Neuropsychology of epilepsy in Malaysia: a narrative review

The aim of this study is to describe the development of neuropsychological research among epilepsy patients in Malaysia so far, the current trend and the focus of future research endeavour. The research in epilepsy grows concurrently with the interest in the field of neuropsychology in Malaysia. Beginning with the presurgical evaluation of epilepsy patients as part of the epilepsy protocols, research areas expanded further into neuropsychological profiling. The current trend in Malaysia is determining the factors influencing neuropsychological outcomes as well as the risk factors associated with low quality of life among epilepsy patients. The future neuropsychological research should emphasize on the effectiveness of neurorehabilitation of epilepsy patients as well as psychosocial and cultural issues particularly on social stigma and employability in line with the research priorities set by the Research Task Force of the ILAE Commission on Asian and Oceanian Affairs for people with epilepsy in Asia-Oceanic region

Dietary Polyphenols Consumption and Its Relation with Cognitive and Mental Health in Aging: A Review

Literature review suggests that polyphenols in particular fl avonoids, are benefi cial for mental health during aging process. This review examines the effect of consumption of all polyphenols groups on mental health and cognitive status during aging process. The keywords searched were “mental health,” “depression,” “anxiety,” “stress” and “cognitive” combined with “dietary,” and “polyphenols.” The databases including PubMed, Web of Science and CAB Abstracts were searched for a period of 10 years. A total of 11 studies were identifi ed to fulfi ll the inclusion criteria. From this review, polyphenols may confer benefi cial effects towards mental health, in particular the decline in cognitive functions during aging process, however, some studies showed contradictory results. Polyphenols have been proven to improve language and verbal ability, which is among the main vulnerable aspects in cognitive decline in pathological brain aging. In contrast, polyphenols intake did not seem to affect executive functioning. The effects of polyphenols towards cognitive status were more prominent among the elderly as compared to young and middle-aged adults. This review also shows that fl avonoids is the main type of polyphenols that confer positive effects towards cognitive status during aging. This review provides evidence that consumption of polyphenols may lead to cognitive and mental health benefi ts. Further clinical trials involving human subjects are required with carefully designed methodology to elucidate the potential mechanisms underlying the relationship between polyphenols consumption and improvement in cognitive and mental health statu

Role of sensation seeking and aggression on risk riding behaviors among motorcycle street racers in Malaysia

In Malaysia, Illegal motorcycle street racers (locally known as Mat Rempit) is a well known phenomena. Racing on the public roads and performing dangerous stunts action not only endangered themselves but also threaten other road users. This article examines the relationship between impulsive traits, sensation seeking, aggression and risk taking behaviors among illegal motorcycle street racers in Malaysia. Some 564 motorcyclists (identified as Mat Rempit) were interviewed and requested to complete self-reported questionnaires on aggression, sensation seeking, and risky riding. This study found that the Mat Rempit who participated in illegal street racing scored higher on aggression, sensation seeking, and risk taking behaviors as compared to the group of respondents not involved. Results also revealed that those higher on overall impulsive sensation seeking traits also scored relatively high on aggression and risky riding. Regression analysis showed aggression, and sensation seeking behaviors contributed to 16.1% of the total variance in risky riding. This study suggested that effective enforcement as well as special rehabilitation program is needed for this group

Relationship between traditional Malaysian vegetables (ulam) intake and cognitive status among middle-aged adults from low cost residential areas

Ulam is fresh traditional Malaysian vegetables which normally consumed in raw form or after a short blanching process. It contains high antioxidants and polyphenols. However, there is limited study about the relationship between ulam consumption and cognitive status. Thus, a cross sectional study was conducted to determine the relation with cognitive function among 132 middle-aged Malays adults (45-59 years old), recruited by convenient sampling from low income residences in Klang Valley. Respondents were interviewed to obtain data on sociodemography, dietary intake and total ulam intake and also measured for anthropometric parameters at respective community centres. Cognitive status was measured using Digit Span (attention and working memory), Rey auditory verbal learning test (RAVLT) (verbal memory) and comprehensive trail making test (CTMT) (cognitive flexibility). The average ulam intake by the respondents was 15.1 ± 8.2g/day and the top five highest consumed ulam were petai (68.1%), pucuk paku (62.9%), ulam raja (56.8%), pegaga (54.6%) and kesum (44.7%).There was a significant correlation between ulam intake with Digit Span (r = 0.265, p = 0.006), total immediate recall of RAVLT (r = 0.427, p < 0.001) and CTMT (r = 0.257, p = 0.007). Analysis of multiple regression indicated that total ulam intake was a significant predictor for Digit Span (R2 = 0.152, p < 0.05), RAVLT (R2 = 0.335, p = 0.001) and CTMT (R2 = 0.310, p < 0.001). In conclusion, this study showed that ulam has the potential to protect against cognitive decline, however, randomized control trials should be conducted to determine the efficacy of the ulam as neuroprotective agent

