Relações de trabalho e maternidade no contexto esportivo: um estudo de caso / Labor and maternity relationships in the sports context: a case study / Relaciones de trabajo y maternidad en el contexto deportivo: un estudio de caso

A Psicologia Social do Trabalho tem contribuído para a visibilidade e ampliação da compreensão do trabalho em seus diferentes formatos e contextos de atividade, alertando para a necessidade de se olhar para os trabalhos não regulamentados, como é o caso da atleta profissional. Nesse contexto, ainda mais fragilizada é a relação de trabalho da mulher atleta, principalmente, quando ela decide ser mãe e a precariedade no trabalho se acentua. Este artigo examina a trajetória de uma atleta de rendimento da seleção brasileira de vôlei, Tandara Caixeta, por meio do que tem sido veiculado nas mídias eletrônicas, especialmente os sites esportivos, sobre sua relação trabalhista com um clube. Foram analisadas 31 reportagens em sites que relacionavam com a gravidez e sua busca na justiça por seus direitos trabalhistas. A partir dos materiais coletados foi possível compreender que a problemática em questão versou sobre dois principais pontos: a relação contratual e a desproteção das atletas por ocasião da maternidade. Conclui-se que o apoio social, familiar e da equipe é fundamental para um retorno saudável da atleta ao seu rendimento, mas o apoio financeiro é fundamental para a manutenção do bem-estar e satisfação laboral. (AU)

Social Work Psychology has contributed to enhancing the visibility and understanding of work across its various formats and activity contexts, emphasizing the importance of considering unregulated forms of labor, as seen in the case of professional female athletes. Within this context, the working relationship of female athletes becomes even more fragile, particularly when they decide to become mothers, amplifying the challenges within their working arrangements. This article examines the journey of a high-performance athlete from the Brazilian volleyball team, Tandara Caixeta, based on her electronic media coverage, particularly on sports websites, regarding her employment relationship with a club. Thirty-one reports related to pregnancy and her pursuit of labor rights through legal action were analyzed. The collected materials enabled us to discern two primary issues: the contractual relationship and the lack of protection for athletes during maternity. The study concludes that social, family, and team support are crucial for a healthy return of the athlete to her performance, but financial support is essential for maintaining overall well-being and job satisfaction. (AU)

La Psicología del Trabajo Social ha contribuido para la visibilidad y amplia-ción de la comprensión del trabajo en sus diferentes formatos y contextos de actividad, alertando sobre la necesidad de mirar el trabajo no regulado, como es el caso del deportista profesional. En este contexto, la relación laboral de la deportista es aún más frágil, especialmente cuando decide ser madre y se acentúa la precariedad del trabajo. Este artículo propone seguir la trayectoria de una deportista de élite de la selección brasileña de voleibol, Tandara Caixeta, a través de lo publicado en medios electrónicos, especialmente sitios web depor-tivos, sobre su relación laboral con su club. Se analizaron 31 denúncias en sitios web relacionados con el embarazo, que reclamaron sus derechos laborales en los tribunales. A partir de los materiales recolectados se pudo entender que el tema en cuestión trataba sobre dos puntos principales: la relación contractual y la desprotección de los deportistas durante la maternidad. Se concluye que el apoyo social, familiar y de equipo es fundamental para un retorno saludable de la deportista a su desempeño, pero el apoyo económico es fundamental para mantener el bienestar y la satisfacción laboral. (AU)

Anxiety, Depression, and Apathy as Predictors of Cognitive Decline in Patients With Parkinson's Disease-A Three-Year Follow-Up Study.

