Tot hier ... en nú verder - behoeften van ouderen tijdens de coronapandemie in Nederland

Begin 2020 bereikte het coronavirus Nederland. Hoewel we nu een stuk meer weten over het coronavirus SARS-CoV-2, was er in het begin vooral heel veel onbekend. Ouderen werden in één keer als ‘kwetsbaar’ bestempeld.1 De coronamaatregelen waren gericht op het beschermen van ouderen tegen COVID-19 infectie, maar zorgden ook voor minder participatie en meer angst en eenzaamheid bij ouderen.3 4 1 5 Bovendien kwam de autonomie van ouderen onder druk te staan.6 Hoewel ouderenparticipatie aan een opmars bezig is, wordt de mening van ouderen niet altijd meegenomen in beleid over ouderen. Deze periode heeft nog eens benadrukt hoe belangrijk het is om niet alleen te spreken over ouderen, maar om vooral ook in gesprek te blijven met ouderen. Dit is een van de belangrijkste lessen uit ons onderzoek naar welzijn en ondersteuning van ouderen tijdens de coronaperiode. We blikken hier terug op de situatie van twee jaar corona, en kijken ook vooruit naar wat er nodig is in de toekomst

Dopaminergic medication reduces striatal sensitivity to negative outcomes in Parkinson's disease

Reduced levels of dopamine in Parkinson's disease contribute to changes in learning, resulting from the loss of midbrain neurons that transmit a dopaminergic teaching signal to the striatum. Dopamine medication used by patients with Parkinson's disease has previously been linked to behavioural changes during learning as well as to adjustments in value-based decision-making after learning. To date, however, little is known about the specific relationship between dopaminergic medication-driven differences during learning and subsequent changes in approach/avoidance tendencies in individual patients. Twenty-four Parkinson's disease patients ON and OFF dopaminergic medication and 24 healthy controls subjects underwent functional MRI while performing a probabilistic reinforcement learning experiment. During learning, dopaminergic medication reduced an overemphasis on negative outcomes. Medication reduced negative (but not positive) outcome learning rates, while concurrent striatal blood oxygen level-dependent responses showed reduced prediction error sensitivity. Medication-induced shifts in negative learning rates were predictive of changes in approach/avoidance choice patterns after learning, and these changes were accompanied by systematic striatal blood oxygen level-dependent response alterations. These findings elucidate the role of dopamine-driven learning differences in Parkinson's disease, and show how these changes during learning impact subsequent value-based decision-making

Tot hier … en nú verder – behoeften van ouderen tijdens de coronapandemie in Nederland

Begin 2020 bereikte het coronavirus Nederland. Hoewel we nu een stuk meer weten over het coronavirus SARS-CoV-2, was er in het begin vooral heel veel onbekend. Ouderen werden in één keer als ‘kwetsbaar’ bestempeld.1 De coronamaatregelen waren gericht op het beschermen van ouderen tegen COVID-19 infectie, maar zorgden ook voor minder participatie en meer angst en eenzaamheid bij ouderen.3 4 1 5 Bovendien kwam de autonomie van ouderen onder druk te staan.6 Hoewel ouderenparticipatie aan een opmars bezig is, wordt de mening van ouderen niet altijd meegenomen in beleid over ouderen. Deze periode heeft nog eens benadrukt hoe belangrijk het is om niet alleen te spreken over ouderen, maar om vooral ook in gesprek te blijven met ouderen. Dit is een van de belangrijkste lessen uit ons onderzoek naar welzijn en ondersteuning van ouderen tijdens de coronaperiode. We blikken hier terug op de situatie van twee jaar corona, en kijken ook vooruit naar wat er nodig is in de toekomst

Dynamic Functional Connectivity and Symptoms of Parkinson’s Disease: A Resting-State fMRI Study

