Little is known about the relationship between emotional creativity and age-related cognitive decline. This study explored how deficits in some cognitive abilities are related to emotional creativity, i.e., cognitive abilities relating to originality and appropriateness in emotional experience. One hundred and eighty-seven older adults (mean age = 63.2; 58.4% females) were administered the Emotional Creativity Inventory, the Frontal Systems Behavior Scale, and the Cognitive Complaint Interview. As hypothesized, emotional creativity was negatively related to apathy and positively to disinhibition/emotional dysregulation. Several processes, such as apathy-related loss of interest, unconcern, subjective lack of energy, and changed perception of one's disinhibited emotional reactions, may explain the observed results.
In this study, we explored the effect of non-computerized cognitive rehabilitation in patients with Parkinson's disease in comparison with an intervention with elements of music therapy after the completion of a three-month program and one year after the end of the intervention. After the initial neuropsychological examination, the respondents were divided into two intervention groups. The experimental group (n = 26) underwent a twelve-week program of cognitive rehabilitation at a frequency of 60 minutes once a week. The control group (n = 27) underwent an intervention program with elements of music therapy at the same frequency. Respondents who underwent the cognitive rehabilitation program improved in the delayed recall from visual memory in the follow-up examination after the end of the cognitive intervention. One year after the end, the effect of cognitive rehabilitation persisted in delayed recall from visual memory and in executive mental flexibility. Cognitive rehabilitation is an effective approach to compensate for cognitive deficits in P D, but other approaches to cognitive stimulation may be equally effective.
Neuropsychiatric symptoms and reduced health-related quality of life (HRQoL) are frequent in multiple sclerosis, where are associated with structural brain changes, but have been less studied in clinically isolated syndrome (CIS).To characterize HRQoL, neuropsychiatric symptoms (depressive symptoms, anxiety, apathy and fatigue), their interrelations and associations with structural brain changes in CIS.Patients with CIS (n = 67) and demographically matched healthy controls (n = 46) underwent neurological and psychological examinations including assessment of HRQoL, neuropsychiatric symptoms and cognitive functioning, and MRI brain scan with global, regional and lesion load volume measurement.The CIS group had more, mostly mild, depressive symptoms and anxiety, and lower HRQoL physical and social subscores (p≤0.037). Neuropsychiatric symptoms were associated with most HRQoL subscores (β≤-0.34, p≤0.005). Cognitive functioning unlike clinical disability was associated with depressive symptoms and lower HRQoL emotional subscores (β≤-0.29, p≤0.019). Depressive symptoms and apathy were associated with right temporal, left insular and right occipital lesion load (ß≥0.29, p≤0.032). Anxiety was associated with lower white matter volume (ß = -0.25, p = 0.045).Mild depressive symptoms and anxiety with decreased HRQoL are present in patients with CIS. Neuropsychiatric symptoms contributing to decreased HRQoL are the result of structural brain changes and require complex therapeutic approach in patients with CIS.
Summary Fragmentary myoclonus is a result of muscle activity consisting of brief potentials in surface electromyography during polysomnography. Excessive fragmentary myoclonus is defined by increased intensity of the potentials. A few studies report excessive fragmentary myoclonus occurrence in neurodegenerative diseases. Because idiopathic rapid eye movement sleep behaviour disorder is considered as an early stage of neurodegeneration with involvement of the brainstem, we charted the prevalence and quantified the intensity of excessive fragmentary myoclonus in idiopathic rapid eye movement sleep behaviour disorder . Twenty‐nine patients (one woman, 28 men, mean age 68 years, SD 6.2) and 29 controls (two women, 27 men, mean age 65.6 years, SD 8.6) underwent polysomnography . Fragmentary myoclonus potentials were identified and counted according to internationally used criteria. Fragmentary myoclonus intensity was quantified by the fragmentary myoclonus index. E xcessive fragmentary myoclonus was diagnosed in 75.9% (22 subjects) in idiopathic rapid eye movement sleep behaviour disorder , while in 34.5% (10 subjects) among the controls ( p = 0.003). Quantitative analysis showed a wide‐range fragmentary myoclonus index in idiopathic rapid eye movement sleep behaviour disorder (4.0–632.4; median 60.7) and in the controls (0.8–938.1; median 34.3). The overall difference in fragmentary myoclonus index was not significant between the groups; however, patients with idiopathic rapid eye movement sleep behaviour disorder showed trends for higher fragmentary myoclonus index scores in wakefulness ( p = 0.027), N1 ( p = 0.032), N3 ( p = 0.046) and R ( p = 0.007). F ragmentary myoclonus index does not correlate with age, idiopathic rapid eye movement sleep behaviour disorder duration or R stage atonia deficiency. The prevalence of excessive fragmentary myoclonus is higher in idiopathic rapid eye movement sleep behaviour disorder compared with the controls, so fragmentary myoclonus should be taken into account in future research of rapid eye movement sleep behaviour disorder and motor control in sleep.
