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Pachalska M.,Center for Cognition and Communication | Bidzan L.,Medical University of Gdansk | Bidzan M.,University of Gdansk | Goral-Polrola J.,Old Polish University
Medical Science Monitor | Year: 2015

Background: The purpose of the present study was to assess the influence of vascular factors on the degree of intensity and rate of progression of cognitive disorders in the course of Alzheimer Disease (AD). Material/Methods: The research group consisted of 39 persons, all of whom were diagnosed with AD according to the NINCDS/ADRDA criteria. We divided these patients into 2 subgroups, based on the vascular factors measured by the modified Hachinski Ischemic Scale (Ha-mod): group A, without the vascular component (HA-mod score of 0–1 point), and group B, with the vascular component (a score over 1 point). Cognitive functions were evaluated at baseline and again 2 years later, using the Cognitive Part of the Alzheimer Disease Assessment Scale (ADAS-cog). Results: We found that the patients from subgroup B, with the stronger vascular component, demonstrated the highest intensity of cognitive disorders at baseline, both in terms of the overall ADAS-cog score, and in the subscores for ideational praxis, orientation, spoken language ability, comprehension of spoken language, and word-finding difficulty in spontaneous speech. Another variable which was connected with the intensity of dementia was age. After 2 years, however, the rate of progression of cognitive disorders was not significantly different between the 2 groups. Conclusions: The severity of vascular factors correlates directly with the intensity of cognitive disturbances. At the 2-year follow-up examination, however, no correlation was observed in the research group between greater vascular involvement and more rapid progression of cognitive disorders, as measured by the ADAS-cog scale. © Med Sci Monit, 2015.

Bidzan M.,University of Gdansk | Bidzan L.,Medical University of Gdansk | Pachalska M.,Center for Cognition and Communication
Annals of Agricultural and Environmental Medicine | Year: 2014

Objective. Vascular changes are observed in most cases of Alzheimer's disease (AD). Observations of AD and vascular disease (VD) allow us to surmise that vascular changes may not only affect cognitive impairment in AD but may also have a negative influence on the neuropsychiatric symptoms which often occur in the course of the disease. The aim of the study was to evaluate the impact of vascular factors on the neuropsychiatric symptoms in Alzheimer's Disease. Material and methods. The study included 48 people with a preliminary diagnosis of Alzheimer's Disease on the basis of NINCDS/ADRDA criteria. The evaluation of impairments in cognitive functioning was carried out by means of the Alzheimer Disease Assessment Scale - the cognitive part (ADAS - cog), whereas the behavioural and psychological symptoms were evaluated by means of the Neuropsychiatric Inventory - the version adapted for residents of nursing homes for the elderly (Neuropsychiatric Inventory - Nursing Home Version) (NPI - NH). The score on the Hachinski scale was the basis for dividing the study participants into two groups - those with a mild vascular component (0-1 points on the Hachinski scale) and those with a severe vascular component (2-4 points). Results. The analyzed groups did not differ with respect to the intensity of cognitive impairments (ADAS-cog) or age of the participants. Scores obtained on the NPI - NH scale as well as some of its elements (depression/dysphoria and anxiety) had a discriminating value. Studies show that vascular factors are a serious risk factor for neuropsychiatric symptoms in AD. Conclusions. Vascular factors in Alzheimer's Disease influence the presence of neuropsychiatric symptoms. In the course of angiogenic dementia a greater frequency in depressive disorders was shown. The most visible differences between individuals with a greater and lesser burden of vascular factors was in the realm of depressive and dysphoric disorders.