Research has shown that dynamic functional connectivity (dFC) in Parkinson’s disease (PD) is associated with better attention performance and with motor symptom severity. In the current study, we aimed to investigate dFC of both the default mode network (DMN) and the frontoparietal network (FPN) as neural correlates of cognitive functioning in patients with PD. Additionally, we investigated pain and motor problems as symptoms of PD in relation to dFC. Twenty-four PD patients and 27 healthy controls participated in this study. Memory and executive functioning were assessed with neuropsychological tests. Pain was assessed with the Numeric Rating Scale (NRS); motor symptom severity was assessed with the Unified Parkinson’s Disease Rating Scale (UPDRS). All subjects underwent resting-state functional magnetic resonance imaging (fMRI), from which dFC was defined by calculating the variability of functional connectivity over a number of sliding windows within each scan. dFC of both the DMN and FPN with the rest of the brain was calculated. Patients performed worse on tests of visuospatial memory, verbal memory and working memory. No difference existed between groups regarding dFC of the DMN nor the FPN with the rest of the brain. A positive correlation existed between dFC of the DMN and visuospatial memory. Our results suggest that dynamics during the resting state are a neural correlate of visuospatial memory in PD patients. Furthermore, we suggest that brain dynamics of the DMN, as measured with dFC, could be a phenomenon specifically linked to cognitive functioning in PD, but not to other symptoms

Non-motor symptoms in Parkinson's disease: An explorative network study

Research on the association between non-motor symptoms (NMS) of Parkinson's discasc (PD) and patients' quality of life (QoL) has given insight into the burden of NMS. Most studies investigate NMS by assessing the contribution of individual symptoms to QoL. However, symptoms could also have an interactive relationship, which might not be fully taken into account when only studying these individual contributions. Recently, a network approach has been developed that treats symptoms as nodes and associations between symptoms as edges in a network, providing the opportunity to investigate the dimensional spectrum of NMS. In the current cross-sectional study, we investigated NMS with both approaches: first, we assessed individual contributions of NMS to QoL. Second, we aimed to assess NMS using a network approach. Seventy PD patients completed questionnaires on NMS and QoL. Our primary analysis shows that the domains Mood and Pain are significant contributors to QoL. Our secondary network analysis suggests that Mood and Sleep play central roles in the NMS-network, and that Mood and Cognition are strongly related. Because of power issues, the generalizability of our explorative results is limited. However, complementary information from the network analysis does suggest that focusing on sleep problems might help both mood and pain symptoms, which negatively affect QoL. Investigating symptoms not only as individual and independent entities but rather as part of a connected network could show how treating one symptom affects other symptoms

Non-motor symptoms in Parkinson's disease:An explorative network study

Research on the association between non-motor symptoms (NMS) of Parkinson's disease (PD) and patients' quality of life (QoL) has given insight into the burden of NMS. Most studies investigate NMS by assessing the contribution of individual symptoms to QoL. However, symptoms could also have an interactive relationship, which might not be fully taken into account when only studying these individual contributions. Recently, a network approach has been developed that treats symptoms as nodes and associations between symptoms as edges in a network, providing the opportunity to investigate the dimensional spectrum of NMS. In the current cross-sectional study, we investigated NMS with both approaches: first, we assessed individual contributions of NMS to QoL. Second, we aimed to assess NMS using a network approach. Seventy PD patients completed questionnaires on NMS and QoL. Our primary analysis shows that the domains Mood and Pain are significant contributors to QoL. Our secondary network analysis suggests that Mood and Sleep play central roles in the NMS-network, and that Mood and Cognition are strongly related. Because of power issues, the generalizability of our explorative results is limited. However, complementary information from the network analysis does suggest that focusing on sleep problems might help both mood and pain symptoms, which negatively affect QoL. Investigating symptoms not only as individual and independent entities but rather as part of a connected network could show how treating one symptom affects other symptoms

Non-motor symptoms in Parkinson's disease: An explorative network study

Research on the association between non-motor symptoms (NMS) of Parkinson's disease (PD) and patients' quality of life (QoL) has given insight into the burden of NMS. Most studies investigate NMS by assessing the contribution of individual symptoms to QoL. However, symptoms could also have an interactive relationship, which might not be fully taken into account when only studying these individual contributions. Recently, a network approach has been developed that treats symptoms as nodes and associations between symptoms as edges in a network, providing the opportunity to investigate the dimensional spectrum of NMS. In the current cross-sectional study, we investigated NMS with both approaches: first, we assessed individual contributions of NMS to QoL. Second, we aimed to assess NMS using a network approach. Seventy PD patients completed questionnaires on NMS and QoL. Our primary analysis shows that the domains Mood and Pain are significant contributors to QoL. Our secondary network analysis suggests that Mood and Sleep play central roles in the NMS-network, and that Mood and Cognition are strongly related. Because of power issues, the generalizability of our explorative results is limited. However, complementary information from the network analysis does suggest that focusing on sleep problems might help both mood and pain symptoms, which negatively affect QoL. Investigating symptoms not only as individual and independent entities but rather as part of a connected network could show how treating one symptom affects other symptoms