A four-month home-based tDCS study on patients with Alzheimer’s disease

In the present open-label study, our first aim was to study the tolerability and feasibility of long-term treatment with transcranial direct current stimulation (tDCS) and the second aim was to measure whether the treatment led to cognitive improvement. Participants with AD used a tDCS home-treatment kit inducing a low current (2 mA) via two scalp electrodes 30 minutes daily for 4 months. A total of 8 participants were recruited. The treatment technique was manageable for the participants and their spouses, and no troublesome side effects were reported. No significant effects of treatment were found after 4 months

Døgnvariasjoner for innleggelser ved akuttpsykiatriske enheter

Akuttpsykiatriske enheter gir øyeblikkelig hjelp til pasienter med særlig vanskelige og kompliserte tilstander med behov utover det som kan ivaretas i kommunehelsetjenesten eller ved distriktspsykiatriske senter (DPS). Flere studier har de siste årene sett på antallet innleggelser og hyppigheten av tvangsbruk i akuttpsykiatriske enheter i Norge (Bjerke et al., 2019; Tøgersen et al., 2015; Wynn, 2018). Bjerke, Gjelstad og Ruud viser at antallet tvangsinnleggelser holdt seg stabilt i perioden 2010 til 2017 (Bjerke et al., 2019). Videre er det funnet at den gjennomsnittlige liggetiden i psykisk helsevern er redusert med 30 % i perioden fra 2009 til 2018 (Statistisk sentralbyrå, 2019). Noen studier har også sett på tidspunkt for innleggelser i akuttpsykiatrien, det vil si når på døgnet pasienter blir lagt inn. Dette har imidlertid ikke blitt undersøkt de siste 10 årene og etter at samhandlingsreformen trådte i kraft (St.meld. nr. 47, 2008). Innleggelser ved akuttpsykiatriske enheter viser noe ulike mønstre. En norsk multisenterstudie fra 2006 der 19 akuttpsykiatriske enheter deltok, viste at gjennomsnittlig 48 % av innleggelsene i akuttpsykiatrien fant sted på dagtid, mens 42 % på kveldstid og 10 % på natt (Gråwe, Hatling & Ruud, 2006). En annen norsk studie fant at 24 % av pasientene ble innlagt mellom klokken (kl.) 16:00 og 22:00, mens 19 % ble lagt inn mellom kl. 22:00 og kl. 08:00, og øvrige innleggelser fant sted på dagtid (Deraas et al., 2006). Videre viste en undersøkelse av 1323 psykiatriske akuttinnleggelser på Lovisenberg Sykehus at 52 % av innleggelsene fant sted på dagtid, altså mellom klokken 08:00 og 16:00 (Berg, 2007). Det ble funnet at 39 % ble innlagt mellom klokken 16:00 og 01:00 og 9 % i tidsrommet 01:00–08:00. Forskjellene mellom tidspunktene var imidlertid ikke signifikante. Hensikten med den nåværende studien er å undersøke hvordan innleggelser i akuttpsykiatriske enheter fordeler seg over døgnet. Vi forventet å finne at flertallet av innleggelsene skjedde på dagtid

Transcranial direct current stimulation as a memory enhancer in patients with Alzheimer’s disease: a randomized, placebo-controlled trial

Background: The purpose of this study was to assess the efficacy of transcranial direct current stimulation (tDCS) on verbal memory function in patients with Alzheimer’s disease. Methods: We conducted a randomized, placebo-controlled clinical trial in which tDCS was applied in six 30-minute sessions for 10 days. tDCS was delivered to the left temporal cortex with 2-mA intensity. A total of 25 patients with Alzheimer’s disease were enrolled in the study. All of the patients were diagnosed according to National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association criteria. Twelve patients received active stimulation, and thirteen patients received placebo stimulation. The primary outcome measure was the change in two parallel versions of the California Verbal Learning Test–Second Edition, a standardized neuropsychological memory test normalized by age and gender. The secondary outcome measures were the Mini Mental State Examination, clock-drawing test, and Trail Making Test A and B. Results: Changes in the California Verbal Learning Test–Second Edition scores were not significantly different between the active and placebo stimulation groups for immediate recall (p = 0.270), delayed recall (p = 0.052), or recognition (p = 0.089). There were nonsignificant differences in score changes on the Mini Mental State Examination (p = 0.799), clock-drawing test (p = 0.378), and Trail Making Test A (p = 0.288) and B (p = 0.093). Adverse effects were not observed. Conclusions: Compared with placebo stimulation, active tDCS stimulation in this clinical trial did not significantly improve verbal memory function in Alzheimer’s disease. This study differs from previous studies in terms of the stimulation protocol, trial design, and application of standardized neuropsychological memory assessment. Trial registration: ClinicalTrials.gov identifier NCT02518412. Registered on 10 August 2015

