Functional cognitive disorder in subjective cognitive decline—A 10‐year follow‐up

Objectives: In memory clinics, patients with significant memory complaints without objective neuropsychological findings are common. They are classified as subjective cognitive decline (SCD) and, as a group, face a heightened risk for future dementia. However, the SCD group is heterogeneous and comprises patients suffering from a somatoform condition, namely functional cognitive disorder (FCD). These patients make up at least 11% of memory clinics' attendees. The aim of this long-term follow-up study was to investigate if patients diagnosed with FCD also face a higher risk of developing dementia. Methods: Forty-two Patients were recruited at a university hospital memory clinic. FCD was diagnosed according to the Schmidtke criteria (see Table 1). Ten years later, all were invited again. Participants were interviewed, screened for depression and given neuropsychological tests of verbal memory and information processing speed. Cognitive impairment was defined as performance below 1.5 standard deviations (SD) of the age-related mean. Results: Twenty-eight of 42 patients (67%) took part in this follow-up. The group's mean results in both cognitive measures were stable over time. All individual performances were within 1.5 SD. With 10 patients (24%), brief contact was successful and manifest dementia could be excluded. Four patients (10%) could not be contacted. Conclusions: In retrospect, the Schmidtke criteria for FCD safely identified memory clinic attendees with SCD who did not proceed to Mild Cognitive Impairment or dementia. None of the patients who could be contacted for this follow-up after a decade (90% of baseline participants) showed signs of dementia

Sjuksköterskans utmaningar med att uppmärksamma depression hos äldre

Bakgrund: Psykisk ohälsa är vanligt hos äldre i form av nedstämdhet, ångest och depression, där vem som helst kan drabbas, vilket påverkar livskvaliteten negativt. Att åldras kan innebära försämringar av både fysiska samt psykiska funktioner och förlust av närstående som förknippas med social isolering, vilket ökar risken att drabbas av depression. En normaliserad uppfattning att depression är en normal del av åldrandet i kombination med samhällets stigmatisering medför att äldre inte söker vård för psykiska besvär och orsakar onödigt lidande samt ökar risken för självmord. Syftet: Syftet var att belysa sjuksköterskors erfarenheter av depression i mötet med äldre. Metod: Litteratursökningen resulterade i 14 artiklar och integrerade både kvalitativa samt kvantitativa data. Dessa analyserades via kvalitativ innehållsanalys och sammanställdes i en litteraturstudie. Resultat: Att balansera mellan organisatoriska krav och patientbehov i kombination med bristande resurser var utmaningar som sjuksköterskan ställdes inför, vilket påverkade relationerna negativt. Ömsesidiga utbyten och ett bekräftande bemötande resulterade i etablering av förtroendefulla relationer, där patienten kände trygghet och vågade öppna sig känslomässigt. Diskussion: Förtroendefulla ömsesidiga relationer ansågs vara det främsta verktyget för att effektivt uppmärksamma och hantera depression. Sjuksköterskans stöd till patienten med depression ökar känslan av begriplighet samt hanterbarhet och kan i ett längre perspektiv leda till en mer meningsfull vardag, där det ömsesidiga utbytet stärker både patientens och sjuksköterskans känsla av sammanhang. Slutsats: Utbildningsinsatser till sjuksköterskor visade sig stärka förtroendet för omvårdnadsförmågan till äldre med depression. Genom att prioritera utbildningar kan det bidra till att främja äldres psykiska hälsa.2024-03-22</p

Effect of Cannabidiol on Interictal Epileptiform Activity and Sleep Architecture in Children with Intractable Epilepsy: A Prospective Open-Label Study

Background!#!Cannabidiol has been shown to be effective in seizure reduction in patients with Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis. However, very little is known about its potential to reduce interictal epileptiform activity and improve sleep architecture.!##!Objective!#!The objective of this prospective study was to evaluate the influence of cannabidiol therapy on the frequency of interictal epileptiform discharges (IEDs) and sleep microstructure in a cohort of children with drug-resistant epilepsy.!##!Methods!#!Children with drug-resistant epilepsy were prospectively followed from November 2019 to January 2021 during an open-label trial of cannabidiol at a dose of 20 mg/kg/day (to a maximum of 50 mg/kg/day) and stable concomitant medication. Electroencephalograms were recorded at baseline (T0) and after 3 months (T1). Two independent raters, blinded to clinical outcome, evaluated 5-min segments of sleep stage 2 or low-noise awake state. IEDs were visually identified and rates per minute calculated. Sleep microstructure was considered improved if sleep structures were seen at T1 that were not present at T0. IED rates at T0 and T1 were compared and correlated with seizure outcome, cannabidiol dose, initial IED rate, and disease duration.!##!Results!#!In total, 35 children (mean ± standard deviation age 10.1 ± 0.86) were included. The IED rate at T1 was significantly lower than at T0 (19.6 ± 19.5 vs. 36.8 ± 27.2, respectively; p &amp;lt; 0.0001). We found a moderate correlation between IED reduction and percentage of seizure reduction compared with baseline (Pearson's r = 0.39; p = 0.02), a moderate negative correlation between IED reduction and IED rate at T0 (r = - 0.34; p = 0.04), and a trend towards a moderate negative correlation between IED reduction and disease duration (r = - 0.32; p = 0.06). Sleep was recorded in 23 patients. Sleep microstructure was initially abnormal in 56.5% of sleep recordings and improved in 84.6% of those cases.!##!Conclusion!#!Our results strongly suggest the utility of cannabidiol in reducing IEDs and improving sleep microstructure in children with drug-resistant epilepsy. Larger controlled studies are needed to evaluate the clinical relevance of this effect in different epilepsy types.!##!Trial registration!#!DRKS00013177; 25 June 2019

Dynamic facial emotion recognition and affective prosody recognition are associated in patients with temporal lobe epilepsy

Abstract Deficits in facial emotion recognition have frequently been established in temporal lobe epilepsy (TLE). However, static, rather than dynamic emotion recognition paradigms have been applied. Affective prosody has been insufficiently studied in TLE, and there is a lack of studies investigating associations between auditory and visual emotion recognition. We wished to investigate potential deficits in a dynamic morph task of facial emotion recognition and in an affective prosody recognition task, as well as associations between both tasks. 25 patients with TLE and 24 healthy controls (CG) performed a morph task with faces continuously changing in their emotional intensity. They had to press a button, as soon as they were able to recognize the emotion expressed, and label it accordingly. In the auditory task, subjects listened to neutral sentences spoken in varying emotional tones, and labeled the emotions. Correlation analyses were conducted across both tasks. TLE patients showed significantly reduced prosody recognition compared to CG, and in the morph task, there was a statistical trend towards significantly reduced performance for TLE. Recognition rates in both tasks were significantly associated. TLE patients show deficits in affective prosody recognition, and they may also be impaired in a morph task with dynamically changing facial expressions. Impairments in basic social-cognitive tasks in TLE seem to be modality-independent

Third International Congress on Epilepsy, Brain and Mind: Part 1

International audienc