Sub-item Scores Research Articles

PIN95 PATIENT KNOWLEDGE ABOUT VACCINE-PREVENTABLE DISEASES: BASELINE RESULTS OF THE VACCINE EDUCATION THROUGH PHARMACISTS AND SENIOR CENTERS (VEPSC) TRIAL

Older adults experience low zoster and pneumonia vaccination rates, especially among minorities. Engaging patients in education about vaccines and vaccine-preventable diseases may be an important factor in increasing vaccine uptake. Vaccine Education through Pharmacists and Senior Centers (VEPSC) is a vaccine education trial of older adults being completed in senior community centers. Aim of VEPSC is to test effectiveness of didactic pharmacist-delivered education (PHARM) versus interactive peer-led small group education (PEER) in improving knowledge and beliefs about vaccination for zoster, influenza, and pneumonia. Purpose of this analysis is to present baseline knowledge results. VEPSC was conducted through Delaware Valley senior community centers from Fall 2017-Fall 2018. Participants completed knowledge and beliefs questionnaires at baseline, immediately post-program, and one month post-program. Knowledge scores were calculated as number of correct answers (max total score=22; max subitem scores for zoster, influenza, and pneumonia were 8, 7, and 7 respectively); baseline knowledge results were compared by race (Caucasian vs. other) via Wilcoxon Rank-Sum test and by group via ANOVA. Baseline sample had 280 participants (127 PEER, 153 PHARM). Groups were similar for all demographics except race: PEER was predominantly African-American (81.9%); PHARM was 45.1% African-American, 39.9% Caucasian (p<0.0001). Caucasians had statistically higher mean baseline knowledge than other races: total knowledge score (13.51 vs. 10.79, p<0.0001), zoster (4.71 vs. 3.49, p<0.0001), influenza (5.20 vs. 4.39, p=0.0007), pneumonia (3.60 vs. 2.91, p=0.014). Baseline mean total knowledge score and pneumonia subscore differed by group with PEER scoring higher than PHARM for both (total 11.74 PEER vs. 10.99 PHARM, p=0.0196; pneumonia 3.25 PEER vs. 2.91 PHARM, p=0.0197). Baseline mean zoster and influenza subscores did not statistically differ by group (zoster 3.87 PEER vs. 3.63 PHARM; influenza 4.62 PEER vs. 4.45 PHARM). Significant opportunity exists to improve older adults’ knowledge of vaccine-preventable diseases through a senior community center model.

Predictive factors for long-term clinical outcomes of deep brain stimulation in the treatment of primary Meige syndrome.

Primary Meige syndrome is characterized by blepharospasm and orofacial-cervical dystonia. Deep brain stimulation (DBS) is recognized as an effective therapy for patients with this condition, but previous studies have focused on clinical effects. This study explored the predictors of clinical outcome in patients with Meige syndrome who underwent DBS. Twenty patients who underwent DBS targeting the bilateral subthalamic nucleus (STN) or globus pallidus internus (GPi) at the Chinese People's Liberation Army General Hospital from August 2013 to February 2018 were enrolled in the study. Their clinical outcomes were evaluated using the Burke-Fahn-Marsden Dystonia Rating Scale at baseline and at the follow-up visits; patients were accordingly divided into a good-outcome group and a poor-outcome group. Putative influential factors, such as age and course of disease, were examined separately, and the factors that reached statistical significance were subjected to logistic regression analysis to identify predictors of clinical outcomes. Four factors showed significant differences between the good- and poor-outcome groups: 1) the DBS target (STN vs GPi); 2) whether symptoms first appeared at multiple sites or at a single site; 3) the sub-item scores of the mouth at baseline; and 4) the follow-up period (p < 0.05). Binary logistic regression analysis revealed that initial involvement of multiple sites and the mouth score were the only significant predictors of clinical outcome. The severity of the disease in the initial stage and presurgical period was the only independent predictive factor of the clinical outcomes of DBS for the treatment of patients with Meige syndrome.

Exploring regional variations in the cross-cultural, international implementation of the Patient Reported Outcomes Burdens and Experience (PROBE) study.

