Apathy syndrome: a clinical entity?

Apathy is defined as a disorder of motivation that expresses itself at an emotional, cognitive and behavioural level. Apathy can occur as a symptom and a syndrome. In the recent years diagnostic criteria and a number of scales for measuring apathy in elderly with psychiatric or neurological disorders have been introduced. Two scales are specifically developed to measure apathy, the Apathy Evaluation Scale (AES) from Marin and the Apathy Scale (AS) from Starkstein. Both scales have been translated into Dutch. The AS is more convenient. The AS in addition can be used when applying the criteria for the apathy syndrome which has been introduced in 2001 by Starkstein. In addition, the Neuropsychiatric Inventory (NPI) and the 'Gedragsobservatieschaal voor de Intramurale Psychogeniatrie' (GIP) (a scale in Dutch) have an apathy domain. Conceptual problems surrounding apathy have only partly been resolved. The criteria for the apathy syndrome can only be used for assessing the extent of the problem. Apathy and depression are strongly correlated. Studies show that apathy as a syndrome can occur without concomitant depression in the elderly, but regularly occurs besides a depressive disorder, in percentages varying between 9% and 53% of the population under study. Especially the varying validity of an apathy syndrome in relation to late life depression needs further clarification.     

Apathy, but not depression, reflects inefficient cognitive strategies in Parkinson's disease

Background

The relationship between apathy, depression and cognitive impairment in Parkinson''s disease (PD) is still controversial. The objective of this study is to investigate whether apathy and depression are associated with inefficient cognitive strategies in PD.

Methods

In this prospective clinical cohort study conducted in a university-based clinical and research movement disorders center we studied 48 PD patients. Based on clinical evaluation, they were classified in two groups: PD with apathy (PD-A group, n = 23) and PD without apathy (PD-NA group, n = 25). Patients received clinical and neuropsychological evaluations. The clinical evaluation included: Apathy Evaluation Scale-patient version, Hamilton Depression Rating Scale-17 items, the Unified Parkinson''s Disease Rating Scale and the Hoehn and Yahr staging system; the neuropsychological evaluation explored speed information processing, attention, working memory, executive function, learning abilities and memory, which included several measures of recall (immediate free, short delay free, long delay free and cued, and total recall).

Findings

PD-A and PD-NA groups did not differ in age, disease duration, treatment, and motor condition, but differed in recall (p<0.001) and executive tasks (p<0.001). Immediate free recall had the highest predictive value for apathy (F =  10.94; p = 0.002). Depression and apathy had a weak correlation (Pearson index  = 0.3; p<0.07), with three items of the depression scale correlating with apathy (Pearson index between .3 and.4; p<0.04). The depressed and non-depressed PD patients within the non-apathetic group did not differ.

Conclusion

Apathy, but not depression, is associated with deficit in implementing efficient cognitive strategies. As the implementation of efficient strategies relies on the fronto-striatal circuit, we conclude that apathy, unlike depression, is an early expression of executive impairment in PD.     

Changes in sleep characteristics of rat preclinical model of Parkinson’s disease based on attenuation of the ubiquitin—proteasome system activity in the brain

Numerous experimental and epidemiological data indicate a high significance of environmental neurotoxins, specifically, inhibitors of the ubiquitin–proteasome system, in pathogenesis of Parkinson’s disease (PD). To develop a preclinical model of PD in rats we used a technique of intranasal administration of lactacystin, a natural proteasome inhibitor, into the brain. It was found that three weeks after the first lactacystin administration it induced a little degeneration of dopaminergic neurons in the olfactory bulb and substantia nigra pars compacta without any olfactory dysfunction and motor behavior disorders. Besides, its effect led to the appearance of some signs of sleep disorders: increased somnolence (especially in the dark, active daily phase), fragmentation of slow-wave sleep, decreased EEG delta rhythm during slow-wave sleep. These signs share some similarity with PD and could be useful in clinical studies for the quick search for polysomnographic markers of the early PD stage.     

