| 1. |
- Macfarlane, M. D., et al.
(författare)
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Shape abnormalities of the caudate nucleus correlate with poorer gait and balance: Results from a subset of the ladis study
- 2015
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481. ; 23:1, s. 59-
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Tidskriftsartikel (refereegranskat)abstract
- Objective Functional deficits seen in several neurodegenerative disorders have been linked with dysfunction in frontostriatal circuits and with associated shape alterations in striatal structures. The severity of visible white matter hyperintensities (WMHs) on magnetic resonance imaging has been found to correlate with poorer performance on measures of gait and balance. This study aimed to determine whether striatal volume and shape changes were correlated with gait dysfunction. Methods Magnetic resonance imaging scans and clinical gait/balance data (scores from the Short Physical Performance Battery [SPPB]) were sourced from 66 subjects in the previously published LADIS trial, performed in nondisabled individuals older than age 65 years with WMHs at study entry. Data were obtained at study entry and at 3-year follow-up. Caudate nuclei and putamina were manually traced using a previously published method and volumes calculated. The relationships between volume and physical performance on the SPPB were investigated with shape analysis using the spherical harmonic shape description toolkit. Results There was no correlation between the severity of WMHs and striatal volumes. Caudate nuclei volume correlated with performance on the SPPB at baseline but not at follow-up, with subsequent shape analysis showing left caudate changes occurred in areas corresponding to inputs of the dorsolateral prefrontal, premotor, and motor cortex. There was no correlation between putamen volumes and performance on the SPPB. Conclusion Disruption in frontostriatal circuits may play a role in mediating poorer physical performance in individuals with WMHs. Striatal volume and shape changes may be suitable biomarkers for functional changes in this population. © 2015 American Association for Geriatric Psychiatry.
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| 2. |
- Balercia, G., et al.
(författare)
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Thyroid function in Klinefelter syndrome: a multicentre study from KING group
- 2019
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Ingår i: Journal of Endocrinological Investigation. - : Springer Science and Business Media LLC. - 0391-4097 .- 1720-8386. ; 42:10, s. 1199-1204
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Tidskriftsartikel (refereegranskat)abstract
- - Purpose: The prevalence and the etiopathogenesis of thyroid dysfunctions in Klinefelter syndrome (KS) are still unclear. The primary aim of this study was to evaluate the pathogenetic role of hypogonadism in the thyroid disorders described in KS, with the scope to distinguish between patients with KS and hypogonadism due to other causes (Kallmann syndrome, idiopathic hypogonadotropic hypogonadism, iatrogenic hypogonadism and acquired hypogonadotropic hypogonadism after surgical removal of pituitary adenomas) called non-KS. Therefore, we evaluated thyroid function in KS and in non-KS hypogonadal patients. Methods: This is a case–control multicentre study from KING group: Endocrinology clinics in university-affiliated medical centres. One hundred and seventy four KS, and sixty-two non-KS hypogonadal men were enrolled. The primary outcome was the prevalence of thyroid diseases in KS and in non-KS. Changes in hormonal parameters were evaluated. Exclusion criterion was secondary hypothyroidism. Analyses were performed using Student’s t test. Mann–Whitney test and Chi-square test. Results: FT4 was significantly lower in KS vs non-KS. KS and non-KS presented similar TSH and testosterone levels. Hashimoto’s thyroiditis (HT) was diagnosed in 7% of KS. Five KS developed hypothyroidism. The ratio FT3/FT4 was similar in both groups. TSH index was 1.9 in KS and 2.3 in non-KS. Adjustment for differences in age, sample size and concomitant disease in multivariate models did not alter the results. Conclusions: We demonstrated in KS no etiopathogenic link to hypogonadism or change in the set point of thyrotrophic control in the altered FT4 production. The prevalence of HT in KS was similar to normal male population, showing absence of increased risk of HT associated with the XXY karyotype. © 2019, Italian Society of Endocrinology (SIE).
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| 3. |
- Hillert, J., et al.
