Late onset depression: Association with clinical and imaging indicators of prodromal Parkinson’s disease

The pathology of late onset depression (LOD) is unclear, with vascular and structural abnormalities reported through the use of magnetic resonance imaging (MRI). Parkinson’s disease (PD) can be preceded by LOD several years before overt motor symptoms. Use of the Dopamine Transporter Single Photo Emission Computerised Tomography (DAT SPECT) has been approved by the Food and Drugs Administration (FDA) for imaging pre synaptic dopaminergic dysfunction; aiding diagnosis in disorders such as PD. We investigated; a) presence of early clinical features associated with PD in patients with LOD (pLOD), b) dopaminergic functioning in pLOD, c) structural and vascular pathology associated with LOD. This thesis also compared visual and semi quantitative analysis (SQA) methods when rating DAT SPECTs. When compared with healthy controls (HC) (n=30) overall, pLOD (n=36) scored significantly higher on symptoms of apathy, REM sleep behaviour disorder (RBD), sleep symptoms associated with PD and autonomic and motor dysfunction. Seven pLOD were visually rated with abnormal uptake in comparison to one HC, also confirmed by the SQA which additionally found that overall, pLOD (n=29 with a DAT SPECT) had significantly lower binding in the caudate nuclei (CN). The pLOD with visually abnormal SPECTs had significantly lower clinical scores relating to olfactory dysfunction, cognition and autonomic dysfunction compared to pLOD with normal SPECTs. There were no significant group differences in structural or vascular pathology. There were significant correlations between age and left and right hippocampi (HIPP) and amygdala (AMY) and global white matter (WM) and grey matter (GM) volumes in pLOD (n=28 with an MRI). Overall, in controls (n=25), age and gender correlated with global WM. Severity of depression was not associated with regional volumes. An audit of the correct use of clinical indications for the DAT SPECT at an NHS trust confirmed correct use in all cases (n=74) and a comparison of visual and SQA methods when rating DAT SPECTS in clinical cases also confirmed very good agreement between methods

IMPACT OF MULTICULTURAL ENVIRONMENT OF INTERNATIONAL ISLAMIC UNIVERSITY MALAYSIA ON STUDENTS’ ACCULTURATION

This research aimed to study the effect of exposure to Multicultural environment of educational institutions on the acculturation of its students. The study puts forth many types of research that show the positive effects of intergroup contact between groups of diverse ethnic backgrounds and cultural heritages in reducing prejudice and negative stereotyping towards the out-group. This study investigated whether or not the Internationalization process of the International Islamic University, Malaysia, with a multicultural environment, helps its students to, accept the differences that other cultures bring, be comfortable with differences and also seek diversity of contact. The study employed Miville-Guzman Universality – Diversity Scale, (M-GUDS-S) to collect data by survey method from 400 IIUM undergraduate students selected using Quota sampling. 200 of them were first-year students and the rest were fourth-year students. The result indicated that the multicultural environment at IIUM does lead to Acculturation among students. It showed that the fourth year students were significantly more appreciative of and comfortable with differences. However, in terms of seeking diversity of contact, there was no significant difference between first-year and fourth-year students. Based on the findings it has been suggested that if efforts are made to establish optimal conditions for positive intergroup contact to take place, intergroup prejudice can be reduced and problems of coexistence in the Muslim countries and communities can thus be addressed

Impact of multicultural environment of International Islamic University Malaysia on students’ acculturation

This research aimed to study the effect of exposure to Multicultural environment of educational institutions on the acculturation of its students. The study puts forth many types of research that show the positive effects of intergroup contact between groups of diverse ethnic backgrounds and cultural heritages in reducing prejudice and negative stereotyping towards the out-group. This study investigated whether or not the Internationalization process of the International Islamic University, Malaysia, with a multicultural environment, helps its students to, accept the differences that other cultures bring, be comfortable with differences and also seek diversity of contact. The study employed Miville-Guzman Universality – Diversity Scale, (M-GUDS-S) to collect data by survey method from 400 IIUM undergraduate students selected using Quota sampling. 200 of them were first-year students and the rest were fourth-year students. The result indicated that the multicultural environment at IIUM does lead to Acculturation among students. It showed that the fourth year students were significantly more appreciative of and comfortable with differences. However, in terms of seeking diversity of contact, there was no significant difference between first-year and fourth-year students. Based on the findings it has been suggested that if efforts are made to establish optimal conditions for positive intergroup contact to take place, intergroup prejudice can be reduced and problems of coexistence in the Muslim countries and communities can thus be addressed

Late onset depression: Dopaminergic deficit and clinical features of prodromal Parkinson's disease: A cross-sectional study

Background: Late onset depression (LOD) may precede the diagnosis of Parkinson's disease (PD) or dementia with Lewy bodies (DLB). We aimed to determine the rate of clinical and imaging features associated with prodromal PD/DLB in patients with LOD. Methods: In a cross-sectional design, 36 patients with first onset of a depressive disorder (Diagnostic and Statistical Manual of Mental Disorders IV criteria) diagnosed after the age of 55 (LOD group) and 30 healthy controls (HC) underwent a detailed clinical assessment. In addition, 28/36 patients with LOD and 20/30 HC underwent a head MRI and 29/36 and 25/30, respectively, had dopamine transporter imaging by 123I-ioflupane single-photon emission computed tomography (SPECT) imaging. Image analysis of both scans was performed by a rater blind to the participant group. Results of clinical assessments and imaging results were compared between the two groups. Results: Patients with LOD (n=36) had significantly worse scores than HC (n=30) on the PD screening questionnaire (mean (SD) 1.8 (1.9) vs 0.8 (1.2); p=0.01), Movement Disorder Society Unified Parkinson's Disease Rating Scale total (mean (SD) 19.2 (12.7) vs 6.1 (5.7); p<0.001), REM-sleep behaviour disorder screening questionnaire (mean (SD) 4.3 (3.2) vs 2.1 (2.1); p=0.001), Lille Apathy Rating Scale (mean (SD)-23.3 (9.6) vs-27.0 (4.7); p=0.04) and the Scales for Outcomes in PD-Autonomic (mean (SD) 14.9 (8.7) vs 7.7 (4.9); p<0.001). Twenty-four per cent of patients with LOD versus 4% HC had an abnormal 123I-ioflupane SPECT scan (p=0.04). Conclusions: LOD is associated with increased rates of motor and non-motor features of PD/DLB and of abnormal 123I-ioflupane SPECTs. These results suggest that patients with LOD should be considered at increased risk of PD/DLB