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All Journal MNJ (Malang Neurology Journal) Jurnal Kesehatan Prima Majalah Kedokteran Neurosains Journal of Pain, Vertigo and Headache Journal of Global Pharma Technology Journal of General Procedural Dermatology and Venereology Indonesia IJRETINA - International Journal of Retina
Shahdevi Nandar Kurniawan, Shahdevi Nandar
Neurology Department, Medical Faculty, Brawijaya University, Saiful Anwar General Hospital, Malang, Indonesia.
Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Parkinson’s Disease Quality of Life: Disease Severity Outweighs Pain Impact Raisa, Neila; Maziya, Yulianda; Rahma, Annisa; Harbiyanti, Novita Titis; Kurniawan, Shahdevi Nandar
Jurnal Kesehatan Prima Vol 18, No 2 (2024): AUGUST
Publisher : poltekkes kemenkes mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/jkp.v18i2.1657

Abstract

Introduction: Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease, progressively affecting both motor and non-motor systems in patients. In addition to the commonly recognized motor symptoms such as tremor, rigidity, and bradykinesia, non-motor symptoms such as chronic pain are often underdiagnosed. Pain in Parkinson's patients can manifest in various forms, including musculoskeletal pain, neuropathic pain, and dystonic pain. While pain is not a primary symptom defining Parkinson's, its impact on patients' quality of life is profound, contributing to reduced mobility, sleep disturbances, increased risk of falls, and poor mental health, including depression and anxiety. This study aimed to explore the relationship between the severity of Parkinson's disease, pain levels, and quality of life in Parkinson's patients. Method: A cross-sectional observational study was conducted at the Neurology Clinic of RSUD Dr. Saiful Anwar in East Java from October 2023 to March 2024, using purposive sampling techniques. We assessed Parkinson's severity (Hoehn & Yahr scale), pain levels (Numeric Rating Scale), and quality of life (Parkinson's Disease Questionnaire-39 (PDQ-39) Indonesian Version). Result: The study found that PDQ-39 INA scores were significantly associated with Parkinson's disease severity (n = 11, p = 0.012), indicating a significant impact of disease severity on quality of life. However, no significant relationship was found between PDQ-39 scores and pain levels (p = 0.117). Pearson correlation analysis showed no significant relationship between Parkinson's severity scale and pain level (r = 0.461, p = 0.154). Specifically, Parkinson's severity significantly affected PDQ-39 scores (p = 0.001), while pain levels did not have a significant effect (p = 0.399). Conclusion: This study reveals that while pain is a critical issue, it is the severity of Parkinson's disease that has a more substantial impact on patients' quality of life.
UNRAVELING THE BEST NON-PHARMACOLOGICAL INTERVENTIONS FOR COGNITIVE FUNCTION AND DEPRESSION IN ELDERLY WITH COGNITIVE IMPAIRMENT: A NETWORK META-ANALYSIS Masykur, Umar Jundullah; Janet, Karensa Abby; Putri, Dwi Sandhi Aulia Pramesti; Jatmiko, Sarazata Indi Rozaany; Kurniawan, Shahdevi Nandar
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.2025.011.01.16

Abstract

Background: Emerging evidence suggests that non-pharmacological interventions can improve cognitive function and alleviate depressive symptoms in elderly individuals with cognitive impairment. However, the comparative effectiveness of these interventions remains unclear. Objective: This network meta-analysis (NMA) compares the efficacy of eight non-pharmacological interventions—Virtual Reality (VR) or Exergame, Computerized Cognitive Training (CCT), Mind-Body Exercise (MBE), Physical Exercise, Music or Art Therapy, Health Education, Treatment as Usual (TAU), and a Control group (no intervention, placebo)—on cognitive function and depression in elderly individuals with cognitive impairment. Methods: Randomized controlled trials (RCTs) published up to August 10, 2024, were systematically searched in Web of Science, PubMed, Embase, and Cochrane Library databases. A Frequentist random-effects network meta-analysis was conducted using R. Results: Total 46 RCTs with 3043 participants were included. The pooled results showed that CCT (SMD = 2.33, 95% CI [1.34, 3.32]), Physical Exercise (SMD = 2.24, 95% CI [1.24, 3.23]), and VR or Exergame (SMD = 2.09, 95% CI [1.10, 3.08]) significantly improved global cognition. VR or Exergame was also effective in enhancing attention (SMD = -3.49, 95% CI [-6.85, -0.14]), executive function (SMD = -75.54 (95% CI [-118.24, -33.04]), and reducing depressive symptoms (SMD = -2.62, 95% CI [-4.08, -1.15]). Conclusion: This NMA highlights the superior efficacy of CCT, Physical Exercise, and VR or Exergame in improving global cognition in elderly individuals with cognitive impairment. Additionally, VR or Exergame is particularly effective for enhancing attention, executive function, and reducing depressive symptoms, suggesting it should be integrated into cognitive rehabilitation programs.
RETINAL NERVE FIBER LAYER THICKNESS ASSOCIATED WITH SEVERITY OF DIABETIC PERIPHERAL NEUROPATHY IN DIABETES MELLITUS TYPE 2 Putri, Mutiara Kristiani; Arfan, Muhammad; Rahmasari, Herisa; Dewi, Nadia Artha; Rosandi, Rulli; Kurniawan, Shahdevi Nandar
International Journal of Retina Vol 8 No 1 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss001.320

