Brain Sciences最新文献

{"title":"Polyneuropathy in Cerebrotendinous Xanthomatosis: Diagnostic Challenges and Potential for Therapeutic Intervention.","authors":"Antonio Edvan Camelo-Filho, Pedro Lucas Grangeiro Sá Barreto Lima, Francisco Luciano Honório Barreto Cavalcante, Oliver Reiks Miyajima, Carolina Figueiredo Santos, Rodrigo Fagundes da Rosa, André Luiz Santos Pessoa, Pedro Braga-Neto, Paulo Ribeiro Nóbrega","doi":"10.3390/brainsci14111159","DOIUrl":"10.3390/brainsci14111159","url":null,"abstract":"<p><p>Cerebrotendinous xanthomatosis (CTX) is a rare metabolic disorder caused by mutations in the <i>CYP27A1</i> gene, leading to cholestanol accumulation in various tissues, including peripheral nerves. Polyneuropathy is an underrecognized feature with considerable variability in clinical presentation and neurophysiological findings in CTX. This review assesses the prevalence, clinical manifestations, and diagnostic methodologies of polyneuropathy in CTX, exploring its underlying mechanisms and potential treatment outcomes. A literature review was conducted using PubMed, Embase, and the Virtual Health Library databases with search terms related to CTX and polyneuropathy. A total of 892 articles were initially identified, with 59 selected for in-depth analysis. The review focused on studies examining peripheral nerve involvement in CTX, including nerve conduction studies, electromyography, and nerve ultrasound. Polyneuropathy in CTX was observed in 50% to 77.7% of patients across multiple case series. Neurophysiological findings varied, with reports of axonal, demyelinating, and mixed polyneuropathies. Clinical presentation included lower limb atrophy, pes cavus, and distal weakness, with sensory symptoms less frequently reported. Treatment with chenodeoxycholic acid (CDCA) showed potential in improving nerve conduction parameters, although the response was variable and dependent on the timing of intervention. Polyneuropathy in CTX presents significant diagnostic challenges due to its heterogeneous presentation and varying neurophysiological findings. Early recognition and intervention are crucial for improving patient outcomes. Peripheral nerve ultrasound is a promising diagnostic tool, complementing traditional neurophysiological assessments. Further research is needed to standardize protocols and explore the full therapeutic potential of CDCA in managing CTX-related polyneuropathy.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Situation Awareness Variations on Multimodal Physiological Responses in High-Speed Train Driving.","authors":"Wenli Dong, Weining Fang, Hanzhao Qiu, Haifeng Bao","doi":"10.3390/brainsci14111156","DOIUrl":"10.3390/brainsci14111156","url":null,"abstract":"<p><strong>Background: </strong>In safety-critical environments, human error is a leading cause of accidents, with the loss of situation awareness (SA) being a key contributing factor. Accurate SA assessment is essential for minimizing such risks and ensuring operational safety. Traditional SA measurement methods have limitations in dynamic real-world settings, while physiological signals, particularly EEG, offer a non-invasive, real-time alternative for continuous SA monitoring. However, the reliability of SA measurement based on physiological signals depends on the accuracy of SA labeling.</p><p><strong>Objective: </strong>This study aims to design an effective SA measurement paradigm specific to high-speed train driving, investigate more accurate physiological signal-based SA labeling methods, and explore the relationships between SA levels and key physiological metrics based on the developed framework.</p><p><strong>Methods: </strong>This study recruited 19 male high-speed train driver trainees and developed an SA measurement paradigm specific to high-speed train driving. A method combining subjective SA ratings and task performance was introduced to generate accurate SA labels.</p><p><strong>Results: </strong>The results of statistical analysis confirmed the effectiveness of this paradigm in inducing SA level changes, revealing significant relationships between SA levels and key physiological metrics, including eye movement patterns, ECG features (e.g., heart rate variability), and EEG power spectral density across theta, alpha, and beta bands.</p><p><strong>Conclusions: </strong>This study supports the use of multimodal physiological signals for SA assessment and provides a theoretical foundation for future applications of SA monitoring in railway operations, contributing to enhanced operational safety.