Browsing by Subject "Neuropsykologia"

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  • Kauhanen, Lina-Lotta (Helsingin yliopisto, 2021)
    Objective: The coronavirus disease COVID-19 causes neuropsychological problems to a proportion of patients having contracted the illness in the months following the illness and on a more long-term basis. Currently there is little knowledge about how the required level of care in the acute phase affects the presence of symptoms and their change over time. The objective of this study was to investigate the neuropsychological effects of COVID-19 from a patient self-reported symptoms and cognitive screening perspective. The study examines the effects of the required level of care in the acute phase and time since contracting the illness on self-reported symptoms and cognitive screening results three and six months after the acute phase. Furthermore, the aim was to illustrate the relationship between these two assessments. Methods: The data was collected within the RECOVID-20 project (Helsinki and Uusimaa Hospital District and University of Helsinki). Subjects (N = 164, of which 96 women, mean age 54.1 years) contracted COVID-19 in the spring of 2020. The data was collected from three different levels of care as required by the acute phase: intensive care unit patients, regular inpatient wards and patients who were ill at home. Self-reported symptoms were assessed with the A-B Neuropsychological Assessment Schedule and cognitive performance was measured by the Montreal Cognitive Assessment-Blind screening tool three and six months after the acute phase. Group differences and change over time was analysed using multivariate variance analyses and linear mixed models. Results and conclusions: About a third of all patients reported neuropsychological symptoms regardless of the level of care required in the acute phase both three and six months after the acute phase. Symptoms consisted mainly of fatigue, slowing and concentration problems. In the cognitive screening patients having received ICU and inpatient ward care performed worse compared to patients having been ill at home, but a statistically significant result was not detected when controlling for age. A statistically significant relationship between self-reported symptoms and cognitive performance was observed only in ICU patients at three months. Although the majority of COVID-19 patients do not have significant symptoms after the acute phase, there are patients that show preliminary signs of more chronic symptoms based on both self-reported symptoms and cognitive screening. More research is needed to investigate the causes of these symptoms.
  • Kallio, Eeva-Liisa (Helsingin yliopisto, 2019)
    Dementia is an age-related, progressive and chronic syndrome, which is characterized by cognitive decline from a person’s prior performance level, neuropsychiatric symptoms, and severe inability to manage everyday activities. The most common late-life cause of dementia is Alzheimer’s disease, followed by vascular dementia, Lewy body dementia, and mixed dementia. The limited efficacy of current pharmacological treatments has directed research increasingly to various non-pharmacological therapies, such as cognitive training (CT). The findings so far are inconsistent and conflicting. The two aims of this thesis were (1) to systematically evaluate the current evidence on the effects of CT in dementia; and (2) to explore the feasibility and effectiveness of a systematic CT program for patients with established dementia in a randomized controlled trial (RCT). The effects of CT on participants’ cognition, psychological well-being, and health-related quality of life (HRQoL) were investigated in a Finnish Cognitive Intervention (FINCOG) trial among older home-dwelling patients with mild to moderate dementia who participated in regular adult day care. The systematic review focused on 35 eligible RCTs including participants with dementia, using restorative or compensatory CT programs, and concerning the effects of CT on cognition, functional abilities, psychological well-being, and quality of life of patients. Beneficial effects of CT were primarily reported on global cognition, training-specific functioning, and occasionally on mood, however, several limitations in research methodology decrease the current grade of evidence. Low methodological quality of a trial resulted predominantly from low statistical power, poorly described randomization methods, and non-robust statistical methodology. Furthermore, CT interventions were highly heterogeneous, trial drop-outs inadequately described, and intention-to-treat analysis as well as long-term follow-up infrequently used. The FINCOG participants (n = 147) were randomized in two arms: CT intervention (n = 76), and control groups (n = 71). Measures of cognition, psychological well-being, and HRQoL were assessed before the intervention, and three and nine months after baseline assessment. A systematic 12-week CT program was conducted in adult day-care centers twice a week for 45 minutes. Regular CT was found to be feasible, and subjective gain was achieved by 76 % of the feedback responders. However, CT did not improve or stabilize cognition in older adults with dementia. Moreover, the participants did not benefit from CT either in terms of their HRQoL, or psychological well-being. In conclusion, the findings of this thesis do not support the effectiveness of CT among older patients with established dementia.
