The Effect of Multiprobiotics on Memory and Attention in Fibromyalgia: A Pilot Randomized Controlled Trial

Fibromyalgia syndrome (FMS) is a chronic, generalized and diffuse pain disorder accompanied by cognitive deficits such as forgetfulness, concentration difficulties, loss of vocabulary and mental slowness, among others. In recent years, FMS has been associated with altered intestinal microbiota, suggesting that modulating gut microbiota (for example, through probiotics) could be an effective therapeutic treatment. Thus, the aim of the present study was to continue exploring the role of probiotics in cognitive processes in patients with FMS. A pilot randomized controlled trial was conducted in 31 patients diagnosed with FMS to compare the effects of a multispecies probiotic versus a placebo on cognitive variables (memory and attention) after eight weeks. Results showed that treatment with a multispecies probiotic produced an improvement in attention by reducing errors on an attention task, but it had no effect on memory. More specifically, a tendency to reduce errors of omission (Go trials) during the Go/No-Go Task was observed after treatment. These findings, along with our previous results in impulsivity, underline the relevance of using probiotics as a therapeutic option in FMS, although more research with a larger sample size is required.

Attentional function in fibromyalgia and rheumatoid arthritis

Concentration difficulties, forgetfulness and mental slowness are common in fibromyalgia syndrome (FMS); initial findings suggest that rheumatoid arthritis (RA) may also be accompanied by cognitive impairments. This study aimed to compare attentional performance between patients with FMS and RA. Attention was quantified in the domains of alerting, orienting and executive control using the Attentional Network Test–Interaction (ANT-I) in 56 women with FMS, 41 women with RA and 50 healthy women. Pain severity was statistically controlled in the group comparison. While FMS patients exhibited longer reaction times and made more errors on the ANT-I than RA patients and healthy women, performance did not differ between RA patients and healthy women. The magnitude of group differences did not vary by the experimental conditions of the ANT-I, suggesting a general attentional deficit in FMS rather than specific impairments in the domains of alerting, orienting and executive control. Differences between patient groups may relate to the different pathogenetic mechanisms involved in the disorders, i.e. inflammatory processes in RA and central nervous sensitization in FMS. In FMS, heightened activity in the pain neuromatrix may interfere with attention, because it requires enhanced neural resources in brain areas that are involved in both pain and attentional processing.

Intestinal Parasites and Theta Brainwave Changes in Children

Background: Parasitic diseases are one of the health problems in all societies, especially in developing countries. Infection with parasites, especially in children, can be associated with learning disorders, malnutrition, anaemia, and physical disorders. On the other hand, an abnormal increase in the theta brainwave amplitude may also be one of the causes of mental slowness and disability in children’s learning, decentralization, or attention deficit hyperactivity disorder (ADHD). Objectives: In this study, we assessed the possible effects of intestinal parasites on brainwave changes in children in Karaj Health centers. Methods: A stool examination was done to separate healthy and infected children. Then, using a diagnostic interview and electroencephalography, the theta-wave was recorded in both groups. Results: From 69 children who participated in this study, 8.7% were infected with one or more intestinal parasites. Around 14.49% of all children had a high theta wave, but the interesting point was that 100% of infected children had a high theta brainwave (P value = 0.001). In contrast, only 6.34% of healthy people had high theta waves. Conclusions: In this study, there was a significant relationship between parasitic infection and brain wave changes. Parasitic diseases may alter brainwaves with unknown mechanisms and affect the ability and activities of the brain.

Fibromyalgia Symptoms Overview

Fibromyalgia syndrome (FMS) can be conceptualized as a chronic disorder characterized by widespread musculoskeletal pain and other accompanying symptoms such as fatigue, insomnia, depression, anxiety and cognitive impairments. The etiology of FMS remains unknown, being one of the most accepted hypothesis the presence of central sensitization to pain and impairments in endogenous pain inhibitory mechanisms. The history of the development of FMS concept reveals how other symptoms -apart from pain- has become also relevant in FMS diagnosis and treatment. The central symptom of FMS is pain. FMS patients generally report high levels of clinical pain, which are related to greater impairments in health related quality of life, cognitive abilities and disease course. Fatigue and sleeping difficulties are also common symptoms of FMS. Fatigue have shown positive associations with pain, stiffness, sleep problems, increased body mass index, FMS severity, tenderness, disability, cognitive complaints, anxiety and depression. The majority of FMS patients report poor sleep quality, take longer to fall asleep, generally wake up during the night, sleep fewer hours, and usually wake up unrefreshed. Emotional disturbances (i.e., depression, anxiety) are also frequent in FMS. In fact, depression and anxiety disorders have showed a negative impact on the clinical course and work capacity of FMS patients. Cognitive impairments are also a relevant symptom in FMS. The most common complaints among FMS patients are executive function deficits, attention problems, forgetfulness, concentration difficulties, and mental slowness. Regarding the most frequent treatments for FMS, these can be classified as non-psychological and psychological. The former includes analgesic drugs, adjuvant drugs (i.e., antidepressants, benzodiazepines, anticonvulsants, etc.), nerve blocks, electrostimulation at different levels, infiltrations, etc. The psychological therapies with the most evidence are cognitive-behavioral, acceptance and commitment therapy and mindfulness. FMS is associated with a severe reduction of health related quality of life and psychosocial impairments. It is necessary to take all FMS symptoms and its relations into account in order to provide a more tailored and effective treatment, as well as, to improve the health related quality of life of FMS patients.