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological Abnormalities Associated with Alcohol Dependence During Long-Term Rehabilitation Treatment of German Inpatients.","authors":"Josef Rabl, Dieter Geyer, Dario Kroll, Fabrizio Schifano, Norbert Scherbaum","doi":"10.3390/brainsci14111160","DOIUrl":"10.3390/brainsci14111160","url":null,"abstract":"<p><strong>Background: </strong>Alcohol dependence is associated with several neuropsychological abnormalities, such as increased impulsivity or attentional bias towards drug-related stimuli. However, it is debated whether these abnormalities are on the decline after long-term abstinence from alcohol. Inpatient rehabilitation treatment enables the longitudinal investigation of such variables during a long, largely secured, period of abstinence.</p><p><strong>Methods: </strong>This study involved alcohol-dependent patients consecutively admitted for a duration of 14-26 weeks to an inpatient rehabilitation treatment center located in a hospital specializing in substance use disorders. Craving and impulsivity were assessed with the means of two questionnaires (e.g., OCDS-G and BIS-11); conversely, attentional bias and problems with inhibition were measured with the help of two computer-based experiments (e.g., dot-probe task and stop-signal-reaction task). Investigations were conducted at entry, after 6 weeks, and during the last two weeks of the inpatient treatment.</p><p><strong>Results: </strong>A total of 130 patients with alcohol dependence (mean age 43.3 years; 78.5% male) completed the first, <i>N</i> = 102 the second, and <i>N</i> = 83 the final assessment. Over the whole period of inpatient treatment, there was a significant decrease in patients' scores for both craving (t(83) = 7.8, <i>p</i> < 0.001) and impulsivity (t(82) = -3.75, <i>p</i> < 0.001, t(82) = 4.4, <i>p</i> < 0.001). However, there were no significant changes regarding attentional bias (t(82) = 0.16, <i>p</i> = 0.494) and inhibitory control (t(76) = 0.04, <i>p</i> = 0.482) scores.</p><p><strong>Conclusions: </strong>Neuropsychological abnormalities associated with alcohol dependence might persist even after a long abstinence period. The decrease in both craving and impulsivity levels may be explained by the protected, alcohol-free, hospital environment; however, patients' risk of post-discharge relapse may remain high, as the basic neurobiological mechanisms of alcohol dependence may persist for long periods, and possibly for more than 3-6 months.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Section of Neurological Manifestations Among SARS-CoV-2 Omicron Subvariants-Single-Center Study.","authors":"Justyna Jachman-Kapułka, Aleksander Zińczuk, Krzysztof Simon, Marta Rorat","doi":"10.3390/brainsci14111161","DOIUrl":"10.3390/brainsci14111161","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The Omicron variant of SARS-CoV-2 is undergoing constant mutation. New strains vary in neuropathogenicity and the neurological spectrum of disease. The aim of this study was to assess the frequency and clinical characteristics of neurological manifestations during the Omicron dominance among hospitalized patients, including the differences between three subsequent periods. <b>Methods</b>: This retrospective single-center study included 426 hospitalized adults with confirmed COVID-19 divided into three periods (O1, O2, and O3) dependent on the dominance of Omicron subvariants in Poland. Demographic and clinical data, in particular neurological manifestations, were collected and compared. <b>Results</b>: The median age of the group was 74, older in subsequent (later) periods. The number of patients with a history of previous SARS-CoV-2 infection or vaccination increased with the duration of the pandemic. The severity of COVID-19 became lower in successive periods. Neurological manifestations were observed in 55.4% of patients, and the most frequent were delirium, headache, myalgia, dizziness, cerebrovascular diseases, and encephalopathy. In subsequent periods of Omicron dominance, a higher frequency of neurological manifestations such as delirium, transient ischemic attack (TIA), and encephalopathy was observed. Headache or myalgia was related to a shorter hospitalization while delirium, cerebrovascular diseases, and ischemic stroke were linked with an increased risk of death. <b>Conclusions</b>: The Omicron variant of SARS-CoV-2 presents a wide spectrum of neurological manifestations. Although there is an improvement in the survival rate of patients with COVID-19, the frequency of neurological manifestations increases. The occurrence of delirium, cerebrovascular diseases, and ischemic stroke results in higher mortality.