Objective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH)...Show moreObjective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved between T1 and T2. Proactive coping declined between T0 and T2 and between T1 and T2. Cognition of the control group did not change, but participation improved between T0 and T1 and proactive coping declined between T0 and T1. There was no significant difference between the control and intervention groups in improvements in cognition between T0 and T1 (p = 0.090). However, there was a significant difference between the control and intervention groups in changes in participation between T0 and T1 (p = 0.001) and in changes in coping between T0 and T1 (p < 0.001). The location of SAH played a role in the differences in participation, but not in cognition and coping. For treatment type and time since SAH, no significant effects were found. Conclusion. There was no effect of the rehabilitation program on cognition. The control group had a better participation level after three months and the intervention group worsened. The intervention group had a stable coping style after three months, whereas the control group declined in the use of proactive coping. Only the characteristic location of the aneurysm played a role in the participation level after three months, but not in cognition or coping. The other characteristics did not play a role in the changes. This study indicates that some long-term complaints can improve after the rehabilitation program, but more research is needed.Show less
Objective: Multiple Sclerosis (MS) is a chronic neurological disorder characterized by a wide range of symptoms, of which physical and cognitive impairments are prominent. Cognitive functioning in...Show moreObjective: Multiple Sclerosis (MS) is a chronic neurological disorder characterized by a wide range of symptoms, of which physical and cognitive impairments are prominent. Cognitive functioning in MS has received increasing attention due to its significant impact on quality of life. However, the exact relationship between physical functioning and cognitive functioning in people with MS (PwMS) remains insufficiently understood. This study aimed to explore the predictive value of physical outcome measures on cognitive functioning. Furthermore, the influence of disease severity and anxiety and depression on the relationship between physical outcome measures and cognitive functioning is explored. Methods: Conducted as part of the ‘Don’t be late!’ project, this study included 23 PwMS (Mean age = 46.63, SD = 11.13; 60.9 % female). Physical functioning was assessed using balance, walking speed, grip strength, dexterity and endurance. Furthermore, cognitive functioning was assessed using the Minimal Assessment of Cognitive Functions in MS and disease severity and anxiety and depression were measured using the Expanded Disability Status Scale and the Hospital Anxiety and Depression Scale, respectively. Multiple regression analyses were performed to determine the predictive value of physical functioning on cognitive functioning. Mediation analyses were performed with disease severity and anxiety and depression as mediating factors. Results: No significant model for the predictive value of physical outcome measures on cognitive functioning was found (p = .117). Furthermore, the study found no significant mediating effects of disease severity (p = .979) or anxiety and depression (p = .633) on this relationship. Due to missing values on the Paced Auditory Serial Addition Test (PASAT), a post-hoc analysis was conducted. Significant effects were found for the predictive value of balance (p = .016), dexterity (p = .045) and walking speed (p = .008) on cognitive functioning. Conclusion: The study identified significant links between balance, dexterity, walking speed, and cognitive functioning in PwMS. It faced limitations including a small sample size and its cross-sectional nature. Despite these limitations, this study suggests that the interplay between physical and cognitive domains in MS is multifaceted and warrants more nuance investigation.Show less
Introduction: In daily life, individuals constantly encounter stimuli from both external environmental sources and internal emotional triggers. Often, these stimuli are filtered out, but sometimes...Show moreIntroduction: In daily life, individuals constantly encounter stimuli from both external environmental sources and internal emotional triggers. Often, these stimuli are filtered out, but sometimes this process fails, leading to a sensation of being 'overstimulated.' This can negatively impact daily functioning. As people age, sensory perception typically declines, which might affect stimulus processing. The aim of this study is to investigate whether there is a relationship between age and the degree of sensory processing. Method: Demographic data (age, gender, education level) were collected from individuals aged 18-67 years. Sensory processing was measured using the validated Sensory Processing Sensitivity Questionnaire (SPSQ). The relationship between age and sensory processing was analyzed in SPSS using Pearson's correlation analysis. Post-hoc, participants were divided into two groups: younger (<50 years) and older (≥50 years). The SPSQ scores between these groups were compared using an independent samples t-test. Results: A total of 134 individuals participated in the study. The median age was 44.5 years (IQR = 22.00 - 54.25) and 37.3% were male. The average SPSQ score for the group was 187.5 (SD = 25.3, range = 120-257). There was no significant relationship between age and SPSQ score (r = -.088, 95% CI [-.254, .083], p = .31). Additionally, there was no significant difference in SPSQ scores between the older (SPSQ score: 189.21) and younger (SPSQ score: 185.34) groups (t(133) = -.880, p = .190). Discussion: Contrary to our hypothesis, there was no effect of age on sensory processing sensitivity. This may indicate that there are no issues with sensory processing in individuals younger than 67 years. Several options for future research are discussed.Show less
Vascular damage, like cerebral amyloid angiopathy (CAA), is a comorbidity in the majority of Alzheimer’s disease (AD) patients. Vascular reactivity has been introduced as a novel marker for...Show moreVascular damage, like cerebral amyloid angiopathy (CAA), is a comorbidity in the majority of Alzheimer’s disease (AD) patients. Vascular reactivity has been introduced as a novel marker for vascular damage in CAA. It is measured as the blood oxygen level dependent (BOLD) response in the visual cortex after visual stimulation. It may detect underlying vascular factors early in the disease, like in patients with subjective (SCI) or mild cognitive impairment (MCI). In these stages, SCI patients start to experience subjective cognitive complaints, whereas these can be objectified in MCI patients. The aim of this study is to measure and compare vascular reactivity in memory clinic patients and controls, and explore its association with cognition. We performed 3T MRI in 43 controls, 17 SCI, 20 MCI, and 12 AD patients and obtained 3D T1-weighted images, FLAIR, and visually stimulated BOLD fMRI scans. The main independent variable was patient group. Dependent variables were three vascular reactivity parameters time-to-peak, time-to-baseline, and amplitude of the BOLD response. Univariate linear models were performed to comparedifferences in vascular reactivity between memory clinic patients and controls, and separate patient groups and controls. Linear regression analyses were performed to explore the association between vascular reactivity and cognition. All analyses were corrected for age, gender, gray matter volume, white matter hyperintensities, and CAA. BOLD amplitudes were smaller in dementia and MCI (ps < .001), but not SCI patients (p = .77).Time-to-peak and time-to-baseline showed no differences between groups (ps > .07). Lower amplitude of the BOLD response was associated with poorer performance of global cognitive, memory, executive, and language functioning (ps < .04). Our findings demonstrate that dementia and MCI are associated with lower vascular reactivity, reflected as amplitude of the BOLD response. In our sample, lower vascular reactivity is also associated with poorer cognitive functioning. These results indicate that impaired vascular reactivity plays a key role early in dementia and is an independent contributor to cognitive decline. Potentially, vascular reactivity could be used as a marker for amyloid-beta and as an alternative way to quantify vascular damage. Ultimately, it could aid in the development of interventions focused on amyloid-beta removal and could serve as a marker for disease progression.Show less
