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Cuoco S, Cappiello A, Carotenuto I, Bisogno R, Abate F, Tepedino MF, Pellecchia MT, Erro R, Barone P, Picillo M. Apathy evaluation scale-informant version in progressive supranuclear palsy: Psychometric properties and clinical correlates. Parkinsonism Relat Disord 2023; 107:105293. [PMID: 36682220 DOI: 10.1016/j.parkreldis.2023.105293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Affiliation(s)
- Sofia Cuoco
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Arianna Cappiello
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Immacolata Carotenuto
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Rossella Bisogno
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Filomena Abate
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Maria Francesca Tepedino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Roberto Erro
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Paolo Barone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy
| | - Marina Picillo
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", Neuroscience Section, University of Salerno, Baronissi, Italy.
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Rogozinski S, Klietz M, Respondek G, Oertel WH, Grothe MJ, Pereira JB, Höglinger GU. Reduction in Volume of Nucleus Basalis of Meynert Is Specific to Parkinson’s Disease and Progressive Supranuclear Palsy but Not to Multiple System Atrophy. Front Aging Neurosci 2022; 14:851788. [PMID: 35431891 PMCID: PMC9012106 DOI: 10.3389/fnagi.2022.851788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/24/2022] [Indexed: 12/29/2022] Open
Abstract
Objectives To study in vivo gray matter (GM) volumes of the nucleus basalis of Meynert (nbM) in different parkinsonian syndromes and assess their relationship with clinical variables. Methods T1-weighted magnetic resonance images from patients with progressive supranuclear palsy (PSP, N = 43), multiple system atrophy (MSA, N = 23), Parkinson’s disease (PD, N = 26), and healthy controls (HC, N = 29) were included. T1-weighted images were analyzed using a voxel-based morphometry approach implemented in the VBM8 toolbox, and nbM volumes were extracted from the spatially normalized GM images using a cyto-architectonically-defined nbM mask in stereotactic standard space. NbM volumes were compared between groups, while controlling for intracranial volume. Further, within each group correlation analyses between nbM volumes and the Mini Mental Status Examination (MMSE), Hoehn and Yahr stage, PSP Rating Scale, Unified Parkinson’s Disease Rating Scale part III and Frontal Assessment Battery scores were performed. Results Significantly lower nbM volumes in patients with PSP and PD compared to HC or patients with MSA were found. No significant correlations between MMSE and nbM volumes were detected in any of the subgroups. No significant correlations were found between clinical scores and nbM volumes in PSP or other groups. Conclusion nbM volumes were reduced both in PD and PSP but not in MSA. The lack of significant correlations between nbM and cognitive measures suggests that other factors, such as frontal atrophy, may play a more important role than subcortical cholinergic atrophy in PSP patients. These results may indicate that other drug-targets are needed to improve cognitive function in PSP patients.