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Role of Invasion-Related Extracellular Matrix Molecules in Diffusely Infiltrating Grade 2 and 3 Astrocytomas.","authors":"László Szivos, József Virga, Zoltán Mészár, Melinda Rostás, Andrea Bakó, Gábor Zahuczki, Tibor Hortobágyi, Álmos Klekner","doi":"10.3390/brainsci14111157","DOIUrl":"10.3390/brainsci14111157","url":null,"abstract":"<p><strong>Background: </strong>Astrocytoma, an IDH-mutant is a common primary brain tumor. Total surgical resection is not feasible due to peritumoral infiltration mediated by extracellular matrix (ECM) molecules.</p><p><strong>Methods: </strong>This study aimed at determining the expression pattern of ECM molecules in different prognostic groups of WHO grade 2 and grade 3 patients and identifying the effect of onco-radiotherapy on tumor cell invasion of grade 3 patients. Gene and protein expression of ECM molecules was determined by qRT-PCR and immunohistochemistry, respectively.</p><p><strong>Results: </strong>In the different prognostic groups of grade 2 tumors HMMR, IDH-1, MKI-67, PDGF-A and versican, in grade 3 tumors integrin α-3, and in both groups integrin α-3 and IDH-1 mRNA expression was significantly different. Regarding protein expression, only integrin αV expression changed significantly in the prognostic groups of grade 2 tumors.</p><p><strong>Conclusions: </strong>Based on the invasion spectrum determined by this joint gene and protein expression analysis, there was a sensitivity of 87.5% and a negative predictive value of 88.9% regarding the different prognostic groups of grade 2 astrocytoma. For grade 3 tumors, the applied standard oncotherapeutic modalities apparently lacked significant anti-invasive effects.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142724622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reassessing the Neural Correlates of Social Exclusion: A Replication Study of the Cyberball Paradigm Using Arterial Spin Labeling.","authors":"Karin Labek, Roberto Viviani","doi":"10.3390/brainsci14111158","DOIUrl":"10.3390/brainsci14111158","url":null,"abstract":"<p><strong>Background/objectives: </strong>The cyberball paradigm has been used in numerous neuroimaging studies to elicit activation in neural substrates of social exclusion, which have been interpreted in terms of activity associated with \"social pain\". The objectives of the study were to assess not only the replicability but also the specificity of the areas activated by this paradigm.</p><p><strong>Methods: </strong>Functional imaging with arterial spin labeling, an approach to image longer mental states.</p><p><strong>Results: </strong>We replicated findings of previous meta-analyses of this paradigm in the inferior frontal gyrus and ventral cingular cortex. However, these areas were also active in a watch condition (in which participants were not excluded), although less so.</p><p><strong>Conclusions: </strong>These findings relativize a simple and specific interpretation of these areas as the neural substrates of social exclusion and social pain, as in previous studies. In a broader experimental context, similar activations have been reported by neuroimaging studies when semantic disambiguation and evaluation of action goals are required, an interpretation that may also apply to the effects elicited by this paradigm.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Window Coverage and Liquid Biopsy in the First-Line Therapy of Severe Sudden Sensorineural Hearing Loss.","authors":"Alexander Kilgue, Rayoung Kim, Lars-Uwe Scholtz, Conrad Riemann, Christoph J Pfeiffer, Matthias Schürmann, Ingo Todt","doi":"10.3390/brainsci14111154","DOIUrl":"10.3390/brainsci14111154","url":null,"abstract":"<p><strong>Introduction: </strong>Based on clinical practice guidelines, the application of corticosteroids as a first-line therapy is common. Although sudden sensorineural hearing loss (SSHL) etiology is primarily idiopathic, hearing loss can result from a perilymphatic fistula (PLF). Recent findings show evidence of a specific rate of PLF based on a cochlin-tomoprotein (CTP) detection test. Based on this rate of PLF treatment, the concepts of SSNHL need to be re-evaluated. The present study aimed to evaluate CTP in SSNHL patients and compare pre-surgical and post-surgical pure tone hearing thresholds after round and oval window sealing as first-line treatment.