The disorders of verbal communication in patients with diabetes mellitus type 2: Causes and treatment

© Medwell Journals, 2015. The study describes the decline of verbal and communicative functions in patients with diabetes mellitus type 2. The researchers reveal the causes of verbal communication impairment and describe some methods of its estimation (baseline neurocognitive tests, Mini-Mental State Examination and Montreal Cognitive Assessment) as well as the research outcomes. We discuss certain problems of verbal contact in these patients from neurological, neurolinguistic and neuropsychological points of view. Verbal communication disorders evidently declare themselves through short and long-term verbal memory impairments and language attention decline. They negatively affect cognitive functions, significantly reducing the patient’s capability for adequate communication. The researchers suggest some ways of medical and linguistic assistance to patients with diabetes mellitus type 2 in clinical practice. They accentuate the need for timely diagnostics and help for these patients. The research was conducted at Department of Neurology No. 1, Republic Clinical Hospital No. 2 (Kazan, Russia), the clinical base of Kazan Federal University

Cognitive impairment in diabetes mellitus and hypertension, a possibility of correction

Objective: to evaluate cognitive functions in patients with type 2 diabetes mellitus (DM2) and hypertension and the efficacy of Ginkgo biloba extract Egb 761®. Patients and methods: 120 patients with DM2 and 50 hypertensive patients with no complications or a history of stroke and/or myocardial infarction, without active complaints of hypomnesia and other cognitive functions were examined. The exclusion criteria were prior stroke and/or myocardial infarction; clinically significant diseases of the peripheral arteries and major arteries of the head; DM2 decompensation; glomerular filtration rate <60 ml/min; proliferative retinopathy; and other endocrine diseases. The investigators used the following methods for the evaluation of cognitive functions: the Mini-Mental State Examination, the Montreal Cognitive Assessment, and the hand-eye coordination test (Parts A and B). Results and discussion: 85% of the patients with DM2 were found to have cognitive impairments (CI): disorders of attention, short-term memory, and thinking speed. Out of them, 82.5% had moderate CI and 2.5% had dementia. 30% of the hypertensive patients were diagnosed as having moderate CIs and 10% had dementia. At the same time, the degree of CI was higher in the patients with MD2 than in those with hypertension. The use of Egb 761® 240 mg/day for 3 months had a statistically significant positive impact on cognitive functions (improvements in short-term memory, concentration, and thinking speed) and everyday activity. Conclusion: The authors consider that CIs are the first sign of encephalopathy in DM2. It is also noted that DM2 has a more pronounced impact on cognitive functions than hypertension. Egb 761® can be used as an effective drug to treat CI in these diseases

Myogenic Trigger Zone of Trapezius Muscle Increases the Tone of the Middle Cerebral Artery

© 2016, Springer Science+Business Media New York.A myogenic trigger zone (MTZ) has been shown to affect the tone of the surface arteries of the head and lower limbs. However, it remains largely unknown whether the tone of the intracranial arteries is regulated by MTZ. The aim of the present study was to investigate the effect of MTZ in trapezius muscle on the tone of the middle cerebral artery. Using ultrasound measurements of the peak velocity of blood flow and the Lindegaard index (LI), we found that the presence of an active MTZ in a trapezius muscle was per se associated with an increased LI values and that pressure stimulation of the MTZ further increases LI. When MTZ was eliminated by means of manual therapy, the indices of blood flow and LI returned to normal values. We conclude that the reflex spasm of the middle cerebral artery can occur in the presence of an active MTZ-TM and that this phenomenon contributes to the pathogenesis and the clinical symptoms associated with the cervicogenic and tension headaches

Tension type headache: GABA-ergic drug anvifen efficacy

© 2016, Media Sphera. All rights reserved.Objective. To assess the efficacy of aminophenylbutyric acid (anvifen), a synthetic GABA-receptor agonist, in the treatment of adult patients with tension type headache (TTH). Material and methods. Eighty-seven patients with episodic TTH (ETTH) and 30 patients with chronic TTH (CTTH) were examined. The area under the headache curve, sleep quality, the Hospital Anxiety and Depression Scale (HADS) scores and stress resistance measured by an original questionnaire were evaluated. Results. Anvifen in dose of 250 mg TID during 3 weeks had a positive effect on all parameters studied, excluding the area under the headache curve in CTTH. Similar results were demonstrated after the subsequent course of treatment for 3 weeks. Conclusion. Anvifen was highly effective in ETTH but less effective in CTTH. A combination of anvifen with antidepressants can be recommended for patients with CTTH