OBJECTIVE: Anxiety, depression, and apathy are the most common neuropsychiatric symptoms in Parkinson's disease (PD) patients. They impair cognitive functioning and have a profound impact on quality of life. This follow-up study aims to investigate the predictive value of anxiety, depression, and apathy on the development of Mild Cognitive Impairment (MCI) in PD patients. METHODS: Twenty-nine cognitively unimpaired PD patients (mean age 68.2 SD ± 7.12 years; 13 women) participated in this study. At Baseline (BL) levels of apathy (Apathy Evaluation Scale, AES), depression (Beck Depression Inventory, BDI-II), and anxiety (Beck Anxiety Inventory, BAI), were assessed. Cognitive status was reassessed three years later according to MCI/non-MCI status. For statistics, we used binary logistic regression and receiver operating characteristic curve (ROC) analysis to examine anxiety, apathy, and depression at BL as a predictor of MCI status three years later. RESULTS: Eight of the 29 patients developed MCI. Anxiety level at BL was found to predict MCI status at three-year follow-up (OR = 1.20, CI = 1.02-1.41, p = 0.02), while depression (OR = 1.16, CI = 0.93-1.47, p = 0.20) and apathy (OR = 1.06, CI = 0.92-1.23, p = 0.40) did not predict MCI status. The area under the ROC curve (AUC) of BAI for discriminating PD-non-MCI from PD-MCI was 0.79 (CI = 0.61-0.98). The optimal classification threshold yielded a sensitivity of 75.0 % and a specificity of 76.2 %. Neither apathy nor depression at BL discriminated between PD-non-MCI patients from PD-MCI three years later. CONCLUSIONS: This study shows an association between anxiety and the development of MCI in PD patients, although the association between apathy, depression, and MCI did not reach a significant level.

Effects of Rhythmic Interventions on Cognitive Abilities in Parkinson's Disease.

OBJECTIVE: The objective of this study is to compare 2 different rhythmic, high-intensive interventions, that is, rhythmic speech-language therapy (rSLT) versus rhythmic balance-mobility training (rBMT), against a no-therapy (NT) condition in patients with Parkinson's disease and against healthy controls (HCs) with regard to the change in or enhancement of cognitive abilities. METHODS: The 4 groups (rSLT: N = 16; rBMT: N = 10; NT: N = 18; and HC: N = 17) were matched for age, sex, and educational level and were tested in 6 cognitive domains: working memory, executive function, visuo-construction, episodic memory, attention, and word retrieval. Assessments took place at baseline, at 4 weeks (T1), and at 6 months (T2). Rhythmic interventions were provided 3 times per week for 4 weeks in total. To analyze true intervention effects between groups and across time, statistical analyses included reliable change index. Intergroup differences were assessed with multivariate assessment of variance, while differences within groups were assessed with 95% confidence intervals of mean difference. RESULTS: The rSLT improved working memory and word retrieval (p < 0.05), possibly a beneficial transfer effect of the training method per se. In contrast, the NT group worsened in phonemic and semantic shifting (p < 0.01). Observed improvements in flexibility and in episodic memory in the HC may be linked to training effects of retesting. CONCLUSIONS: Rhythmic cues are resistant to neurodegeneration and have a strong motivating factor. As thus, these may facilitate high-intensive and demanding training. Although both trainings were superior to NT, the improvement of cognitive abilities depends on the specific training method. Further, therapy may be more effective when delivered by a therapist rather than by an impersonal computer program.

Does Quantitative Electroencephalography Refine Preoperative Cognitive Assessment in Parkinson's Disease Patients Treated with Deep Brain Stimulation? A Follow-Up Study.

OBJECTIVE: Deep brain stimulation (DBS) in Parkinson's disease (PD) is associated with an increased risk of post-operative cognitive deterioration. Preoperative neuropsychological testing can be affected and limited by the patient's collaboration in advanced disease. The purpose of this study was to determine whether preoperative quantitative electroencephalography (qEEG) may be a useful complementary examination technique during preoperative assessment to predict cognitive changes in PD patients treated with DBS. METHODS: We compared the cognitive performance of 16 PD patients who underwent bilateral subthalamic nucleus DBS to the performance of 15 PD controls (matched for age, sex, and education) at baseline and at 24 months. Cognitive scores were calculated for all patients across 5 domains. A preoperative 256-channel resting EEG was recorded from each patient. We computed the global relative power spectra. Correlation and linear regression models were used to assess associations of preoperative EEG measures with post-operative cognitive scores. RESULTS: Slow waves (relative delta and theta band power) were negatively correlated with post-operative cognitive performance, while faster waves (alpha 1) were strongly positively correlated with the same scores (the overall cognitive score, attention, and executive function). Linear models revealed an association of delta power with the overall cognitive score (p = 0.00409, adjusted R2 = 0.6341). Verbal fluency (VF) showed a significant decline after DBS surgery, which was correlated with qEEG measures. CONCLUSIONS: To analyse the side effects after DBS in PD patients, the most important parameter is verbal fluency capacity. In addition, correlation with EEG frequency bands might be useful to detect particularly vulnerable patients for cognitive impairment and be supportive in the selection process of patients considered for DBS.