A clinical-radiological framework of the right temporal variant of frontotemporal dementia

The concept of the right temporal variant of frontotemporal dementia (rtvFTD) is still equivocal. The syndrome accompanying predominant right anterior temporal atrophy has previously been described as memory loss, prosopagnosia, getting lost and behavioural changes. Accurate detection is challenging, as the clinical syndrome might be confused with either behavioural variant FTD (bvFTD) or Alzheimer’s disease. Furthermore, based on neuroimaging features, the syndrome has been considered a right-sided variant of semantic variant primary progressive aphasia (svPPA). Therefore, we aimed to demarcate the clinical and neuropsychological characteristics of rtvFTD versus svPPA, bvFTD and Alzheimer’s disease. Moreover, we aimed to compare its neuroimaging profile against svPPA, which is associated with predominant left anterior temporal atrophy. Of 619 subjects with a clinical diagnosis of frontotemporal dementia or primary progressive aphasia, we included 70 subjects with a negative amyloid status in whom predominant right temporal lobar atrophy was identified based on blinded visual assessment of their initial brain MRI scans. Clinical symptoms were assessed retrospectively and compared with age- and sex-matched patients with svPPA (n = 70), bvFTD (n = 70) and Alzheimer’s disease (n = 70). Prosopagnosia, episodic memory impairment and behavioural changes such as disinhibition, apathy, compulsiveness and loss of empathy were the most common initial symptoms, whereas during the disease course, patients developed language problems such as word-finding difficulties and anomia. Distinctive symptoms of rtvFTD compared to the other groups included depression, somatic complaints, and motor/mental slowness. Aside from right temporal atrophy, the imaging pattern showed volume loss of the right ventral frontal area and the left temporal lobe, which represented a close mirror image of svPPA. Atrophy of the bilateral temporal poles and the fusiform gyrus were associated with prosopagnosia in rtvFTD. Our results highlight that rtvFTD has a unique clinical presentation. Since current diagnostic criteria do not cover specific symptoms of the rtvFTD, we propose a diagnostic tree to be used to define diagnostic criteria and call for an international validation.

AGEISM IN HEALTH CARE: 72 IS NOT A DIAGNOSIS

This poster examines what value, if any, there is in using age as a predictor or impetus for testing, examining and diagnosing older adults. In a cross sectional survey (Davis et al. (2011) used the Expectations Regarding Aging Scale to assess primary care clinicians perceptions of aging in the domains of physical/mental health and cognitive functioning. Sixty-four percent of respondents agreed with the statement “Having more aches and pains is an accepted part of aging while 61% agreed that the “Human body is like a car when it gets old it gets worn out. And 51% agreed that one should expect to become more forgetful with age while 17% agreed that mental slowness is impossible to escape. How might these attitudes and biases effect how older adults are diagnosed, heard, spoken to, and treated (medical treatment as well as patient/professional interaction)? Are older patients/clients underserved or over served? Is forgetting where you put your keys always or even usually a sign of dementia? How helpful then is the use of age and are there other factors that should and can take precedence? What do we know and what don’t we know if we know someone’s age? Successful and innovative tools are explored that acknowledge age biases and strategies are presented to change age biases in education, training and practice.

Wearable sensor-based data analysis for neurological disease symptoms evaluation utilising quantitative approach.

The paper describes implementation of an analytical method and conclusions of novel approach to clinical trials monitoring and evaluation. Based on clinical trials observations a set of requirements for validating symptoms of neurological diseases have been formulated, concentrating on the ones which can be registered using wearable sensors. The constructed tool utilizes conventional surveying methods supplemented with biomedical sensor for neurological symptoms recognition and intensity evaluation. Developed mobile system is aimed at clinical trials assistance utilising sensor-based state evaluation. Such quantitative approach is a supplement for patient’s subjective evaluation of health state. This work is a discussion on pros and cons of such process composition and its supplementation with technology. Existing methodology relies on health state evaluation based on iteratively answered questionnaires, which in our understanding cannot be fully controlled and reliable. Utilisation of actigraphy and electromyography provides efficient means of some gestures recognition but most of all PD tremor identification and evaluation of their intensity, therefore can be used for ON/OFF state and dyskinesia identification and evaluation. In order to recognise specific states for PD patients (tremors, bradykinesias, rigidity, mental slowness, etc.) a set of additional techniques have been designed and implemented.

Effect of Rajat Bhasma with Smritisagar Rasa in Parkinson

Parkinson is a disorder of nerve cell in the brain that is produced by the Dopamine, The global incidence is about 0.2/1000 and a prevalence of 1.5/1000 in U.K. The brain revels a loss of pigmentation in the substania nigra and locus of ceruleus, loss of pigmentation is accompanied by gliosis in the substania nigra and the other basal ganglion. Symptoms appear after a 60% to 80% loss of pigmented neuron. In Ayurveda Rajat Bhasma which has Vata-Shamak, Madhura Vipaka, Kashaya-Amla Rasa, Sheetala, Snigdha and also Brimhana so it play important role in nervous system and Smiritisagar Rasa has Tikshna, Ushna, Vyavayi as well as Yogvahi properties, Kapha-vata Shamak and Bhawna Dravya are Brahmi, Vacha, Malkangni also helpful in mental slowness and depression. Aim of this article is to know about the disease and its management by Ayurvedic perspective.