250 results match your criteria: "Institute of Clinical Medicine - Neurology[Affiliation]"

Background: Frailty is a common geriatric syndrome associated with poor clinical outcomes. Effectiveness of lifestyle intervention programmes among frail older people has been examined earlier, but effects of interventions on prevention of frailty have been rarely studied. The aim of this study was to investigate to what extent the multidomain lifestyle intervention in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) affected changes in frailty status among older men and women at risk of cognitive disorders.

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A hypothetical intervention on the use of hearing aids for the risk of dementia in people with hearing loss in UK Biobank.

Am J Epidemiol

December 2024

Department of Social Sciences, Institute for Research on Socio-Economic Inequality (IRSEI), University of Luxembourg, Esch-sur-Alzette, Luxembourg.

Observational studies have reported that hearing aid (HA) use is associated with a reduced risk of dementia diagnosis, suggesting a possible protective effect. However, extant observational studies do not explicitly model causal effects, while randomised controlled trials on the effect of HA on dementia exhibit short follow-up. Here we used self-report, hearing tests, and healthcare records in UK Biobank to design a hypothetical intervention for the effect of HA use on the risk of dementia diagnosis in people with incident hearing loss (HL).

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This study investigated longitudinal physical activity (PA) profiles over 7 years in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). Cognition, depression, pain, and PA motives were included as determinants of the PA profiles. The 1259 participants, aged 60-77 years at baseline, were randomized into either a control group receiving general health advice, or an intervention group offered a comprehensive 2-year multidomain intervention including physical exercise, diet advice, cognitive training, and vascular risk factor management.

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X-chromosome-wide association study for Alzheimer's disease.

Mol Psychiatry

December 2024

Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, LabEx DISTALZ - U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, Lille, France.

Article Synopsis
  • A study was conducted to investigate the X-chromosome's role in Alzheimer's Disease (AD), which had been overlooked in previous genome-wide association studies.
  • The research included 115,841 AD cases and 613,671 controls, considering different X-chromosome inactivation (XCI) states in females.
  • While no strong genetic risk factors for AD were found on the X-chromosome, seven significant loci were identified, suggesting areas for future research.
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Computerized decision support to optimally funnel patients through the diagnostic pathway for dementia.

Alzheimers Res Ther

November 2024

Alzheimer Center Amsterdam and Department of Neurology, VU University Medical Center, Amsterdam UMC, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands.

Background: The increasing prevalence of dementia and the introduction of disease-modifying therapies (DMTs) highlight the need for efficient diagnostic pathways in memory clinics. We present a data-driven approach to efficiently guide stepwise diagnostic testing for three clinical scenarios: 1) syndrome diagnosis, 2) etiological diagnosis, and 3) eligibility for DMT.

Methods: We used data from two memory clinic cohorts (ADC, PredictND), including 504 patients with dementia (302 Alzheimer's disease, 107 frontotemporal dementia, 35 vascular dementia, 60 dementia with Lewy bodies), 191 patients with mild cognitive impairment, and 188 cognitively normal controls (CN).

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Neurofilament light and glial fibrillary acidic protein in mood and anxiety disorders: A systematic review and meta-analysis.

Brain Behav Immun

January 2025

Neuropsychiatry Centre, The Royal Melbourne Hospital, Melbourne, Australia; Department of Psychiatry, University of Melbourne, Melbourne, Australia. Electronic address:

Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are biomarkers of neuronal injury measurable in cerebrospinal fluid (CSF) and blood. Despite their potential as diagnostic tests for neurodegenerative disorders, it is unclear how they behave in mood and anxiety disorders. We conducted a systematic review and meta-analysis to investigate whether NfL and GFAP concentrations were altered in adults with mood and anxiety disorders compared to healthy controls.

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Article Synopsis
  • * Concerns are raised about purely biological definitions being used in clinical settings, especially since many biomarker-positive but cognitively normal individuals may never develop symptoms, complicating diagnosis and patient understanding.
  • * The authors advocate for a combined clinical-biological definition of AD that accommodates at-risk and presymptomatic stages, emphasizing the need for caution in diagnosing AD without fully understanding the implications for patients.
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Background: Dementia preventive interventions targeting multiple modifiable risk factors are a promising approach. However, the impact of modifiable risk factors in the presence of beta-amyloid or phosphorylated-tau (p-tau) pathology is unclear.

Methods: The objective of the study was to examine the role of modifiable risk factors (vascular factors, depression, and smoking) in the progression to mild cognitive impairment (MCI) or dementia among 434 cognitively unimpaired (CU) and 611 individuals with MCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database.

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Risk Variants Associated With Normal Pressure Hydrocephalus: Genome-Wide Association Study in the FinnGen Cohort.

