Utjecaj duboke mozgovne stimulacije na kvalitetu života bolesnika s Parkinsonovom bolešću

Introduction. Deep Brain Stimulation (DBS) is an electrical stimulation of the individual cells of the central nervous system. DBS is today most often used to treat movement disorders such as Parkinson\u27s disease, dystonia, Tourette syndrome etc. The goal of DBS is improving the quality of life of patients, specifically by improving their motor function, reduction in drug therapy they use as well as reducing pain and neurological deficits. Methods. We analyzed the quality of life pre- and post-operatively in 95 patients with DBS implantations. The patients were operated on at the Department of Neurosurgery of the University Hospital Dubrava in Zagreb for treating Parkinson’s disease. The patients which were included were operated on from 2007-2015. All patients underwent this highly specialized procedure that consists of implanting electrodes in the subthalamic nuclei (STN) as well as extension and battery implantation. Results. Four characteristics were analyzed: the patient’s ability to clothe, eat and walk independently without assistance as well as their overall satisfaction with the quality of life after the procedure. After the onset of the stimulation, improvement wwas seen in all of the observed parameters. Conclusion. This kind of procedure has been shown to be justified in treating Parkinson’s disease symptoms and improving the quality of life and independence in these patients.Uvod. Duboka mozgovna stimulacija jest ciljana primjena električnih stimulacija na pojedine stanice središnjega živčanog sustava. Najčešća je primjena duboke mozgovne stimulacije kod neuroloških oboljenja kao što su Parkinsonova bolest, distonija, Touretteov sindrom i sl. Cilj je primjene duboke mozgovne stimulacije smanjenje medikamentozne terapije, poboljšanje motoričke funkcije, smanjenje boli i neurološkog deficita te poboljšanje kvalitete života. Metode. Analizirali smo devedeset i pet dubokih mozgovnih implantacija učinjenih na Zavodu za neurokirurgiju Kliničke bolnice Dubrava u svrhu liječenja Parkinsonove bolesti u razdoblju od 2007. do 2015. godine. Svim je bolesnicima učinjena visokospecijalizirana operacija kojom se implantiraju elektrode u suptalamičku jezgru (STN) te se provedu ekstenzije i implantira baterija. Rezultati. Četiri su parametra ispitana prije i poslije operacije: bolesnikova mogućnost samostalnog oblačenja, jedenja i hodanja te njihov osobni dojam kvalitete života i mogućnosti samostalnog života. Nakon stimulacije, ukupno gledajući, došlo je do poboljšanja u sve četiri navedene kategorije. Zaključak. Duboka mozgovna stimulacija pokazala se posve opravdanom kod bolesnika s Parkinsonovom bolešću, pomažući u poboljšanju kvalitete života bolesnika

Natural course of behavioral addictions: A 5-year longitudinal study

BACKGROUND: Resolving the theoretical controversy on the labeling of an increasing number of excessive behaviors as behavioral addictions may also be facilitated by more empirical data on these behavioral problems. For instance, an essential issue to the classification of psychiatric disorders is information on their natural course. However, longitudinal research on the chronic vs. episodic nature of behavioral addictions is scarce. The aim of the present study, therefore, was to provide data on prevalence, substance use comorbidity, and five-year trajectories of six excessive behaviors—namely exercising, sexual behavior, shopping, online chatting, video gaming, and eating. METHODS: Analyses were based on the data of the Quinte Longitudinal Study, where a cohort of 4,121 adults from Ontario, Canada was followed for 5 years (2006 to 2011). The response rate was 21.3%, while retention rate was 93.9%. To assess the occurrence of each problem behavior, a single self-diagnostic question asked people whether their over-involvement in the behavior had caused significant problems for them in the past 12 months. To assess the severity of each problem behavior reported, the Behavioral Addiction Measure was administered. A mixed design ANOVA was used to investigate symptom trajectories over time for each problem behavior and whether these symptom trajectories varied as a function of sex. RESULTS: The large majority of people reported having problematic over-involvement for just one of these behaviors and just in a single time period. A main effect of time was found for each problem behavior, indicating a moderately strong decrease in symptom severity across time. The time x sex interaction was insignificant in each model indicating that the decreasing trend is similar for males and females. The data also showed that help seeking was very low in the case of excessive sexual behavior, shopping, online chatting, and video gaming but substantially more prevalent in the case of excessive eating and exercising. CONCLUSIONS: The present results indicate that self-identified excessive exercising, sexual behavior, shopping, online chatting, video gaming, and/or eating tend to be fairly transient for most people. This aspect of the results is inconsistent with conceptualizations of addictions as progressive in nature, unless treated. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-015-0383-3) contains supplementary material, which is available to authorized users

Is dysfunctional use of the mobile phone a behavioural addiction? Confronting symptom-based versus process-based approaches

Dysfunctional use of the mobile phone has often been conceptualized as a ‘behavioural addiction’ that shares most features with drug addictions. In the current article, we challenge the clinical utility of the addiction model as applied to mobile phone overuse. We describe the case of a woman who overuses her mobile phone from two distinct approaches: (1) a symptom-based categorical approach inspired from the addiction model of dysfunctional mobile phone use and (2) a process-based approach resulting from an idiosyncratic clinical case conceptualization. In the case depicted here, the addiction model was shown to lead to standardized and non-relevant treatment, whereas the clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific, empirically based psychological interventions. This finding highlights that conceptualizing excessive behaviours (e.g., gambling and sex) within the addiction model can be a simplification of an individual's psychological functioning, offering only limited clinical relevance