De relatie tussen apathie,depressie en cognitief functioneren bij patiënten met MCI en dementie

Background

In dementia, apathy and depression are often seen as one disorder because of the many overlapping symptoms. However, for therapy a correct differentiation is essential. Moreover, apathy and depression are likely both associated with different cognitive deficits and progression of the disease. In this research we give an overview of cognitive domains associated with apathy and depression in MCI patients and report how often both disorders occur in a population sample.

Method

We administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to 117 cognitively healthy controls (GC), 97 patients with mild cognitive impairment (MCI) and 50 patients with dementia (DEM). In addition, the Apathy Evaluation Scale clinical version (AES-C) and the Geriatric Depression Scale (GDS) were administered.

Results

The number of patients with apathy increased with cognitive decline with respectively 3.4%, 10.4% and 41.5% of patients in the GC, MCI and DEM group. The prevalence of isolated depression was highest in the MCI group (18.8%). Correlation analyses in the MCI group showed that apathy and not depression was associated with a deficit in encoding, attention and global cognitive functioning.

Conclusion

The prevalence of apathy and depressive symptoms is different in patients with MCI, DEM and GC, and within the MCI group apathy and depression are associated with different cognitive domains.

     

Lifestyle regularity measured by the social rhythm metric in Parkinson's disease

Parkinson's disease (PD) is a chronic progressive motor disorder that may present with a spectrum of symptoms and disease severity. Therapy is frequently associated with motor fluctuations and dyskinesias; therefore, monitoring of motor fluctuations and daily abilities is important for adequate management. The Social Rhythm Metric (SRM) is a diary-like questionnaire that quantifies the extent to which a person's life is regular vs. irregular on a daily basis with respect to event timing. Lifestyle regularity has been assessed by the SRM in other clinical situations. The aim of this study was to evaluate lifestyle regularity in a population with PD using the SRM and its relationship to clinical and therapeutic factors. Twenty-eight consecutive patients with PD and 14 control subjects were studied. Severity of motor dysfunction was evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS). Depressive symptoms were assessed with the Montgomery Asberg Depressive Rating Scale (MADRS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and subjective daytime sleepiness with the Epworth sleepiness scale. Daily lifestyle regularity was assessed by the SRM for 2 weeks. Patients with PD had lower SRM scores than controls, and those with motor fluctuations had even lower scores (p=0.04). Patients with motor fluctuations showed more clinical disability (p=0.01), a worse quality of sleep (p=0.02), and more depressive symptoms (p=0.02). SRM results were correlated with PSQI values (p=0.016). Our findings show that the regularity of daily activities as measured by the SRM is disorganized in patients with PD and that this irregularity is related to sleep quality.     

Phagnalon Metlesicsii Nova Sp. Aus Westsizilien,Mit Einem Überblick Über Die Gruppe Von Phagnalon Rupestre Im Mittelmeerraum

Abstract

«Phagnalon metlesicsii», a new species from Western Sicily, with a survey of the «Ph. rupestre» — group in the Mediterranean Region. — Phagnalon metlesicsii, a new species of the complex Ph. rupestre — Ph. graecum, is described. It is entirely glabrous and occurs in Western Sicily (M. Cofano) on vertical limestone rocks, nearly 200 mts. above the sea, in community with a flora particularly rich on endemics. The variability of the whole complex is discussed and some infraspecific taxa are proposed.     