The Patient Reported Outcomes Burdens and Experience (PROBE) study has developed and validated the PROBE questionnaire for assessing patient-reported outcomes in people with haemophilia and participants without bleeding disorders. To explore the regional variations in the international implementation of the PROBE questionnaire. Data were collected from participants in four regions (Western Pacific, South America, North America and Europe). Participants were able to choose English or translated versions of the PROBE questionnaire into their first language. We used analysis of variance methods and multivariable regression to determine the relative contribution of the variance explained by region controlling for haemophilia diagnosis, age group and levels of educations. We also explored interactions between region and the other components. We used 862 questionnaires from 14 countries. Mean age of participants was 40.03years (standard deviation 13.89), and 73.67% were male. After adjusting, region contributed 0.44%-7.98% of the variance component in subitem scores and 0.26% in the PROBE score. Years of education contributed 0.34% in the PROBE score. Age and haemophilia diagnosis contributed 3.42% and 22.42% of the PROBE score. The results demonstrate that the PROBE questionnaire is valid to implement for assessing health status among patients with haemophilia and participants without bleeding disorders across regions.

Multicenter cross-sectional study of the clinical features and types of treatment of spinal cord-related pain syndrome

BackgroundWe termed chronic neuropathic pain (NeP) in patients with diseases associated with spinal cord damage as “spinal cord-related pain syndrome”. We conducted a survey of patients with the syndrome to assess the type and severity of NeP and its effect on QOL, and treatment modalities. MethodsThis cross-sectional study was conducted in 185 patients recruited from 15 medical institutions. We analyzed the questionnaires sent to clinicians (basic information, magnetic resonance imaging (MRI) findings, type and effectiveness of medications) and patients [modified Neuropathic Pain Symptom Inventory (NPSI) and short form (SF)-36 healthy survey]. ResultsThe incidence of spinal cord-related pain syndrome was highest in patients with cervical spondylotic myelopathy, ossification of posterior longitudinal ligament (OPLL) and spinal cord injury. The number of patients with at-level pain was higher than those with below-level pain; dysesthesia/paresthesia, spontaneous and evoked pain types were mainly seen in patients with at-level pain and dysesthesia/paresthesia was common among those with below-level pain. NPSI score was higher than 10 in the majority of patients, and the subscore for dysesthesia/paresthesia was significantly the highest. The NPSI score was the highest in patients with severe hyperintense signal increase on MRI. The scores of all SF-36 sub-items were significantly lower than the national average. The majority of patients used non-steroid anti-inflammatory drugs and gabapentin/pregabalin; the latter was significantly effective for allodynia, compared with other medications, regardless of the pain level. ConclusionsThe majority of patients with spinal cord-related pain syndrome suffered from severe NeP, which affected physical activity. The pain phenotype varied according to the level of the lesion and dysesthesia/paresthesia was the most intense. Compared with other medications, gabapentin/pregabalin was significantly effective especially for dysesthesia/paresthesia and evoked pain regardless of the pain level.

NIHSS sub-item scores predict collateral flow in acute middle cerebral artery infarction.

The status of collateral vessels has important clinical implications in acute ischemic stroke. To evaluate which components of ischemic symptoms were predictive of pretreatment collateral status, we tested the hypothesis that sub-item scores from the National Institutes of Health Stroke Scale (NIHSS) are associated with leptomeningeal collateral status in acute ischemic stroke with middle cerebral artery (MCA) occlusion. This study included consecutive patients with acute M1 occlusion who underwent revascularization treatment for acute MCA infarction. We evaluated clinical factors and the NIHSS score according to the collateral status assessed by multiphase perfusion computed tomography. Eighty-six patients were included (48 good collateral status, 38 poor collateral status). The patients with poor collateral status were more likely to have a higher total NIHSS score (18 versus 11, p < 0.001) and atrial fibrillation (65.8% versus 41.7%, p = 0.026) than patients with good collateral flow. In a multiple logistic regression, the NIHSS sub-items such as profound "facial palsy" (score 2 versus 0-1) and "visual field defect" (score 2 versus 0-1) were independently associated with poor collateral status. Among the NIHSS sub-items, severe facial palsy and visual field defect were associated with poor collateral status in acute MCA stroke with M1 occlusion. Decision on whether to treat these patients endovascularly should be made more cautiously due to the possibility of a poor outcome.