Dynamic Functional Connectivity of EEG: From Identifying Fingerprints to Gender Differences to a General Blueprint for the Brain's Functional Organization.

An individual's brain functional organization is unique and can reliably be observed using modalities such as functional magnetic resonance imaging (fMRI). Here we demonstrate that a quantification of the dynamics of functional connectivity (FC) as measured using electroencephalography (EEG) offers an alternative means of observing an individual's brain functional organization. Using data from both healthy individuals as well as from patients with Parkinson's disease (PD) (n = 103 healthy individuals, n = 57 PD patients), we show that "dynamic FC" (DFC) profiles can be used to identify individuals in a large group. Furthermore, we show that DFC profiles predict gender and exhibit characteristics shared both among individuals as well as between both hemispheres. Furthermore, DFC profile characteristics are frequency band specific, indicating that they reflect distinct processes in the brain. Our empirically derived method of DFC demonstrates the potential of studying the dynamics of the functional organization of the brain using EEG.

Cognitive decline in Parkinson's disease is associated with reduced complexity of EEG at baseline.

Parkinson's disease is a neurodegenerative disorder requiring motor signs for diagnosis, but showing more widespread pathological alterations from its beginning. Compared to age-matched healthy individuals, patients with Parkinson's disease bear a 6-fold lifetime risk of dementia. For individualized counselling and treatment, prognostic biomarkers for assessing future cognitive deterioration in early stages of Parkinson's disease are needed. In a case-control study, 42 cognitively normal patients with Parkinson's disease were compared with 24 healthy control participants matched for age, sex and education. Tsallis entropy and band power of the δ, θ, α, ß and γ-band were evaluated in baseline EEG at eyes-open and eyes-closed condition. As the θ-band showed the most pronounced differences between Parkinson's disease and healthy control groups, further analysis focussed on this band. Tsallis entropy was then compared across groups with 16 psychological test scores at baseline and follow-ups at 6 months and 3 years. In group comparison, patients with Parkinson's disease showed lower Tsallis entropy than healthy control participants. Cognitive deterioration at 3 years was correlated with Tsallis entropy in the eyes-open condition (P < 0.00079), whereas correlation at 6 months was not yet significant. Tsallis entropy measured in the eyes-closed condition did not correlate with cognitive outcome. In conclusion, the lower the EEG entropy levels at baseline in the eyes-open condition, the higher the probability of cognitive decline over 3 years. This makes Tsallis entropy a candidate prognostic biomarker for dementia in Parkinson's disease. The ability of the cortex to execute complex functions underlies cognitive health, whereas cognitive decline might clinically appear when compensatory capacity is exhausted.

EEG Slowing and Axial Motor Impairment Are Independent Predictors of Cognitive Worsening in a Three-Year Cohort of Patients With Parkinson's Disease.

Objective: We aimed to determine whether the combination of two parameters: (a) score of axial impairment and limb rigidity (SAILR) with (b) EEG global relative median power in the frequency range theta 4-8 Hz (GRMPT) predicted cognitive outcome in patients with Parkinson's disease (PD) better than each of these measures alone. Methods: 47 non-demented patients with PD were examined and re-examined after 3 years. At both time-points, the patients underwent a comprehensive neuropsychological and neurological assessment and EEG in eyes-closed resting-state condition. The results of cognitive tests were normalized and individually summarized to obtain a "global cognitive score" (GCS). Change of GCS was used to represent cognitive changes over time. GRMPT and SAILR was used for further analysis. Linear regression models were calculated. Results: GRMPT and SAILR independently predicted cognitive change. Combination of GRMPT and SAILR improved the significance of the regression model as compared to using each of these measures alone. GRMPT and SAILR only slightly correlate between each other. Conclusion: The combination of axial signs and rigidity with quantitative EEG improves early identification of patients with PD prone to severe cognitive decline. GRMPT and SAILR seem to reflect different disease mechanisms. Significance Combination of EEG and axial motor impairment assessment may be a valuable marker in the cognitive prognosis of PD.

A Comparison of Serial Position Effects in Patients with Mild Cognitive Impairment due to Parkinson's Disease or to Alzheimer's Disease.

