National Repository of Dissertations in Serbia
    • English
    • Српски
    • Српски (Serbia)
  • English 
    • English
    • Serbian (Cyrilic)
    • Serbian (Latin)
  • Login
View Item 
  •   NaRDuS home
  • Универзитет у Београду
  • Медицински факултет
  • View Item
  •   NaRDuS home
  • Универзитет у Београду
  • Медицински факултет
  • View Item
JavaScript is disabled for your browser. Some features of this site may not work without it.

Prospektivna studija kognitivnih poremećaja u Parkinsonovoj bolesti: klinički, neuropsihološki i morfološki prediktori

Prospective study of cognitive impairment in Parkinson's disease: clinical, neuropsychological and morphological predictors

Thumbnail
2018
Disertacija.pdf (10.39Mb)
IzvestajKomisije17880.pdf (245.5Kb)
Author
Stojković, Tanja M.
Mentor
Stefanova, Elka
Committee members
Kostić, Vladimir
Svetel, Marina
Semnic, Marija
Metadata
Show full item record
Abstract
Kognitivni poremećaji predstavljaju važan nemotorni simptom Parkinsonove bolesti (PB) i značajno utiču na kvalitet života, prognozu bolesti i smrtnost obolelih. Prevalenca blagog kognitivnog poremećaja u PB (PB-BKP) procenjena je na 19-38%, u zavisnosti od primenjenih dijagnostičkih kriterijuma. U ranijim istraživanjima kod PB-BKP pacijenata najčešće su prijavljivani ispadi na planu egzekutivnih funkcija, pažnje i u vizuospacijalnom domenu, dok je primena najnovijih dijagnostičkih preporuka Radne grupe Društva za poremećaje pokreta, iz 2012. godine, ukazala na značajnu zastupljenost ispada u domenu pamćenja. Studije praćenja su pokazale da oko 80% pacijenata razvija demenciju (PBD) nakon 20 godina trajanja PB. Međutim, neki pacijenti godinama ostaju kogintivno očuvani, dok se kod drugih oštećenja kognicije javljaju ubrzo po postavljanju dijagnoze PB, a neurobiološki osnov ovog relativno stabilnog ili progresivnog toka nije sasvim jasan. Godine starosti, dužina trajanja PB, veća motorna... onesposobljenost, depresija, apatija, halucinacije, poremećaji sna i ortostatska hipotenzija identifikovani kao prediktori PBD. Vaskularno opterećenje je, takođe, povezivano sa kognitivnim oštećenjima u PB, a poslednjih godina posebno je aktuelno ispitivanje vaskularnih faktora rizika koji se mogu modifikovati. Nekonvencionalnim metodama magnetne rezonance (MR) moguće je ustanoviti stepen i distribuciju atrofije moždane kore, kao pokušaj „in vivo“ mapiranja promena u centralnom nervnom sistemu koje leže u osnovi kognitivnih poremećaja u PB. Kod PB-BKP pacijenata ustanovljena je atrofija temporalnog, parijetalnog i frontalnog korteksa, dok su PBD pacijenti akumulirali difuzne kortikalne promene u frontalnim, temporalnim, parijetalnim i okcipitalnim režnjevima. Prospektivne studije koje su se bavile ovom problematikom, na većem broju ispitanika, su retke. Ciljevi: a) utvrditi učestalost i tip kognitivnih poremećaja u našoj grupi pacijenata obolelih od PB; b) ispitati demografske i kliničke karakteristike pacijenata kod kojih postoje PB-BKP i/ili PBD u poređenju sa PB pacijentima kod kojih se ne beleže kognitivni poremećaji; c) utvrditi učestalost PB pacijenata kod kojih se, tokom perioda praćenja od četiri godine, beleži kognitivno pogoršanje, definisano kao prelazak iz stanja očuvane kognicije u stadijum PBPBK i/ili razvoj PBD; d) definisati demografske i kliničke prediktore kognitivnog pogoršanja u PB; e) ispitati specifičnosti obrazaca istanjenja moždane kore povezanih sa kognitivnim pogoršanjem u PB...

Cognitive disorders are one of the most important non-motor symptoms of Parkinson's disease (PD), with significant impact on quality of life, prognosis and mortality. The prevalence of mild cognitive impairment (PD-MCI) is estimated at 19-38%, depending on the applied diagnostic criteria. In previous PD-MCI studies, executive dysfunctions, attention and visuospatial deficits were most frequently reported, while the application of the latest Movement Disorders Society Task Force, diagnostic recommendations, form 2012., pointed out to the significance of memory impairment. Prospective studies have shown that about 80% of patients develop dementia (PDD) after 20 years of PD duration. However, some patients remain cognitively intact for years, while others develop cognitive impairment soon after PD diagnosis, and the neurobiological basis of this relatively stable or progressive course is not entirely clear. Age, PD duration, increased motor disability, depression, apathy, hallucinations, ...sleep disorders and orthostatic hypotension have been identified as PDD predictors. Vascular burden has also been associated with cognitive impairment in PD and, in recent years, examination of vascular risk factors that can be modified is particularly important. Unconventional magnetic resonance imaging (MR) technics can determine the degree and distribution of cortical atrophy as an attempt of "in vivo" maping of central nervous system changes that underlie cognitive deterioration in PD. In PD-MCI patients, atrophy of temporal, parietal and frontal cortex was established, while PDD patients accumulated extensive cortical changes in the frontal, temporal, parietal and occipital lobe. Prospective studies addressing this this issue, on a large number of patients, are rare. Objectives: a) to examine the frequency and profile of cognitive disorders in our PD cohort; b) to examine clinical associated with PD-MCI and PDD; b) to determine the frequency of PD patients with signs of cognitive deterioration during a four-year follow-up, defined as PD-MCI and/or PDD conversion; c) to define clinical predictors of cognitive deterioration in PD; d) to investigate specific patterns of cortical damage associated with cognitive decline in PD. Material and methods: The study included 133 consecutive patients diagnosed according to the current clinical criteria for PD. The research partly had the characteristics of the crosssection study, while the other part was a prospective cohort study. A pre-designed semistructured questionnaire was used to collect data on sociodemographic characteristics of patients...

Faculty:
Универзитет у Београду, Медицински факултет
Date:
25-09-2018
Keywords:
Parkinsonova bolest / Parkinson's disease / mild cognitive impairment in Parkinson's disease / Parkinson's dementia / vascular risk factors / multimodal magnetic resonance imaging / white matter lesions volume / cortical thinning / blagi kognitivni poremećaj u Parkinsonovoj bolesti / demencija u Parkinsonovoj bolesti / vaskularni faktori rizika / multimodalno magnetnorezonantno snimanje mozga / hiperintenziteti bele mase / istanjenje korteksa
[ Google Scholar ]
Handle
https://hdl.handle.net/21.15107/rcub_nardus_10077
URI
https://nardus.mpn.gov.rs/handle/123456789/10077
http://eteze.bg.ac.rs/application/showtheses?thesesId=6108
https://fedorabg.bg.ac.rs/fedora/get/o:18543/bdef:Content/download
http://vbs.rs/scripts/cobiss?command=DISPLAY&base=70036&RID=50644239

DSpace software copyright © 2002-2015  DuraSpace
About NaRDus | Contact us

OpenAIRERCUBRODOSTEMPUS
 

 

Browse

All of DSpaceUniversities & FacultiesAuthorsMentorCommittee membersSubjectsThis CollectionAuthorsMentorCommittee membersSubjects

DSpace software copyright © 2002-2015  DuraSpace
About NaRDus | Contact us

OpenAIRERCUBRODOSTEMPUS