(författare)
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Expert opinion on the use of contraception in people with multiple sclerosis
- 2022
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Ingår i: Multiple Sclerosis Journal. - : Sage Publications. - 1352-4585 .- 1477-0970. ; 28:Suppl. 3, s. 187-188
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The most appropriate use, type, and timing of contraception in people with multiple sclerosis (PwMS) is poorly understood, and specific guidance is absent.Aims and Objectives: To provide insight into potential clinical guidelines for the use of contraception by PwMS through development of recommendations by a consensus-based program led by international clinical experts.Methods: A multidisciplinary steering committee (SC) of 13 international expert healthcare professionals (HCPs) identified 15 key clinical questions on the use of contraception in PwMS, which addressed issues relating to patient-centred care, selection of contraception for PwMS, and time needed to use contraception since the last dose of disease modifying therapies (DMTs). Twenty-five clinical recommendations addressing the questions were drafted using evidence obtained from a comprehensive systematic literature review combined with expert opinion from the SC. An extended faculty of 32 HCPs from 18 countries including a patient association representative, and the SC members (n=12), voted on the recommendations. Consensus on recommendations was achieved when ⩾75% of respondents expressed an agreement score of 7–9, on a 9-point scale.Results: Overall, consensus was achieved on 24 out of 25 clinical recommendations. In detail, consensus in the range of 90–100% was achieved on 11 recommendations, 12 recommendations achieved 80–89% consensus, and 1 recommendation achieved 75–79% consensus (n=44). The strength of recommendations ranged from 7–9. The one statement failing to achieve consensus scored 74.1%. Clinical recommendations are provided on the process of prescribing contraception for PwMS, including the recommended types of HCPs involved and optimal topics to discuss; the range of contraceptive options and the key considerations involved in selecting an appropriate method of contraception; and the timing of starting and stopping contraception in relation to the use of DMTs.Conclusions: These expert recommendations were based on a robust consensus approach, providing timely and practical guidance on the use of contraception for HCPs treating PwMS and will form the basis of further publications and clinical tools.
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| 7. |
- Olesen, Pernille J, et al.
(författare)
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The predictive value of cerebral ischemic lesions for dementia
- 2008
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Ingår i: Vas-Cog, Singapore 14-16 Jan 2009.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background & Objective Changes in white matter are known to be related to dementia and cognitive decline. We examined whether CT-detected white matter lesions (WMLs) predicted dementia or cognitive decline in a population followed for five years. Methods A representative sample of persons aged 70-82 years were examined with a neuropsychiatric examination and a CT scan in 2000-2001 (N=657). A follow-up examination was performed in 2005 (N=503). People without dementia at the time of CT scanning and who participated in the examinations in 2005 were included (N=497). The Wahlund scale was used to define WMLs using a score from 0 (no lesions) to 3 (severe lesions). Cognitive status was assessed with the Mini Mental State Examination (MMSE). The difference in MMSE score from 2000 to 2005 (∆MMSE) was used as a general measure on cognitive decline. Differences in performance on other neuropsychiatric tests were included to get more sensitive measures of change in cognitive function. Regression analyses were applied to analyze whether WMLs could predict the outcome of dementia or cognitive decline five years later. Results Thirty-seven people were diagnosed with dementia in 2005 (7.4%), of these 12 (32%) had any WML of severity >1 on the CT performed five years earlier. For the non-demented group the comparable number was 77 (17%). Significant cognitive decline according to ∆MMSE was seen in the group who were diagnosed with dementia. Preliminary regression analysis shows that cognitive decline and parieto-occipital WMLs predicted onset of dementia. Conclusion The findings suggest that WMLs are weak predictors of dementia. Only WMLs in parieto-occipital areas were related to dementia five years later. Further analyses will show the relation between WMLs and decline in cognitive symptoms.
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| 8. |
- Olesen, Pernille J, et al.