Fear of diseases among people over 50 years of age : a survey

The aim of this study was to investigate the association between well-known diseases and fear of them in individuals over 50 years of age. Information on the fear of diseases can be relevant for both public health information purposes and clinical setting diagnostics. However, very few studies have investigated the fear of diseases in individuals over the age of 50. We used an electronic survey method and asked individuals older than 50 to report their fear of eight different diseases. Fear of diseases was the outcome measure. A 10-point Likert scale questionnaire was used to assess the fear of contracting different diseases, including cancer, Alzheimer’s disease, cardiovascular disease, HIV, depression, diabetes, skin disorders (eczema and psoriasis), and chronic pain. There were 376 respondents. Cancer and Alzheimer’s disease were associated with the most fear. Fear of these two diseases was significantly higher than for other diseases (p = 0.01). Age had no significant impact on the fear of diseases (p = 0.68). Of the 376 respondents, 39% reported a strong fear (10 points) of Alzheimer’s disease, whereas 30% reported a strong fear of cancer. Only 2% reported a strong fear of cardiovascular disease. This study suggests that cancer and Alzheimer’s disease evoke the most fear

Nevropsykologiske senskader hos boksere: en systematisk gjennomgang

Background: The aim of this systematic review was to investigate the risk of neuropsychological sequelae from boxing. Method: We conducted a systematic search in the databases Medline, Embase, PsychInfo and Web of Science. Studies with boxers, control groups, using neuropsychological assessment and brain-imaging/biomarkers were included. Nine articles met these criteria. Results: The results revealed that processing speed was reduced in six of the nine studies among both amateur and professional boxers. Processing speed correlated negatively with volume of thalamus and number of boxing fights (fight exposure). Three studies found reduced fine motoric skills among professional boxers, but not among amateur boxers. Boxers with more than 15 years of experience had significantly reduced verbal memory compared to controls. Eight of the nine studies found that both amateur and professional boxers had reduced cognitive capacity and/or positive findings on biomarkers. Conclusion: Based on the results, it is reasonable to assume that neuropsychological sequelae are related to career length and number of fights. There may be a dose–response relationship between the number of punches to the head and the risk of neuropsychological sequelae. Methodological limitations (such as low statistical power and short-term follow-up) should be taken into consideration. There is a need for more longitudinal studies to further investigate neuropsychological sequelae of boxing

The relation of hippocampal subfield volumes to verbal episodic memory measured by the California Verbal Learning Test II in healthy adults

Total hippocampal volume has previously been shown to correlate with performance on tests for verbal episodic memory. However, there are sparse evidence on how hippocampal subfield volumes are related to verbal episodic memory in healthy adults. The present study investigated the association between volumes of separate hippocampal subfields and verbal episodic memory performance in healthy volunteers. Forty-seven participants (31 females) between 20–71 years age underwent testing with the California Verbal Learning Test II (CVLT II), and the Wechsler Abbreviated Scale of Intelligence (WASI) to obtain an estimate of cognitive functioning. T1-weighted MR images were obtained after cognitive testing, and volumetric estimates adjusted for age and estimated total intracranial volume were calculated in the FreeSurfer 6.0 software suite for cerebral -and hippocampal structures. The sample performed within the statistical normal range on both CVLT II and WASI. Significant correlations adjusted for multiple testing were found between CVLT II subtests of total learning, free immediate recall and free delayed recall and volumes of the left Cornu Ammonis (CA) 1–4 subfields. There were no significant correlations between right hippocampal subfields and CVLT II performance, and no significant correlation between WASI results and hippocampal subfields. The present results suggest that better verbal episodic memory measured by the CVLT II is associated with relative larger volumes of specific left CA hippocampal subfields in healthy adults. Due to the small sample size and large age-span of the participants, the present findings are preliminary and should be confirmed in larger samples

High-Definition Transcranial Direct Current Stimulation Improves Delayed Memory in Alzheimer’s Disease Patients: A Pilot Study Using Computational Modeling to Optimize Electrode Position

Background: The optimal stimulation parameters when using transcranial direct current stimulation (tDCS) to improve memory performance in patients with Alzheimer’s disease (AD) are lacking. In healthy individuals, inter-individual differences in brain anatomy significantly influence current distribution during tDCS, an effect that might be aggravated by variations in cortical atrophy in AD patients. Objective: To measure the effect of individualized HD-tDCS in AD patients. Methods: Nineteen AD patients were randomly assigned to receive active or sham high-definition tDCS (HD-tDCS). Computational modeling of the HD-tDCS-induced electric field in each patient’s brain was analyzed based on magnetic resonance imaging (MRI) scans. The chosen montage provided the highest net anodal electric field in the left dorsolateral prefrontal cortex (DLPFC). An accelerated HD-tDCS design was conducted (2 mA for 3×20 min) on two separate days. Pre- and post-intervention cognitive tests and T1 and T2-weighted MRI and diffusion tensor imaging data at baseline were analyzed. Results: Different montages were optimal for individual patients. The active HD-tDCS group improved significantly in delayed memory and MMSE performance compared to the sham group. Five participants in the active group had higher scores on delayed memory post HD-tDCS, four remained stable and one declined. The active HD-tDCS group had a significant positive correlation between fractional anisotropy in the anterior thalamic radiation and delayed memory score. Conclusion: HD-tDCS significantly improved delayed memory in AD. Our study can be regarded as a proof-of-concept attempt to increase tDCS efficacy. The present findings should be confirmed in larger samples