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Affiliation(s)
- Sophia Rogozinski
- Department of Neurology, Hanover Medical School, Hanover, Germany
- *Correspondence: Sophia Rogozinski,
| | - Martin Klietz
- Department of Neurology, Hanover Medical School, Hanover, Germany
| | - Gesine Respondek
- Department of Neurology, Hanover Medical School, Hanover, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Wolfgang H. Oertel
- Department of Neurology, Philipps University of Marburg, Marburg, Germany
| | - Michel J. Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Joana B. Pereira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Günter U. Höglinger
- Department of Neurology, Hanover Medical School, Hanover, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
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Street D, Malpetti M, Rittman T, Ghosh BCP, Murley AG, Coyle-Gilchrist I, Passamonti L, Rowe JB. Clinical progression of progressive supranuclear palsy: impact of trials bias and phenotype variants. Brain Commun 2021; 3:fcab206. [PMID: 34541533 PMCID: PMC8445397 DOI: 10.1093/braincomms/fcab206] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/14/2021] [Accepted: 07/20/2021] [Indexed: 01/21/2023] Open
Abstract
Progressive supranuclear palsy causes diverse clinical presentations, including classical Richardson’s syndrome and several variant phenotypes. Clinical trials of disease-modifying therapies have recently been completed, with more planned for the next 2 years. However, many people with progressive supranuclear palsy do not meet eligibility criteria for these clinical trials. Understanding clinical progression with different phenotypes would improve trial design and enhance the accuracy of risk–benefit and cost–benefit assessments of new treatments for progressive supranuclear palsy. We set out to determine rates of motor and cognitive progression of possible, probable and definite progressive supranuclear palsy, with different phenotypes, from a representative cohort in a regional UK healthcare service. Longitudinal clinical data from people with Richardson’s syndrome and variant phenotypes were analysed using linear mixed-modelling, using both the full and modified versions of the Progressive Supranuclear Palsy Rating Scale, Mini-Mental State Examination and the revised Addenbrooke’s Cognitive Examination. Subgroup analyses considered patients meeting recent Phase II trial entry criteria and patients with neuropathological confirmation. Two hundred and twenty-seven patients [male = 59%, mean age (±standard deviation), 71.8 (±7.0) years] were followed for a mean 21.6 (±15.6) months. One hundred and seventy-four (77%) had Richardson’s syndrome at the outset, 25 had cortical variant presentations (13%, frontal, corticobasal, speech and language variants) and 28 had subcortical variant presentations (14%, parkinsonism, postural instability and gait freezing variants). Across all participants, annual progression in Richardson’s syndrome was faster than variant phenotypes on the Mini-Mental State Examination (−1.8 versus −0.9/year, P = 0.005) and revised Addenbrooke’s Cognitive Examination (−5.3 versus −3.0/year, P = 0.01) but not the Progressive Supranuclear Palsy Rating Scale (9.0 versus 7.1/year, P = 0.2) nor the modified Progressive Supranuclear Palsy Rating Scale (2.7 versus 2.3/year, P = 0.4). However, for those with more than 1 years’ follow-up, a significant difference was observed between Richardson’s syndrome and variant phenotypes in Progressive Supranuclear Palsy Rating Scale (8.7 versus 6.3/year, P = 0.04). Survival was longer in variant phenotypes than Richardson’s syndrome [7.3 (±3.9) versus 5.6 (±2.0) years, P = 0.02]. Pathologically confirmed cases (n = 49) supported these findings. Patients meeting basic trial-eligibility criteria (n = 129) progressed faster on the Progressive Supranuclear Palsy Rating Scale than trial-not-eligible patients (10.1 versus 6.1/year, P = 0.001). In conclusion, phenotypes other than Richardson’s syndrome show slower progression and longer survival. Trial criteria do not select representative progressive supranuclear palsy cases. This has implications for trial design, and application of trial results to clinically more diverse patient populations.