(författare)
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White matter lesions in the elderly increases the risk of major depression five years later
- 2009
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Ingår i: IFPE, Wien 16-19 April 2009.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective To study the association between ischemic white matter lesions (WMLs) and major depressive episode (MDE) in a population-based sample followed for five years. Methods A randomized sample of non-demented elderly was investigated in 2000-2001 and in 2005-2006 with psychiatric and physical examinations. Among those who participated at baseline (n=914), 813 were alive in 2005 and 681 (84%) took part in the follow-up examination. A computerized tomography (CT) of the head was done on 462 individuals aged 70-86 years at baseline. Women (n=329) were stratified into two age-groups, 70- (n=196) and 78-86-year olds (n=133). WMLs were rated from 0 (none) to 3 (severe). Results The prevalence of MDE was lower in 2000 (3.6%; n=12/329) than in 2005 (7.3%; n=24/329). Moderate to severe WMLs were present in 11.6% (n=38/329). In 70-year old women, WMLs detected in 2000 were associated with an increased risk of having MDE in 2005 (OR=6.98; CI=2.06-23.67; p=0.002). WMLs were not associated with MDE in 2000 or with MDE in those older than 70-years at baseline. Conclusion WMLs in 70-year old women were associated with an increased risk of MDE five years later.
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| 9. |
- Scott, Gregory, et al.
(författare)
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Minocycline reduces chronic microglial activation after brain trauma but increases neurodegeneration.
- 2018
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Ingår i: Brain : a journal of neurology. - : Oxford University Press (OUP). - 1460-2156 .- 1460-2156. ; 141:2, s. 459-471
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Tidskriftsartikel (refereegranskat)abstract
- Survivors of a traumatic brain injury can deteriorate years later, developing brain atrophy and dementia. Traumatic brain injury triggers chronic microglial activation, but it is unclear whether this is harmful or beneficial. A successful chronic-phase treatment for traumatic brain injury might be to target microglia. In experimental models, the antibiotic minocycline inhibits microglial activation. We investigated the effect of minocycline on microglial activation and neurodegeneration using PET, MRI, and measurement of the axonal protein neurofilament light in plasma. Microglial activation was assessed using 11C-PBR28 PET. The relationships of microglial activation to measures of brain injury, and the effects of minocycline on disease progression, were assessed using structural and diffusion MRI, plasma neurofilament light, and cognitive assessment. Fifteen patients at least 6 months after a moderate-to-severe traumatic brain injury received either minocycline 100 mg orally twice daily or no drug, for 12 weeks. At baseline, 11C-PBR28 binding in patients was increased compared to controls in cerebral white matter and thalamus, and plasma neurofilament light levels were elevated. MRI measures of white matter damage were highest in areas of greater 11C-PBR28 binding. Minocycline reduced 11C-PBR28 binding (mean Δwhite matter binding = -23.30%, 95% confidence interval -40.9 to -5.64%, P = 0.018), but increased plasma neurofilament light levels. Faster rates of brain atrophy were found in patients with higher baseline neurofilament light levels. In this experimental medicine study, minocycline after traumatic brain injury reduced chronic microglial activation while increasing a marker of neurodegeneration. These findings suggest that microglial activation has a reparative effect in the chronic phase of traumatic brain injury.
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| 10. |
- Simoni, M, et al.
(författare)
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Prevalence of CT-detected cerebral abnormalities in an elderly Swedish population sample.
- 2008
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Ingår i: Acta neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 118:4, s. 260-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To measure the prevalence of computed tomography (CT)-detected cerebral lesions in a population-based sample of elderly persons living in Göteborg, Sweden. METHODS: Cerebral CT-scans were performed in the case of 466 women (mean age 74.3 +/- 5.1 years) and 191 70-year-old men. A single rater assessed white matter lesions (WML) using four different scales, lacunar lesions, large infarcts, cortical atrophy, and basal ganglia calcifications. RESULTS: White matter lesions frequency assessed by different scales ranged between 54.5% and 68.5%. Lacunar lesions were detected in 46.7% (30.1% had lacunes >5 mm) and cerebral infarcts in 3.0% of participants. Overall, 72.8% of participants evidenced cerebral vascular abnormalities. Severe cortical atrophy was more common in temporal (6.4%) and frontal (6.7%) lobes, than in parietal (1.7%) and occipital (1.1%) lobes. Basal ganglia calcifications were found in 38.7% of participants. WML, lacunar lesions, large infarcts, and degree of cortical atrophy correlated positively with age. More lacunes, basal ganglia calcifications, and occipital lobe atrophy were associated with male gender. CONCLUSIONS: Vascular and other brain lesions are very common on CT-scan in an elderly population, but large vascular lesions are rare. This study provides the first reference for the prevalence of CT-detected abnormalities in an elderly Swedish population.
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