老年帕金森病患者睡眠障碍的危险因素及其对认知功能、心理状态和衰弱的影响

摘要 目的：探讨老年帕金森病（PD）患者睡眠障碍的危险因素,并观察睡眠障碍对认知功能、心理状态和衰弱的影响。方法：选取2018年3月~2021年9月期间中国人民解放军海军青岛特勤疗养中心收治的91例老年PD患者作为研究对象,根据是否存在睡眠障碍将入选的91例患者分为睡眠障碍组（n=56）及非睡眠障碍组（n=35）。采用蒙特利尔认知评估量表（MoCA）评估所有患者的认知功能状况。采用汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）评价患者焦虑、抑郁情况。采用Tilburg衰弱评估量表评估所有患者的衰弱情况。采用多因素Logistic回归分析探讨老年PD患者睡眠障碍的危险因素,并观察睡眠障碍对认知功能、心理状态和衰弱的影响。结果：睡眠障碍组的视空间与执行功能、语言、命名、延迟回忆、注意、抽象、定向评分及总分均低于非睡眠障碍组（P<0.05）。睡眠障碍组的HAMA、HAMD评分均高于非睡眠障碍组（P<0.05）。睡眠障碍组的心理衰弱、躯体衰弱、社会衰弱评分及总分均高于非睡眠障碍组（P<0.05）。多因素Losgistic回归分析结果显示：HAMA评分偏高、多巴丝肼片等效剂量偏高、HAMD评分偏高、Hcy偏高是老年PD患者睡眠障碍的危险因素（P<0.05）。结论：HAMA评分偏高、Hcy偏高、多巴丝肼片等效剂量偏高、HAMD评分偏高是老年PD患者睡眠障碍的危险因素。同时,睡眠障碍可加重老年PD患者的认知功能障碍和衰弱程度,增加抑郁焦虑情绪。     

De <Emphasis Type="Italic">BPSD-DS</Emphasis> evaluatieschaal voor dementiegerelateerde gedragsveranderingen bij mensen met downsyndroom

Behavioral and psychological symptoms of dementia (BPSD) have not been comprehensively studied in people with Down syndrome, despite their high risk on dementia. A novel evaluation scale was developed to identify the nature, frequency and severity of behavioral changes (83 behavioral items in 12 clinically defined sections). Central aim was to identify items that change in relation to the dementia status. Structured interviews were conducted with informants of people with Down syndrome without dementia (DS, N?=?149), with questionable dementia (DS?+?TD, N?=?65) and with diagnosed dementia (DS?+?AD, N?=?67). Group comparisons showed a pronounced increase in frequency and severity of items about anxiety, sleep disturbances, agitation & stereotypical behavior, aggression, apathy, depressive symptoms, and, eating/drinking behavior. The proportion of individuals presenting an increase was highest in the DS?+?AD group and lowest in the DS group. Interestingly, among DS?+?TD individuals, a substantial proportion already presented increased anxiety, sleep disturbances, apathy and depressive symptoms, suggesting that these changes may be early alarm signals of dementia. The scale may contribute to a better understanding of the changes, adapting daily care/support, and providing suitable therapies to people with Down syndrome. The scale needs to be optimized based on the results and experiences. The applicability, reliability and validity require further study.     

Lifestyle Regularity Measured by The Social Rhythm Metric in Parkinson's Disease

Parkinson's disease (PD) is a chronic progressive motor disorder that may present with a spectrum of symptoms and disease severity. Therapy is frequently associated with motor fluctuations and dyskinesias; therefore, monitoring of motor fluctuations and daily abilities is important for adequate management. The Social Rhythm Metric (SRM) is a diary‐like questionnaire that quantifies the extent to which a person's life is regular vs. irregular on a daily basis with respect to event timing. Lifestyle regularity has been assessed by the SRM in other clinical situations. The aim of this study was to evaluate lifestyle regularity in a population with PD using the SRM and its relationship to clinical and therapeutic factors. Twenty‐eight consecutive patients with PD and 14 control subjects were studied. Severity of motor dysfunction was evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS). Depressive symptoms were assessed with the Montgomery Asberg Depressive Rating Scale (MADRS), sleep quality with the Pittsburgh Sleep Quality Index (PSQI), and subjective daytime sleepiness with the Epworth sleepiness scale. Daily lifestyle regularity was assessed by the SRM for 2 weeks. Patients with PD had lower SRM scores than controls, and those with motor fluctuations had even lower scores (p=0.04). Patients with motor fluctuations showed more clinical disability (p=0.01), a worse quality of sleep (p=0.02), and more depressive symptoms (p=0.02). SRM results were correlated with PSQI values (p=0.016). Our findings show that the regularity of daily activities as measured by the SRM is disorganized in patients with PD and that this irregularity is related to sleep quality.     