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Affiliation(s)
- Duncan Street
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Maura Malpetti
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Boyd C P Ghosh
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK.,Wessex Neurological Centre, University Hospitals Southampton NHS Foundation Trust, Southampton SO16 6YD, UK
| | - Alexander G Murley
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Ian Coyle-Gilchrist
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK.,Norfolk and Norwich NHS Foundation Trust, Norwich NR4 7UY, UK
| | - Luca Passamonti
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK.,Consiglio Nazionale delle Ricerche (CNR), Istituto di Bioimmagini e Fisiologia Molecolare (IBFM), Milano, 20090 Segrate (MI), Italy
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University Hospitals NHS Trust, University of Cambridge, Cambridge CB2 0SZ, UK.,Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, UK
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Murley AG, Rouse MA, Coyle-Gilchrist ITS, Jones PS, Li W, Wiggins J, Lansdall C, Vázquez Rodríguez P, Wilcox A, Patterson K, Rowe JB. Predicting loss of independence and mortality in frontotemporal lobar degeneration syndromes. J Neurol Neurosurg Psychiatry 2021; 92:737-744. [PMID: 33563798 PMCID: PMC8223632 DOI: 10.1136/jnnp-2020-324903] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To test the hypothesis that in syndromes associated with frontotemporal lobar degeneration, behavioural impairment predicts loss of functional independence and motor clinical features predict mortality, irrespective of diagnostic group. METHODS We used a transdiagnostic approach to survival in an epidemiological cohort in the UK, testing the association between clinical features, independence and survival in patients with clinical diagnoses of behavioural variant frontotemporal dementia (bvFTD n=64), non-fluent variant primary progressive aphasia (nfvPPA n=36), semantic variant primary progressive aphasia (svPPA n=25), progressive supranuclear palsy (PSP n=101) and corticobasal syndrome (CBS n=68). A principal components analysis identified six dimensions of clinical features. Using Cox proportional hazards and logistic regression, we identified the association between each of these dimensions and both functionally independent survival (time from clinical assessment to care home admission) and absolute survival (time to death). Analyses adjusted for the covariates of age, gender and diagnostic group. Secondary analysis excluded specific diagnostic groups. RESULTS Behavioural disturbance, including impulsivity and apathy, was associated with reduced functionally independent survival (OR 2.46, p<0.001), even if patients with bvFTD were removed from the analysis. Motor impairments were associated with reduced absolute survival, even if patients with PSP and CBS were removed from the analysis. CONCLUSION Our results can assist individualised prognostication and planning of disease-modifying trials, and they support a transdiagnostic approach to symptomatic treatment trials in patients with clinical syndromes associated with frontotemporal lobar degeneration.
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Affiliation(s)
- Alexander G Murley
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Neurology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Matthew A Rouse
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Ian T S Coyle-Gilchrist
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Neurology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - P Simon Jones
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Win Li
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Julie Wiggins
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Claire Lansdall
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Alicia Wilcox
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Karalyn Patterson
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - James B Rowe
- Clinical Neurosciences, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
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Validation of the Parkinson's Disease Caregiver Burden Questionnaire in Progressive Supranuclear Palsy. PARKINSONS DISEASE 2021; 2021:9990679. [PMID: 34046156 PMCID: PMC8128535 DOI: 10.1155/2021/9990679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 01/10/2023]
Abstract
Progressive supranuclear palsy (PSP) is an atypical Parkinson syndrome with axial akinetic-rigid symptoms, early postural instability, and ocular motor impairments. Patients experience a rapid loss of autonomy and care dependency; thus, caregivers must assist in the activities of daily living early in the course of the disease. Caregiver burden is an extremely important factor in disease management. However, there are no specific questionnaires for assessment of caregiver burden in PSP. This study aims to validate the Parkinson's disease caregiver burden questionnaire (PDCB) as a specific measure of caregiver burden in PSP. PSP patients were assessed by the PSP rating scale, PSP quality-of-life questionnaire (PSP-QoL), Montreal cognitive assessment test (MoCA), and geriatric depression scale (GDS-15). Caregivers filled out the short form 36-health survey, GDS-15, PDCB, and the caregiver burden inventory (CBI). 22 patient caregiver pairs completed the study. PDCB showed a highly significant correlation with the CBI (r 0.911; p < 0.001). Internal reliability of the PDCB measured by Cronbach's alpha was favourable at 0.803. These data support the specificity of the PDCB in PSP caregivers. Future studies with larger sample sizes of PSP patients and caregivers and a multicentric longitudinal design should be performed to gain further insight of caregiver burden in PSP.
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Safin SM, Derevyanko HP, Blinova NM. [Progressive supranuclear paralysis with levodopa-induced dyskinesia]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:110-115. [PMID: 33834727 DOI: 10.17116/jnevro2021121031110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Progressive supranuclear palsy (PNP) is a neurodegenerative disease characterized by a combination of progressive akinetic-rigid syndrome, postural instability with frequent falls, supranuclear ophthalmoplegia, pseudobulbar syndrome and frontal dementia. The disease usually develops after the sixth decade of life, and has a progressive course. An own description of the clinical case of progressive supranuclear palsy in a 79-year-old patient with oromandibular hyperkinesis while taking levodopa is presented.
