Publications by authors named "Natasa Klepac"

Background: Individuals with specific gene variants that encode for a Triggering Receptor Expressed on Myeloid cells 2 have a higher prevalence of Alzheimer's disease (AD). By interacting with amyloid and apolipoproteins, the TREM2 receptor regulates the number of myeloid cells, phagocytosis, and the inflammatory response. Higher expression has been suggested to protect against AD.

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Article Synopsis
  • A decrease in serotonergic transmission is an early sign of Alzheimer's disease (AD) and affects serotonin receptors, impacting behavioral and psychological symptoms in patients.
  • The study analyzed 115 AD patients, 53 with mild cognitive impairment, and 2701 healthy controls to see if specific gene polymorphisms were linked to faster disease progression and AD-related pathology.
  • Findings showed significant associations between certain genetic markers and changes in cerebrospinal fluid biomarkers, as well as poorer cognitive performance, suggesting these polymorphisms may play a role in AD's development and progression.
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Background: It is estimated that up to 90% of patients with dementia are affected by behavioral and psychiatric symptoms during the course of the disease. The aim of this study was to investigate the prevalence of depression in dementia and mild cognitive impairment (MCI), the use of benzodiazepines and antidepressants among them and the impact of former education on their cognitive decline.

Subjects And Methods: In the study we have enrolled 100 patients with clinical diagnoses of either MCI or dementia, as was established by a single cognitive neurology subspecialist.

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Article Synopsis
  • * There has been a steady annual increase in DMT usage (9%) and associated costs (14.6%), with specific treatments like IFN-beta 1-a seeing particularly rapid growth.
  • * New DMTs such as dimethyl fumarate and fingolimod are now available, but access is limited in Croatia compared to other countries, indicating a potential for continued growth in prescriptions and costs in the future.
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Background: The dopaminergic system is functionally compromised in Alzheimer's Disease (AD). The activity of Monoamine Oxidase B (MAOB), the enzyme involved in the degradation of dopamine, is increased during AD. Also, increased expression of MAOB occurs in the postmortem hippocampus and neocortex of patients with AD.

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Background: Neuroinflammation plays an important role in Alzheimer's disease (AD). During this process, activated microglia release pro-inflammatory cytokines such as interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor α (TNFα) that participate in neuron damage, but also anti-inflammatory cytokines (such as IL-10), which maintain homeostasis of immune response. Previous studies showed the association of IL-1α -889C/T (rs1800587), IL-1β-1473G/C (rs1143623), IL-6 -174C/G (rs1800795), IL-10 -1082G/A (rs1800896), and TNFα -308A/G (rs1800629) polymorphisms with AD.

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The noradrenergic and dopaminergic systems are affected in Alzheimer's disease (AD). Polymorphisms in genes encoding enzymes and proteins that are components of these systems can affect products of transcription and translation and lead to altered enzymatic activity and alterations in overall dopamine and noradrenaline levels. Catechol-O-methyltransferase (COMT) and monoamine oxidase B (MAOB) are the enzymes that regulate degradation of dopamine, while dopamine β-hydroxylase (DBH) is involved in synthesis of noradrenaline.

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Introduction: Alzheimer's disease (AD) is the world leading cause of dementia. Early detection of AD is essential for faster and more efficacious usage of therapeutics and preventive measures. Even though it is well known that one ε4 allele of apolipoprotein E gene increases the risk for sporadic AD five times, and that two ε4 alleles increase the risk 20 times, reliable genetic markers for AD are not yet available.

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Introduction: The pathological process of Alzheimer's disease (AD) in the brain likely begins 20-30 years earlier than the emergence of its first clinical symptoms and symptoms of AD often overlap with the symptoms of other primary causes of dementia. Therefore, it is crucially important to improve early and differential diagnosis of the disease. Event-related potentials (ERP) measured non-invasively by electroencephalography have shown diagnostic potential in AD.

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Background: The diagnosis of either Alzheimer's disease (AD) or vascular dementia (VaD) is still largely based on clinical guidelines and exclusion of other diseases that may lead to dementia.

Aims: In this study, we assessed whether the use of sensitive and specific biomarkers such as phosphorylated tau proteins could contribute to an earlier and more accurate diagnosis of AD and VaD, as well as to their differentiation.

Material And Methods: A total of 198 patients, of which 152 had AD, 28 VaD, and 18 were healthy controls (HC), were included in the analyses.

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Objectives: Treatment-resistant schizophrenia (TRS) continues to be a challenge in modern psychiatry. Most of these patients have severe neurocognitive deficits. Electroconvulsive therapy (ECT) has proved effective and safe in the treatment of TRS, but because of potential neurocognitive adverse effects, it is associated with many controversies.

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The aim of this study was to explore differences in the intensity of depressiveness, sleep disturbances and sleepiness between post-traumatic stress disorder (PTSD) patients and patients with depression. A total of 170 patients were examined, including 120 PTSD patients and 50 patients with depression. All participants completed the Beck Depression Inventory, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale.

