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  • 1
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 35, No. 2 ( 2021-02), p. 117-130
    Abstract: Background. Patients with Parkinson’s disease (PD) are highly vulnerable to develop cognitive dysfunctions, and the mitigating potential of early cognitive training (CT) is increasingly recognized. Predictors of CT responsiveness, which could help to tailor interventions individually, have rarely been studied in PD. This study aimed to examine individual characteristics of patients with PD associated with responsiveness to targeted working memory training (WMT). Methods. Data of 75 patients with PD (age: 63.99 ± 9.74 years, 93% Hoehn & Yahr stage 2) without cognitive dysfunctions from a randomized controlled trial were analyzed using structural equation modeling. Latent change score models with and without covariates were estimated and compared between the WMT group ( n = 37), who participated in a 5-week adaptive WMT, and a waiting list control group ( n = 38). Results. Latent change score models yielded adequate model fit (χ 2 -test p 〉 .05, SRMR ≤ .08, CFI ≥ .95). For the near-transfer working memory composite, lower baseline performance, younger age, higher education, and higher fluid intelligence were found to significantly predict higher latent change scores in the WMT group, but not in the control group. For the far-transfer executive function composite, higher self-efficacy expectancy tended to significantly predict larger latent change scores. Conclusions. The identified associations between individual characteristics and WMT responsiveness indicate that there has to be room for improvement (e.g., lower baseline performance) and also sufficient “hardware” (e.g., younger age, higher intelligence) to benefit in training-related cognitive plasticity. Our findings are discussed within the compensation versus magnification account. They need to be replicated by methodological high-quality research applying advanced statistical methods with larger samples.
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2100545-X
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  • 2
    In: Neurorehabilitation and Neural Repair, SAGE Publications, Vol. 36, No. 4-5 ( 2022-04), p. 306-316
    Abstract: Contralesional 1-Hz repetitive transcranial magnetic stimulation (rTMS) over the right pars triangularis combined with speech-language therapy (SLT) has shown positive results on the recovery of naming in subacute (5–45 days) post-stroke aphasia. NORTHSTAR-CA is an extension of the previously reported NORTHSTAR trial to chronic aphasia ( 〉 6 months post-stroke) designed to compare the effectiveness of the same rTMS protocol in both phases. Methods Sixty-seven patients with left middle cerebral artery infarcts (28 chronic, 39 subacute) were recruited (01-2014 to 07-2019) and randomized to receive rTMS (N = 34) or sham stimulation (N = 33) with SLT for 10 days. Primary outcome variables were Z-score changes in naming, semantic fluency and comprehension tests and adverse event frequency. Intention-to-treat analyses tested between-group effects at days 1 and 30 post-treatment. Chronic and subacute results were compared. Results Adverse events were rare, mild, and did not differ between groups. Language outcomes improved significantly in all groups irrespective of treatment and recovery phase. At 30-day follow-up, there was a significant interaction of stimulation and recovery phase on naming recovery ( P 〈 .001). Naming recovery with rTMS was larger in subacute (Mdn = 1.91/IQR = .77) than chronic patients (Mdn = .15/IQR = 1.68/ P = .015). There was no significant rTMS effect in the chronic aphasia group. Conclusions The addition of rTMS to SLT led to significant supplemental gains in naming recovery in the subacute phase only. While this needs confirmation in larger studies, our results clarify neuromodulatory vs training-induced effects and indicate a possible window of opportunity for contralesional inhibitory stimulation interventions in post-stroke aphasia. NORTHSTAR trial registration https://clinicaltrials.gov/ct2/show/NCT02020421 .
    Type of Medium: Online Resource
    ISSN: 1545-9683 , 1552-6844
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2100545-X
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  • 3
    In: Parkinsonism & Related Disorders, Elsevier BV, Vol. 113 ( 2023-08), p. 105330-
    Type of Medium: Online Resource
    ISSN: 1353-8020
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2027635-7
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  • 4
    In: Neurological Sciences, Springer Science and Business Media LLC, Vol. 43, No. 5 ( 2022-05), p. 3153-3163
    Abstract: Subjective cognitive decline (SCD) may occur very early in the course of Parkinson’s disease (PD) before the onset of objective cognitive decline. Data on neural correlates and determinants of SCD in PD are rare. Objective The aim of the present study was to identify neural correlates as well as sociodemographic, clinical, and neuropsychological predictors of SCD in patients with PD. Methods We retrospectively analyzed 30 patients with PD without cognitive impairment (23% female, 66.90 ± 7.20 years, UPDRS-III: 19.83 ± 9.29), of which n  = 12 patients were classified as having no SCD (control group, PD-CG) and n  = 18 as having SCD (PD-SCD). Neuropsychological testing and 18-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) were conducted. SCD was assessed using a questionnaire covering multiple cognitive domains. Results SCD subscores differed significantly between PD-CG and PD-SCD and correlated significantly with other scales measuring related concepts. FDG-PET whole-brain voxel-wise regression analysis revealed hypometabolism in middle frontal, middle temporal, and occipital areas, and the angular gyrus as neural correlates of SCD in PD. Next to this hypometabolism, depressive symptoms were an independent significant determinant of SCD in a stepwise regression analysis (adjusted R 2 = 50.3%). Conclusion This study strengthens the hypothesis of SCD being an early manifestation of future cognitive decline in PD and, more generally, early pathological changes in PD. The early identification of the vulnerability for future cognitive decline constitutes the basis for successful prevention and delay of this non-motor symptom.