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Affiliation(s)
- Sh M Safin
- Bashkir State Medical University, Ufa, Russia
| | | | - N M Blinova
- Bashkir State Medical University, Ufa, Russia
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Pantelyat A, Higginbotham L, Rosenthal L, Lanham D, Nesspor V, AlSalihi M, Bang J, Wang J, Albert M. Association of Progressive Supranuclear Palsy Rating Scale with Progressive Supranuclear Palsy Quality of Life Scale. NEURODEGENER DIS 2021; 20:139-146. [PMID: 33789283 DOI: 10.1159/000514519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/15/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION There is growing interest in using patient-reported outcomes as end points in clinical trials, such as the progressive supranuclear palsy quality of life (PSP-QoL) scale. However, this tool has not been widely validated and its correlation with validated motor scales has not been explored. To evaluate the potential utility of using PSP-QoL as an outcome, it is important to examine its relationship with a standard scale used to evaluate neurologic parameters, such as the PSP Rating Scale. METHODS PSP-QoL and PSP Rating Scale scores were gathered from 60 clinically diagnosed PSP patients, including patients with Richardson syndrome PSP (PSP-RS, n = 43) and those with non-RS PSP variants (n = 17). Linear regression analysis adjusted for age, sex, and disease duration was used to evaluate the cross-sectional relationship between the total and subscale scores of the 2 instruments. RESULTS Among 60 PSP patients, there was a significant correlation between total PSP-QoL and PSP Rating Scale scores. The physical and mentation subscales of each instrument also demonstrated significant correlations. Comparisons among PSP subtypes indicated that worsening PSP-QoL Total and Physical subscale scores correlated with worsening PSP Rating Scale gait subscale scores more strongly for the non-RS PSP variants than for PSP-RS. DISCUSSION There is a significant association between the total scores and many of the subscale scores of the PSP-QoL and the PSP Rating Scale. Additionally, the relationship between these measures may differ for PSP-RS and non-RS variants. These findings suggest that the PSP-QoL may be useful in clinical trials as a patient-reported outcome measure. Large prospective multicenter studies utilizing the PSP-QoL are necessary to examine its relationship to disease evolution and changes in the PSP Rating Scale.
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Affiliation(s)
- Alexander Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Lenora Higginbotham
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Liana Rosenthal
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Diane Lanham
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Vanessa Nesspor
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mina AlSalihi
- Kansas City University College of Osteopathic Medicine, Kansas City, Missouri, USA
| | - Jee Bang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Ding X, Abner EL, Schmitt FA, Crowley J, Goodman P, Kryscio RJ. Mental Component Score (MCS) from Health-Related Quality of Life Predicts Incidence of Dementia in U.S. Males. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 8:169-174. [PMID: 33569563 DOI: 10.14283/jpad.2020.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND The Medical Outcomes Study Questionnaire Short Form 36 health survey (SF-36) measures health-related quality of life (HRQoL) from the individual's point of view and is an indicator of overall health status. OBJECTIVE To examine whether HRQoL shows differential changes over time prior to dementia onset and investigate whether HRQoL predicts incidence of dementia. DESIGN Prevention of Alzheimer's Disease (AD) by Vitamin E and Selenium (PREADViSE) trial, which recruited 7,547 non-demented men between 2002 and 2009. A subset of 2,746 PREADViSE participants who completed up to five SF-36 assessments at annual visits was included in the current analysis. SETTING Secondary data analysis of PREADViSE data. PARTICIPANTS A subset of 2,746 PREADViSE participants who completed up to five SF-36 assessments at annual visits was included in the current analysis. MEASUREMENTS Two summary T scores were generated for analysis: physical component score (PCS) and mental component