Structural MRI Correlates of Episodic Memory Processes in Parkinson's Disease Without Mild Cognitive Impairment.

BackgroundChanges in episodic memory are common early in Parkinson's disease (PD) and may be a risk factor for future cognitive decline. Although medial temporal lobe (MTL) memory and frontostriatal (FS) executive systems are thought to play different roles in distinct components of episodic memory impairment in PD, no study has investigated whether different aspects of memory functioning are differentially associated with MTL and FS volumes in nondemented patients without mild cognitive impairment (PD-woMCI).ObjectivesThe present study investigated MRI markers of different facets of memory functioning in 48 PD-woMCI patients and 42 controls.MethodsRegional volumes were measured in structures comprising the MTL and FS systems and then correlated with key indices of memory from the California Verbal Learning Test.ResultsIn PD-woMCI patients, memory was impaired only for verbal learning, which was not associated with executive, attention/working memory, or visuospatial functioning. Despite an absence of cortical atrophy, smaller right MTL volumes in patients were associated with poorer verbal learning, long delayed free recall, long delayed cued recall, and recognition memory hits and false positives. Smaller right pars triangularis (inferior frontal) volumes were also associated with poorer long delayed cued recall and recognition memory hits. These relationships were not found in controls.ConclusionsThe findings indicate that MTL volumes are sensitive to subtle changes in almost all facets of memory in PD-woMCI, whereas FS volumes are sensitive only to memory performances in cued-testing formats

Відеокапсульна ендоскопія в діагностиці хвороби Крона

The aim of the work: to improve the effectiveness of diagnosis of Crohn’s disease. Materials and Methods. The study analyzed 288 patients with irritable bowel syndrome. Depending on the diagnostic tactics, patients were divided into 2 groups. Groups of patients were comparable in age and sex. Group 1 included patients with irritable bowel syndrome for the period from 2010 to 2013, who were diagnosed by traditional methods without the use of video capsule endoscopy. This group consisted of 143 patients (49.6 %). Group 2 of patients were diagnosed according to the algorithm developed by us, using video capsule endoscopy, ileocolonoscopy and, if necessary, enteroscopy with biopsy from the affected areas. This group consisted of 145 patients (50.3 %). Results and Discussion. The results of the examination of patients of the first and second groups showed that Crohn’s disease was detected in 20 (13.9 %) patients of the group 1 and due to the use of video capsule endoscopy, colonoscopy, enteroscopy, biopsy was detected in 48 (33.1%) patients of the group 2. In addition, 68 patients of the group 1 with a diagnosis of irritable bowel syndrome, who were under dynamic observation in our clinic, were examined according to the developed algorithm. The results showed that 25 (36.7 %) patients out of 68 had Crohn’s disease of the small intestine.Цель работы: повысить эффективность диагностики болезни Крона. Материалы и методы. Проведен анализ диагностики 288 пациентов с синдромом раздраженной кишки. В зависимости от диагностической тактики пациенты были разделены на 2 группы. Группы больных были сопоставимы по возрасту и полу. В первую группу вошли пациенты с синдромом раздраженной кишки за период с 2010 по 2013 года, которым выполнялась диагностика традиционными методами без применения видеокапсульной эндоскопии. Данная группа насчитывала 143 пациента (49,6 %). Во второй группе пациентам проводилась диагностика по разработанному нами алгоритму, то есть с применением видеокапсульной эндоскопии, илиоколоноскопии и при необходимости энтероскопии с забором биопсии с пораженных участков. Данная группа насчитывала 145 пациентов (50,3 %). Результаты исследований и их обсуждение. Полученные результаты обследования пациентов первой и второй группы показали, что болезнь Крона была обнаружена у 20 (13,9 %) пациентов первой группы и благодаря использованию видеокапсульной эндоскопии, колоноскопии, энтероскопии, биопсии была обнаружена у 48 (33,1 %) пациентов второй группы. Кроме этого, в 68 пациентов первой группы с диагнозом синдром раздраженной кишки, которые находились под динамическим наблюдением в нашей клинике, было проведено обследование по разработанному алгоритму. Результаты показали, что у 25 (36,7 %) пациентов из 68 была обнаружена болезнь Крона тонкой кишки.Мета роботи: підвищити ефективність діагностики хвороби Крона. Матеріали і методи. Проведено аналіз діагностики 288 пацієнтів із синдромом подразненої кишки. Залежно від діагностичної тактики пацієнти були розділені на 2 групи. Групи хворих були порівняними за віком та статтю. В першу групу увійшли пацієнти з синдромом подразненої кишки за період з 2010 по 2013 роки, яким виконувалася діагностика традиційними методами без застосування відеокапсульної ендоскопії. Дана група налічувала 143 пацієнти (49,6 %). У другій групі пацієнтам проводилася діагностика за розробленим нами алгоритмом, тобто з застосуванням відеокапсульної ендоскопії,  ілеоколоноскопії та за необхідністю ентероскопії із забором біопсії з уражених ділянок. Дана група налічувала 145 пацієнтів (50,3 %). Результати досліджень та їх обговорення. Отримані результати обстеження пацієнтів першої та другої групи показали, що хвороба Крона була виявлена у 20 (13,9 %) пацієнтів першої групи та завдяки використанню відеокапсульної ендоскопії, колоноскопії, ентероскопії, біопсії була виявлена у 48 (33,1 %) пацієнтів другої групи. Крім цього, у 68 пацієнтів першої групи з діагнозом синдром подразненої кишки, які знаходилися під динамічним спостереженням у нашій клініці, було проведено обстеження за розробленим алгоритмом. Результати показали, що у 25 (36,7 %) пацієнтів з 68 було виявлено хворобу Крона тонкої кишки