</p><p><strong>Material and methods: </strong>A total of 30 patients with unilateral SSNHL with a pure tone average (PTA) (4 Freq. of 60 dB or more were enrolled in a prospective study. All patients underwent tympanoscopy for middle ear exploration as a first-line treatment. After intraoperative observation of a possible PLF, all patients obtained middle ear lavage to gain CTP samples for following ELISA-based CTP detection tests. All patients received round window and oval window sealing with fascia. PTA hearing thresholds were analyzed post-surgically 3 weeks after treatment based on 4-frequency bone conduction (BC).</p><p><strong>Results: </strong>The average preoperative pure tone BC threshold was 97.7 dB compared with the 69 dB postoperative BC threshold. Mean BC improved by 20.3 dB after middle ear exploration and window sealing. A total of 56% (17 of 30) of patients recovered at least 10 dB. The middle ear cochlin-tomoprotein detection rate was 70% positive.</p><p><strong>Conclusions: </strong>The combination of early tympanoscopy and inner ear-specific cochlin-tomoprotein as a detection tool for suspected PLF showed evidence of PLF as a key causative in SSNHL.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Insights into the Mental Health of Healthcare Workers: Emotional Shifts During Two Years of the COVID-19 Crisis.","authors":"Maia Stanisławska-Kubiak, Grażyna Teusz, Michał Ziarko, Ewa Mojs","doi":"10.3390/brainsci14111155","DOIUrl":"10.3390/brainsci14111155","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies have highlighted the prevalence of mental health disorders among healthcare professionals during the COVID-19 pandemic, with varying indications of emotional strain. This study compares the psychological functioning of healthcare workers at the onset of the pandemic and two years later, offering a comprehensive assessment of their emotional and mental health status in the evolving context of COVID-19.</p><p><strong>Methods: </strong>This longitudinal analysis examined the relationship between stress, emotional processing, and their positive/negative impacts on medical personnel working in Polish hospitals and outpatient clinics in 2020 (<i>n</i> = 285) and 2022 (<i>n</i> = 252). The study employed the Toronto Alexithymia Scale-20 (TAS-20), Cohen's Perceived Stress Scale (PSS-10), Mini-COPE, Acceptance of Illness Scale (AIS), Emotional Processing Scale (EPS), STAI, and PANAS to assess psychological responses and coping mechanisms.</p><p><strong>Results: </strong>Findings revealed a significant increase in denial, substance use, self-blame, negative mood, and impaired psychological and somatic functioning, alongside heightened symptoms of depression and anxiety. Conversely, a marked decrease in planning, positive reinterpretation, acceptance, religious coping, and seeking social support (both emotional and instrumental) was observed over the two-year period.</p><p><strong>Conclusion: </strong>The prolonged nature of the COVID-19 pandemic has profoundly affected the psychological resilience of healthcare professionals, eroding critical emotional resources necessary for maintaining interpersonal relationships and mental well-being. These results underscore the need for targeted interventions to support the mental health of medical staff in the ongoing crisis.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroticism Overestimated? Neuroticism Versus Hypertonia, Pain and Rehabilitation Outcomes in Post-Spinal Cord Injury Patients Rehabilitated Conventionally and with Robotic-Assisted Gait Training.","authors":"Alicja Widuch-Spodyniuk, Beata Tarnacka, Bogumił Korczyński, Aleksandra Borkowska","doi":"10.3390/brainsci14111153","DOIUrl":"10.3390/brainsci14111153","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present study was to analyse the association between neuroticism (one of the Big Five personality traits) and the most common secondary sensorimotor complications occurring in patients after spinal cord injury (SCI), i.e., muscle spasticity (hypertonia) and pain, and to investigate the associations between neuroticism and the effects of conventional rehabilitation (dynamic parapodium) and those using robotic-assisted gait training (RAGT) in this group of patients. In addition, the association of neuroticism with self-efficacy, personal beliefs about pain control, and adopted coping strategies among SCI patients was analysed. These data can be used as a reference for designing effective forms of therapy and support dedicated to this group of patients.