A review on online intervention for anxiety disorder

Anxiety Disorders share features of excessive fear and anxiety related behavioral disturbances. Diagnosis of Anxiety Disorders often leads to a high financial burden to the sufferers and economical lost to the society with high rates of health care costs and days on sick leave. Online intervention is seen as a good option to deal with anxiety issues. Therefore this paper aimed to review past studies on online intervention programs for anxiety related problems and its effectiveness. Eight studies from electronic databases PubMed, PsycINFO, MEDLINE, and CINAHL were identified. The findings suggest that an online intervention program can be effective in reducing anxiety symptoms. Several different psychological treatments for Anxiety Disorders exist, but Cognitive Behavioral Therapy (CBT) is the most used in online intervention program. Online program using CBT targeting Anxiety Disorders is commonly based on psychoeducation, cognitive restructuring, and relaxation. Additional interventions components often used in online intervention programs are problem-solving, worry exposure, mindfulness, and relapse prevention. In conclusion, the online interventions for Anxiety Disorders could serve as cost and time effective alternatives, but with certain considerations, especially on adherence towards the treatment

Hubungan antara faktor demografik dan klinikal dengan kefungsian fizikal pesakit strok

Strok adalah antara punca penyakit yang menyebabkan berlakunya kecelaan fizikal dan limitasi aktiviti kepada pesakit dalam melaksanakan tugasan harian mereka sehinggakan kepada satu peringkat, pesakit akan mengalami ketidakupayaan. Kajian ini bertujuan untuk mengkaji perkaitan setiap faktor demografik dan klinikal yang dipercayai terlibat dengan status kefungsian fizikal pesakit yang telah mengalami strok. Kajian ini juga cuba untuk melihat perbezaan kefungsian fizikal pesakit mengikut faktor-faktor tersebut dan juga melihat hubungan antara faktor-faktor tadi dengan kefungsian fizikal. Seramai 147 orang responden yang lulus ujian saringan kognitif terlibat. Alat ujian Indeks Aktiviti Kehidupan Seharian Barthel (ADL) telah ditadbirkan kepada responden selepas enam minggu serangan strok bagi mengukur tahap kefungsian fizikal mereka. Hasil kajian mendapati terdapat perbezaan yang signifikan [F(3, 143) = 4.06; p < 0.01) antara tahap pendidikan yang berbeza dengan tahap kefungsian fizikal pesakit. Faktor klinikal pula menunjukkan perbezaan kefungsian fizikal lebih tinggi secara signifikan (p < 0.01) pada serangan otak kanan berbanding kiri.Terdapat perbezaan yang signifikan (p < 0.01) pada kefungsian fizikal pesakit dalam kepercayaan pemulihan mereka. Di samping itu, bilangan serangan strok pesakit juga menunjukkan perbezaan yang signifikan [F(1, 145)= 11.19; p < 0.01] pada kefungsian fizikal mereka. Ujian korelasi yang dijalankan menunjukkan bahagian otak yang diserang mempunyai hubungan positif yang signifikan (r = 0.24; p < 0.01) dengan kefungsian fizikal pesakit strok. Kesimpulannya, faktor demografik dan klinikal turut memainkan peranan dalam menentukan tahap kefungsian fizikal pesakit strok dan faktor-faktor tersebut perlu dipertimbangkan dalam usaha untuk meningkatkan kefungsian fizikal pesakit pada masa hadapan

Validation and Optimal Cut-Off Scores of the Bahasa Malaysia Version of the Montreal cognitive assessment (MoCA-BM) for mild cognitive impairment among community dwelling older adults in Malaysia

The goal of this study was to examine the reliability and validity of the Bahasa Malaysia version of the Montreal cognitive assessment (MoCA-BM) and to determine its optimal cut-off score among older adults with mild cognitive impairment (MCI), after adjustments for age, gender, levels of education, physical functioning and depressive symptoms. A total of 2237 community dwelling older adults aged 60 years and above were randomly selected for the study, excluding those with MMSE score below 14. Instruments administered were the MoCA-BM, the Malay Mini-Mental State Examination (MMMSE), the Rey Auditory Verbal Learning Test (RAVLT), the Digit Span and the Digit Symbol subtests of the Wechsler Adult Intelligence Scale (WAIS), activities of daily living (ADL) and the Geriatric Depression Scale (GDS). MCI were determined using the Petersen’s 2014 criteria as the gold standard. SPSS version 22 was used for reliability and validity analysis and optimal cut-off score detection. Cronbach’s α of the MoCA-BM was 0.691 and concurrent validity was high between MoCA-BM and MMMSE scores (r=0.741). Optimal cut-off point for MoCA-BM to detect MCI among older adults in Malaysia was 17/18, with sensitivity of 68.2% and specificity of 61.3%. Using this cut-off, 38.9% of participants were detected to be at risk of MCI. In conclusion, MoCA-BM is a reliable and valid screening instrument for MCI among Malaysian elderly community. The newly derived optimal cut-off for MCI is much lower than the original MoCA with modest ability to discriminate between normal and MCI older adults in the community