Prospective memory impairments in Alzheimer's Disease and behavioral variant frontotemporal dementia: Clinical and neural correlates

BACKGROUND: Prospective memory (PM) refers to a future-oriented form of memory in which the individual must remember to execute an intended action either at a future point in time (Time-based) or in response to a specific event (Event-based). Lapses in PM are commonly exhibited in neurodegenerative disorders including Alzheimer's disease (AD) and frontotemporal dementia (FTD), however, the neurocognitive mechanisms driving these deficits remain unknown. OBJECTIVE: To investigate the clinical and neural correlates of Time- and Event-based PM disruption in AD and the behavioral-variant FTD (bvFTD). METHODS: Twelve AD, 12 bvFTD, and 12 healthy older Control participants completed a modified version of the Cambridge Prospective Memory test, which examines Time- and Event-based aspects of PM. All participants completed a standard neuropsychological assessment and underwent whole-brain structural MRI. RESULTS: AD and bvFTD patients displayed striking impairments across Time- and Event-based PM relative to Controls, however, Time-based PM was disproportionately affected in the AD group. Episodic memory dysfunction and hippocampal atrophy was found to correlate strongly with PM integrity in both patient groups, however, dissociable neural substrates were also evident for PM performance across dementia syndromes. CONCLUSION: Our study reveals the multifaceted nature of PM dysfunction in neurodegenerative disorders, and suggests common and dissociable neurocognitive mechanisms, which subtend these deficits in each patient group. Future studies of PM disturbance in dementia syndromes will be crucial for the development of successful interventions to improve functional independence in the patient's daily life

Modeling Neurodegeneration in Zebrafish

The zebrafish, Danio rerio, has been established as an excellent vertebrate model for the study of developmental biology and gene function. It also has proven to be a valuable model to study human diseases. Here, we reviewed recent publications using zebrafish to study the pathology of human neurodegenerative diseases including Parkinson’s, Huntington’s, and Alzheimer’s. These studies indicate that zebrafish genes and their human homologues have conserved functions with respect to the etiology of neurodegenerative diseases. The characteristics of the zebrafish and the experimental approaches to which it is amenable make this species a useful complement to other animal models for the study of pathologic mechanisms of neurodegenerative diseases and for the screening of compounds with therapeutic potential

Cognitive rehabilitation, self-management, psychotherapeutic and caregiver support interventions in progressive neurodegenerative conditions: a scoping review

BACKGROUND: Despite their potentially significant impact, cognitive disability may be overlooked in a number of progressive neurodegenerative conditions, as other difficulties dominate the clinical picture. OBJECTIVE: We examined the extent, nature and range of the research evidence relating to cognitive rehabilitation, self-management, psychotherapeutic and caregiver support interventions in Parkinsonian disorders, multiple sclerosis (MS), frontotemporal dementias (FTD), motor neuron disease and Huntington’s disease. METHODS: Scoping review based on searches of MEDLINE and CINAHL up to 15 March 2016. RESULTS: We included 140 eligible papers. Over half of the studies, and almost all the randomised controlled trials, related to MS, while a number of single case studies described interventions for people with FTD. CR interventions addressed functional ability, communication and interaction, behaviour or memory. The majority of psychotherapy interventions involved cognitive behavioural therapy for depression or anxiety. Self-management interventions were mainly available for people with MS. There were few reports of interventions specific to caregivers. Numerous methodological challenges were identified. CONCLUSIONS: The limited range of studies for all conditions except MS suggests a need firstly to synthesise systematically the available evidence across conditions and secondly to develop well-designed studies to provide evidence about the effectiveness of CR and other psychological interventions

The need for harmonization and innovation of neuropsychological assessment in neurodegenerative dementias in Europe: consensus document of the Joint Program for Neurodegenerative Diseases Working Group