OBJECTIVE: The first (primacy region) and last (recency region) items of a word list are generally better memorized than items from the middle region. The recency effect depends on short-term memory (STM) and the primacy effect on long-term memory (LTM), where verbal information is transferred from STM into LTM by maintenance rehearsal. We compared the serial position effects (SPE) between patients with mild cognitive impairment (MCI) due to Parkinson's disease (PD), i.e., PD-MCI, and patients with MCI due to Alzheimer's disease (AD-MCI), and evaluated the influence of SPE and frontostriatal deficits on verbal memory recall. METHODS: Four similar groups of subjects participated in the study: 26 PD-MCI patients, 26 cognitively normal patients with PD (PD-CN), 26 AD-MCI patients, and 26 normal controls (NC). Verbal episodic memory, verbal span, attentional capacity, executive functions, and verbal working memory performance were assessed. Measures for primacy and recency regions were defined at the first trial of a 16-items word list. Hierarchical regression models were used to investigate the contribution of frontostriatal deficits beyond SPE on verbal memory recall performance ("long-delay free recall") in PD and AD patients. RESULTS: Primacy effects were significantly diminished in both PD-MCI and AD-MCI patients relative to NC and PD-CN (all p < 0.01). Compared to PD-MCI patients, AD-MCI patients exhibited significantly worse "delayed-recall 'savings'." Reduced primacy effect was predictive for decreased recall performance in PD and AD. The conducted hierarchical regression model revealed that in PD, but not in AD patients, performance of attention and executive function significantly increased the prediction of free recalled words. CONCLUSIONS: Reduced recall performance is likely due to impaired transition of newly learned material from STM into LTM in AD and in PD. Whereas AD-MCI patients suffer from a storage deficit, the similarly reduced recall performance found in patients with PD-MCI may additionally be related to deficient attentional and executive capacity.

Nonmotor-Related Quality of Life in Parkinson's Patients with Subjective Memory Complaints: Comparison with PDQ-39.

BACKGROUND: Parkinson's disease (PD) is associated with cognitive decline, progressing from subjective memory complaints (SMC) via mild cognitive impairment (MCI) to dementia. SMC are only measurable by an interview and thus rely on individuals reporting a subjectively perceived worsening of cognitive functioning. Cognitive decline is accompanied by a reduction in quality of life (QoL); however, the extent to which SMC manifest a reduction of QoL remains unclear. OBJECTIVE: To determine the association between SMC and deterioration of QoL in patients suffering from PD. METHODS: A total of 46 cognitively unimpaired PD patients (29 men and 17 women) completed PDQ-39, two assessments to measure SMC (Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and a Self-Assessment questionnaire), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). Multiple regression modelling was conducted to investigate the confounding effect of depression and anxiety. RESULTS: The PDQ-39 domain cognitions, but not the PDQ-39 sum score, correlated significantly with the SMC Self-Assessment questionnaire (r = 0.57; p < 0.001). The conducted regression model indicates a significant confounding effect of depression and anxiety (p < 0.001, R 2 = 0.55). CONCLUSION: In our study, SMC is significantly related to a reduction of cognitive QoL. In addition, we observed significant relation to anxiety and depression levels. In contrast to our main hypothesis, we found no association with overall QoL; this lack of association could be due to unstandardized questionnaires and emphasizes the need of validated tools for evaluating SMC.

Effects of Cognitive Performance and Affective Status on Fatigue in Parkinson's Disease.

BACKGROUND: Fatigue is a common non-motor symptom in Parkinson's disease (PD) and is typically assessed via self-reported questionnaires such as the Parkinson's Fatigue Scale (PFS). The PFS captures the presence of subjective experience of physical fatigue as well as its impact on daily functioning. OBJECTIVES: We aimed to investigate whether different variables (cognition, neuropsychiatric symptoms, disease-related measures) are associated with the experience of physical fatigue in comparison to fatigue affecting daily functioning. METHOD: Sixty-two non-demented PD patients were evaluated through questionnaires assessing fatigue, daytime sleepiness, apathy, depression, anxiety, and cognition. Items of fatigue were classified and summarized into two index variables measuring either the subjective experience of physical fatigue or the impact of fatigue on daily functioning. Linear regression with a stepwise elimination procedure was conducted to select the significant predictors for each index variable separately. RESULTS: Subjective experience of physical fatigue (Model 1; r 2 = 0.46; p <0.01) was significantly associated with higher levels of depression (b =0.07; p <0.01), anxiety (b =0.03; p <0.05), and lower performances in verbal episodic memory (b =-0.16; p <0.05). Fatigue affecting daily functioning (Model 2; r 2 = 0.44; p <0.05) was significantly related to higher levels of depression (b = 0.07; p < 0.01), anxiety (b = 0.03; p > 0.05), and lower motor functioning (b = 0.01; p = 0.05). CONCLUSIONS: In conclusion, our work supports associations between fatigue and other neuropsychiatric symptoms in PD and extends prior work suggesting that motor disturbances are specifically linked to fatigue-related impairment of daily functioning, but not to the subjective experience of physical fatigue.