Effect of agomelatine 25–50 mg on functional outcomes in patients with major depressive disorder

PurposeThe purpose of this work is to investigate the effect of agomelatine on functioning compared with placebo in patients suffering from Major Depressive Disorder (MDD). MethodsData from two randomized, parallel, double-blind, placebo-controlled short-term agomelatine trials conducted by the manufacturer, one in adult and one in older patients, that evaluated the effect on social functioning, were pooled. The short term effect of agomelatine on social functioning was assessed using the Sheehan Disability Scale (SDS), according to SDS total and sub-item scores, as well as on functional response and remission rates. The Hamilton Depression rating scale was used to quantify severity of depression symptoms. A meta-analytic method using a random effect model was used to assess differences in treatment. ResultsIn total, 633 patients (422 on agomelatine; 211 on placebo) were included in the analyses. At endpoint, there was a significant difference in favor of agomelatine vs placebo of 3.47 (0.62) (95% confidence interval: [2.26; 4.67]; P < 0.001) on the SDS total score. Rates of symptomatic response and remission according to HAM-D17 total score were significantly higher in patients taking agomelatine (54.3% and 18.3% respectively) than in those taking placebo (29.4% and 9.5% respectively) with respective differences of 24.9%, p < 0.001 and 9.3%, p < 0.001. The functional response rates were 52.9% on agomelatine and 34.5% on placebo, with a significant placebo-agomelatine difference in favor of agomelatine of 18.30 ± 4.39% (95% CI: [9.69; 26.91], p < 0.001). The functional remission rates were 22.3% with agomelatine and 10.2% with placebo, with a significant difference in favor of agomelatine of 11.7 ± 3.11% (95% CI: [5.61; 17.79], p < 0.001). Combined symptomatic and functional response rates were 42.1% on agomelatine and 23.2% on placebo (p < 0.001), and the combined symptomatic and functional remission rates were 13.9% on agomelatine and 6.8% on placebo (p < 0.005). ConclusionThis study confirms the efficacy of agomelatine in improving social functioning in MDD patients.

Transcranial Direct Current Stimulation of the Left Temporal Lobe Modulates Insight

Creativity is the ability to come up with new and original solutions to problems. It is characterized along a dipole spectrum, with the opposing ends defined as convergent and divergent thinking. Previous studies have provided evidence that various cognitive functions and insight into non-verbal problems can be enhanced using non-invasive brain stimulation. The aim of this pilot study was to investigate whether convergent and divergent thinking, as well as insight, can be modulated by transcranial direct current stimulation (tDCS) over the anterior temporal lobe (ATL). Bilateral tDCS (1.5 mA, 20 minutes) was used to modulate activity of the right (AR tDCS) and the left (AL tDCS) ATL. Twenty-one participants performed a divergent thinking test (DTT) during tDCS, while a Remote Associates Task (RAT) was administered before and after tDCS to assess convergent thinking. A control experiment, using a Simple Reaction Time (SRT) Task, was conducted in 10 subjects before and after ATL tDCS in order to investigate whether its effects reflect attention or motor effects on the dominant hand. Results from this preliminary study showed that AL tDCS reduced RAT reaction times (RTs) by 20%. Both AL and AR tDCS did not change RAT accuracy, or the DTT total or sub-item scores. No differences were found in the SRT task after either AL or AR tDCS. These findings suggest that left but not right ATL is involved in convergent thinking. Conversely, both left and right temporal cortex tDCS-induced excitability changes failed to modulate divergent thinking. Limitations are discussed.

Could istradefylline be a treatment option for postural abnormalities in mid-stage Parkinson's disease?

BasegroundPostural abnormalities are refractory complications observed in mid- to late-stage Parkinson's disease (PD). MethodsWe analyzed the effects of istradefylline, a selective adenosine A2A receptor antagonist, on posture in 21 levodopa-treated PD patients from the subanalysis of a three-month open-label study. ResultsThe subitem score of posture (3.13) on the Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III significantly improved following istradefylline treatment (baseline, 1.3±1.0 points vs 3months, 0.9±0.9 points; p<0.05). Among 18 patients who had postural abnormalities at baseline, defined as 1 point or greater on MDS-UPDRS part III subitem 3.13, posture improved in 9 (50%) and was unchanged in 9 (50%) patients after istradefylline treatment. Improved and unchanged groups did not show differences in baseline characteristics, except for tendency for a higher rate of Hoehn and Yahr stage IV and V (Off state) observed in the improved group. Changes in scores of posture (3.13) did not correlate with those of other MDS-UPDRS part III items, PD Questionnaire-8, PD Sleep Scale-2 and Epworth Sleepiness Scale. ConclusionBased on our preliminary findings, istradefylline could be an effective treatment option for postural abnormalities in mid-stage PD patients.

