shin ◽  
Young-Chul Choi ◽  
Dae-Seong Kim
Keyword(s):  
Pilot Study ◽  
Enzyme Replacement Therapy ◽  
Replacement Therapy ◽  
Pompe Disease ◽  
Late Onset ◽  
Enzyme Replacement ◽  
Open Pilot

scholarly journals Cognitive Trajectories Following Acute Infection in Older Patients With and Without Cognitive Impairment: An 1-Year Follow-Up Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Ana Rita Silva ◽  
Patrícia Regueira ◽  
Ana Luísa Cardoso ◽  
Inês Baldeiras ◽  
Isabel Santana ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Older Patients ◽  
Acute Infection ◽  
Systemic Infection ◽  
Change Score ◽  
Cognitive Change ◽  
Dementia Patients ◽  
Delirium Superimposed On Dementia

Introduction: Dementia is a known risk factor for both delirium and acute systemic infections which may also play a significant role in promoting or accelerating neurodegenerative disease. Infections are both the main causes of hospitalization of dementia patients and can be a major precipitant of delirium but currently it is not possible to predict the risk of cognitive decline in older patients exposed to acute infection.Objectives: We aimed to determine the level of cognitive change at 1-year follow up in individuals with different patterns of cognitive function (dementia, delirium, delirium superimposed on dementia) at the time of their hospitalization due to a systemic infection and to correlate these cognitive patterns with clinical status variables.Methods: We recruited 53 hospitalized geriatric patients with a systemic infection, and we collected 12-months follow up data for 34 patients. These patients were classified in four groups: no cognitive impairment (controls—C), delirium only (D), dementia only (Dem), and delirium superimposed to dementia (DD). Cognitive performance was measured by change in score on the Montreal Cognitive Assessment (MoCA) and delirium was identified using Confusion Assessment Measure (CAM). We examined performance on the MoCA in the first year after hospitalization, controlling for demographic characteristics, coexisting medical conditions, and type of infection.Results: For the 34 patients to whom follow-up data was available, delirium presence in individuals with prior dementia (DD group) was associated with a negative mean change score of 3-point (p &lt; 0.02) at 1 year follow up, whereas dementia patients without delirium had a mean change score of 1.5-point lower at 12-months (p = 0.04), when comparing follow-up and baseline MoCA scores. Cognitively healthy patients did not significantly decrease their MoCA score at follow-up (p = 0.15). MoCA and NPI scores during hospitalization were significantly correlated with the level of cognitive decline in the four groups (r = 0.658, p &lt; 0.01 and r = 0.439, p = 0.02, respectively).Conclusions: Premorbid dementia and delirium superimposed on dementia during hospitalization in older patients with acute infections predict cognitive decline at 1 year following admission. Taken together, our findings suggest a pathophysiological interaction between neurodegenerative changes, acute infection, and delirium.

scholarly journals Argentina-Alzheimer's disease neuroimaging initiative (Arg-ADNI): neuropsychological evolution profile after one-year follow up

2018 ◽  
Vol 76 (4) ◽  
pp. 231-240 ◽  
Author(s):  
Patricio Chrem Méndez ◽  
Ismael Calandri ◽  
Federico Nahas ◽  
María Julieta Russo ◽  
Ignacio Demey ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Functional Performance ◽  
Neuropsychological Test ◽  
Neuropsychological Testing ◽  
Semantic Fluency ◽  
Dementia Patients ◽  
One Year ◽  
Normal Controls

ABSTRACT The Argentina-Alzheimer's disease neuroimaging initiative (Arg-ADNI) study is a longitudinal prospective cohort of 50 participants at a single institution in Buenos Aires, Argentina. Longitudinal assessments on a neuropsychological test battery were performed on 15 controls, 24 mild cognitive impairment (MCI) patients and 12 Alzheimer's disease (AD) dementia patients. In our study population, there was a high prevalence of positive AD biomarkers in the AD group, 92.3% (12/13); and a low prevalence in the normal controls, 20%; almost half (48%) of the patients diagnosed with MCI had positive amyloid detection. After a one year, the significant differences found at baseline on neuropsychological testing were similar at the follow-up assessment even though the AD group had significantly altered its functional performance (FAQ and CDR). The exception was semantic fluency, which showed greater impairment between the AD group and MCI and normal controls respectively. For these tests, the addition of AD biomarkers as a variable did not significantly alter the variations previously found for the established clinical group's model. Finally, the one-year conversion rate to dementia was 20% in the MCI cohort.

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