Anna Tsiakiri

Democritus University of Thrace

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Κonstantinos Vadikolias

Democritus University of Thrace

Pinelopi Vlotinou

University of West Attica

Foteini Christidi

Democritus University of Thrace

Nikolaos Aggelousis

Democritus University of Thrace

Dimitrios Tsiptsios

Democritus University of Thrace

Aspasia Serdari

University Hospital of Alexandroupolis

Christos Kokkotis

Democritus University of Thrace

Spyridon Plakias

University of Thessaly

Konstantinos Tsamakis

National and Kapodistrian University of Athens

Georgia Karakitsiou

Democritus University of Thrace

Cooperative Institutions

Democritus University of Thrace

Aristotle University of Thessaloniki

National and Kapodistrian University of Athens

Greek Association of Alzheimer's Disease and Related Disorders

University Hospital of Alexandroupolis

AHEPA University Hospital

University of Ioannina

Eginition Hospital

University of Thessaly

University General Hospital Attikon

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A Comprehensive Review on the Role of Resting State Functional Magnetic Resonance Imaging in Predicting Post-stroke Motor and Sensory Outcome

Foteini Christidi Ilias Orgianelis Ermis Merkouris Christos Koutsokostas Dimitrios Tsiptsios

Stroke is a major leading cause of chronic disability, often affecting patients’ motor and sensory functions. Functional magnetic resonance imaging (fMRI) is the most commonly used method of functional neuroimaging and allows the non-invasive study of brain activity. The time-dependent coactivation of different brain regions at rest is described as resting-state activation. As a non-invasive task-independent functional neuroimaging approach, resting-state fMRI (rs-fMRI) may provide therapeutically useful information on both the focal vascular lesion and the connectivity-based reorganization and subsequent functional recovery in stroke patients. Considering the role of prompt and accurate prognosis in stroke survivors along with the potential of rs-fMRI in identifying patterns of neuroplasticity in different post-stroke phases, this review provides a comprehensive overview of the latest literature regarding the role of rs-fMRI in stroke prognosis in terms of motor and sensory outcome. Our comprehensive review suggests that with the advancement of MRI acquisition and data analysis methods, rs-fMRI emerges as a promising tool to study the motor and sensory outcome in stroke patients and evaluate the effect of different interventions.

Stroke

Functional Imaging

Stroke Recovery

10.20944/preprints202312.1582.v1

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Processing Speed and Attentional Shift/Mental Flexibility in Patients with Stroke: A Comprehensive Review on the Trail Making Test in Stroke Studies

Anna Tsiakiri Foteini Christidi Dimitrios Tsiptsios Pinelopi Vlotinou Sofia Kitmeridou

The Trail Making Test (TMT) is one of the most commonly administered tests in clinical and research neuropsychological settings. The two parts of the test [part A (TMT-A) and part B (TMT-B)] enable the evaluation of visuoperceptual tracking and processing speed (TMT-A), as well as divided attention, set-shifting and cognitive flexibility (TMT-B). The main cognitive processes that are assessed using TMT, i.e. processing speed, divided attention and cognitive flexibility, are often affected in patients with stroke. Considering the wide use of TMT in research and clinical settings since its introduction in neuropsychological practice, the purpose of our review was to provide a comprehensive overview on the use of TMT in stroke patients in an attempt to mainly identify its role for the evaluation of post-stroke cognitive dysfunction and progression over time, the identification of the underlying neuroanatomical pathology related to impaired TMT performance, and the association with other stroke outcomes, such motor function, driving ability and quality of life. Our comprehensive review underscores that the TMT stands as an invaluable asset in the stroke assessment toolkit, contributing nuanced insights into diverse cognitive, functional, and emotional dimensions. As research progresses, continued exploration of the TMT potential across these domains is encouraged, fostering a deeper comprehension of post-stroke dynamics, and enhancing patient-centered care across hospitals, rehabilitation centers, research institutions, and community health settings. Its integration into both research and clinical practice reaffirms TMT status as an indispensable instrument in stroke-related evaluations, enabling holistic insights that extend beyond traditional neurological assessments.

Cognitive flexibility

Stroke

Trail Making Test

10.20944/preprints202401.0015.v1

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A Scoping Review on Coping Strategies and Quality of Life of Stroke Caregivers: Often Underestimated Variables in Stroke Recovery Process?