Bidzan L.,Medical University of Gdansk | Bidzan M.,University of Gdansk | Pachalska M.,Andrzej Frycz Modrzewski Cracow University | Pachalska M.,Center for Cognition and Communication
Medical Science Monitor | Year: 2012

Background: The symptoms of Alzheimer's disease (AD) are numerous, including worsening of mood, psychotic symptoms, aggressive and impulsive behaviours, and many others. It is generally assumed that there exists a relationship between the severity of dementia and aggressive symptoms. The aim of this study was to assess the relationship between aggressive and impulsive behaviours and cognitive function disorders in AD patients. Material/Methods: Forty-eight AD patients living in a nursing home were included in the research group on the basis of NINCDS/ADRDA criteria. The subjects underwent two years of naturalistic observation. The intensity of agitation and aggressive behaviours was assessed on the basis of the Cohen-Mansfield Agitation Inventory (CMAI). The Alzheimer's Disease Assessment Scale Cog (ADAS-cog) was used to assess cognitive function. Pharmacotherapy administered during the observation period was also taken into account. Results: Thirty-one patients completed the two year long observation. Individuals with more severe cognitive deficiencies demonstrated a greater intensity of aggressive and impulsive behaviours, as assessed using the CMAI scale. Aggression escalated together with the development of dementia disorders. The intensity of dementia disorders was most significantly connected with physical agitation and verbal aggression. The use of neuroleptics and mood stabilisers decreased the progression of aggressive and impulsive behaviours. Conclusions: There is a relationship between cognitive functioning disorders and the intensification of aggressive and impulsive behaviours. More severe forms of dementia are connected with greater intensification of aggressive and impulsive behaviours as the disease progresses. Periodical administration of pharmacotherapy may reduce the development of aggressive behaviours. © Med Sci Monit.

Zielinska J.,Pedagogical University of Cracow | Goral-Polrola J.,Old Polish University | Polrola P.,Jan Kochanowski University | Luckos M.,Andrzej Frycz Modrzewski University | And 3 more authors.
Annals of Agricultural and Environmental Medicine | Year: 2016

Objective. The study aimed to evaluate the hyperactivity of the frontal lobes in a patient with obsessive-compulsive disorders. Case description. A 21-year-old female met the diagnostic criteria of DSM-5 since her behaviour was characterized by a preoccupations with negative thoughts and by repetitive attempts to decrease or stop those behaviours. Two working hypotheses were tested to find neuromarkers of OCD and anxiety in the patient described. In agreement with the 'OCD hypothesis' an increase of the frontal beta activity and an increase of the parietalalpha activity pattern was found. The 'anxiety' hypothesis found confirmation in an increased left temporal P1 wave in response to the visual stimuli observed in ERPs. In all three conditions (EO, EC, GO/NOGO task), two characteristics were deviant from the normative average data in EEG spectra. First, an increase of frontal beta activity and the increase of parietal alpha activity was noted. The independent component analysis applied for 700 ms EEG fragments in GO and NOGO conditions revealed a strong activation over the central areas. Conclusions. Specific patterns of QEEG and ERPs, the increase of beta activity frontally, and the increase of parietal alpha activity pattern which produce hyper-frontality, might be useful in the diagnosis of an OCD patient. ERPs in a GO/NOGO task can be used in the assessment of functional brain changes in OCD patients. © 2016, Institute of Agricultural Medicine. All rights reserved.

Pachalska M.,Andrzej Frycz Modrzewski Cracow University | Pachalska M.,Center for Cognition and Communication | Ledwoch B.,Maria Curie Sklodowska University | Moskala M.,Jagiellonian University | And 4 more authors.
Medical Science Monitor | Year: 2012

Background:The aim of present article is to compare patients with damage to the orbitofrontal cortex and prison inmates in terms of social intelligence and social intelligence monitoring. In addition, personal principles and emotional regulation of behavior will be assessed in both groups. Material/Methods: 20 patients with orbitofrontal cortical injury, 20 prisoners and 20 controls answered questions fromthe Social Interactions Assessment Questionnaire. Then they evaluated their self disclosure, reported their emotions related to self disclosure and declared their personal principles concerning conversations with strangers. Results: The patients with damage to the orbitofrontal cortex disclosed themselves to a stranger less appropriately than did other subjects, and did not assess it critically. They also violated their own declared principles, but did not feel embarrassed because of that. The prison inmates spoke out less forthrightly on many topics and felt confused during the whole examination. Conclusions: Damage to the the orbital part of frontal lobes may result in a disorder of self-disclosure monitoring and impairment of social intelligence in conversations with unknown persons. Prison inmates give information about themselves unwillingly, which may result from their specific experiences during criminal and judicatory procedures and confinement. © Med Sci Monit.

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