Palmar ridge systems

A six — or seven — (fingers) «sites» system with sequential invading of interdigital ridge bundles agrees very well with actual data from literature. The palmridges of the left hand lag one «period» behind those of the right hands. Main line formulas and the regularities in their frequencies are to a large extent predictable and can be understood from the 7- «sites» model proposed in this publication.     

Insediamento e Diffusione di Buddleia Davidii Franch

Abstract

«Buddleya davidii» in «Valtellina» (North Italy), its settling and diffusion. — Vegetational areas where «Buddleya davidii» is naturalised in Valtellina are described and the subsequent phases are followed through 18 years.     

Preclinical dopaminergic dysfunction in rapid eye movement sleep behavior disorder

Patients with idiopathic rapid eye movement sleep behavior disorder have been reported to be at increased risk for developing Parkinson’s disease (PD), dementia with Lewy bodies, or multiple system atrophy. 6-[18F]fluoro-L-m-tyrosine/Positron emission topography (PET) is useful for evaluating PD patients from the early stage of the disease. Substantia nigra hyperechogenicity is a marker of vulnerability to PD. Decrease in 6-[18F]fluoro-L-m-tyrosine uptake in the striatum or hyperechogenic alterations in the substantia nigra may suggest the existence of an underlying neurode-generative disorder such as PD or dementia with Lewy bodies associated with preclinical dopaminergic dysfunction in patients with idiopathic rapid eye movement sleep behavior disorder.

     

Alteration in the Expression of Parkinson’s-Related Genes in Rat Hippocampus by Exercise and Morphine Treatments

Russian Journal of Genetics - Parkinson’s disease (PD) as a genetically heterogeneous disease is the second common neurological disorder which is associated with motor deficits and dementia...     

Sulla Presenza di Ificellarioli e di Conidi in Mieobionti Lichenici Coltivati in « Vitro ». Riassunto

Abstract

On the presence of « hyphycellariola » (swollen celles) and conidia in three lichenized fungi cultivated « in vitro ». — The Authors refer to the presence of « cellariola » (and « hyphycellariola ») found in pure cultures « in vitro » of the mycobiont of Xanthoria parietina and describe the morphology of conidia in the fungus isolated from Sarcogyne similis and Acarospora fuscata.

As far as the « cellariola » and « hyphycellariola » are concerned, it is the first note relative to the mycobionts of Lichens.

The Authors report the data of the utilized medium and the morphological observations.

This previous studies will be intensified by further research.     

Paradise lost: Mitochondrial eve refuted

Being based solely on neontological data, all «unique parent» evolutionary hypotheses, of which «Mitochondrial Eve» is one, fall into the category ofscala naturae. Mathematical treatment of neontological data bases, using cladistic approaches does not confer the status of scientific hypotheses onto such scenarios. Apart from these fundamental problems, such hypotheses are flawed on a number of other bases, including the fact that there is a proportion of parental contribution to mitochondrial lineages, despite widely publicised statements that mithocondrial DNA in mammals is «strictly» maternally inherited. Other weaknesses of «unique mother» hypotheses on that their proponents endeavour to describe the evolution of diploid organisms on the basis of variability in extant haploid organelles, the evolution of which is delinked from that of the diploid organism. A further difficulty is that it is not possible to reconstruct interspecific relationships on the basis of intraspecific variability. There is a general ignorance among proponents of «unique mother» hypotheses regarding the distribution of biological variability on the surface of the globe, a fact which renders the molecular clock inaccurate, and which upsets the simplistic proposal that molecular diversity equates with time. «Unique mother» scenarios are also invalidated by the presence of shared chromosome and other polymorphisms in african great apes and humans at similar percentages in the different lineages, a fact which indicates that these evolving populations did not experience «bottlenecks». These and other difficulties effectively refute the «Mitochondrial Eve» hypothesis, which in any case much resembles creationism of a special kind, in which the offspring of a breeding pair are visualised as belonging to a species different from its parents. Such extreme examples of the punctuational mode of evolution are highly likely to be incorrect.     