Neurology

September 2024

From the Department of Neurosurgery (J. Räsänen, K.M., V.E.K., M.O., J.E.J., V.L.), Kuopio University Hospital and Institute of Clinical Medicine-Neurosurgery, and Institute of Biomedicine (S. Heikkinen, K.M., A.L., T.K., M.H.), University of Eastern Finland, Kuopio; Institute for Molecular Medicine Finland (FIMM) (J.M., A.P.), Helsinki Institute of Life Science (HiLIFE), University of Helsinki; Department of Neurology (A.J.), Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Finland; Univ. Lille (B.G.-B., C.B., J.-C.L.), Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liées au Vieillissement, France; Department of Neurosurgery (M.O., K.L., J.S.), University of Helsinki and Helsinki University Hospital; Clinical Neurosciences (C.A., J.F., A.K., J. Rinne), Department of Neurosurgery, University of Turku and Turku University Hospital; Department of Neurosurgery (A.R.), Tampere University Hospital; Unit of Clinical Neuroscience (M.K., M.v.u.z.F.), Neurosurgery, University of Oulu and Medical Research Center, Oulu University Hospital; Finnish Institute for Health and Welfare (THL) (M.P.); University of Helsinki (M.P.); Department of Neurosciences (A.M.K., A.M.P.), University of Helsinki; Department of Geriatrics (A.M.K.), Helsinki University Hospital; NeuroCenter (A.M.K.), Kuopio University Hospital; Institute of Clinical Medicine-Neurology (V.J., H.S.), University of Eastern Finland; School of Medicine (A.M.), Institute of Clinical Medicine, Pathology and Forensic Medicine, and Translational Cancer Research Area, University of Eastern Finland; Department of Clinical Pathology (A.M.), Kuopio University Hospital; Unit of Clinical Medicine (S. Helisalmi), University of Eastern Finland, Kuopio, Finland; Department of Neurosurgery (P.K.E.), Oslo University Hospital-Rikshospitalet; Institute of Clinical Medicine (P.K.E.), Faculty of Medicine, and KG Jebsen Centre for Brain Fluid Research (P.K.E.), University of Oslo, Norway; Analytical and Translational Genetics Unit (A.P., M.I.K.), Department of Medicine, Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (A.P., M.I.K.), and Stanley Center for Psychiatric Research (A.P., M.I.K.), Broad Institute for Harvard and MIT, Cambridge, MA.

Background And Objectives: Large-scale genome-wide studies of chronic hydrocephalus have been lacking. We conducted a genome-wide association study (GWAS) in normal pressure hydrocephalus (NPH).

Methods: We used a case-control study design implementing FinnGen data containing 473,691 Finns with genotypes and nationwide health records.

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Article Synopsis
  • Neuropathologic changes associated with Alzheimer's disease, like Aβ accumulation and neuroinflammation, are commonly found in the brains of normal pressure hydrocephalus patients.
  • Researchers developed a deep learning platform to analyze Aβ levels and microglia surrounding Aβ plaques in cortical biopsies from 120 patients who underwent shunting.
  • The study found that higher Aβ presence was linked to worse cognitive outcomes, such as dementia and memory impairment, whereas the density of surrounding microglia had no correlation to cognitive decline.
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Correlation of cerebral small vessel disease burden with outcome after lower extremity amputation.

J Diabetes Complications

September 2024

Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland; Department of Musculoskeletal Surgery and Diseases, Tampere University Hospital, Tampere, Finland. Electronic address:

Aims: This study assessed whether changes associated with cerebral small vessel disease (CSVD) evaluated from head computed tomography (CT) images captured for non-related clinical purposes predict overall survival (OS), leg salvage (LS), and amputation-free survival (AFS) after lower extremity amputation (LEA).

Methods: We retrospectively included a cohort of 240 patients who had undergone a lower extremity amputation in Tampere University Hospital between the years 2007 and 2020 and had a head CT scan (within one year before amputation). A neuroradiologist graded the white matter lesions (WMLs) and reported infarcts, and the latter's effects on OS, LS, and AFS were evaluated.

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Incidence and Prevalence of Early-Onset Dementia in Finland.

Neurology

August 2024

From the Research Unit of Clinical Medicine (J.K., A.L., L.L., I.R., L.T., N.-M.S.), Neurology, University of Oulu; MRC (J.K., L.T., N.-M.S.); Neurocenter (J.K., L.T., N.-M.S.), Neurology, Oulu University Hospital; Law School (M.A., A.M.-P.-L.), University of Eastern Finland, Joensuu; Institute of Clinical Medicine - Neurology (K.A., S.H., A.K., H.S., K.K., E.S.); A.I. Virtanen Institute for Molecular Sciences (A.H.), University of Eastern Finland, Kuopio; Clinical Neurosciences (A.M.P.), Faculty of Medicine, University of Helsinki; and Neuro Center - Neurology (P.H., E.S.), Kuopio University Hospital, Finland.

Article Synopsis
  • - The study examines the incidence and prevalence of early-onset dementia (EOD) in two areas of Finland from 2010 to 2021, finding that the crude incidence rate was 12.3 cases per 100,000 persons per year with specific age groups showing higher rates.
  • - Out of the 794 new EOD cases identified, Alzheimer’s disease (AD) was the most common subtype, making up 48.2% of cases, followed by behavioral variant frontotemporal dementia at 12.7%.
  • - The findings indicate that the incidence rates for EOD are higher than previous reports, with a notable increase in early-onset AD cases over time, while other EOD subtypes remained
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Introduction: Dementia is a multifactorial disease with Alzheimer's disease (AD) and vascular dementia (VaD) pathologies making the largest contributions. Yet, most genome-wide association studies (GWAS) focus on AD.