BioMed (2023)

Anna Tsiakiri Pinelopi Vlotinou Aikaterini Paschalidou Christos Konstantinidis Foteini Christidi

The purpose of the present study was to review all available work published within the last decade focusing on coping strategies in stroke caregivers and their impact on quality of Life (QoL) and psycho-emotional status. A literature search of two databases (MEDLINE, Scopus) was conducted to identify all relevant full-text English studies published between 2013–2023. Sixteen articles were traced and were finally included. Cognitive and behavioral coping strategies were beneficial for stroke caregivers’ and survivors’ QoL. The level of mutuality in the caregiver-survivor relationship was associated with the impact of depressive symptoms on caregivers’ QoL and the protective effect of mutuality on survivors’ QoL over time. The level and quality of social support were positively associated with QoL for stroke caregivers and survivors. Caregivers’ preparedness was a moderator for the impact of depression on both caregivers’ and survivors’ QoL. High levels of spirituality had a significant role in ameliorating the negative impact of depressive symptoms on the psychological and physical QoL of stroke caregivers and survivors. In conclusion, the study of coping strategies can be used as a psychological reserve in the process of stroke rehabilitation and actively contribute to improving the QoL of both caregivers and stroke survivors.

Moderation

Stroke

Preparedness

Cognitive appraisal

10.3390/biomed3030029

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Unraveling Childhood Obesity: A Grounded Theory Approach to Psychological, Social, Parental, and Biological Factors

Children (2024)

Georgia Karakitsiou Spyridon Plakias Foteini Christidi Anna Tsiakiri

Childhood obesity is a major medical and public health issue of global interest, which is influenced by a diverse array of factors and carries significant medical and psychosocial implications. Despite the extensive studies that have been conducted to explore the specific issue, the impact of several factors that influence, generate, worsen, and make chronic the phenomenon needs further exploration. This study aimed to construct a grounded theory that includes and connects the psychological, social, parental, and biological factors affecting childhood obesity. Key psychological factors include mental health issues such as depression and emotional eating, while social factors encompass socioeconomic status and cultural influences. Parental factors involve parenting styles and feeding practices, and biological factors relate to genetic predispositions and prenatal conditions. These factors interact in complex ways, highlighting the multifactorial nature of childhood obesity. The study employed a qualitative grounded theory approach, using research articles to achieve a thorough understanding. Qualitative analysis of the articles was conducted using Atlas.ti 24.0 software. Twenty-five research articles were required to reach theoretical saturation. The analysis resulted in 336 codes that were grouped into seven broad categories and twenty-four different subcategories. Through the construction of the theoretical framework, it was recognized that obesity in minors is a complex and multifactorial issue and that the network of causes and influencing factors covers a broad spectrum ranging from the individual to the family, and subsequently to society at large, which interact with each other.

10.3390/children11091048

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A Holistic Approach to Expressing the Burden of Caregivers for Stroke Survivors: A Systematic Review

Healthcare (2024)

Eftychia Tziaka Anna Tsiakiri Pinelopi Vlotinou Foteini Christidi Dimitrios Tsiptsios

This systematic review explores the multifaceted challenges faced by caregivers of stroke survivors, addressing the global impact of strokes and the anticipated rise in survivors over the coming decades. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a thorough literature search identified 34 relevant studies published between 2018 and 2023. The review categorizes caregiver burden into four domains: physical health, social functioning, financial issues, and psychological health. Caregivers often experience a decline in physical health, marked by chronic fatigue, sleep disturbances, and pain. Emotional distress is prevalent, leading to anxiety and depression, especially in cases of high burden. Financial strains arise from medical expenses and employment changes, exacerbating the overall burden. Contextual factors, such as cultural norms and resource availability, influence the caregiver experience. The Newcastle–Ottawa scale assessed the methodological quality of studies. The conclusion emphasizes tailored interventions and support systems for caregivers, with practical recommendations for healthcare professionals, therapists, mental health professionals, financial counselors, and policymakers. This comprehensive review enhances the understanding of caregiver experiences and provides actionable insights to improve stroke care and rehabilitation The study’s novelty lies in its holistic examination of caregiver burden in stroke care, its focus on the recent literature, and its emphasis on forecasting caregiver outcomes, contributing valuable insights for proactive intervention strategies.

Caregiver Burden

10.3390/healthcare12050565

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Investigating the Effects of Sociodemographic Characteristics on Psychological Factors That Impact on Educational Process of Adult Learners in Second Chance Schools in Greece

Review of European Studies (2021)

Georgia Karakitsiou Anna Tsiakiri Katerina Kedraka

The present study deals with the influence of various psychological factors faced by adults during the educational process at Second Chance Schools in Greece. We studied how the feelings of shame, anxiety and depression were associated with the demographic characteristics of the adult learners of these schools. Ninety-five trainees took part in the research whose results indicated that socio-demographic characteristics have an impact on psychological factors that can contribute to the educational process of adult learners. Sex and marital status were related to the feeling of shame (especially the body shame) and this may be an inhibitory factor to initial integration in or continuation with the studies in SCSs. Single and employed individuals were less vulnerable to development of depression and anxiety disorders, which has been found to have a negative effect on academic achievement. Based on such aspects, counseling approaches and interventions could be designed and implemented by Counselors Psychologists to improve the counseling services provided by the SCSs.