Quality of Life in Patients with Type 2 Diabetes Mellitus

© 2016, Springer Science+Business Media New York.The article presents the results of a survey which included 120 patients with type 2 diabetes mellitus (DM-2) without complications, without stroke in anamnesis, with no active complaints about loss of memory, and/or other cognitive functions. The assessment tools for cognitive functions were MMSE, MoCA test, and TMT (parts A and B). SF-36 test was used to assess the quality of life (QoL). It was revealed that the QoL in patients with type 2 diabetes was significantly lower than in the general population. The correlation between QoL and the duration of the disease, the degree of cognitive impairment, and emotional state of patients was evaluated. It was revealed that QoL indicators significantly reduced with the growth of cognitive impairment and emotional disorders. The most significant reduction is revealed in the role functioning indexes and role-emotional functioning indexes

Alexithymia as a Predictor of Chronic Tension Headaches

© 2016, Springer Science+Business Media New York.Alexithymia as a violation of inter-hemispheric communication which has no visible organic brain changes is now regarded as a predictor of many chronic physical and neurological diseases, but it has not yet been regarded in connection with chronic tension headaches. The authors examined 137 people with tension-type headache (33 men, 84 women) aged 30–50 years (average age 40,75 ± 6,29) in order to clarify a link to alexithymia. The diagnosis of tension headache was conducted according to the International classification of headaches, 3rd edition (beta version). The authors used the original headache diary, Toronto alexithymia scale, Hospital anxiety and depression scale, the measurement of the space under the curve of headache. It was found that the patients with alexithymia have difficulty in describing the place of headaches (the average number of word descriptors at most 1 word), distrust of doctors, abuse of analgesics and tend to use alternative medicine methods. The intensity (p = 0.0001) and the frequency of headaches (p = 0.0028) is significantly higher in patients with alexithymia, and the more common are depression (p = 0.042) and impaired nocturnal sleep (p = 0.001). Patients with chronic tension-type headache associated with sleep disorders, adaptation and symptoms of depression should be considered as alexithymic personalities until the contrary is proved. Physicians should be aware of the fact that alexithymic patients have problems with feelings verbalization, and if patient’s complaints are vague a doctor should use questionnaires, words-descriptors, phrases-descriptors and other auxiliary verbal techniques for accurate diagnosis

Alexithymia as a Predictor of Chronic Tension Headaches

© 2016, Springer Science+Business Media New York.Alexithymia as a violation of inter-hemispheric communication which has no visible organic brain changes is now regarded as a predictor of many chronic physical and neurological diseases, but it has not yet been regarded in connection with chronic tension headaches. The authors examined 137 people with tension-type headache (33 men, 84 women) aged 30–50 years (average age 40,75 ± 6,29) in order to clarify a link to alexithymia. The diagnosis of tension headache was conducted according to the International classification of headaches, 3rd edition (beta version). The authors used the original headache diary, Toronto alexithymia scale, Hospital anxiety and depression scale, the measurement of the space under the curve of headache. It was found that the patients with alexithymia have difficulty in describing the place of headaches (the average number of word descriptors at most 1 word), distrust of doctors, abuse of analgesics and tend to use alternative medicine methods. The intensity (p = 0.0001) and the frequency of headaches (p = 0.0028) is significantly higher in patients with alexithymia, and the more common are depression (p = 0.042) and impaired nocturnal sleep (p = 0.001). Patients with chronic tension-type headache associated with sleep disorders, adaptation and symptoms of depression should be considered as alexithymic personalities until the contrary is proved. Physicians should be aware of the fact that alexithymic patients have problems with feelings verbalization, and if patient’s complaints are vague a doctor should use questionnaires, words-descriptors, phrases-descriptors and other auxiliary verbal techniques for accurate diagnosis

