Anna Starowicz-Filip

PSDRS, BDI, MoCA and MMSE as screening tools for the evaluation of mood and cognitive functions in patients at the early stage of cerebral stroke

Summary Aims. To evaluate the suitability of the Post-Stroke Depression Scale (PSDRS) for detecting affective dis- orders, to examine the correlation of depressed mood states with cognitive disorders in patients at an ear- ly stage of cerebral stroke, and to attempt a comparison of the effectiveness of detecting depressive and cognitive disorders with the selected clinical scales. Material and methods. The examination involved 43 patients within the first week after cerebral stroke. It was carried out with the application of two screening scales, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), and two scales for the evaluation of the degree of de- pressiveness: PSDRS and Beck Depression Inventory (BDI). Results . A significant negative correlation of the results of the PSDRS and MoCA scales was shown. De- pressed mood in patients post-cerebral stroke was statistically significantly correlated with the disorders in selected cognitive skills: visual and spatial functions, memory, attention functions and abstracting ability. Conclusions . The PSDRS and MoCA scales proved to be more effective tools for the evaluation of de- pressive and cognitive disorders in patients at an early stage after cerebral stroke than the conventionally applied MMSE and BDI scales. The examination results additionally show a significant dependence be- tween mood and the cognitive impairment in this group of patients. With the weakening of cognitive func- tioning, the patients mood also became depressed. stroke / post-stroke depression / cognitive functions

Analysis of anterior cerebral artery tortuosity: association with anterior communicating artery aneurysm rupture

BACKGROUNDnMany researchers have found a correlation between tortuous arteries and development of aneurysms in cerebral arteries. However, there are no studies analyzing the impact of tortuosity on risk of subarachnoid hemorrhage (SAH) occurrence. Therefore, we decided to determine whether tortuosity of the anterior cerebral artery can be related to the rupture of anterior communicating artery aneurysm and to severity and treatment outcome of SAH.nnnMETHODSnWe retrospectively analyzed anterior cerebral artery anatomy of 121 patients with anterior communicating artery aneurysms. From patients medical records, we obtained their history including previous and current diseases and medications. For each patient we calculated relative length, sum of angle metrics, triangular index, product of angle distance, and inflection count metrics.nnnRESULTSnPatients with SAH had significantly higher relative length (0.70 ± 0.19 vs. 0.63 ± 0.22; Pxa0= 0.03) and significantly lower inflection count metrics (0.10 ± 0.08 vs. 0.16 ± 0.19; P < 0.01), respectively. In multivariate logistic regression analysis, after adjustment of all possible confounders, diabetes mellitus (odds ratio [OR], 0.154; 95% confidence interval [CI], 0.032-0.553; P < 0.01) and higher inflection count metrics (OR, 0.604; 95% CI, 0.357-0.909; Pxa0= 0.042) remained independently associated with lower risk of SAH. We also found an independent correlation between aneurysm dome size (Rxa0=xa0-0.289; Pxa0= 0.02) and triangular index (Rxa0= 0.273; Pxa0= 0.03) and Glasgow Coma Scale score on admission.nnnCONCLUSIONSnHigher anterior cerebral artery tortuosity might be a protective factor against anterior communicating artery aneurysm rupture.

The Role of the Cerebellum in the Regulation of Language Functions

The present paper is a review of studies on the role of the cerebellum in the regulation of language functions. This brain structure until recently associated chiefly with motor skills, visual-motor coordination and balance, proves to be significant also for cognitive functioning. With regard to language functions, studies show that the cerebellum determines verbal fluency (both semantic and formal) expressive and receptive grammar processing, the ability to identify and correct language mistakes, and writing skills. Cerebellar damage is a possible cause of aphasia or the cerebellar mutism syndrome (CMS). Decreased cerebellocortical connectivity as well as anomalies in the structure of the cerebellum are emphasized in numerous developmental dyslexia theories. The cerebellum is characterized by linguistic lateralization. From the neuroanatomical perspective, its right hemisphere and dentate nucleus, having multiple cerebellocortical connections with the cerebral cortical language areas, are particularly important for language functions. Usually, language deficits developed as a result of a cerebellar damage have subclinical intensity and require applying sensitive neuropsychological diagnostic tools designed to assess higher verbal functions.

Executive dysfunction in late-life depression.

OBJECTIVESnNowadays there are numerous reports stressing the occurrence of cognitive functions disorders in late-life depression (LLD). More and more frequently the studies stress the role of executive dysfunctions in LLD. The purpose of the study was an evaluation of the components of executive functions in non-demented LLD patients, as well as an evaluation of the relation between the individual components of executive functions and the level of depressiveness.nnnMETHODSnThe study included 87 persons with depression and 100 persons in the control group. For the purpose of a screening evaluation of cognitive functions the Mini-MentalState Examination (MMSE) was applied. For the evaluation of the level of executive functions efficiency the following were chosen: a) Trail Making Test (TMT), b) Verbal Fluency Tests (VFT) and c) go/no-go task (GNG).nnnRESULTSnA significant difference was found in the levels of efficiency of all the components of executive functions in patients with late-life depression. The patients with depression demonstrated the slowest psychomotor speed and worse results in the tests evaluating cognitive flexibility, semantic fluency and inhibition. Statistically significant relation was observed between the higher result in GDS-SF (Geriatric Depression Scale-Short Form) and the worse performance in the GNG test.nnnCONCLUSIONSnThe patients with depression demonstrated a significant impairment of executive functions. A relation was found between the cognitive control disorder and the level of depressiveness. Executive dysfunctions can play an important role in the persistence of depressive symptoms. Identification of patients with depression and executive dysfunctions has significant therapeutic implications.