Shame

Depression

10.5539/res.v13n2p122

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Cognitive and psychological rehabilitation for patients with mild Alzheimer’s disease (AD) and patients with mild cognitive impairment (MCI)

F. Kounti Anastasia Efklides Grigorios Kioseoglou Konstantina Karagiozi E. Bacoglidou

Cognitive rehabilitation therapy

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Effectiveness of Nonpharmacological Approaches in Patients with Mild Cognitive Impairment

Neurodegenerative Diseases (2010)

Magda Tsolaki Fotini Kounti Christina Agogiatou Eleni Poptsi Evangelia Bakoglidou

Background: Mild cognitive impairment (MCI) patients are at increased risk of developing dementia. There is a conflict if cognitive interventions can improve cognitive and functional performances in order to delay the development of dementia. Objectives: This study aimed to examine the effectiveness of a holistic cognitive rehabilitation program on patients with MCI. Methods: The participants, 176 MCI patients with Mini-Mental State Examination = 27.89 (1.73), were classified into 2 groups matched for age, gender, education and cognitive abilities: (1) patients (104) on nonpharmacological therapy and (2) patients (72) on no therapy at all. The effectiveness of the interventions was assessed by neuropsychological evaluation performed at baseline and at the end of the interventions. Results: Between-group difference in benefit of the experimental group was demonstrated in abilities of executive function (p = 0.004), verbal memory (p = 0.003), praxis (p ≤ 0.012), daily function (p = 0.001) and general cognitive ability (p ≤ 0.005). The experimental patients improved cognitive and functional performances, while the control patients demonstrated deterioration in daily function (p = 0.004). Conclusions: Our findings indicate that nonpharmacological therapy of the holistic approach can improve MCI patients’ cognitive and functional performances.

Cognitive rehabilitation therapy

Cognitive Training

Cognitive remediation therapy

10.1159/000320575

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Citations (88)

Influence of Social and Demographic Factors on the Montreal Cognitive Assessment (MoCA) Test in Rural Population of North-Eastern Greece

Geriatrics (2021)

Anna Tsiakiri Κonstantinos Vadikolias Grigorios Trιpsianis Pinelopi Vlotinou Aspasia Serdari

The current study aims to investigate the influence of socio-demographic factors on the Montreal Cognitive Assessment (MoCA) test results in a Greek-speaking population consisting of a sample of healthy older adults, individuals with mild cognitive impairment (MCI), and dementia patients in rural areas. In addition, the current research focuses on determining optimal cut-off scores for the clinical diagnoses of MCI and dementia. The data originated from 283 participants in an ongoing registry of the Neurology Department of Alexandroupolis University Hospital, recruited in different rural districts of north-eastern Greece, across a broad range of educational and occupational categories. Total and sub-domain scores for the MoCA varied significantly, according to sex, age, and education, among the three study groups. The optimal cut-off points of 25/26 for the MoCA total score was determined to classify healthy subjects from individuals with MCI, 24 to discriminate healthy participants from demented, and 21/22 to discriminate subjects with MCI from dementia. Overall, the clinical use of the MoCA test can be supported by demographically adjusted standard scores in a Greek-speaking rural population. These findings serve to improve the diagnostic accuracy and utility of the MoCA test.

Montreal Cognitive Assessment

10.3390/geriatrics6020043

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Trust in Healthcare, Medical Mistrust, and Health Outcomes in Times of Health Crisis: A Narrative Review

Societies (2024)

Elisavet Souvatzi Magdalini Katsikidou Aikaterini Arvaniti Spyridon Plakias Anna Tsiakiri

Background/Objectives: The concepts of trust and distrust in health systems during health crises are significantly related to public adoption of health behaviors and health outcomes. The aim of this review is to examine trust and mistrust during times of health crisis, such as periods of viral pandemics and epidemics, and how these concepts relate to public health behaviors and, by extension, affect health outcomes. Methods: A focused search was conducted in PubMed and Scopus using a Boolean expression to identify relevant articles written in the English language and published between 2003 and 2023. The research methods comprised content analysis, thematic analysis, and a word cloud visualization to identify frequent themes related to trust and mistrust in healthcare systems. Results: The analysis included 57 studies and revealed that trust in healthcare systems, institutions, and professionals plays a significant role in shaping public health behaviors during health crises. The study also highlighted how mistrust leads to negative health outcomes, such as increased belief in conspiracy theories, vaccine hesitancy, and non-compliance with public health measures. Conclusions: The review emphasizes the importance of building and maintaining trust in healthcare systems to ensure better public health outcomes during crises. It calls for further research to better understand the nuances of trust and mistrust, aiming to inform public health strategies and interventions that could lead to more effective crisis management and improved health outcomes.

Narrative review

10.3390/soc14120269

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