    Type of Medium: Online Resource
    ISSN: 1590-1874 , 1590-3478
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 1481772-X
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  • 5
    Online Resource
    Online Resource
    Hogrefe Publishing Group ; 2018
    In:  Zeitschrift für Neuropsychologie Vol. 29, No. 3 ( 2018-08-01), p. 148-159
    In: Zeitschrift für Neuropsychologie, Hogrefe Publishing Group, Vol. 29, No. 3 ( 2018-08-01), p. 148-159
    Abstract: Zusammenfassung. Diese Übersichtsarbeit beschäftigt sich mit (neuro-)psychologischen Geschlechtseffekten beim idiopathischen Parkinsonsyndrom (IPS). Frauen mit IPS leiden häufiger an Depressionen als Männer; das Geschlechterverhältnis ist jedoch ausgeglichener als in der Allgemeinbevölkerung. Hinsichtlich der Kognition deuten neue Befunde auf einen stärkeren Abbau des verbalen Gedächtnisses bei Frauen mit IPS hin. Im Bereich Lebensqualität scheinen Geschlechtsunterschiede besonders dann deutlich zu werden, wenn spezifische Unterdomänen der HrQoL betrachtet werden. Zusammenfassend lässt sich feststellen, dass Geschlechtsunterschiede beim IPS in verschiedenen (neuro-)psychologischen Bereichen bestehen und diese klinisch relevant erscheinen. Die Befundlage ist jedoch lückenhaft, und zugrundeliegende Mechanismen sind unklar. Weitere Forschung ist daher erforderlich.
    Type of Medium: Online Resource
    ISSN: 1016-264X , 1664-2902
    Language: German
    Publisher: Hogrefe Publishing Group
    Publication Date: 2018
    detail.hit.zdb_id: 2091184-1
    SSG: 5,2
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  • 6
    In: Journal of Central Nervous System Disease, SAGE Publications, Vol. 12 ( 2020-01), p. 117957351989946-
    Abstract: Cognitive impairment is a very frequent and severe nonmotor symptom of Parkinson’s disease (PD). Early intervention in this at-risk group for cognitive decline may be crucial for long-term preservation of cognitive functions. Computerized working memory training (WMT) has been proven beneficial in non-PD patient populations, but such evidence is still needed for patients with PD. Objective: This study aimed to evaluate the effect of WMT on visuo-spatial working memory (WM) in cognitively unimpaired patients with PD. Methods: A single-blind randomized controlled trial encompassing 76 patients with PD but no cognitive impairment according to level II diagnostic criteria was conducted. Thirty-seven patients engaged in home-based adaptive WMT 5 times per week for a period of 5 weeks, whereas the remaining patients were in the waiting list arm of the study (control group [CG]). Working memory performance was evaluated using a computerized task before and after intervention and at 14-week follow-up, allowing to quantify the precision of WM on a continuous scale, ie, to test not only if an item was remembered but also how well the location of this item was retained. Results: Coincidently, the WMT group showed slightly worse WM performance compared with the CG at baseline, which was ameliorated after WMT. This training-induced effect remained stable until follow-up. Conclusion: Patients showing relatively low WM performance, despite not formally diagnosable as Parkinson’s disease with mild cognitive impairment (PD-MCI), seem to benefit from home-based WMT. Thus, WMT could potentially be implemented in future trials as a time- and cost-efficient route to counteract subtle cognitive changes in early disease stages. Trial registration: German Clinical Trial Register (drks.de, DRKS00009379)
    Type of Medium: Online Resource
    ISSN: 1179-5735 , 1179-5735
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2586873-1
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  • 7
    In: Frontiers in Neurology, Frontiers Media SA, Vol. 12 ( 2021-3-8)
    Abstract: Objective: Depressive symptoms have a high prevalence in patients with Parkinson's disease (PD) and are associated with cognitive dysfunction. Especially in PD with mild cognitive impairment (MCI), a time-efficient and valid instrument for the assessment of depression primarily focusing on psychological symptoms and disregarding confounding somatic symptoms is needed. We performed an examination of the psychometric properties of the Beck Depression Inventory II (BDI-II) and the Beck Depression Inventory Fast Screen (BDI-FS). Methods: The sample consisted of 64 patients [22 females and 42 males, mean age: 67.27 years ( SD = 7.32)]. Depressive symptoms were measured in a cohort of PD patients with MCI. For the