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All Journal MNJ (Malang Neurology Journal) Majalah Kedokteran Neurosains Neurona Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Acta Neurologica Indonesia
Amanda Tiksnadi
Universitas Indonesia
Health Professions Medicine & Pharmacology Neuroscience Public Health

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PERBAIKAN AFASIA PADA STROKE SUBKORTIKAL PASCA rTMS Amanda Tiksnadi*
NEURONA Vol 33 No 1 Desember 2015
Publisher : Neurona Majalah Kedokteran Neuro Sains

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

IS A MANIFESTATION OF LANGUAGE DISORDERS THAT COMMONLY RESULTS FROM DAMAGE TO CORTICAL PORTIONS OF THE BRAIN THAT ARE RESPONSIBLE FOR LANGUAGE RECENTLY APHASIA FOLLOWING LESIONS TO THE BASAL GANGLIA THALAMUS OR OTHER NONCORTICAL REGION HAS ALSO BEEN REPORTED IN SINGLE CASE REPORTS AND CASE SERIES PEOPLE WITH APHASIA HAVE A LONG RECOVERY PERIOD OF MONTHS OR YEARS MANY LIVE WITH MAJOR IMPAIRMENT IN COMMUNICATION FOR THE REST OF THEIR LIVES
The Autonomic-Cognition Clinical Correlation in Indonesian Parkinson’s Disease Subjects Jody, Abraham Al; Tiksnadi, Amanda; Hildaria, Margareth; Asmoro, Anastasia; Candra, Putri Nabilah; Tunjungsari, Dyah
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.247

Abstract

Background: Dysautonomia and cognitive impairment are common in PD, affecting quality of life and disease progression. Understanding their connection enables earlier identification of at-risk patients. This study investigates the correlation between dysautonomia and cognitive impairment in Indonesian PD patients. Methods and Materials: This cross-sectional study collected demographic and clinical data, including SCOPA-COG INA and SCOPA-AUT INA. Independent t-tests, Mann-Whitney U tests, Pearson’s, and Spearman’s correlation tests analyzed associations. Results: We recruited 33 PD subjects, primarily male (72.7%) and elderly (63.6%). The median age was 61 years, with 60.6% having a disease duration of at least 5 years and 66.7% at a mild stage. Median levodopa equivalent daily dose (LEDD) was 325 mg. Median SCOPA-COG INA and SCOPA-AUT INA were 24 and 17. Cognitive impairment was present in 45.4%, and dysautonomia in 15.2%. Elderly subjects had lower SCOPA-COG INA (20.19±7.18 vs 27.58±5.98). Cognitively impaired subjects had worse SCOPA-AUT INA (20.6±7.81 vs. 13.89±6.43) and higher LEDD (408.33±140.25 vs. 275.28±134.51). Cognitively impaired subjects had worse SCOPA-AUT INA urinary symptoms (p<0.05). No differences were found between subjects with and without dysautonomia or when divided by median SCOPA-AUT INA. SCOPA-COG INA and SCOPA-AUT INA were significantly correlated (ρ = -0.368, p < 0.05), as were the SCOPA-COG INA memory domain and SCOPA-AUT INA cardiovascular domain (ρ = 0.399, p < 0.05). Conclusion: In Indonesian PD patients, cognitive impairment is significantly correlated with dysautonomia. Age, age at onset, and LEDD were significantly associated with cognitive impairment but not with dysautonomia. Further exploration could enhance understanding of this correlation.
THE ASSOCIATION OF SOCIODEMOGRAPHIC FACTORS WITH MOTOR SYMPTOMS IN PATIENTS WITH PARKINSONISM Dyson, Nathaniel Gilbert; Tiksnadi, Amanda
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.01.20

Abstract

Background: Motor symptoms in patients with parkinsonism severely impair daily activities. Sociodemographic factors are known to play an important role in various chronic diseases, but their relationship with parkinsonism has not been studied yet. Objective: This study aims to determine the association between sociodemographic factors and motor symptoms among patients with parkinsonism. Methods: This cross-sectional study was conducted at Dr. Cipto Mangunkusumo National Hospital Jakarta by using the MDS Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part II questionnaire about daily motor symptoms. The target sample in this study were patients with parkinsonism based on a doctor's diagnosis, fluent in Indonesian, and had internet access. Results: A total of 50 respondents were recruited with the most motor symptoms being difficulty dressing (90%), followed by writing, doing hobbies, tremors, and balance (88%). Bivariate analysis found that patients with low education, low income, and married had significantly worse motor symptoms (p<0.05). Multivariate analysis revealed that low education level and married status were significant risk factors, while high income level was a protective factor against poor motor symptoms. Conclusion: Sociodemographic factors were significantly associated with motor symptoms in parkinsonism patients. This study recommends personalized patient management based on the patient's sociodemographic factors.
Transcranial Pulse Stimulation as a New Navigated Focal Brain Therapy for Vascular Cognitive Impairment: Case Report Gunawan, Andrie; Tiksnadi, Amanda; Tunjungsari, Dyah; Kathy Putri Sari, Christine
Acta Neurologica Indonesia Vol. 2 No. 03 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i03.33