Persistent postural-perceptual dizziness

© 2017, Media Sphera, All rights reserved. Objective. To study persistent postural perceptual dizziness (PPPD) in outpatients with benign paroxysmal positional vertigo (BPPV) and patients with presbiataxia (PAt). Material and methods. Eighty-four patients with PPPD, including 14 with Meniere’s disease (MD), 19 with BPPV, 17 with a history of ischemic stroke (IS) in the vertebrobasilar system and 34 with Pat, were examined. For the diagnosis of anxiety, the original 15-point questionnaire with the Likert Scale structure was used. Patients received anvifen (aminophenylbutyric acid hydrochloride) in dose of 250 mg 3 times a day for 6 weeks. Results and conclusion. The most common trigger of PPPD was sleep deprivation. The highest level of anxiety was identified in the PAt group (19,5±2,89). There was a good effect of the drug: it reduced anxiety in all patients studied. The quality of sleep was improved as well. The authors recommend anvifen as the drug of choice in patients with PPPD during vestibular rehabilitation and cognitive-behavioral therapy

The Influence of Diabetes Mellitus Duration and Type of Therapy on Cognitive Decline

© 2016, Springer Science+Business Media New York.We studied 120 patients with compensated diabetes mellitus type 2 (DM-2). The inclusion criterion was the absence of memory loss complaints from the patient and/or his/her relatives. The exclusion criteria were diabetes decompensation, myocardial infarction and/or stroke in anamnesis, glomerular filtration rate below 60 ml/min, the presence of proliferative retinopathy, and/or other endocrine diseases. To diagnose the cognitive decline (CD) we used Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA test), Trail Making Test (parts A and B). 77.5 % patients with type 2 diabetes out of 120 had moderate CD; 5 % had a significant CD (dementia). The control group consisted of 50 patients with arterial hypertension, which was comparable with the DM-2 group. In assessing the correlations, we found that the CD in DM-2 group is independent of disease duration and the type of diabetic therapy. We discovered a positive correlation between the age of patients and the speed of cognitive decline. Comparison of patients in DM-2 group with the control group showed that results in patients with hypertension (MMSE, MoCA test) were significantly higher (p < 0.01), and the test time of TMT part A and part B was significantly lower (p < 0.01) than that in patients with DM-2. The authors believe that the CD in DM-2 has different pathogenic mechanisms than other complications of type 2 diabetes mellitus, in particular, the insulin resistance of brain tissue

Alexithymia and psychosomatic diseases in adolescents: primary headaches

Background. Alexithymia is traditionally regarded as a factor which influences the development of psychosomatic diseases and contribute to a more severe and prolonged course of somatic diseases the high level of alexithymia indicates the deficit in  cognitive processes associated with awareness, exteriorization and regulation of feelings and emotions. In recent years, a lot of research has been conducted on the comorbidity of alexithymia and psychosomatic diseases in adults, but there are very few studies in relation to children and adolescents.The aim. To analyze psychosomatic diseases associated with the high level of alexithymia in adolescents, to study the correspondence of alexithymia and central sensitization (CS) in adolescents with primary headaches (migraine and tension-type headache).Methods. The diagnosis of headache was based on the criteria for the International Classification of Headache, 3rd edition. The study group included 84 adolescents, average age – 14 [13; 16] (51 females, 33 males). CS was assessed using the Russian version of “Central Sensitization Inventory” (2020) for adolescents. Alexithymia was  assessed using the Russian version of “Alexithymia questionnaire for children” (2019). Headache intensity was measured using the Visual Analogue Scale. There were also assessed the number of months and days per month with headaches; duration of night sleep; age of phrasal speech start.Results and discussion. The results showed the direct correlation between levels of alexithymia and central sensitization (rS = 0.49; p = 0.00001), the number of days with headaches per month and central sensitization severity (rS = 0.24; p = 0.027). There was no significant correlation between alexithymia severity and headaches duration (rS= 0.06; p = 0.5), no reliable results on the correspondence of alexithymia severity, age of phrasal speech start and nocturnal sleep.Conclusion. A high level of alexithymia is observed in adolescents with various somatic diseases. Primary headaches are associated with a high level of alexithymia and the severity of central sensitization. Pediatricians and neurologists should be advised to assess the level of alexithymia and central sensitization in adolescents with headaches