Abstract

Purpose: To identify whether the Retinal Nerve Fiber Layer is useful in detecting severity of peripheral neurodegeneration in diabetic patients Methods: A cross-sectional study was conducted. 36 people were enrolled in this study which is divided into two groups. 18 people with type 2 diabetes mellitus (DM) with Diabetic Peripheral Neuropathy (DPN) and 18 people with type 2 DM non-DPN. All subjects were 40-60 years old, and the best corrected visual acuity was better than 0,2 logMAR. An Optical Coherence Tomography (OCT) examination was carried out to determine the Retinal Nerve Fiber Layer (RNFL) thickness, and an Electroneuromyography examination was applied to establish a diagnosis of DPN. Data were analyzed with independent T-test and Spearman correlation analysis. Results: The average RNFL thickness in the DM with DPN was thinner than the RNFL thickness in the DM non-DPN group (100.22 ± 38; vs 102.61±9.11; p 0.444). At temporal quadrant and nasal quadrant, RNFL was also thinner in DM DPN group than DM non-DPN group (71.78±12.21, vs 76.33 ± 8.53, p 0.203; and 75.11±11.38 vs 77.39 ± 14, p 0.596). Sural and tibial amplitude (14.44±2.87 and 6.85± 4.98) , were the most significant predictor values in determining the severity of DPN (p=0.000). Average, temporal, and nasal RNFL thinning has an inverse association with DPN severity (r=-0,285; -0,258;and -0,126) Conclusion: RNFL was thinner at average, temporal, nasal quadrant in the DM group with DPN compared to DM non-DPN group. RNFL thickness has an inverse association with the severity of the DPN although they were not statistically significant. Keywords: Diabetes Mellitus, Diabetic Peripheral Neuropathy, Retinal Nerve Fiber Layer
COMPREHENSIVE REHABILITATION APPROACH FOR MEDIAN NERVE NEUROPATHY COMPLICATED BY CERVICAL RADICULOPATHY: CASE REPORT IN A YOUNG GAME Yudiansyah, Anggi Gilang; Kurniawan, Shahdevi Nandar; Lestari, Dwi Indriani; Pringga, Gutama Arya
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi 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.jphv.2025.006.01.02

Abstract

Background: Median nerve neuropathy, particularly associated with repetitive strain activities such as gaming, is increasingly recognized in clinical practice. This condition often necessitates a multidisciplinary and holistic approach for effective management, aiming to prevent long-term complications and improve functional outcomes. Case: A 21-year-old male presented with progressive weakness, paresthesia, and atrophy in the first three digits of both hands, attributed to excessive gaming, exceeding 12 hours daily. Neurological examination revealed marked weakness in muscles innervated by the median nerve, and electromyography (EMG) confirmed bilateral median nerve compression, compounded by cervical radiculopathy at the C6-7-8-T1 levels. Discussion: This case underscores the necessity of evaluating both peripheral nerve pathology and potential cervical radiculopathy in patients with extensive upper limb use. Intensive gaming, characterized by poor ergonomic practices, can exacerbate nerve compression, leading to significant neuropathic changes. The implemented multidisciplinary rehabilitation approach involved patient education on ergonomic modifications, targeted physical therapy to strengthen affected muscle groups, and strategies to optimize posture and reduce repetitive strain. This comprehensive intervention aimed to alleviate symptoms, restore function, and prevent further deterioration. Conclusion: The case highlights the complexities involved in managing median nerve neuropathy exacerbated by cervical radiculopathy in individuals engaged in repetitive, high-intensity activities. A comprehensive, evidence-based rehabilitation strategy is crucial for achieving optimal recovery, minimizing recurrence, and enhancing the patient’s quality of life. Further research is warranted to explore the long-term efficacy of such interventions and to develop tailored rehabilitation protocols for similar cases in the gaming community.
Parkinson’s Disease Quality of Life: Disease Severity Outweighs Pain Impact Raisa, Neila; Maziya, Yulianda; Rahma, Annisa; Harbiyanti, Novita Titis; Kurniawan, Shahdevi Nandar
Jurnal Kesehatan Prima Vol. 18 No. 2 (2024): AUGUST
Publisher : poltekkes kemenkes mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32807/jkp.v18i2.1657