Phase lag index and spectral power as QEEG features for identification of patients with mild cognitive impairment in Parkinson's disease.

OBJECTIVES: To identify quantitative EEG frequency and connectivity features (Phase Lag Index) characteristic of mild cognitive impairment (MCI) in Parkinson's disease (PD) patients and to investigate if these features correlate with cognitive measures of the patients. METHODS: We recorded EEG data for a group of PD patients with MCI (n = 27) and PD patients without cognitive impairment (n = 43) using a high-resolution recording system. The EEG files were processed and 66 frequency along with 330 connectivity (phase lag index, PLI) measures were calculated. These measures were used to classify MCI vs. MCI-free patients. We also assessed correlations of these features with cognitive tests based on comprehensive scores (domains). RESULTS: PLI measures classified PD-MCI from non-MCI patients better than frequency measures. PLI in delta, theta band had highest importance for identifying patients with MCI. Amongst cognitive domains, we identified the most significant correlations between Memory and Theta PLI, Attention and Beta PLI. CONCLUSION: PLI is an effective quantitative EEG measure to identify PD patients with MCI. SIGNIFICANCE: We identified quantitative EEG measures which are important for early identification of cognitive decline in PD.

Quantitative EEG and Verbal Fluency in DBS Patients: Comparison of Stimulator-On and -Off Conditions.

Introduction: Deep brain stimulation of the subthalamic nucleus (STN-DBS) ameliorates motor function in patients with Parkinson's disease and allows reducing dopaminergic therapy. Beside effects on motor function STN-DBS influences many non-motor symptoms, among which decline of verbal fluency test performance is most consistently reported. The surgical procedure itself is the likely cause of this decline, while the influence of the electrical stimulation is still controversial. STN-DBS also produces widespread changes of cortical activity as visualized by quantitative EEG. The present study aims to link an alteration in verbal fluency performance by electrical stimulation of the STN to alterations in quantitative EEG. Methods: Sixteen patients with STN-DBS were included. All patients had a high density EEG recording (256 channels) while testing verbal fluency in the stimulator on/off situation. The phonemic, semantic, alternating phonemic and semantic fluency was tested (Regensburger Wortflüssigkeits-Test). Results: On the group level, stimulation of STN did not alter verbal fluency performance. EEG frequency analysis showed an increase of relative alpha2 (10-13 Hz) and beta (13-30 Hz) power in the parieto-occipital region (p ≤ 0.01). On the individual level, changes of verbal fluency induced by stimulation of the STN were disparate and correlated inversely with delta power in the left temporal lobe (p < 0.05). Conclusion: STN stimulation does not alter verbal fluency performance in a systematic way at group level. However, when in individual patients an alteration of verbal fluency performance is produced by electrical stimulation of the STN, it correlates inversely with left temporal delta power.

Among Early Appearing Non-Motor Signs of Parkinson's Disease, Alteration of Olfaction but Not Electroencephalographic Spectrum Correlates with Motor Function.

Olfactory decline is a frequent and early non-motor symptom in Parkinson's disease (PD), which is increasingly used for diagnostic purposes. Another early appearing sign of PD consists in electroencephalographic (EEG) alterations. The combination of olfactory and EEG assessment may improve the identification of patients with early stages of PD. We hypothesized that olfactory capacity would be correlated with EEG alterations and motor and cognitive impairment in PD patients. To the best of our knowledge, the mutual influence of both markers of PD-olfactory decrease and EEG changes-was not studied before. We assessed the function of odor identification using olfactory "Screening 12 Test" ("Sniffin' Sticks®"), between two samples: patients with PD and healthy controls (HC). We analyzed correlations between the olfactory function and demographical parameters, Unified Parkinson's Disease Rating Scale (UPDRS-III), cognitive task performance, and spectral alpha/theta ratio (α/θ). In addition, we used receiver operating characteristic-curve analysis to check the classification capacity (PD vs HC) of olfactory function, α/θ, and a combined marker (olfaction and α/θ). Olfactory capacity was significantly decreased in PD patients, and correlated with age, disease duration, UPDRS-III, and with items of UPDRS-III related to gait and axial rigidity. In HC, olfaction correlated with age only. No correlation with α/θ was identified in both samples. Combined marker showed the largest area under the curve. In addition to EEG, the assessment of olfactory function may be a useful tool in the early characterization and follow-up of PD.