Therapeutic efficacy of the combined therapy of daoyin prescription and cognitive training on vascular cognitive impairment

Objective To investigate the therapeutic efficacy of the combined therapy of daoyin prescription and cognitive training on vascular dementia(VD). Methods Totally 75 patients with VD were randomly divided into 3 treatment groups: daoyin prescription, cognitive training and two combined treatments(n=25 each)for 3 months.Mini mental state examination(MMSE), Loewenstein occupational therapy cognitive assessment(LOTCA)and activities of daily living scale(ADL)were used for assessing therapeutic efficacy among three treatment groups. Results There were no significant differences in baseline clinical data among the three groups(P>0.05), possessing data comparability.Scores of MMSE, LOTCA, ADL and LOTCA subitems of orientation, visual perception, spatial perception, visual movement, thinking operation and attention were significantly improved in the 3 groups after 3 months intervention versus pre-treatment with three treatments(all P<0.01). There were significant differences in scores of MMSE, LOTCA, ADL and LOTCA subitems of orientation, visual perception, visuo-motor organization and attention between combination therapy group versus daoyin prescription group and cognitive training group(all P<0.05). Conclusions Combined treatments of daoyin prescription and cognitive training have better effect on vascular cognitive function in patients with and VD.It can markedly improve the activities of daily living and cognitive function.It is worthy of further research in clinical medicine. Key words: Daoyin prescription; Cognition impairment; Dementia, vascular; Rehabilation

Effects of the Brain-Derived Neurotrophic Factor Val66Met polymorphism and resting brain functional connectivity on individual differences in tactile cognitive performance in healthy young adults.

Cognitive processes involve input from multiple sensory modalities and obvious differences in the level of cognitive function can be observed between individuals. Evidence to date understanding the biological basis of tactile cognitive variability, however, is limited compared with other forms of sensory cognition. Data from auditory and visual cognition research suggest that variations in both genetics and intrinsic brain function might contribute to individual differences in tactile cognitive performance. In the present study, by using the tactual performance test (TPT), a widely used neuropsychological assessment tool, we investigated the effects of the brain-derived neurotrophic factor (BDNF) Val66Met polymorphism and resting-state brain functional connectivity (FC) on interindividual variability in TPT performance in healthy, young Chinese adults. Our results showed that the BDNF genotypes and resting-state FC had significant effects on the variability in TPT performance, together accounting for 32.5% and 19.1% of the variance on TPT total score and Memory subitem score respectively. Having fewer Met alleles, stronger anticorrelations between left posterior superior temporal gyrus and somatosensory areas (right postcentral gyrus and right parietal operculum cortex), and greater positive correlation between left parietal operculum cortex and left central opercular cortex, all correspond with better performance of TPT task. And FC between left parietal operculum cortex and left central opercular cortex might be a mediator of the relationship between BDNF genotypes and Memory subitem score. These data demonstrate a novel contribution of intrinsic brain function to tactile cognitive capacity, and further confirm the genetic basis of tactile cognition. Our findings might also explain the interindividual differences in cognitive ability observed in those who are blind and/or deaf from a new perspective.

The disorder of lived corporeality: A possible link between attachment style and eating disorder psychopathology

IntroductionAccording to the trans-diagnostic perspective, disturbances in eating patterns of eating disorders (EDs) are considered as epiphenomena secondary to the patient's overvaluation of his/her body shape and weight.ObjectivesThe phenomenological theory states that the main feature of ED psychopathology is a disturbance in the way affected persons experience their own body (embodiment). Insecure attachment may promote the development of unstable self-identity leading to use body weight as a source of self-definition.AimsThe aim of our study was to assess the role of embodiment impairments in the relationships between attachment stiles and ED psychopathology.MethodsOne hundred twelve ED patients and 108 healthy subjects filled in the Identity and Eating Disorders (IDEA) questionnaire, which assesses embodiment and personal identity abnormalities, the eating disorder inventory-2 (EDI-2) and the experiences in close relationships (ECR) scale, which defines attachment styles.ResultsED patients showed IDEA, EDI-2 and ECR scores significantly higher than controls. Significant correlations between IDEA scores, insecure attachment and almost all EDI-2 sub-item scores emerged in ED patients but not in controls. IDEA total score mediated the relationship between avoidant attachment and EDI-2 interoceptive awareness.ConclusionsThese findings demonstrate that in ED patients insecure attachment is correlated to disorder of identity and lived corporeality that, in turn, mediates the association between attachment and a specific ED psychopathological trait. Therefore, we suppose that early relationships, through the development of disturbances in identity and embodiment, lead to altered perception of bodily signals and deranged discrimination of one's emotions, which could contribute to EDs.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cortisol awakening response in binge-purging and restrictive anorexia nervosa

