Caregiver Burden in Parkinson Disease With Dementia Compared to Alzheimer Disease in Korea.

Caregiver Burden in Parkinson Disease With Dementia Compared to Alzheimer Disease in Korea.

Filed under: Depression Treatment

J Geriatr Psychiatry Neurol. 2012 Nov 21;
Shin H, Youn J, Kim JS, Lee JY, Cho JW

We compared caregiver burden in Parkinson disease with dementia (PDD) to that in Alzheimer disease (AD) and examined the factors contributing to the burden in PDD. Totally, 42 patients with PDD and 109 patients with AD and their caregivers participated in this study. The caregiver burden was measured using the Burden Interview (BI). Scores of Barthel activities of daily living (BADLs), Mini-Mental State Examination, Clinical Dementia Rating of patients, and score of Center for Epidemiologic Studies Depression scale, and Euro-quality of life of the caregivers were examined. The Unified Parkinson’s Disease Rating Scale (UPDRS) and Hoehn and Yahr stage of the patients were administered to assess burden relating to parkinsonism on PDD. We used multiple linear regression to assess the predictors. The BI of caregivers was higher in PDD (47.9, Standard deviation [SD]: 3.8) than in AD (36.3, SD:2.1). In the AD group, the BI was predicted by cognitive function ((? ± SE: -0.8 ± 0.4, P value =.04) and basic ADL status of patients (? ± SE: -1.3 ± 0.1, P < .001), depressive symptoms (? ± SE: 1.1 ± 0.1, P < .001), and poor quality of life (? ± SE: -0.2 ± 0.1, P = .017) in caregivers. In PDD group, BI was predicted only by scores of Part 1 on the UPDRS (? ± SE: 2.9 ± 1.3, P = .03) of patients and depressive symptoms (? ± SE: 1.1 ± 0.2, P < .001) of the caregivers. We concluded the caregiver burden is higher in PDD than in AD and factors predicting burden are different in AD and PDD. In patients with PDD, the neuropsychiatric problems are the major contributor to caregiver burden. HubMed – depression

The chemotherapy long-term effect on cognitive functions and brain metabolism in lymphoma patients.

Filed under: Depression Treatment

Q J Nucl Med Mol Imaging. 2012 Nov 21;
Baudino B, D’agata F, Caroppo P, Castellano G, Cauda S, Manfredi M, Geda E, Castelli L, Mortara P, Orsi L, Cauda F, Sacco K, Ardito R, Pinessi L, Geminiani G, Torta R, Bisi G

AIM:A growing number of neuropsychological studies reported that chemotherapy may impair brain functions, inducing persistent cognitive changes in a subset of cancer survivors. The aim of this paper was to investigate the neural basis of the chemotherapy induced neurobehavioral changes by means of metabolic imaging and neuropsychological testing. METHODS: We studied the resting brain [18F]FDG-PET/CT images of 50 adult cancer patients with diagnosis of lymphoma: 18 patients were studied prior and 32 after to chemotherapy. All patients underwent to a neuropsychological examination assessing cognitive impairment (tests for shifting attention, verbal memory, phonemic fluency), depression, anxiety and distress. RESULTS: Compared to no chemotherapy patients, the treated group showed significant bilateral lower rate of glucose metabolism in prefrontal cortices, cerebellum, medial cortices and limbic brain areas. The metabolism of these regions negatively correlated with number of cycles and positively with post-chemotherapy time. The treated group showed a poorer performance in many frontal functions, but similar level of depression, anxiety and distress. CONCLUSIONS:Chemotherapy induced significant long-term changes in metabolism of multiple regions with a prevailing involvement of the prefrontal cortex. The observed cognitive dysfunctions could be explained by these changes. The recovery from chemotherapy is probably affected by treatment duration and by the time elapsed after its end. We speculated that the mechanism could be an accelerating ageing / oxidative stress that, in some patients at risk, could result in an early and persistent cognitive impairment.
HubMed – depression

Imbalance between Th17 and Treg Cells May Play an Important Role in the Development of Chronic Unpredictable Mild Stress-Induced Depression in Mice.

Filed under: Depression Treatment

Neuroimmunomodulation. 2012 Nov 20; 20(1): 39-50
Hong M, Zheng J, Ding ZY, Chen JH, Yu L, Niu Y, Hua YQ, Wang LL

Background: Recent data suggest that major depression is potentially associated with dysregulated cytokine production. However, the roles of T helper (Th) cells and their subsets in the development of depression still remain to be determined. The present study assessed changes in Th cell subsets and cytokines during the development of depression in a mouse model. Methods: Chronic unpredictable mild stress (CUMS) was used to simulate depression behavior in mice. The open field test, sucrose preference, and ingestion were used as evaluative indicators of depressive behavior. During the CUMS protocol, on days 3, 7, 14, and 21, we assessed behavioral changes, cytokine levels in serum or stimulated (CD3/CD28) cell culture medium, and mRNA expression (ELISA, RT-PCR), regulatory T (Treg) and Th17 subsets in spleen (ex vivo, flow cytometry, RT-PCR), and CD3/rIL-23-stimulated Th17 cell proliferation (MTT assay). Results: The results showed that in the depression model mice, IL-4 mRNA expression and serum levels increased on day 7, while no detectable change was observed in IFN-?. Notably, a reduced proportion of Th17 cells with decreased proliferation capacity was observed at later stages, in parallel with a decline in serum IL-23 levels. In contrast, an increased Treg cell proportion and increased Foxp3 mRNA expression were observed in the mid-stages. Correlation analysis showed that the proportion of Tregs was correlated negatively with sucrose preference, while the proliferation of Th17 cells was notably correlated positively with sucrose preference. Also, an increased TGF-? level was detected in serum and was believed to be a key factor responsible for the imbalance between Th17 and Treg cells. Furthermore, the sucrose preference in TGF-? type I receptor blockade mice increased considerably, compared with CUMS mice. Conclusion: These results indicate that in CUMS-induced depression, behavioral changes may closely correlate with the imbalance between Th17 and Treg cell subsets, and TGF-? may be a key regulatory cytokine.
HubMed – depression

Transcranial Magnetic Stimulation: An Alternative Depression Treatment – Mayo Clinic – Simon Kung, MD, psychiatrist at Mayo Clinic, describes using transcranial magnetic stimulation (TMS) for treating depression. A non-medication alternative.

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