Abstract

Introduction: Parkinson's disease is the second most common neurodegenerative disorder after Alzheimer's disease, progressively affecting both motor and non-motor systems in patients. In addition to the commonly recognized motor symptoms such as tremor, rigidity, and bradykinesia, non-motor symptoms such as chronic pain are often underdiagnosed. Pain in Parkinson's patients can manifest in various forms, including musculoskeletal pain, neuropathic pain, and dystonic pain. While pain is not a primary symptom defining Parkinson's, its impact on patients' quality of life is profound, contributing to reduced mobility, sleep disturbances, increased risk of falls, and poor mental health, including depression and anxiety. This study aimed to explore the relationship between the severity of Parkinson's disease, pain levels, and quality of life in Parkinson's patients. Method: A cross-sectional observational study was conducted at the Neurology Clinic of RSUD Dr. Saiful Anwar in East Java from October 2023 to March 2024, using purposive sampling techniques. We assessed Parkinson's severity (Hoehn & Yahr scale), pain levels (Numeric Rating Scale), and quality of life (Parkinson's Disease Questionnaire-39 (PDQ-39) Indonesian Version). Result: The study found that PDQ-39 INA scores were significantly associated with Parkinson's disease severity (n = 11, p = 0.012), indicating a significant impact of disease severity on quality of life. However, no significant relationship was found between PDQ-39 scores and pain levels (p = 0.117). Pearson correlation analysis showed no significant relationship between Parkinson's severity scale and pain level (r = 0.461, p = 0.154). Specifically, Parkinson's severity significantly affected PDQ-39 scores (p = 0.001), while pain levels did not have a significant effect (p = 0.399). Conclusion: This study reveals that while pain is a critical issue, it is the severity of Parkinson's disease that has a more substantial impact on patients' quality of life.
COMPARATIVE EFFECTIVENESS OF NON-PHARMACOLOGICAL INTERVENTIONS FOR DIABETIC NEUROPATHIC PAIN: A NETWORK META-ANALYSIS OF PAIN INTENSITY AND NEUROPATHIC SYMPTOM OUTCOMES Aqila, Hammadah; Masykur, Umar Jundullah; Janet, Karensa Abby; Sulistomo, Hikmawan Wahyu; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.08

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and a major cause of chronic neuropathic pain, leading to reduced quality of life. Owing to the limited efficacy and tolerability of pharmacological treatments, non-pharmacological interventions have emerged as important alternative or adjunctive options. Objective: This study aimed to compare and rank the effectiveness of non-pharmacological interventions for neuropathic pain management in patients with DPN using a network meta-analysis (NMA). Methods: This systematic review and network meta-analysis was prospectively registered in PROSPERO (CRD420261295534). A systematic literature search was conducted in PubMed, Springer Nature, the Cochrane Library, and Taylor & Francis from inception to May 30, 2025. Randomized controlled trials evaluating non-pharmacological interventions for DPN-related neuropathic pain were included. Pain intensity and neuropathic pain symptom scores were analyzed using a frequentist random-effects NMA. Treatment effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs), and intervention rankings were estimated using the surface under the cumulative ranking curve (SUCRA). Results: Forty-seven RCTs involving 3,354 participants and 10 intervention categories were included. For pain intensity, invasive neuromodulation demonstrated the greatest reduction compared with control (SMD = –5.94; 95% CI –7.78 to –4.11) and ranked highest (SUCRA = 0.97). Acupuncture-based therapies and manual/massage therapies also showed notable effects. For neuropathic pain symptom scores, invasive neuromodulation again ranked highest (SMD = –3.20; 95% CI –5.96 to –0.43; SUCRA = 0.74), followed by acupuncture-based and electromagnetic field therapies. Sensitivity analyses confirmed the robustness of the findings, although potential publication bias was detected for pain intensity outcomes. Conclusion: This NMA provides a comprehensive comparative ranking of non-pharmacological interventions for neuropathic pain in DPN, highlighting invasive neuromodulation as the most effective modality and supporting the role of selected non-pharmacological therapies in clinical practice.
EFICACY OF NON-INVASIVE NEUROMODULATION IN REDUCING PAIN INTENSITY AND IMPROVING QUALITY OF LIFE IN PATIENTS WITH DIABETIC NEUROPATHY: A SYSTEMATIC REVIEW AND META ANALYSIS Dewi, Diana Evita; Febriandha, Alfidha Muntaz Sobrina; Putri, Syarellia Safira; Izzaty, Adzura Qannita Chifka; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.15