score (MCS), each with a mean of 50 (standard deviation of 10); higher scores are better. Linear mixed models (LMM) were applied to determine if mean component scores varied over time or by eventual dementia status. Cox proportional hazards regression was used to determine if the baseline component scores were associated with dementia incidence, adjusting for baseline age, race, APOE-4 carrier status, sleep apnea, and self-reported memory complaint at baseline. RESULTS The mean baseline MCS score for participants who later developed dementia (mean± SD: 53.9±9.5) was significantly lower than for those participants who did not develop dementia during the study (mean±SD: 56.4±6.5; p = 0.005). Mean PCS scores at baseline (dementia: 49.3±7.9 vs. non-dementia: 49.8±7.8) were not significantly different (p = 0.5) but LMM analysis showed a significant time effect. For MCS, the indicator for eventual dementia diagnosis was significantly associated with poorer scores after adjusting for baseline age, race, and memory complaint. Adjusted for other baseline risk factors, the Cox model showed that a 10-unit increase in MCS was associated with a 44% decrease in the hazard of a future dementia diagnosis (95% CI: 32%-55%). CONCLUSION The SF-36 MCS summary score may serve as a predictor for future dementia and could be prognostic in longitudinal dementia research.
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Affiliation(s)
- X Ding
- Xiuhua Ding, M.D., Ph.D., Department of Public Health, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, USA, , phone: 270-745-3618, Fax: 270-745-6950
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Akdal G, Boz H, Kiriş A, Koçoğlu K, Çolakoğlu B, Çakmur R. Balance and gait disturbances and quality of life in patients with idiopathic parkinson's disease and progressive supranuclear palsy. NEUROL SCI NEUROPHYS 2021. [DOI: 10.4103/nsn.nsn_148_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lu J, Yu Z, Zhang X, Wu M, Lin S, Zhu Y, Xu Z, You L, Wei F, Tang M, Jin M, Wang J, Chen K. Association between social health status and health-related quality of life among community-dwelling elderly in Zhejiang. Health Qual Life Outcomes 2020; 18:110. [PMID: 32345322 PMCID: PMC7189640 DOI: 10.1186/s12955-020-01358-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 04/08/2020] [Indexed: 12/11/2022] Open
Abstract
Background Population aging is an inevitable trend and previous studies have showed the relationship between social health related factors and health-related quality of life (HR-QOL) in the elderly. The objective of this study is to investigate the association of social health status with HR-QOL among community-dwelling elderly in Zhejiang. Methods This cross-sectional study was based on community-dwelling elderly individuals from July 2018 to September 2018 in Zhejiang, China. HR-QOL was measured by the 12-item Short-Form Health Survey (SF-12). Social health status was estimated by the long-form of the Social Health Scale for the Elderly (SHSE-L) and classified into three categories (poor, moderate and good). Multivariable linear regression models were conducted to evaluate the association between social health status and HR-QOL (PCS, MCS and SF-12 total score). Results A total of 2952 elderly participants were included in this study. The mean age was 70.68 ± 7.75 years (mean ± SD); of the eligible participants, more than half (50.4%) were females; the mean scores were 48.10 ± 8.49, 47.70 ± 7.09 and 47.90 ± 5.86 for PCS, MCS and SF-12 total score, separately. Results from the multivariable models showed that social health status was positively related to HR-QOL after adjusting for covariates. Compared with individuals with a poor social health status, those who had a moderate or good social health status were more likely to report better HR-QOL (for moderate social health status: β = 1.90(95%CI: 1.09, 2.71) for PCS, β = 1.78(1.08, 2.48) for MCS, β = 1.84(1.29, 2.39) for SF-12 total score; for good social health status: β = 3.29(2.24, 4.34) for PCS, β = 3.10(2.12, 4.01) for MCS, β = 3.20(2.48, 3.91) for SF-12 total score). Conclusion In our study, we found that social health status was positively associated with HR-QOL among the elderly in Zhejiang. Our findings could provide valuable information for decision-makers to develop interventions to improve the HR-QOL of the elderly.