  • Immonen, Satu; Launes, Jyrki; Järvinen, Ilkka; Virta, Maarit; Vanninen, Ritva; Schiavone, Nella; Lehto, Eliisa; Tuulio-Henriksson, Annamari; Lipsanen, Jari; Michelsson, Katarina; Hokkanen, Laura (2020)
    The aim was to examine cross-sectional association between moderate alcohol consumption and total brain volume in a cohort of participants in early middle-age, unconfounded by age-related neuronal change. 353 participants aged 39 to 45 years reported on their alcohol consumption using the AUDIT-C measure. Participants with alcohol abuse were excluded. Brain MRI was analyzed using a fully automated method. Brain volumes were adjusted by intracranial volume expressed as adjusted total brain volume (aTBV). AUDIT-C mean of 3.92 (SD 2.04) indicated moderate consumption. In a linear regression model, alcohol consumption was associated with smaller aTBV (B=- 0.258, p
  • Peltonen, Kati; Launes, Jyrki; Koskinen, Sanna; Vartiainen, Matti; Pajunen, Sara; Pertab, Jon; Laitala, Tiina; Hokkanen, Laura (2020)
    Abstract The usefulness of on-field signs in predicting concussion outcome is under debate. We studied the prevalence of these signs and analyzed the predictive value for post-injury cognitive recovery in Finnish elite-level youth ice hockey players. Of the 570 consecutive athletes, 52 were concussed during seasons 2015-2017. After exclusion criterion analysis included 34 hockey players (14-20 years-old). Follow-up assessment was performed seven days post-injury and compared with pre-injury baseline. Cognitive performance was assessed using the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT?) battery. Hierarchical regression analyses were conducted to examine the relationship between on-field signs of concussion and the post-injury change in cognitive performance. The findings indicated that on-field loss of consciousness, amnesia, and vacant look were associated with larger decrements in cognition. Loss of consciousness accounted for 22% of the variance in verbal memory scores; amnesia accounted for 15% of the variance in verbal memory scores, and the presence of vacant look accounted for 9% of the variance in visual memory performance. The presence of loss of consciousness, amnesia, or vacant look is risk factors for longer recovery times and predict the need for extended cognitive follow-up.
  • Mansikka, Tuomas (Helsingin yliopisto, 2018)
    The relationship between cognition and functional capability is an important research topic as it concerns the ecological validity of clinical neuropsychology. The purpose of this thesis was to explore the relationship between executive functioning and functional capability in very mild to moderate Alzheimer's disease. A further goal was to investigate the effect of dementia severity on the relationship between executive functioning and functional capability. The study sample consisted of relatively aged individuals (mean age 83.53 years), which is meritable, since very few analogous studies have been conducted with as old a sample. The sample of this study consisted of Alzheimer's disease patients who participated in an intervention study involving elderly dementia patients by Helsinki University Central Hospital during 2014–2016. Baseline measurements of the study were used. The sample (n=97) was split into very mild/mild (n=55) and moderate (n=42) Alzheimer's disease using the Clinical Dementia Rating scale (CDR). Executive functioning and functional capability were measured using the Frontal Assessment Battery (FAB) and Alzheimer's Disease Cooperative Study–Activities of Daily Living (ADCS-ADL), respectively. The relationship between executive functioning and fuctional capability was measured using regression analysis. In this study the relationship between executive functioning and functional capability could not be replicated. Furthermore, dementia severity was found to have no effect on the relationship between executive functioning and functional capability. There might have been notable dementia comorbidity, physical morbidity and old age fragility within the sample which have had an impact on the results. Moreover, functional capability was conceptualized using only the total score of the ADL measure. In the future functional capability should be measured more minutely, inspecting the individual items of the selected ADL measure.