Influence of Mild Cognitive Impairment, Depression, and Anxiety on the Quality of Life of Patients with Parkinson Disease.

BACKGROUND: Neuropsychiatric symptoms (NPS) and mild cognitive impairment (MCI) are common in Parkinson disease (PD) and have a negative impact on the patient's quality of life (QoL). We aim to describe the effect of NPS and MCI on each other and on QoL. METHODS: Sixteen MCI and 37 non-MCI PD patients completed different self-assessment questionnaires including the Parkinson's Disease Questionnaire (PDQ-39), the Beck Depression Inventory (BD), the Beck Anxiety Inventory (BAI), and the Self-Report Manic Inventory (SRMI). Linear regression with stepwise elimination was used to select the significant predictors of QoL and to control for confounding factors. RESULTS: The significant linear regression model (R2 = 0.68, p ≤ 0.01) revealed significant effects of MCI (p = 0.03), BDI (p ≤ 0.01), BAI (p ≤ 0.01), age (p = 0.03), a trend of SRMI (p = 0.06), and disease duration (p = 0.08) on QoL. CONCLUSIONS: MCI, anxiety, depression, and age decrease QoL in patients with PD. NPS has the main influence in the prediction of QoL in patients with PD, whereas MCI is only of minor importance.

Apathy in Patients with Parkinson's Disease Correlates with Alteration of Left Fronto-Polar Electroencephalographic Connectivity.

Introduction: Quantitative electroencephalography (QEEG) brain frequency and network analyses are known to differentiate between disease stages in Parkinson's disease (PD) and are possible biomarkers. They correlate with cognitive decline. Little is known about changes in brain networks in relation to apathy. Objective/Aims: To analyze changes in brain network connectivities related to apathy. Methods: 40 PD patients (14 PD with mild cognitive deficits and 26 PD with normal cognition) were included. All patients had extensive neuropsychological testing; apathy was evaluated using the apathy evaluation score (AES, median 24.5, range 18-39). Resting state EEG was recorded with 256 electrodes and analyzed using fully automated Matlab® code (TAPEEG). For estimation of the connectivities between brain regions, PLI (phase lag index) was used, enhanced by a microstates segmentation. Results: After correction for multiple comparisons, significant correlations were found for single alpha2-band connectivities with the AES (p-values < 0.05). Lower connectivities, mainly involving the left fronto-polar region, were related to higher apathy scores. Conclusions: In our sample of patients with PD, apathy correlates with a network alteration mainly involving the left fronto-polar region. This might be due to dysfunction of the cortico-basal loop, modulating motivation.

Correlation of Visuospatial Ability and EEG Slowing in Patients with Parkinson's Disease.

Background. Visuospatial dysfunction is among the first cognitive symptoms in Parkinson's disease (PD) and is often predictive for PD-dementia. Furthermore, cognitive status in PD-patients correlates with quantitative EEG. This cross-sectional study aimed to investigate the correlation between EEG slowing and visuospatial ability in nondemented PD-patients. Methods. Fifty-seven nondemented PD-patients (17 females/40 males) were evaluated with a comprehensive neuropsychological test battery and a high-resolution 256-channel EEG was recorded. A median split was performed for each cognitive test dividing the patients sample into either a normal or lower performance group. The electrodes were split into five areas: frontal, central, temporal, parietal, and occipital. A linear mixed effects model (LME) was used for correlational analyses and to control for confounding factors. Results. Subsequently, for the lower performance, LME analysis showed a significant positive correlation between ROCF score and parietal alpha/theta ratio (b = .59, p = .012) and occipital alpha/theta ratio (b = 0.50, p = .030). No correlations were found in the group of patients with normal visuospatial abilities. Conclusion. We conclude that a reduction of the parietal alpha/theta ratio is related to visuospatial impairments in PD-patients. These findings indicate that visuospatial impairment in PD-patients could be influenced by parietal dysfunction.