Hubungan antara status mood dan fungsi kognitif dalam kalangan warga emas yang mempunyai kecelaan kognitif ringan

Terdapat beberapa bukti menyatakan bahawa status mood mampu mempengaruhi fungsi kognitif dari segi ingatan episodik, ingatan kerja dan penyelesaian masalah. Kajian ini dijalankan untuk menilai hubungan antara status mood dan fungsi kognitif dalam kalangan warga emas yang mempunyai Kecelaan Kognitif Ringan (MCI). Kajian ini melibatkan 12 orang lelaki dan 37 orang wanita dari Lembah Klang yang berusia 60 tahun ke atas. MCI ditakrif berdasarkan kriteria yang dicadangkan oleh Peterson. Fungsi kognitif subjek dinilai dengan menggunakan ujian Mini Mental State (MMS), Rey Auditory Verbal Learning (RAVL), Digit Span, Digit Symbol Substituition (DSS) dan Visual Reproduction; Manakala status mood termasuk ketegangan, kemurungan, kemarahan, kecergasan, penghargaan diri, keletihan dan kekeliruan dinilai melalui soal selidik Profile of Mood States (POMS). Jumlah skor subskala positif dan negatif serta jumlah gangguan mood (Total Mood Disturbance) juga dikira. Hasil kajian ini menunjukkan korelasi positif antara ketegangan (r = 0.325, p = 0.30), kecergarsan (r = 0.235, p = 0.036) dengan ingatan episodik lisan yang dinilai dengan ujian RAVL. Di samping itu, korelasi positif juga dapat diperhatikan antara kecergasan (r = 0.228, p = 0.035) dan skor subskala positif (r = 0.237, p = 0.025) dengan ujian DSS yang menilai kelajuan pemprosesan kognitif. Ujian regresi berganda juga menunjukkan bahawa subjek mempunyai penghargaan diri yang tinggi [OR = 0.390, 95% CI [0.069-0.711], p = 0.019) dan ketegangan (OR = 0.253, 95% CI [0.075-0.431) p = 0.007) mempunyai ingatan episodik yang lebih baik. Skor subskala positif yang lebih tinggi juga mempunyai berhubungkait dengan kelajuan pemprosesan kognitif yang lebih pantas (OR = 0.856, 95% CI [0.099-1.614], p = 0.028). Kesimpulannya, warga emas yang mempunyai mood yang lebih positif adalah lebih cenderung kepada ingatan jangka pendek yang lebih baik dan kelajuan pemprosesan yang lebih cekap

Mood, cognitive function and quality of life improvements in middle aged women following supplementation with Polygonum minus extract

Polygonum minus is a plant rich in flavonoids and antioxidants beneficial for reducing oxidative stress and lipid peroxidation in neuronal membranes. This randomized, double-blind, placebo-controlled study evaluated the potential benefits of P. minus extract (LineMinusTM) towards improving cognitive function, mood status and quality of life. Thirty five middle-aged women (35-55 years old) were randomized into intervention (n=17) and control group (n=18). Two capsules of P. minus (250 mg) or placebo (100 mg maltodextrin) each were taken once daily for six weeks. Cognitive tests, mood and anthropometric measurements were measured at baseline, week 3 and week 6, whilst biomarkers were measured at baseline and week 6. Parameters related to mood and quality of life including energy/fatigue, social functioning and general health significantly improved from baseline to week 6 in the intervention group (p<0.05). Mean score for cognitive tests (i.e. digit span, comprehensive trail making test (CTMT) and three domains of CNS vital sign (CNSVS)] improved significantly in both intervention and control groups (p<0.05). There was a significant decrease of mean uric acid, estimated glomerular filtration rate (eGFR), total cholesterol and glycated hemoglobin (HbA1C) in the intervention group from baseline to week 6. P. minus supplementation has the potential to improve mood and quality of life and no adverse effects were reported by the participants after 6 weeks supplementation

Association between health-related quality of life and psychological distress at different stages of chronic kidney disease

The prevalence of chronic kidney disease (CKD) have increased and become one of the major public health concerns worldwide including Malaysia. Previous studies on CKD generally focused on patients who were already undergoing dialysis treatment; however, studies investigating the stresses experienced by pre-dialysis CKD patients were limited. This study aimed to examine the prevalence of psychological distress and their association with the Health Related Quality of Life (HRQoL) during the different stages of CKD. This cross-sectional study involved 200 pre-dialysis patients from stages 3 to 5, who were recruited from the Nephrology Clinic at the National University of Malaysia Medical Centre (UKMMC). The instruments used in this study were the Short Form 36 (measuring HRQoL) and Hospital Anxiety and Depression Scale (HADS) to measure the psychological distress. The results showed that the prevalence of depression and anxiety increased proportionally with the CKD stages. The HRQoL sub-component scores declined as the CKD stages increased except for social functioning. An impaired HRQoL was associated with depression and anxiety in the CKD patients. The results suggested that it is very important to manage kidney disease at an early stage and that a healthier lifestyle is adopted