Health-related quality of life and ways of coping with stress in patients with migraine.

The aim of our study was to examine the relationship between the mode of coping and health-related quality of life (HRQoL) in patients with migraine. We have also tried to examine the relationship of disease duration and the frequency of attacks with HRQoL and the ways of coping with stress. The research was done on a sample consisting of 106 participants (95 women and 11 men); mean age of 40 years (IQR 28-48) with the migraine lasting for 10 years (IRQ 5-20 years). The average number of attacks, over the last month, was two attacks (IRQ 1-3 attacks). Ways of coping questionnaire were used to estimate the mode of coping with stress and SF-36 questionnaire for HRQoL. The result showed the self-control as the most common way of coping with stress in patients with migraine. They also confirmed the existence of a significant connection of ways of coping with stress and HRQoL in people with migraine. There is a larger number of significant correlations of ways of coping connected with the domains of mental health than with the physical health. Escape/avoidance is significantly negatively correlated with the largest number of HRQoL domains, especially with existence of significant mental health (ρ = -0.447) and role limitation due to the emotional problems (ρ = -0.361). The number of migraine attacks has greater influence on HRQoL in patients with migraine than the disease duration. Our study showed the existence of significant correlations between the ways of coping with stress and HRQoL, especially with mental domains. In some domains, the correlation was even stronger than the one showing the disease duration and the number of attacks. The above-mentioned results suggest the directions in further formulation of psychological interventions that would be helpful for the additional treatment of migraine.

Basic cognitive functions across the menstrual cycle in a controlled female cohort.

AIM: To investigate the role of sex hormones in the modulation of specific cognitive functions across the menstrual cycle of young healthy women, and to apply improved study design by addressing limitations recognized in previous studies. METHODS: A homogenous group of 16 young healthy women, with no history of health problems related to menstrual cycle, major psychiatric and neurological disorders or addictions was included in study. All participants were medical students of similar age (21.56 ± 0.15 year). They were subjected to various cognitive tasks at three different phases of the menstrual cycle: early follicular phase, proven ovulatory phase and mid-luteal phase. Special concern was taken to validate blood hormone levels and to determine preovulatory luteinizing hormone (LH)-peak. RESULTS: Analysis of blood hormone levels confirmed that the test sessions were performed at appropriate time points. Most women were presented with the above average results on utilized cognitive tasks, with no significant changes in immediate memory, working memory, delayed recall, verbal learning, delayed verbal learning or verbal fluency in any phase of the menstrual cycle. In addition, test results did not correlate to measured hormone levels. CONCLUSIONS: The results suggest that changes in estrogen and progesterone levels during each menstrual cycle did not affect women's everyday functioning to any significant extent.

The applause sign in Parkinson's disease patients is related to dysexecutive syndrome.

Recent publications report that a positive applause sign is not only present in patients with neurodegenerative diseases where the subcortical structures are affected but also in patients with cortical dementia. The nature of this sign remains unknown. This study aimed to determine the frequency of the applause sign and its correlation with cognitive impairment in patients with idiopathic Parkinson's disease. The study included 30 non-depressed patients diagnosed with idiopathic Parkinson's disease. Study patients underwent the Unified Parkinson Disease Rating Scale part III, Dementia Rating Scale (DRS), Raven's Colored Progressive Matrices, and Mill Hill Vocabulary tests. Statistical analysis was performed by use of the parametric Student's t-test, nonparametric Mann-Whitney U test and Fisher's exact test, with the level of significance set at p<0.05. Negative applause sign was recorded in 66.7% and positive applause sign in 33.3% of patients. There were no between-group differences according to age, disease duration, or severity of motor symptoms. The positive applause sign group had significantly lower scores on the initiation/perseveration subscale of the DRS and a significantly higher frequency of scores below the cut-off score on the conceptualization and construction subscales of the DRS. The applause sign appears to be part of a broader dysexecutive syndrome in idiopathic Parkinson's disease.

Clinical manifestation and neuroimaging methods in diagnosing basal ganglia calcifications.

The aim of this case study was to evaluate the clinical symptoms in patients with basal ganglia calcifications and compare the neuroimaging methods used in confirming this state. The clinical status and performed transcranial sonography of basal ganglia structures in patients with brain calcifications found by computed brain tomography was examined. In one of these patients DaTSCAN was performed. A large spectrum of different symptoms was found. Transcranial sonography of basal ganglia showed the hyperechogenicity of nucleus lenticularis in eight out of 10 patients. DaTSCAN, which was performed to one patient with parkinsonian signs and the hyperechogenicity of substantia nigra found by transcranial sonography, was normal. Transcranial sonography is a newly neuroimaging method which can contribute to diagnosing basal ganglia calcifications in patients with different neurological signs. Computed tomography of brain remains the most adequate technique in visualising calcifications.

Cognitive dysfunction in idiopathic and vascular parkinsonism.

AIM: To evaluate the characteristics of cognitive disturbances in patients with parkinsonism and to point out the need of following up those changes by highly specific tests. METHODS: The first group consisted of patients with Parkinson's disease, and the second group of patients with vascular parkinsonism. The neuropsychological assessments were performed with mini mental state examination (MMSE) and the Raven progressive matrices. RESULTS: The MMSE has shown a higher percentage of patients with vascular parkinsonism who had dementia. For evaluating the nonverbal possibilities, the aim of understanding the complex situation and the visual perception, the Raven's progressive matrices were used showing that in both groups of the patients those specific changes were highly present. CONCLUSIONS: It was concluded that MMSE and Raven's progressive matrices have to be obtained in early phases of the disease, and have to be repeated to follow up the therapy effect.

[Follow up of traumatic brain injury sequels in war victims]. / Pracenje posljedica traumatske ozljede mozga u stradalnika domovinskog rata.

Most evaluation scales used in the follow up of war victims with traumatic brain injury used to date have been focused on physical disability rather than psychological and social dimensions of the handicap. The aim of this study was to assess the applicability of the European Head Injury Evaluation Chart (EHIEC) in the follow up of traumatic brain injury in patients attending the War Veterans Rehabilitation Center in Osijek. The study included 20 patients with traumatic brain injury sustained during the war in Croatia and their families. The EHIEC form was filled out by a professional examiner using data from the patient's medical records and those obtained by evaluation of the patient's physical, mental and social status on his first visit to the Center. Study results showed the majority of these patients to suffer relatively moderate disability consequential to traumatic head injury (mild to moderate hemiparesis, moderate chronic pain, attention impairment, and frequent affective disorder such as depression and anxiety). The patients had significantly reduced capacity for work and impaired community adaptation. However, EHIEC questionnaire was found to suffer from some shortcomings, including time-consuming procedure, problems with interpretation of answers, and inadequate adaptability to local social service. Additional studies are needed to evaluate the questionnaire applicability to outpatient follow up of individuals with traumatic head injury.