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Background: In spite of the increase in the number of patients with dementia in countries with older population, basic epidemiologic data are still scarce. The objective of this paper is to investigate pharmacoepidemiological characteristics of treatment of dementia in Croatia, and to present them in the context of certain epidemiological characteristics that illustrate the growing pressure this disease exerts on the healthcare system.

Subjects And Methods: Data on medication utilization were taken from Croatian Health Insurance Fund (HZZO) and Agency for Medicinal Products and Medical Devices of Croatia (HALMED).

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Amyloid β (Aβ), total tau (t-tau), and phosphorylated tau (p-tau) are the main cerebrospinal fluid (CSF) biomarkers for early diagnosis of Alzheimer's disease (AD). Detection of AD is critically important in view of the growing number of potential new drugs that may influence the course of the disease in its early phases. However, cut-off levels for these CSF biomarkers have not yet been established.

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In the text that follows, we review the main clinical features, genetic characteristics, and treatment options for Parkinson's disease (PD), considering the age at onset. The clinical variability between patients with PD points at the existence of subtypes of the disease. Identification of subtypes is important, since a focus on homogenous group may lead to tailored treatment strategies.

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We report a case of pathology-proven acute disseminated encephalomyelitis (ADEM) in which the patient's symptoms were solely cognitive. Although cognitive dysfunction is a well-recognized symptom in adults with multiple sclerosis, cognitive assessment of adults with ADEM has rarely been reported. A 35-year-old woman was referred to our center for evaluation of cognitive disturbance and demyelinating lesions seen on brain magnetic resonance imaging (MRI).

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We present a case of Parkinson's disease patient whose initial symptoms were sick sinus syndrome and orthostatic hypotension. Our case illustrates difficulties in distinguishing syncope of primary cardiac or neurological origin and highlights the importance of a diagnostic workup including neurological examination.

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A functional catechol-o-methyltransferase (COMT Val158/108Met) polymorphism, a valine (Val) to methionine (Met) substitution, has been associated with cognitive processing in the normal brain, older age, mild cognitive impairment and in various dementias. COMT is involved in the breakdown of dopamine and other catecholamines, especially in the frontal cortex; hence the carriers of Met allele, with the lower enzymatic activity, are expected to perform better on particular neuro-cognitive tests. The study included 46 patients with dementia and 65 healthy older subjects.

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Alzheimer's disease (AD) is the most common form of dementia and the most common neurodegenerative disease, with a complex genetic background. Genome-wide association studies (GWAS) have yielded important new insights into genetic mechanisms of AD pathology. Current results unequivocally confirm apolipoprotein E (APOE) as a major genetic risk factor for development of late onset AD.

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In Parkinson disease (PD), cognitive impairment is common, occurs mainly in the form of milder deficits (as opposed to dementia), and commonly coincides with depression. In this cross-sectional study, we evaluated whether depression that existed before the onset of typical motor symptoms (pre-PD depression) reflected on the actual cognitive performance. Nondemented nonpsychotic PD patients with (test, n = 27) and without (control, n = 112) a history of pre-PD depression, caliper-matched for age, education, and disease duration were assessed for motor and nonmotor disease characteristics and in a battery of cognitive tests.

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A comparison of nondemented Parkinson's disease patients with lower, intermediate, and higher educational levels indicated an independent association between longer (better) education and less severe depressive difficulties based on the Beck Depression Inventory cognitive-affective items. Well-educated patients also had a better health-related quality of life based on the Parkinson's Disease Questionnaire-39, apparently due to beneficial effects of education on cognitive performance (attention/memory, visuospatial and executive functions) and the degree of depression. More years of education favors milder depressive difficulties and a higher self-perceived life satisfaction in nondemented Parkinson's disease patients.

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The need to understand and improve health-related quality of life (Hr-QoL) in Parkinson's disease (PD) has been emphasized. In order to investigate contributions of depression that existed before the onset of typical motor symptoms ("pre-PD depression"), idiopathic non-demented non-psychotic patients with (n = 32) and without (n = 120) a history of pre-PD depression, free of relevant comorbidity, calliper-matched for age, education and disease duration were evaluated for motor and non-motor disease aspects and Hr-QoL (Parkinson's Disease Questionnaire 39, PDQ-39). History of pre-PD depression was independently associated with higher actual levels of depression and anxiety, poorer sleep quality and mental set shifting, which all contributed to poorer Hr-QoL.

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Background: Poorer cognitive performance in depressed versus nondepressed nondemented Parkinson disease (PD) patients has been suggested.

Objective: Investigate the relationship between level of depression assessed on a depression-measuring scale and cognitive performance in nondemented PD patients.

Methods: Nondemented idiopathic PD patients (n=110) were evaluated for the level of depression [cognitive-affective items of the Beck's Depression Inventory (BDI)] and performance in a set of tests evaluating cognitive domains typically affected in PD (memory, visuospatial, and executive functions).

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