Analysis of motor unit firing characteristics in patients with motor neuron diseases

This study was designed to evaluate firing rate variability in patients with upper/lower motor neuron disorders. Twenty healthy subjects and 19 patients with motor neuron disorders participated in the study. Consecutive motor unit action potential pairs from extensor digitorum communis (EDC) muscle were recorded from each subject with trigger-delay line mode. Patients with motor neuron disorders (17.7?±?10.8?ms) showed significantly higher mean time variability of interpotential interval value than healthy volunteers (10.3?±?0.1?ms) (p?相似文献   

Crepis Bursifolia L., Nuova Stabile Inquilina della Flora Ligustica della Riviera di Ponente

Abstract

«Crepis bursifolia » L., new permanent tenant of the flora in west ligurian coast. — The author declares the permanent presence of « Crepis bursifolia » L. in Liguria, and informs about new stations of this species along the western riviera. The relates, furthermore, the unfavourable results of his close investigation to verify the eventual presence of further station of « C. bursifolia » L. found by former researcher.     

Differences in rapid eye movement sleep behavior disorder manifestation between synucleinopathies and tauopathies

Rapid eye movement sleep behavior disorder (RBD) frequently occurs in synucleinopathies including multiple system atrophy, Parkinson’s disease, and dementia with Lewy bodies despite the clinical course of RBD being different between these disorders. Comparatively, the existence of RBD symptoms is relatively rare in patients with progressive supranuclear palsy, a tauopathy showing atypical parkinsonism compared with Parkinson’s disease. Moreover, in patients with Alzheimer’s disease, which is another tauopathy, RBD symptoms are less frequent than dementia with Lewy bodies, although both disorders share commonalities in terms of the existence of cortical dementia. Thus, RBD is thought to be relatively specific to synucleinopathies.

     

La Cellula: Aspetti Morfologici e Metabolici Dei Suoi Organuli

Abstract

The cell: morphologic and metabolic aspects of its organelles. — Some aspects of the mechanism of the chloroplasts movement induced by light, it has been studied in «Elodea canadensis» leaves. Red, yellow and blue light induce the movement of the chloroplasts. Green light does not promote the movement. 5.10—⁵M CMU completely inhibits cyclosis. Photosynthesis is required for cyclosis. ATP alone, does not Substitute photosynthesis, however in the presence of green light, 5.10—³M ATP, pH 6.5, promotes cyclosis movement. It has been concluded that light has dual role in promoting the movement in «Elodea» leaves: first, inducing photosynthesis and consequently the ATP production; second, light is necessary to start the movement exciting a photo-receptor, visualized like a System Controlling the induction-repression of enzymes. It has been postulated that ATP produced by illuminated chloroplasts, saturated a «SSS» system, connected with another System, «SAV», lowering the plasma viscosity; ATP in this action is not necessarily used as energetic Compound. Successively, by means an unknow photoreceptor, the mechano-enzyme-system, «SEM», promotes cyclosis utilizing ATP as energic source. The movement stop when ATP is exausted or immediately, in the presence of ATP, when the photoreceptor is not working, like happens in the dark.     

丘脑底核-深部脑刺激术术后淡漠的研究进展

帕金森病(Parkinson's disease,PD)是一种由于中脑黑质以及其他核团结构的多巴胺能神经元变性所致的以进行性运动功能障碍为主要表现的疾病。近年来,双侧高频刺激的丘脑底核-深部脑刺激术(STN-DBS)治疗PD效果确切,疗效较好,但其出现了术后淡漠等类似副作用,严重影响了PD治疗效果和患者的生活质量,引起了临床医生的高度重视。本文对STN-DBS术后淡漠发病情况、表现及治疗进行综述,为临床诊治提供思路。