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Affiliation(s)
- Jieming Lu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Zhebin Yu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Xiaocong Zhang
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mengyin Wu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Shujuan Lin
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Yao Zhu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Zenghao Xu
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Liuqing You
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Fang Wei
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mengling Tang
- Department of Epidemiology and Biostatistics, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China
| | - Mingjuan Jin
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbing Wang
- Department of Epidemiology and Biostatistics, the Children's Hospital, National Clinical Research Center for Child Health, Zhejiang University School of Medicine, Hangzhou, China.
| | - Kun Chen
- Department of Epidemiology and Biostatistics, Cancer Institute, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Cognitive and behavioural dysfunctions in a patient with progressive supranuclear palsy (PSP). HEALTH PSYCHOLOGY REPORT 2019. [DOI: 10.5114/hpr.2019.82633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BackgroundThe aim of the case study was to describe the profile of cognitive and emotional functioning of a patient with possible progressive supranuclear palsy (PSP) from a longitudinal perspective.Participants and procedureThis study involved an 71-year-old male patient diagnosed with PSP, and 9 matched healthy subjects. Neuro-psychological examination of the patient was performed twice with a 6 month interval. A set of neuropsycho-logical tests was used to assess both cognition and behaviour.ResultsNeuropsychological assessment revealed executive dysfunction dominance (planning deficits, reduced cogni-tive flexibility and abstract thinking, impulsiveness), reduced verbal fluency, psychomotor slowness and prob-lems with memory retrieval from the long-term memory storage in contrast to significantly better recognition of the previously learned information. According to emotional functioning, frontal change of personality was ob-served, with apathy, disinhibition, lack of insights, impulsiveness and “utilization behaviours”.ConclusionsThe profile of emotional and cognitive impairments met the criteria for dementia. There was a progression of deficits at visit two in comparison to visit one. The longitudinal perspective allowed the dynamics of emotional, cognitive and behavioural changes to be described over time: from depression related to initially preserved criticism of the illness to apathy and emotional blunting and behavioural frontal syndrome connected with the systematic loss of insight.
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Jecmenica-Lukic MV, Pekmezovic TD, Petrovic IN, Dragasevic NT, Kostić VS. Factors associated with deterioration of health-related quality of life in multiple system atrophy: 1-year follow-up study. Acta Neurol Belg 2018; 118:589-595. [PMID: 29949032 DOI: 10.1007/s13760-018-0962-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 06/04/2018] [Indexed: 11/26/2022]
Abstract
The aim of this study was to identify the main contributors to the health-related quality of life (HRQoL) in multiple system atrophy with predominant parkinsonism (MSA-P) and to determine the usefulness of SF-36 in capturing the HRQoL changes over 1-year follow-up. A total of 45 MSA-P and 150 Parkinson's disease (PD) patients were studied. The hierarchical multiple regression analysis was conducted to identify predictors of the SF-36 total score. The magnitude of any change for the HRQoL over 1-year of follow-up, was calculated as an effect size. The average scores for each SF-36 domains, except for the bodily pain, were lower in MSA-P than in PD patients (p < 0.05). The most important predictors of HRQoL in MSA-P, were female gender, older age at onset, SCOPA-AUT score and UMSARS IV, which together with other selected clinical variables accounted for 84% of the variance in the total SF-36 score in the final model in hierarchical analyses. During the 1-year follow-up, the SF 36 was found capable of detecting changes in MSA-P. Our study provided some new insights into potential predictors of the HRQoL and its longitudinal changes in MSA-P, which should be considered when healthcare programs are developed.