</p><p><strong>Methods and procedures: </strong>Quantitative analysis included 110 patients after SCI. The participants were divided by simple randomisation into a rehabilitation group with RAGT and a rehabilitation group with dynamic parapodium therapy (DPT). The following survey instruments were used for data collection: Revised NEO Personality Inventory (NEO-PI-R); Ashworth Scale; the Spinal Cord Independence Measure III (SCIM III); the Walking Index for Spinal Cord Injury II (WISCI-II); the American Spinal Injury Association Impairment Scale (AIS); the Pain Coping Strategies Questionnaire-CSQ; and the Beliefs about Pain Control Questionnaire-BPCQ.</p><p><strong>Outcomes and results: </strong>analyses showed a positive association between neuroticism and spastic tension (rho = 0.39; <i>p</i> < 0.001).</p><p><strong>Conclusions and implications: </strong>the study showed that a high level of neuroticism correlates with a higher level of spasticity, but no such correlation was observed for pain. Additionally, the study did not show a significant correlation between neuroticism and rehabilitation outcome depending on the rehabilitation modality (RAGT vs. DPT). The results underline the importance of carrying out a psychological diagnosis of patients to provide therapeutic support in the rehabilitation process.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11592360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effectiveness of Motor Imagery in Balance and Functional Status of Older People with Early-Stage Dementia.","authors":"Anna Christakou, Christina Bouzineki, Marousa Pavlou, George Stranjalis, Vasiliki Sakellari","doi":"10.3390/brainsci14111151","DOIUrl":"10.3390/brainsci14111151","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dementia involves the loss of cognitive abilities and impairs functional abilities in daily life. In motor imagery (MI) techniques, motor acts are mentally rehearsed without any overt body movements. The purpose of the randomized controlled trial was to examine the effects of MI on the motor function of older adults with dementia.</p><p><strong>Methods: </strong>Overall, 160 participants (43 men, 117 women, MMSE M = 23.20, SD = 0.15) from an Athens Day Care Center of the Alzheimer Association were randomized to (a) the MI and exercise group (experimental group) (n = 55), (b) the only exercise group (1st control group) (n = 52) and (c) the neither MI nor exercise group (2nd control group) (n = 53). The exercise session comprised 24 physiotherapy exercise sessions, lasting 45 min each, twice a week for 12 weeks. The exercises were selected from the Otago Exercise Program. Three assessments were performed: (a) one week prior to the program, (b) at one and a half months and (c) after the program. The experimental group performed a 30-minute MI with exercise program content after the end of every physiotherapy exercise session. The Multidirectional Reach Test, Five Times Sit-to-Stand Test (FTSST), Timed Up and Go test (TUG), Functional Gait Assessment (FGA) and Berg Balance Scale (BBS) were used to assess participants' balance and functional status.</p><p><strong>Results: </strong>In the intention to treat analysis (18 participants dropped out), the 3 × 3 repeated measures ANOVA indicated statistically significant results between the three groups on (a) the TUG (F = 3.06, df (2), <i>p</i> = 0.04), (b) the FTSST (F = 3.00, df (2), <i>p</i> = 0.05), (c) the forward direction test (F = 4.14 df (2), <i>p</i> = 0.02), the lateral right and the lateral left direction tests (F = 3.90, df (2), <i>p</i> = 0.02 and F = 7.87, df (2), <i>p</i> = 0.00, respectively), and (d) the FGA (F = 4.35, df (2), <i>p</i> = 0.01). The Friedman test showed significant statistical significant differences among the three groups for BBS (X² = 7.62, df = 2, <i>p</i> = 0.22), and an effect size of partial η² coefficient for F-tests was found. Post hoc comparisons using a Bonferroni test for ANOVA and Wilcoxon test for Friedman indicated that the mean scores for the experimental group and the 1st control were significantly better than the 2rd control group in many dependent variables.</p><p><strong>Conclusions: </strong>The study showed a positive effect of MI on balance and the functional status of older adults with early stages of dementia with possible beneficial effects on maintaining independence and reducing physical decline.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"14 11","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11591621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}