BDI-II and BDI-FS the psychometric concepts of internal consistency, convergent validity and diagnostic agreement were assessed. Results: Patients gave higher ratings on test items addressing somatic symptoms than those addressing non-somatic ones. The correlation between the absolute total scores of the BDI-II and the BDI-FS was significant ( r = 0.91, p & lt; 0.001), which indicated convergent validity. The Cronbach's alpha values indicated adequate internal consistencies for both measures (BDI-II: 0.84; BDI-FS: 0.78). There was a higher than chance level agreement of diagnoses of the two questionnaires, measured by Cohen's kappa (0.58, p & lt; 0.001). The agreements between previous diagnosis of depression and the diagnoses of the BDI-II/BDI-FS were also significantly higher than chance level (BDI-II: 0.34, p = 0.007, BDI-FS: 0.39, p = 0.002). Additional AUC analysis across different cutoffs showed that performance of BDI-FS was better than BDI-II, supporting the observation of an equivalent or better performance of BDI-FS than BDI-II. Importantly, AUC analysis confirmed that a cutoff = 4 for BDI-FS was suitable in the considered sample of patients with PD-MCI. Discussion: In a cohort of PD-MCI, the BDI-FS demonstrates adequate psychometric properties in comparison to the BDI-II and can be used as a screening measure for assessing depression in cognitively impaired PD patients, focusing solely on psychological symptoms. Still, further research is needed to validate this instrument.
    Type of Medium: Online Resource
    ISSN: 1664-2295
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2021
    detail.hit.zdb_id: 2564214-5
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  • 8
    Online Resource
    Online Resource
    Frontiers Media SA ; 2020
    In:  Frontiers in Aging Neuroscience Vol. 12 ( 2020-10-14)
    In: Frontiers in Aging Neuroscience, Frontiers Media SA, Vol. 12 ( 2020-10-14)
    Type of Medium: Online Resource
    ISSN: 1663-4365
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2558898-9
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  • 9
    In: Parkinsonism & Related Disorders, Elsevier BV, Vol. 72 ( 2020-03), p. 13-22
    Type of Medium: Online Resource
    ISSN: 1353-8020
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2027635-7
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  • 10
    In: Movement Disorders, Wiley, Vol. 38, No. 6 ( 2023-06), p. 990-999
    Abstract: Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) cohorts have provided insights into the earliest neurodegenerative processes in α‐synucleinopathies. Even though polysomnography (PSG) remains the gold standard for diagnosis, an accurate questionnaire‐based algorithm to identify eligible subjects could facilitate efficient recruitment in research. Objective This study aimed to optimize the identification of subjects with iRBD from the general population. Methods Between June 2020 and July 2021, we placed newspaper advertisements, including the single‐question screen for RBD (RBD1Q). Participants' evaluations included a structured telephone screening consisting of the RBD screening questionnaire (RBDSQ) and additional sleep‐related questionnaires. We examined anamnestic information predicting PSG‐proven iRBD using logistic regressions and receiver operating characteristic curves. Results Five hundred forty‐three participants answered the advertisements, and 185 subjects fulfilling inclusion and exclusion criteria were screened. Of these, 124 received PSG after expert selection, and 78 (62.9%) were diagnosed with iRBD. Selected items of the RBDSQ, the Pittsburgh Sleep Quality Index, the STOP‐Bang questionnaire, and age predicted iRBD with high accuracy in a multiple logistic regression model (area under the curve 〉 80%). When comparing the algorithm to the sleep expert decision, 77 instead of 124 polysomnographies (62.1%) would have been carried out, and 63 (80.8%) iRBD patients would have been identified; 32 of 46 (69.6%) unnecessary PSG examinations could have been avoided. Conclusions Our proposed algorithm displayed high diagnostic accuracy for PSG‐proven iRBD cost‐effectively and may be a convenient tool for research and clinical settings. External validation sets are warranted to prove reliability. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
    Type of Medium: Online Resource
    ISSN: 0885-3185 , 1531-8257
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2041249-6
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