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Affiliation(s)
- Milica V Jecmenica-Lukic
- Clinic of Neurology, School of Medicine, University of Belgrade, Ul. Dr Subotića 6, Belgrade, 11000, Serbia
| | - Tatjana D Pekmezovic
- Clinic of Neurology, School of Medicine, University of Belgrade, Ul. Dr Subotića 6, Belgrade, 11000, Serbia
- Institute of Epidemiology, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Igor N Petrovic
- Clinic of Neurology, School of Medicine, University of Belgrade, Ul. Dr Subotića 6, Belgrade, 11000, Serbia
| | - Natasa T Dragasevic
- Clinic of Neurology, School of Medicine, University of Belgrade, Ul. Dr Subotića 6, Belgrade, 11000, Serbia
| | - Vladimir S Kostić
- Clinic of Neurology, School of Medicine, University of Belgrade, Ul. Dr Subotića 6, Belgrade, 11000, Serbia.
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Pan P, Liu Y, Zhang Y, Zhao H, Ye X, Xu Y. Brain gray matter abnormalities in progressive supranuclear palsy revisited. Oncotarget 2017; 8:80941-80955. [PMID: 29113357 PMCID: PMC5655252 DOI: 10.18632/oncotarget.20895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 08/26/2017] [Indexed: 12/11/2022] Open
Abstract
Whole-brain voxel-based morphometry (VBM) studies of progressive supranuclear palsy (PSP) have demonstrated heterogeneous findings regarding gray matter (GM) abnormalities. Here, we used Seed-based d Mapping, a coordinate-based meta-analytic approach to identify consistent regions of GM anomalies across studies of PSP. Totally, 18 original VBM studies, comprising 284 patients with PSP and 367 healthy controls were included. As compared to healthy controls, patients with PSP demonstrated significant GM reductions in both cortical and subcortical regions, including the frontal motor cortices, medial (including anterior cingulate cortex) and lateral frontal cortices, insula, superior temporal gyrus, striatum (putamen and caudate nucleus), thalamus, midbrain, and anterior cerebellum. Our study further suggests that many confounding factors, such as age, male ratio, motor severity, cognitive impairment severity, and illness duration of PSP patients, and scanner field-strength, could contribute to the heterogeneity of GM alterations in PSP across studies. Our comprehensive meta-analysis demonstrates a specific neuroanatomical pattern of GM atrophy in PSP with the involvement of the cortical-subcortical circuitries that mediate vertical supranuclear gaze palsy, motor disabilities (postural instability with falls and parkinsonism), and cognitive-behavioral disturbances. Confounding factors merit attention in future studies.
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Affiliation(s)
- PingLei Pan
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, PR China
| | - Yi Liu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Yang Zhang
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Hui Zhao
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Xing Ye
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
| | - Yun Xu
- Department of Neurology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, PR China.,The State Key Laboratory of Pharmaceutical Biotechnology, Nanjing University, Nanjing, PR China.,Jiangsu Key Laboratory for Molecular Medicine, Nanjing University Medical School, Nanjing, PR China.,Jiangsu Province Stroke Center for Diagnosis and Therapy, Nanjing, PR China.,Nanjing Neuropsychiatry Clinic Medical Center, Nanjing, PR China
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Ou R, Liu H, Hou Y, Wei Q, Cao B, Zhao B, Shang H. Executive dysfunction, behavioral changes and quality of life in Chinese patients with progressive supranuclear palsy. J Neurol Sci 2017; 380:182-186. [DOI: 10.1016/j.jns.2017.07.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 07/22/2017] [Accepted: 07/23/2017] [Indexed: 10/19/2022]
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Bhatia KP, Stamelou M. Nonmotor Features in Atypical Parkinsonism. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 134:1285-1301. [PMID: 28805573 DOI: 10.1016/bs.irn.2017.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Atypical parkinsonism (AP) comprises mainly multiple system atrophy (MSA), progressive supranuclear palsy (PSP), and corticobasal degeneration (CBD), which are distinct pathological entities, presenting with a wide phenotypic spectrum. The classic syndromes are now called MSA-parkinsonism (MSA-P), MSA-cerebellar type (MSA-C), Richardson's syndrome, and corticobasal syndrome. Nonmotor features in AP have been recognized almost since the initial description of these disorders; however, research has been limited. Autonomic dysfunction is the most prominent nonmotor feature of MSA, but also gastrointestinal symptoms, sleep dysfunction, and pain, can be a feature. In PSP and CBD, the most prominent nonmotor symptoms comprise those deriving from the cognitive/neuropsychiatric domain. Apart from assisting the clinician in the differential diagnosis with Parkinson's disease, nonmotor features in AP have a big impact on quality of life and prognosis of AP and their treatment poses a major challenge for clinicians.
