Is caregiver burden of patients with amyotrophic lateral sclerosis related to caregivers' mindfulness, quality of life, and patients' functional level.

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the caregiver burden, mindfulness, and quality of life (QoL) of caregivers of ALS patients and the patient's functional level. METHODS: This study was conducted with 57 ALS patients and their primary caregivers. The data were collected using the Zarit Burden Interview, Mindful Attention Awareness Scale (MAAS), the Short Form-36 (SF-36), and the ALS Functional Rating Scale (ALS-FRS). RESULTS: The mean age of the caregivers was 49.7 ± 12 years; 66 % were female, and 73.7 % were spouses of the patients. Around 65 % of caregivers experienced a moderate to severe caregiver burden. A low and negative correlation was found between the caregiver burden and mindfulness of caregivers of ALS patients. As the mindfulness levels of the caregivers increased, the caregiver burden decreased, and the physical role difficulty score, one of the sub-dimensions of the QoL, increased. Also, caregivers' QoL decreased as caregiver burden increased (except physical function QoL, p < 0.05). Moreover, there was a positive correlation between the caregiver burden and ALSFRS-R scores (bulbar, motor, respiratory, and total) of the caregivers of ALS patients (p < 0.05). DISCUSSION: Improved technology for managing ALS disease has increased patient life expectancy. However, caregivers may experience a high burden as the patient's functional level declines. Increasing caregiver mindfulness can help reduce the burden and improve their QoL.

The functional role of the pulvinar in discriminating between objective and subjective cognitive impairment in major depressive disorder.

INTRODUCTION: Emotionally driven cognitive complaints represent a major diagnostic challenge for clinicians and indicate the importance of objective confirmation of the accuracy of depressive patients' descriptions of their cognitive symptoms. METHODS: We compared cognitive status and structural and functional brain connectivity changes in the pulvinar and hippocampus between patients with total depression and healthy controls. The depressive group was also classified as "amnestic" or "nonamnestic," based on the members' subjective reports concerning their forgetfulness. We then sought to determine whether these patients would differ in terms of objective neuroimaging and cognitive findings. RESULTS: The right pulvinar exhibited altered connectivity in individuals with depression with objective cognitive impairment, a finding which was not apparent in depressive patients with subjective cognitive impairment. DISCUSSION: The pulvinar may play a role in depression-related cognitive impairments. Connectivity network changes may differ between objective and subjective cognitive impairment in depression and may play a role in the increased risk of dementia in patients with depression.

Caregiver Burden and Quality of Life of Caregivers for Patients with Parkinson's Disease Treated with Deep Brain Stimulation.

Objective: This study aimed to identify caregiver burden (CB) and contributing factors to CB for Parkinson's disease (PD) patients under Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) treatment, and investigation the factors, affecting the caregivers' quality of life (QoL). Methods: Twenty-four PD patients under STN-DBS treatment and their caregivers participated in this study. Unified Parkinson's Disease Rating Scale (UPDRS) was applied for the clinical assessment of the patients. Beck Depression Inventory-II (BDI), Hospital Anxiety and Depression Scale (HADS), and Minnesota Impulse Control Disorders Interview (MIDI) were used to screen for neuropsychiatric symptoms of the patients. CB was evaluated with the Caregivers Burden Inventory (CBI) and the Burden Scale for Family Caregivers (BSFC-s). The health-related QoL of caregivers was assessed with the Short Form Survey-36 (SF-36). Results: Mean total CBI and BSFC-s scores of caregivers were 32.53 ± 19.71 and 11.66 ± 8.86, respectively. Nineteen caregivers defined moderate or severe caregiver burden according to BSFC-s. Both CBI and BSFC-s scores were significantly associated with UPDRS-part-1 scores, but not with the age and gender of both the patients and their caregivers, disease duration, PDQ39, BDI, HADS, LARS scores, and scores of patients for other UPDRS parts. The presence of impulse control behaviors (ICBs) significantly increased the total CBI score and total BSFC-s (P < 0.01). The caregivers' total and all domain scores of SF-36 were significantly affected by higher CBI and BSFC-s scores. Conclusions: The CB of the patients under STN-DBS treatment was severe. Non-motor symptoms, particularly impulsivity, significantly increased CB and worsened the caregivers' mental and physical health.