Objective: The influence of demographic variables on the Trail Making Test (TMT) performance in older individuals and empirical findings on clinical validity in predementia states, such as Parkinson's disease mild cognitive impairment (PD-MCI), are limited. The principal aim of this study was to add normative data for the Czech population of older adults and explore the clinimetric properties between PD-MCI and PD patients with normal cognition (PD-NC). Method: The study included 125 PD patients classified as 77 PD-MCI and 48 PD-NC and 528 older individuals (60–74 years, further subdivided for normative tables into 60–64, 65–69 and 70–74 age groups) and very old individuals (aged 75–96, further subdivided into 75–79, 80–84, 85–96) cognitively intact Czech adults. Results: Mostly age, to a lesser extent education but not gender, was associated with most TMT basic and derived indices (TMT-B – A). However, the ratio of TMT-B/TMT-A was independent of both age and education. We provide corresponding T-scores that minimize the effect of demographic variables. The results showed a high discriminative validity of TMT basic and derived indices for the differentiation of PD-MCI from PD-NC (all p < .05). The classification accuracy for the differentiation of PD-MCI from controls was optimal for the TMT-B only (80% area under the curve) based on norm adjusted scores. The classification accuracy of the TMT for PD-MCI vs. PD-NC was suboptimal. Conclusions: The cut-offs and normative standards are useful in clinical practice for those working with PD patients and very old adults.
Kognitivni vysetřeni v diagnostice Alzheimerovy nemoci (AN) je jednim z klicových diagnostických postupů. Se změnou diagnostických
kriterii AN se posouva důraz na stale casnějsi diagnostiku kognitivniho deficitu, jejimž těžistěm je stadium mirne kognitivni poruchy při AN.
Pro odhad kognitivni výkonnosti jsou v casných stadiich AN užitecne screeningove testy kognice, pro komplexni analýzu kognitivni výkonnosti
je nezbytne neuropsychologicke vysetřeni. Ucelem neuropsychologickeho vysetřeni je zjisťovani klinicky významneho kognitivniho
poklesu stejně jako profilace kognitivni výkonnosti pro ucely diferencialni diagnostiky. V clanku shrnujeme podobu a možnosti kognitivniho
vysetřeni v casných stadiich AN s důrazem na stadium MCI a doporucujeme postupy vysetřeni kognitivnich funkci pro klinickou praxi.
Background: Identifying modifiable risk factors for cognitive decline can reduce burden of dementia. Objective: We examined whether homocysteine was associated with memory performance, mediated by entorhinal volume, hippocampal volume, total gray matter volume, or white matter lesions, and moderated by APOE ɛ4 allele, B vitamins, creatinine, total cholesterol, or triglycerides. Methods: All 204 members of the Czech Brain Aging Study with subjective cognitive decline (SCD; n = 60) or amnestic mild cognitive impairment (aMCI; n = 144) who had valid data were included. Linear regression was used, followed by conditional process modeling to examine mediation and moderation. Results: Controlling for age, sex, and education, higher homocysteine was related to poorer memory performance overall (b = –0.03, SE = 0.01, p = 0.017) and in participants with SCD (b = –0.06, SE = 0.03, p = 0.029), but less so in aMCI (b = –0.03, SE = 0.02, p = 0.074); though sensitivity analyses revealed a significant association when sample was reduced to aMCI patients with more complete cognitive data (who were also better functioning; b = –0.04, SE = 0.02, p = 0.022). Results were unchanged in fully adjusted models. Neither mediation by markers of brain integrity nor moderation by APOE ɛ4, B vitamins, creatinine, and cardiovascular factors were significant. Memory sub-analyses revealed that results for SCD were likely driven by non-verbal memory. The homocysteine-memory relationship was significant when hippocampal volume was below the median (b = –0.04, SE = 0.02, p = 0.046), but not at/above the median (p = 0.247). Conclusion: Higher homocysteine levels may adversely influence memory performance, which appears particularly apparent in those without cognitive impairment. Results appear to be independent of brain health, suggesting that homocysteine may represent a good target for intervention.
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