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Affiliation(s)
| | - Maria Stamelou
- HYGEIA Hospital, Athens, Greece; Neurology Clinic, Philipps University Marburg, Marburg, Germany; University of Athens, Athens, Greece.
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Rittman T, Coyle-Gilchrist IT, Rowe JB. Managing cognition in progressive supranuclear palsy. Neurodegener Dis Manag 2016; 6:499-508. [PMID: 27879155 PMCID: PMC5134756 DOI: 10.2217/nmt-2016-0027] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cognitive impairment is integral to the syndrome of progressive supranuclear palsy. It is most commonly described as a frontal dysexecutive syndrome but other impairments include apathy, impulsivity, visuospatial and memory functions. Cognitive dysfunction may be exacerbated by mood disturbance, medication and communication problems. In this review we advocate an individualized approach to managing cognitive impairment in progressive supranuclear palsy with the education of caregivers as a central component. Specific cognitive and behavioral treatments are complemented by treatment of mood disturbances, rationalizing medications and a patient-centered approach to communication. This aims to improve patients’ quality of life, reduce carer burden and assist people with progressive supranuclear palsy in decisions about their life and health, including discussions of feeding and end-of-life issues.
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Affiliation(s)
- Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - James B Rowe
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med 2016; 4:2050312116671725. [PMID: 27757230 PMCID: PMC5052926 DOI: 10.1177/2050312116671725] [Citation(s) in RCA: 457] [Impact Index Per Article: 57.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/10/2016] [Indexed: 12/12/2022] Open
Abstract
According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the “SF-36 Total/Global/Overall Score” cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the “SF-36 Total Score”; 13 studies did not specify their methods but referred to the SF-36 developers’ studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the “SF-36 Total/Global/Overall Score” has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.
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Characteristics of Nonmotor Symptoms in Progressive Supranuclear Palsy. PARKINSONS DISEASE 2016; 2016:9730319. [PMID: 27366342 PMCID: PMC4913008 DOI: 10.1155/2016/9730319] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 05/11/2016] [Indexed: 02/05/2023]
Abstract
Objectives. To explore the clinical correlates of nonmotor symptoms (NMS) in progressive supranuclear palsy (PSP) and their differences from healthy controls and patients with Parkinson's disease (PD). Methods. Twenty-seven PSP patients, 27 age- and gender-matched healthy controls (HC), and 27 age- and gender-matched PD patients were included for this case-control study. NMS were assessed using the Nonmotor Symptoms Scale (NMSS, including 9 domains). Results. All PSP patients reported NMS. The frequency and severity of "sleep/fatigue," "mood/apathy," "attention/memory," "gastrointestinal," "sexual dysfunction," and "miscellaneous" domains in PSP group were significantly higher than those in HC group (P < 0.05). The frequency of "mood/apathy," "attention/memory," and "sexual dysfunction" domains and the severity of "attention/memory" and "gastrointestinal" domains in PSP group were significantly higher than those in PD group (P < 0.05). The "attention/memory" domain in PSP had a significant but weak-to-moderate correlation with age (R = 0.387, P = 0.046) and onset age (R = 0.406, P = 0.036). Conclusions. NMS are common in PSP patients. Patients with PSP seem to be subjected to more frequent and severe specific NMS compared to healthy aging subjects and PD patients. Older PSP patients and late-onset patients are likely to be subjected to cognitive decline.
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