Methods: We conducted a GWAS of all-cause dementia (ACD) and examined the genetic overlap with VaD.

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Background: Dementia is assumed to alter mental capacity, which may necessitate legal guardianship. However, only limited research exists on how dementia affects mental capacity, and most studies have focused solely on a medical perspective and concentrate on memory functions. The aim of this qualitative study was to investigate physicians' and legal experts' perceptions on a broad range of cognitive and neuropsychiatric domains potentially affecting mental capacity and the need for guardianship in people with dementia.

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Autoantibodies directed against the GluA3 subunit (anti-GluA3 hIgGs) of AMPA receptors have been identified in 20%-25% of patients with frontotemporal lobar degeneration (FTLD). Data from patients and in vitro/ex vivo pre-clinical studies indicate that anti-GluA3 hIgGs negatively affect glutamatergic neurotransmission. However, whether and how the chronic presence of anti-GluA3 hIgGs triggers synaptic dysfunctions and the appearance of FTLD-related neuropathological and behavioural signature has not been clarified yet.

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Aim: Emerging evidence suggests association of tooth loss with impaired cognition. However, the differential effects of anterior versus posterior tooth loss, occlusal support loss and chewing ability are not considered comprehensively.

Materials And Methods: We conducted cross-sectional (N = 4036) and longitudinal analyses (N = 2787) on data from Health 2000 and 2011 Surveys for associations of posterior occlusal support loss, anterior versus posterior tooth loss, and chewing ability with baseline cognition and 11-year cognitive decline.

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Background: Multiple sclerosis (MS) progression coincides temporally with menopause. However, it remains unclear whether the changes in disease course are related to the changes in reproductive hormone concentrations. We assessed the association of menopausal hormonal levels with progression-related biomarkers of MS and evaluated the changes in serum neurofilament light chain (sNfL) and glial fibrillary acidic protein (sGFAP) levels during menopausal hormone therapy (MHT) in a prospective baseline-controlled design.

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Background: The pathophysiology of Alzheimer's disease (AD) involves -amyloid (A ) accumulation. Early identification of individuals with abnormal -amyloid levels is crucial, but A quantification with positron emission tomography (PET) and cerebrospinal fluid (CSF) is invasive and expensive.

Methods: We propose a machine learning framework using standard non-invasive (MRI, demographics, APOE, neuropsychology) measures to predict future A -positivity in A -negative individuals.

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Introduction: The U.S. study to protect brain health through lifestyle intervention to reduce risk (U.

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Background: Due to the significant presence of neuropsychiatric symptoms in patients with frontotemporal dementia (FTD) spectrum disorders, psychiatric misdiagnoses, diagnostic delay, and use of psychiatric treatments are common prior to the FTD diagnosis. Furthermore, treatment of diagnosed FTD patients mainly relies on off-label psychopharmacological approaches. Currently, limited real-world data are available regarding the actual use of psychopharmacological medications in FTD.

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Successful development of novel therapies requires that clinical trials are conducted in patient cohorts with the highest benefit-to-risk ratio. Population-based biobanks with comprehensive health and genetic data from large numbers of individuals hold promise to facilitate identification of trial participants, particularly when interventions need to start while symptoms are still mild, such as for Alzheimer's disease (AD). This study describes a process for clinical recall studies from FinnGen.

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Aim: To evaluate whether tooth loss is associated with cognitive decline and incident dementia.

Materials And Methods: We analysed data from the Finnish population-based Health 2000 and follow-up Health 2011 surveys (participants aged ≥30 years and without dementia at baseline; N = 5506 at baseline and 3426 at 11-year follow-up). Dementia diagnoses until 2015 were ascertained from national registers (N = 5542).

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Fatigue and health-related quality of life depend on the disability status and clinical course in RRMS.

Mult Scler Relat Disord

September 2023

Research Unit of Clinical Medicine, Neurology, University of Oulu, P.O. Box 5000, FI-90014 University of Oulu, Finland; Medical Research Center, Oulu University Hospital, P.O. Box 10, FI-90029 OYS, Oulu, Finland; Neurocenter, Neurology, Oulu University Hospital, P.O. Box 10, FI-90029 OYS, Oulu, Finland. Electronic address:

Background: Fatigue is a prominent and disabling symptom of multiple sclerosis (MS), impairing quality of life. The disease course of relapsing remitting MS (RRMS) is individual.

Objectives: We aimed to study the effects of demographic and clinical characteristics, as well as lifestyle risk factors on experienced fatigue and health-related quality of life (HRQoL) among RRMS patients, comparing benign and severe disease types.

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Frontotemporal dementia (FTD) can manifest as diverse clinical phenotypes and is frequently caused by mutations in different genes, complicating differential diagnosis. This underlines the urgent need for valid biomarkers. Altered lysosomal and immune functions proposedly contribute to FTD pathogenesis.

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