ABSTRACT
Background. Multiple sclerosis (MS) is an autoimmune and demyelination disease of the central nervous system that causes progressive accumulation of disability over time. Recent studies have highlighted the correlation between metabolic disorders and cognitive dysfunctions. The present study aims to evaluate the correlation between components of the lipid profile and cognitive dysfunctions in patients affected by MS.Methods. 90 MS inpatients were included in this study. We divided the sample into three subgroups to evaluate the influence of the presence of dyslipidemia: G1 (patients with dyslipidemia), G2 (patients without dyslipidemia), G3 (patients with a higher than normal lipid value). Patients underwent rehabilitation treatment which included conventional physiotherapy, speech therapy, psychological support, cognitive rehabilitation, nutritional therapy, robotic rehabilitation, cognitive rehabilitation, and virtual reality.Results. The results showed that the three subgroups had a significant improvement in global cognitive functioning (MOCA p < 0.00), working memory (BRB-NV SRT-LTS p < 0.00) and in attention process (BRB-NV SDMT p < 0.00). Only in the G2, we observed a significant improvement in visuospatial abilities (RAO SPART p < 0.00). Moreover, we found that the cholesterol was negatively correlated with the cognitive functioning score of the patients after rehabilitation and the EDSS score. While the triglyceride scores were negatively correlated with the working memory score before and after rehabilitation. BMI scores were negatively correlated with the visuospatial ability score.Conclusion. Investigating these aspects could help in managing patients, preventing alterations that compromise the patient's quality of life.
Subject(s)
Cognitive Dysfunction , Dyslipidemias , Multiple Sclerosis , Cognition , Cognitive Dysfunction/etiology , Dyslipidemias/complications , Humans , Lipids , Multiple Sclerosis/complications , Multiple Sclerosis/psychology , Neuropsychological Tests , Quality of LifeABSTRACT
RATIONALE: Limbic encephalitis is a parenchymal inflammation caused by viral, bacterial, or other microbial and postinfectious agents, which is usually expressed by multifocal neurological signs and cognitive impairment. PATIENT CONCERNS: A 50-year-old female was admitted in postacute phase, at our rehabilitative Center, to undertake neuro-motor treatment for a period of 4 months. DIAGNOSES: The patient was affected by limbic encephalitis. Clinical presentation revealed attention, memory and executive dysfunctions, as well as behavioral changes, emotional dysregulation and reduction of self-awareness. INTERVENTIONS: The patients received an intensive cognitive and motor rehabilitation training. OUTCOMES: Neuropsychological assessment and magnetic resonance imaging were performed before and after rehabilitative training to evaluate the cognitive and cerebral changes induced by treatment. The patient showed an improvement in cognitive performances and behavioral aspects. LESSONS: The reducing cognitive deficits, especially memory deficits, could improve quality of life by using available cognitive resources.
Subject(s)
Cognitive Dysfunction/etiology , Cognitive Dysfunction/rehabilitation , Limbic Encephalitis/psychology , Limbic Encephalitis/rehabilitation , Brain/diagnostic imaging , Cognitive Dysfunction/diagnostic imaging , Female , Humans , Limbic Encephalitis/diagnostic imaging , Middle AgedABSTRACT
OBJECTIVE: The differential diagnosis between atypical parkinsonism and Parkinson's disease is difficult, especially in the early stage. Severe postural instability, falls, and complex gait impairments are usually confined to the later stage of Parkinson's disease, while atypical parkinsonism patients may present a severe postural instability with consequent falls in the earlier stages. METHODS: We retrospectively studied 20 subjects with parkinsonism using clinical and baropodometric tools to give quantitative and objective data on the postural, balance, and gait disturbances. RESULTS: The statistical analysis between atypical parkinsonism and Parkinson's disease patients showed a significant difference in the frequency of long lead time parameter, foot area, foot load and speed, and, in particular, atypical parkinsonism patients presented a prevalent long lead time impairment (8/8 patients) when compared with Parkinson's disease patients. DISCUSSION: Beside significant differences in the clinical features between the Parkinson's disease and atypical parkinsonism, our study showed that baropodometric investigation may a valuable tool for the definition of postural and motor extrapyramidal abnormalities, permitting an earlier differentiation between atypical parkinsonism and Parkinson's disease.