Quantitative EEG (QEEG) Measures Differentiate Parkinson's Disease (PD) Patients from Healthy Controls (HC).

Objectives: To find out which Quantitative EEG (QEEG) parameters could best distinguish patients with Parkinson's disease (PD) with and without Mild Cognitive Impairment from healthy individuals and to find an optimal method for feature selection. Background: Certain QEEG parameters have been seen to be associated with dementia in Parkinson's and Alzheimer's disease. Studies have also shown some parameters to be dependent on the stage of the disease. We wanted to investigate the differences in high-resolution QEEG measures between groups of PD patients and healthy individuals, and come up with a small subset of features that could accurately distinguish between the two groups. Methods: High-resolution 256-channel EEG were recorded in 50 PD patients (age 68.8 ± 7.0 year; female/male 17/33) and 41 healthy controls (age 71.1 ± 7.7 year; female/male 20/22). Data was processed to calculate the relative power in alpha, theta, delta, beta frequency bands across the different regions of the brain. Median, peak frequencies were also obtained and alpha1/theta ratios were calculated. Machine learning methods were applied to the data and compared. Additionally, penalized Logistic regression using LASSO was applied to the data in R and a subset of best-performing features was obtained. Results: Random Forest and LASSO were found to be optimal methods for feature selection. A group of six measures selected by LASSO was seen to have the most effect in differentiating healthy individuals from PD patients. The most important variables were the theta power in temporal left region and the alpha1/theta ratio in the central left region. Conclusion: The penalized regression method applied was helpful in selecting a small group of features from a dataset that had high multicollinearity.

Increase of EEG Spectral Theta Power Indicates Higher Risk of the Development of Severe Cognitive Decline in Parkinson's Disease after 3 Years.

Objective: We investigated quantitative electroencephalography (qEEG) and clinical parameters as potential risk factors of severe cognitive decline in Parkinson's disease. Methods: We prospectively investigated 37 patients with Parkinson's disease at baseline and follow-up (after 3 years). Patients had no severe cognitive impairment at baseline. We used a summary score of cognitive tests as the outcome at follow-up. At baseline we assessed motor, cognitive, and psychiatric factors; qEEG variables [global relative median power (GRMP) spectra] were obtained by a fully automated processing of high-resolution EEG (256-channels). We used linear regression models with calculation of the explained variance to evaluate the relation of baseline parameters with cognitive deterioration. Results: The following baseline parameters significantly predicted severe cognitive decline: GRMP theta (4-8 Hz), cognitive task performance in executive functions and working memory. Conclusions: Combination of neurocognitive tests and qEEG improves identification of patients with higher risk of cognitive decline in PD.

Fine Motor Function Skills in Patients with Parkinson Disease with and without Mild Cognitive Impairment.

AIMS: The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. METHODS: Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. RESULTS: PD MCI patients performed significantly worse in precision (p < 0.05), dexterity (p < 0.05), and velocity (arm-hand movements; p < 0.05) compared to PD non-MCI patients. The fine motor function skills were confounded by age. CONCLUSIONS: Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research.

Older Candidates for Subthalamic Deep Brain Stimulation in Parkinson's Disease Have a Higher Incidence of Psychiatric Serious Adverse Events.

OBJECTIVE: To investigate the incidence of serious adverse events (SAE) of subthalamic deep brain stimulation (STN-DBS) in elderly patients with Parkinson's disease (PD). METHODS: We investigated a group of 26 patients with PD who underwent STN-DBS at mean age 63.2 ± 3.3 years. The operated patients from the EARLYSTIM study (mean age 52.9 ± 6.6) were used as a comparison group. Incidences of SAE were compared between these groups. RESULTS: A higher incidence of psychosis and hallucinations was found in these elderly patients compared to the younger patients in the EARLYSTIM study (p < 0.01). CONCLUSIONS: The higher incidence of STN-DBS-related psychiatric complications underscores the need for comprehensive psychiatric pre- and postoperative assessment in older DBS candidates. However, these psychiatric SAE were transient, and the benefits of DBS clearly outweighed its adverse effects.