IntroductionAnorexia nervosa (AN) is a complex psychiatric disorder characterized by severe restriction of food intake and aberrant behaviours. The endogenous stress response system, including the hypothalamus-pituitary-adrenal (HPA) axis, may have a role in the pathophysiology of AN.ObjectivesIt has been shown that specific clinical traits of AN, such as binge-purging behaviours, may be associated with higher psychopathology and poorer outcomes. Therefore, the HPA axis functioning could differ between patients with restrictive AN (ANR) and those with binge-purging AN (ANBP).AimsIn order to evaluate whether HPA axis functioning differs between the two subtypes of AN, we assessed the cortisol awakening response (CAR) of symptomatic ANR and ANBP patients.MethodsOur sample included 17 ANBP and 18 ANR patients, and 42 healthy women. All of them filled in the Eating Disorder Inventory-2 (EDI-2). For CAR assessment, participants collected saliva samples at home. Saliva cortisol concentrations were measured by an enzyme immunoassay method.ResultsANR and ANBP patients exhibited a CAR significantly higher than healthy women. Furthermore, the CAR of ANBP women was higher than that of ANR women and positively correlated with the bulimia subitem score of the EDI-2.ConclusionsPresent findings show, for the first time, differences in the CAR between ANBP and ANR subtypes supporting the idea that binge-purging behaviours may have a specific connection with HPA axis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Association between Montreal Cognitive Assessment Sub-Item Scores and Corresponding Cognitive Test Performance in Patients with Frontotemporal Dementia and Related Disorders

The Montreal Cognitive Assessment (MoCA), a brief screening test developed to detect patients with mild cognitive impairment, is used in clinical settings across North America [Nasreddine et al.: J Am Geriatr Soc 2005;53:695-699]. The MoCA has been demonstrated to be sensitive to cognitive deficits in frontotemporal dementias (FTD) and related disorders [Coleman et al.: Alzheimer Dis Assoc Disord 2016;30:258-263]. Given attentional impairments in patients with FTD, whether and to what extent the abbreviated items on the MoCA may predict performance on corresponding assessments is not known. Testing and demographic data were extracted from a clinical database using a sample of 91 patients with FTD and related disorders. The relationship between MoCA items and corresponding neuropsychological tasks was assessed through McNemar tests and Spearman correlations. While some MoCA items such as letter fluency, orientation, and clock drawing were strongly correlated with the corresponding standard cognitive test, the MoCA trails were insensitive to impairment compared to the full Trail Making B Test (p = 0.01). In contrast, MoCA naming and delayed recall sub-items detected cognitive impairment more frequently than available comparison tests. The MoCA is a sensitive screening measure to detect impairment in patients with FTD and related disorders, but cognitive deficits specific to FTD result in differential performance on MoCA items compared to longer standard cognitive tests.

P183 Transcranial direct current stimulation improves sleep quality

Introduction Sleep disturbance has been recognized as a common and significant complication linked to decreased quality of life in patients with neuropsychiatric disease. Currently, pharmacological therapy is the most common treatment for sleep disturbance, although benefits tend to be limited. Objective We assessed whether transcranial direct current stimulation (tDCS) improves sleep quality in patients with neurological and psychiatric diseases. Materials & methods 26 neuropsychiatric patients (age 19–86, n = 2 stroke, n = 4 dysphagia, n = 3 pain, n = 8 hereditary spastic paraparesis, n = 4 Parkinson’s disease, n = 2 aphasia, n = 3 depression) underwent tDCS treatment. tDCS montage was different for each pathology. The intensity of stimulation was set at 2 mA and delivered for 20 min for 5 consecutive days. The Pittsburgh Sleep Quality Index (PSQI) ( Buysse, 1989 ) was used to assess sleep quality at baseline (T0) and after the tDCS treatment (T1). Results One way ANOVA analysis showed that anodal tDCS improved PSQI total score by 13% [(mean ± SD) T0: 6.3 ± 4 vs T1: 5 ± 3.6; p = 0.004] and PSQI sub-item scores subjective quality of sleep by 22% (T0: 1.1 ± 0.7 vs T1: 0.92 ± 0.68; p = 0.016) and habitual sleep efficiency by 17% (T0: 0.31 ± 0.67 vs T1: 0.04 ± 0.19 p = 0.031). No differences were found between pathology. Conclusion Despite the small sample size and different tDCS montages, data from our observational study showed that anodal tDCS for five days improved sleep quality and efficiency. tDCS could be a non-invasive and valuable new tool for managing sleep disorders.