Cognitive, behavioural, and functional assessment is crucial in longitudinal studies of neurodegenerative dementias (NDD). Central issues, such as the definition of the study population (asymptomatic, at risk, or individuals with dementia), the detection of change/decline, and the assessment of relevant outcomes depend on quantitative measures of cognitive, behavioural, and functional status. Currently, we are far from having available reliable protocols and tools for the assessment of dementias in Europe. The main problems are the heterogeneity of the tools used across different European countries, the lack of standardisation of administration and scoring methods across centres, and the limited information available about the psychometric properties of many tests currently in widespread use. This situation makes it hard to compare results across studies carried out in different centres, thus hampering research progress, in particular towards the contribution to a “big data” common data set. We present here the results of a project funded by the Joint Program for Neurodegenerative Diseases (JPND) and by the Italian Ministry of Health. The project aimed at providing a consensus framework for the harmonisation of assessment tools to be applied to research in neurodegenerative disorders affecting cognition across Europe. A panel of European experts reviewed the current methods of neuropsychological assessment, identified pending issues, and made recommendations for the harmonisation of neuropsychological assessment of neurodegenerative dementias in Europe. A consensus was achieved on the general recommendations to be followed in developing procedures and tools for neuropsychological assessment, with the aim of harmonising tools and procedures to achieve more reliable data on the cognitive-behavioural examination. The results of this study should be considered as a first step to enhancing a common view and practise on NDD assessment across European countries

Intramolecular Conflict: Conformation and Self-Assembly of Architecturally Complex Macromolecules in Solution

The solution behavior of linear polymer chains is well understood, having been the subject of intense study throughout the previous century. As plastics have become ubiquitous in everyday life, polymer science has grown into a major field of study. The conformation of a polymer in solution depends on the molecular architecture and its interactions with the surroundings. Developments in synthetic techniques have led to the creation of precision-tailored polymeric materials with varied topologies and functionalities. In order to design materials with the desired properties, it is imperative to understand the relationships between polymer architecture and their conformation and behavior. To meet that need, this thesis investigates the conformation and self-assembly of three architecturally complex macromolecular systems with rich and varied behaviors driven by the resolution of intramolecular conflicts. First we describe the development of a robust and facile synthetic approach to reproducible bottlebrush polymers (Chapter 2). The method was used to produce homologous series of bottlebrush polymers with polynorbornene backbones, which revealed the effect of side-chain and backbone length on the overall conformation in both good and theta solvent conditions (Chapter 3). The side-chain conformation was obtained from a series of SANS experiments and determined to be indistinguishable from the behavior of free linear polymer chains. Using deuterium-labeled bottlebrushes, we were able for the first time to directly observe the backbone conformation of a bottlebrush polymer which showed self-avoiding walk behavior. Secondly, a series of SANS experiments was conducted on a homologous series of Side Group Liquid Crystalline Polymers (SGLCPs) in a perdeuterated small molecule liquid crystal (5CB). Monodomain, aligned, dilute samples of SGLCP-b-PS block copolymers were seen to self-assemble into complex micellar structures with mutually orthogonally oriented anisotropies at different length scales (Chapter 4). Finally, we present the results from the first scattering experiments on a set of fuel-soluble, associating telechelic polymers. We observed the formation of supramolecular aggregates in dilute (≤0.5wt%) solutions of telechelic polymers and determined that the choice of solvent has a significant effect on the strength of association and the size of the supramolecules (Chapter 5). A method was developed for the direct estimation of supramolecular aggregation number from SANS data. The insight into structure-property relationships obtained from this work will enable the more targeted development of these molecular architectures for their respective applications

The profile of prospective memory impairment in Parkinson's disease and implications for everyday functioning

Prospective memory (ProM) is an aspect of episodic memory that involves remembering to perform an intended action at some designated point in the future, and is critically involved in everyday functioning. Studies suggests that ProM is dependent on the functional integrity of the frontal lobe system and associated executive functions, with time-based ProM relying more heavily on executive processes than event-based ProM. Although individuals with Parkinson's disease (PD) demonstrate impairments in executive functions and strategic aspects of episodic memory, few studies have examined ProM in PD. The present study examined ProM and the relationship between ProM and everyday functioning in 33 PD patients and 26 demographically comparable adults. PD participants were disproportionately impaired in TB ProM (Cohen's d = 1.30) compared to EB ProM (d = 0.63), committed an increased number of omission errors on TB trials, and were worse (at a trend level) than healthy older adults in retrospective memory for the contents of the intentions. TB ProM performance correlated with standardized measures of executive function, working memory, and retrospective episodic memory in PD. Taken together, these results suggest that PD participants are impaired in the executive /strategic and retrospective memory aspects of ProM. There were no significant differences between groups in strategic time monitoring or basic temporal perception, suggesting that TB ProM impairment in PD may not be related to declines in these cognitive processes. Alternatively, these findings may be related to methodological limitations of the tasks used to measure these processes in the present study. Within the PD sample, ProM deficits correlated with two performance-based measures of everyday functioning (financial capacity, medication management) and a self-report measure of medication management. Moreover, ProM impairment uniquely predicted declines on a performance-based measure of financial capacity, but not medication management, over and above other predictors of everyday functioning. Although future studies with larger samples and longitudinal designs are warranted, these results suggest that ProM may provide unique information regarding everyday functioning skills. The present findings have implications for the assessment of ProM in clinical neuropsychological evaluations and for intervention strategies aimed at improving ProM dysfunction in individuals with P