Abstract

Introduction: To evaluate the cognitive function of vascular cognitive impairment (VCI) after transcranial pulse stimulation (TPS) sessions Case Report: TPS is a non-invasive brain stimulation method. Stimulation was administered using NEUROLITH TPS generator (Storz Medical AG) with 3 Hz ultrashort pulses at 0.25 mJ mm-2 energy density over 12 sessions (6000 pulses per session), three times/week. Target areas included the bilateral DLPFC (1600 pulses per hemisphere), parietal regions (P3, P4) (800 pulses per hemisphere), and precuneus (PCu) (1200 pulses). Cognitive function tests were conducted before the first and after the last TPS session, including MMSE, MoCa-Ina, 15 Boston Naming Test Patient, Digit Span, CERAD (Visuoconstruction, Delayed Memory, Recognition, Verbal Fluency), and Trail Making Test A & B. Discussion: Case 1 was a 48-year-old man with VCI and dysphasia post-stroke infarct (10 months prior), affecting the left caudate nucleus, left lentiform nucleus, and left internal capsule. The patient presented memory and executive function issues but preserved recognition. Case 2 was a 62-year-old man with VCI and anomic aphasia, following a cerebral infarction 5 months prior affected the left putamen, corona radiata, internal capsule, and globus pallidus. After 12 sessions, Case 1 showed amplification in working memory but had executive function challenges. Case 2 demonstrated improvement in immediate memory, recognition, and visuoconstruction, but had lingering issues with delayed verbal, visual memory, and executive function. Conclusion: TPS stimulation of areas for cognitive function appears to enhance memory, recognition, and other cognitive function. TPS may be a novel add‐on therapy for VCI post-stroke patients.
PENGARUH STIMULASI MAGNETIK TRANSKRANIAL BERULANG UNTUK MENGURANGI SKALA NYERI PASIEN STROKE DENGAN GANGGUAN KECEMASAN : Case Report Jumraini Tammasse; Kurnia Bintang; Amanda Tiksnadi; Ahmad Zaki
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 42 No 3 (2026): Juni 2026
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v42i3.201

Abstract

Introduction : Central post stroke pain (CPSP) is a chronic central neuropathic pain syndrome associated with somatosensory abnormalities caused by stroke lesion in central nervous system (CNS). Pain which occurs either with a stimulus or spontaneous, usually exist 1-6 months after ischemic or hemorrhagic stroke. CPSP can cause anxiety, depression, sleeping disorder that lead to decrease quality of life in patient due to chronic pain. Transcranial Magnetic Stimulation (TMS) is a non-pharmacological, as well a non-invasive intervention therapy used to relieve chronic pain and anxiety disorders by using a magnetic field converted by electricity through a coild placed on the skull bone, which useful for reorganizing intracranial structures and functions disturbed by stroke lesion. Case : A 49 year-old patient came to clinic with pain in the left arm and leg, suffered since 5 months before admission, occurred with or without stimulus, reduced with analgetic drug but it came again soon after drug consumption. She felt a continuous stabbing and burning sensation with neurological pain rating scale (NPRS) : 6-7. Stroke history 3 years ago and routinely control to neurologist for medication. She felt difficult to sleep and anxiety because this pain. Hamilton Anxiety Rating Scale (HARS) was measured before and after rTMS. Discussion : Improvement in HARS and NPRS score was noted after rTMS, thought to occur due to reorganization of neurotransmitters involved in chronic pain pathophysiology. Conclusion : rTMS helped to improve quality of life in patient with CPSP. Keyword : Central Post Stroke Pain, Repetitive Transcranial Magnetic Stimulation, Anxiety Disorder, Hamilton Anxiety Rating Scale, Neurological Pain Rating Scale.
PEMILIHAN MONTASE TDCS KORTEKS MOTORIK DALAM PRAKTIK NEURORESTORASI: PERSPEKTIF PEMODELAN MEDAN LISTRIK Amanda Tiksnadi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 42 No 3 (2026): Juni 2026
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v42i3.947

Abstract

Introduction: Various transcranial direct current stimulation (tDCS) montages have been used for primary motor cortex (M1) stimulation. However, montage selection is often based on clinical convention rather than differences in the resulting electric field distribution. Aim: To analize the electric field distribution characteristics of commonly used tDCS montages for left M1 stimulation and discuss their implications for neurorestorative practice. Electric field simulations were performed using SimNIBS based on the finite element method (FEM) and the Ernie Extended head model. Five montages were analyzed: C3–C4, C3–Fp2, C3–Fp1, C3–right deltoid (RDt), and C3–left deltoid (LDt), with the anode placed over C3 and a stimulation intensity of 2 mA. Regional analyses were conducted at C3, Cz, and C4. Distinct electric field distributions were observed across all montages. The C3–C4 montage produced the greatest involvement of the medial sensorimotor region and the contralateral hemisphere, whereas C3–Fp1 generated the most localized distribution within the target hemisphere. The C3–Fp2 montage produced the highest electric field intensity at the target region (C3). Extracephalic montages (C3–RDt and C3–LDt) demonstrated relatively lower contralateral hemispheric involvement compared with the bihemispheric montage. The location of the second electrode substantially influences electric field distribution within the sensorimotor network. Each montage exhibits distinct network recruitment characteristics, suggesting that montage selection should be tailored to the intended neuromodulatory objective and the underlying clinical condition.finite element method; FEM neuromodulation; neurorestoration; primary motor cortex; transcranial direct current stimulation; tDCS
Co-Authors Ahmad Zaki Asmoro, Anastasia Candra, Putri Nabilah Dyah Tunjungsari, Dyah Dyson, Nathaniel Gilbert Gunawan, Andrie Hildaria, Margareth Jody, Abraham Al Jumraini Tammasse Kathy Putri Sari, Christine Kurnia Bintang