Эффекты экстракта Цимицифуги кистевидной Ze 450 (симидона) в лечении климактерической симптоматики – обсервационное исследование

Background: Root extracts of Cimicifuga racemosa (L.) Nutt. have been successfully used in the treatment of climacteric complaints.Method: In this observational study, Cimicifuga racemosa (CR) extract Ze 450 was studied in 442 unselected ambulatory female outpatients with menopausal complaints under daily practice conditions. Physicians were suggested to treat patients for the first 3 months with 13 mg/d CR (high dose) and to continue over additional 6 months either with this treatment or to switch to 6.5 mg/d CR (low dose). The choice of treatment and its dose, however, was fully at the discretion of the physician.Results: After 3-months treatment with high dose, symptom severity (Kupperman Menopause Index, KMI) decreased significantly (p < 0.001) from baseline values. Continuation of treatment with high dose or low dose decreased total KMI and its sub-item scores further (high dose, low dose: p < 0.001). However, more patients (84.9%) responded to high dose than to low dose (78.4%) and showed an improvement of symptoms (p = 0.011).Conclusion: This observational study demonstrated that treatment with CR in unselected patients with climacteric complaints under the conditions of daily practice resulted in a significant improvement of menopausal symptoms assessed by the total KMI score and its sub-item scores with an effect size similar to that in a previous randomized, controlled clinical trial. Treatment with both doses Ze 450 (low and high dose) is well tolerated by patients and has an additional positive effect in extending the treatment for more than 3 months, with a further decrease in the total KMI. However, prolonged treatment with a high dose is more efficient, since it, in contrast to the low dose therapy, can significantly reduce each of menopausal symptoms.

Differences in Cortisol Awakening Response between Binge-Purging and Restrictive Patients with Anorexia Nervosa.

Malnutrition and childhood trauma were shown to affect in opposite way the cortisol awakening response (CAR) of patients with anorexia nervosa (AN). To assess the influence of binge-purging behaviour on the CAR of AN patients, we measured the CAR of restrictive AN (ANR) or binge-purging AN (ANBP) patients without history of childhood maltreatment. Seventeen ANBP women, 18 ANR women and 42 healthy women collected saliva samples at awakening and after 15, 30 and 60 min, and filled in the Eating Disorder Inventory-2 (EDI-2). ANR and ANBP patients exhibited a CAR significantly higher than healthy women. Moreover, the CAR of ANBP women was even higher than that of ANR women and positively correlated with the bulimia subitem scores of the EDI-2. Present findings show, for the first time, differences in the CAR between ANBP and ANR subtypes, which may suggest a possible connection between the HPA axis functioning and binge-purging. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Differences in Neuroticism Between Patients with Glaucoma Who Have Discontinued Visits to Ophthalmologists and Those Who Make Regular Visits: Implications for Adherence to Topical Glaucoma Medications.

IntroductionNeuroticism is a personality trait often described in individuals with glaucoma (GLC), but is not necessarily representative of the total population of patients. There is a population of patients with GLC who are invisible to clinical ophthalmologists; in other words, those who once have been diagnosed with GLC, but spontaneously stop visiting an ophthalmologist. Little is known about their neuroticism personality trait. In the present study, the authors compared the level of neuroticism between patients no longer visiting an ophthalmologist and those who continue visit them regularly.MethodsPatients were assigned to two groups according to the duration of their last visit to an ophthalmologist: the Discontinued group included those patients who had not visited an ophthalmologist for the last 6 months, and the Regular Visitor group included those patients who continued to make regular visits to an ophthalmologist. The Japanese version of Ten Items Personality Inventory (TIPI-J), a questionnaire specifically used to assess the Big Five personality traits (extraversion, agreeableness, conscientiousness, neuroticism, and openness), was completed by patients through a dedicated website.ResultsThree-hundred and seventy-three patients with GLC were recruited. The neuroticism score from the TIPI-J in the Discontinued group was significantly lower than that in the Regular Visitor group (7.63 ± 2.23 vs. 8.23 ± 2.21, respectively; P = 0.01). No significant difference was found in the other TIPI-J sub-item scores between the Discontinued and the Regular Visitor groups.ConclusionIn this study, the authors showed that neuroticism trait in patients with GLC who have discontinued visiting their ophthalmologists was lower than that in patients who regularly visited them, on the basis of the Big Five personality traits as measured by the TIPT-J.FundingSanten Pharmaceutical Co., Ltd.

