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25 results

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  • Cultural influence on clock drawing test: A systematic review
  • Giorgia Maestri, Alessia Nicotra, Simone Pomati, Marco Canevelli, Leonardo Pantoni, Ilaria Cova
  • Journal: Journal of the International Neuropsychological Society , First View
  • Published online by Cambridge University Press: 25 November 2022, pp. 1-11
  • View abstract
    Objective:

    Dementia among migrants is an emerging phenomenon worldwide and the development of neuropsychological tests sensitive to cultural differences is increasingly regarded as a priority. The Clock Drawing Test (CDT) is one of the most used screening tools for the detection of cognitive decline. Nevertheless, there is still a debate about its adoption as a cross-cultural assessment.

    Methods:

    To identify cultural variables influencing performance at CDT, we performed a systematic review of literature on three databases of all studies considering the role of at least one of the following: (1) language; (2) education; (3) literacy; (4) acculturation; and (5) ethnicity.

    Results:

    We extrapolated 160 analyses from 105 studies. Overall, an influence of cultural determinants on performance at CDT was found in 127 analyses (79.4%). Regarding specific cultural factors, 22 analyses investigated the effect of ethnicity on CDT scores, reporting conflicting results. Only two scoring systems turned out to be sufficiently accurate in a multicultural population. Language influenced performance in only 1 out of 8 analyses. A higher level of education positively influenced test performance in 118 out of 154 analyses (76.6%), and a better quality of education in 1 analysis out of 2. A negative influence of illiteracy on CDT performance emerged in 9 out of 10 analyses. Acculturation affected performances at CDT in 1 out of 2 studies.

    Conclusions:

    Based on the present findings, caution is needed when using CDT in a multicultural context, even if it requires limited linguistic competence.

Cerebral Small Vessel Disease
  • Cerebral Small Vessel Disease
  • Edited by Leonardo Pantoni, Philip B. Gorelick
  • Published online: 05 June 2014
  • Print publication: 01 May 2014
  • View description
    Small vessel disease is an important frontier in neurology; about 25% of strokes are classified as small vessel, and SVD is the most common cause of vascular cognitive impairment. The risk of developing SVD increases with age, making this a growing concern for countries with aging populations. Despite this, there has been a paucity of information about its causes, diagnosis, prevention and treatment. This volume brings together contributions from leading international experts in the field and discusses pathogenesis, pathophysiology, clinical and radiologic manifestations, prevention and treatment modalities, and future directions for research and practice. Genetic forms of SVD are discussed, as well as the rapid development of neuroimaging techniques as tools for screening and treatment. This authoritative book is essential reading for neurologists, stroke physicians, geriatricians, and interventional neuroradiologists, as well as researchers in the fields of aging and dementia.
  • Relationship between progression of brain white matter changes and late-life depression: 3-year results from the LADIS study
  • Michael J. Firbank, Andrew Teodorczuk, Wiesje M. Van Der Flier, Alida A. Gouw, Anders Wallin, Timo Erkinjuntti, Domenico Inzitari, Lars-Olof Wahlund, Leonardo Pantoni, Anna Poggesi, Giovanni Pracucci, Peter Langhorne, John T. O'Brien,
  • Journal: The British Journal of Psychiatry / Volume 201 / Issue 1 / July 2012
  • Published online by Cambridge University Press: 02 January 2018, pp. 40-45
  • Print publication: July 2012
    • Article
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  • View abstract
    Background

    Brain white matter changes (WMC) and depressive symptoms are linked, but the directionality of this association remains unclear.

    Aims

    To investigate the relationship between baseline and incident depression and progression of white matter changes.

    Method

    In a longitudinal multicentre pan-European study (Leukoaraiosis and Disability in the elderly, LADIS), participants aged over 64 underwent baseline magnetic resonance imaging (MRI) and clinical assessments. Repeat scans were obtained at 3 years. Depressive outcomes were assessed in terms of depressive episodes and the Geriatric Depression Scale (GDS). Progression of WMC was measured using the modified Rotterdam Progression scale.

    Results

    Progression of WMC was significantly associated with incident depression during year 3 of the study (P = 0.002) and remained significant after controlling for transition to disability, baseline WMC and baseline history of depression. There was no significant association between progression of WMC and GDS score, and no significant relationship between progression of WMC and history of depression at baseline.

    Conclusions

    Our results support the vascular depression hypothesis and implicate WMC as causal in the pathogenesis of late-life depression.

  • The use of CT in dementia
  • Marco Pasi, Anna Poggesi, Leonardo Pantoni
  • Journal: International Psychogeriatrics / Volume 23 / Issue S2 / September 2011
  • Published online by Cambridge University Press: 10 June 2011, pp. S6-S12
  • View abstract

    Neuroimaging has become part of the required investigations when assessing a patient with dementia. In this brief paper, we summarize the role of computed tomography (CT) in the routine work-up in dementia and provide some information about the role of the CT scan in the field of dementia research.

    Although CT is far less sensitive than magnetic resonance imaging (MRI) in detecting changes associated with cognitive impairment, it may still have a role in this regard. This role is mainly that of detecting secondary, sometimes treatable causes of cognitive impairment, such as intracranial masses. In this sense, CT should be seen as a first-line tool. Possible advantages of CT are lower cost; shorter acquisition time, making it more adaptable to patients with poor compliance; and the possibility that it can be performed in patients with metal devices, such as a pacemaker.

    The role of CT in the field of dementia research is very restricted in comparison to that of MRI, and is limited to the structural assessment of vascular lesions, and to a lesser extent, to that of degenerative changes, particularly when using specific slicing.

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