Pretreatment Cognitive Profile Likely to Benefit from Donepezil Treatment in Dementia with Lewy Bodies: Pooled Analyses of Two Randomized Controlled Trials

Background/Aims: Based on Mini-Mental State Examination (MMSE) subitem scores, in dementia with Lewy bodies (DLB), we aimed to delineate features of cognitive impairment, identify cognitive domains improved by donepezil, and define a pretreatment cognitive profile likely to benefit from donepezil. Methods: Pooled data were used from two randomized controlled trials of donepezil in DLB (n = 235). Baseline MMSE subitem scores were calculated for all patients. Mean changes in subitem scores at week 12 were compared between the placebo and the active group. Finally, the subgroup identification based on differential effect search (SIDES) method was applied. Results: Baseline subitem scores were relatively low for serial 7's, delayed recall, and copying. Significant improvement by donepezil was found for orientation, serial 7's, repetition, 3-step command, and copying. The subgroup with pretreatment scores of serial 7's = 1, 2, or 3, delayed recall ≥1, and copying = 0 were the best responders. MMSE change in subgroups increased as more of these three conditions were fulfilled. Conclusion: Cognitive domains characteristically impaired in DLB are particularly improved by donepezil. The number of fulfilled conditions for serial 7's = 1, 2, or 3, delayed recall ≥1, and copying = 0 (likely to benefit score) may predict the response to donepezil in DLB patients.

Health-related quality of life in patients with spinal dural arteriovenous fistulae.

Neurological improvement in patients with spinal dural arteriovenous fistulae (SDAVF) is often partial even after adequate treatment. While treatment outcomes have been evaluated primarily on the basis of the postoperative changes in neurological deficits, outcome measures should also reflect the patient-reported outcome (PRO). We conducted a health-related quality of life (HRQOL) survey in 52 SDAVF patients; 33 (63.5%) completed the short-form 36 Health Survey (SF-36) questionnaire. They were 25 males and 8 females ranging in age from 47 to 85 years (mean age 70.0years). The mean follow-up period was 95.6months. We analyzed the completed questionnaires and examined the clinical factors associated with their HRQOL. After treatment, gait- and micturition disturbances persisted in 31 (93.9%) and 31 (93.9%) of our patients; 26 (78.8%) reported chronic leg pain. The SF-36 scores of treated SDAVF patients were significantly lower than the national average of 50 for all 8 sub-items in the questionnaire. The scores for physical functioning (PF) and role-physical (RP) were particularly low. With the exception of bodily pain (BP), there was a significant negative correlation between the Aminoff-Logue scale (ALS) scores for gait- and micturition and the sub-item scores. The score for BP showed a significant positive correlation with the scores for the 7 other SF-36 sub-items. The HRQOL of treated SDAVF patients was lower than the national average with respect to both physical and mental aspects. Persistent post-treatment pain and gait- and micturition disturbances were responsible for their lower HRQOL.

Effect of specific immunotherapy on the psychological health level and quality of life in patients with allergic rhinitis

Objective: To study the effect of specific immunotherapy on the psychological health level and quality of life in patients with allergic rhinitis(AR).Method:Selected 97 cases diagnosed as moderate to severe persistent AR patients, were treated with specific immunotherapy for one year. All patients received the evaluation with symptom check list 90(SCL-90) and rhinoconjunctivitis quality of life questionnaire(RQLQ) before specific immunotherapy, six, and 12 months after specific immunotherapy.Result:The total scores, scores of somatization, obsessive, anxiety, depression and phobia in SCL-90 of AR patients after 12 months treatment were significantly lower than that before treatment（P < 0.05）. Total score of quality of life and subitem score in RQLQ of AR patients after 12 months treatment were obviously lower than that before treatment (P < 0.05）.Conclusion:Specific immunotherapy can effectively alleviate the clinical symptoms and improve psychological health level and quality of life of AR patients.