Abstract

Background: Diabetic neuropathy (DN) is a common complication of diabetes, resulting in chronic neuropathic pain and impaired quality of life. Pharmacological interventions often demonstrate limited efficacy and some accompanied by adverse effects. Non-invasive neuromodulation (NINM) has emerged as a potential treatment modality. With new RCTs emerging, an review is needed to synthesize the latest evidence. Objective: To evaluate the efficacy of NINM in reducing pain and improving quality of life in DN patients. Method: A systematic search was conducted across PubMed, Cochrane, Sage, Science Direct, Google Scholar, and ProQuest. Only RCTs comparing NINM vs Sham were included. Pain outcomes were measured using NRS and VAS. SF-36 was used to evaluate physical and mental components of quality of life. RevMan 5.4 was used for statistical analysis. Results: Nine studies with 523 participants were analyzed. Significant pain reduction was demonstrated in the NINM group compared to the sham group, as measured by VAS [MD = –1.50, 95% CI –2.40 to –0.60, P = 0.001] and NRS [MD = –0.82, 95% CI –1.40 to –0.60, P < 0.00001]. However, no significant improvement was observed in quality of life, both for the SF-36 physical component [MD = 2.34, 95% CI –0.10 to 4.78, P = 0.06] and the mental component [MD = 6.54, 95% CI -1.55 to 14.64, P = 0.11]. Conclusion: NINM proves effective in pain reduction in DN but shows no improvement in quality of life. Further high-quality trials with longer follow-up are needed to determine its effects on physical and mental components.
COMPARATIVE EFFICACY AND SAFETY OF DULOXETINE AND GABAPENTINOID FOR CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY: A SYSTEMATIC REVIEW Zahradewi, Olympia; Kurniawan, Shahdevi Nandar; Budisulistyo, Trianggoro
Journal of Pain, Headache and Vertigo Vol. 7 No. 2 (2026): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi 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/

Abstract

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is chemotherapy’s side effect that can last for years even after treatment stopped. The prevalence after chemotherapy is 68% in the first month. Chemotherapy’s main mechanism is the disruption of the depolymerization cycle of microtubules in the myelin sheath, which interferes with nerve transmission and causes tingling, numbness, and severe pain. Current management of CIPN are antidepressant medications, such as duloxetine, and gabapentinoids (pregabalin and gabapentin). Objective: This systematic review aims to provide comparison of the efficacy and safety between two drugs in reducing neuropathy on CIPN patients, due to lack of previous systematic review on this topic. Methods: A literature review search was conducted in the PubMed database, Sage Journal, and other sources until the date 10th September 2025. Results: Using VAS score, duloxetine showed less capability to lower pain which is around 30.5%, while gabapentinoid by VAS score showed around 73.4%. But when it comes to adverse effect, duloxetine suggested more less severity, such as nausea, dizziness, fatigue, headache, and insomnia; whereas gabapentinoid can cause somnolence, dizziness, ataxia, diplopia, blurred vision, sedation, drowsiness, pedal edema, swelling of the face and eyelids, while the rest developed excessive sedation. Conclusions: Duloxetine is effective and consistent in reducing CIPN compared to gabapentinoids; with gabapentin being superior to pregabalin. This review’s limitation lies in the few studies discussing the efficacy of both drugs on CIPN.
Co-Authors Abdul Gofur Afiyfah Kaysa Waafi Al-Rasyid, Harun Aldita Husna Violita Aldita Husna Violita Andaru Cahya S Anggraini, Vivi Laras Anggraini, Vivid Prety Anisa Syahfitri Hanum Annisatul Hakimah Aqila, Hammadah Asmiragani, Syaifullah Auliya Nur Muthmainnina Badrul Munir Badrul Munir, Badrul Basya Adnani Basyar Adnani Budisulistyo, Trianggoro Chozin, Iin Noor Dalhar, Mochamad Damayanti, Ria DAMAYANTI, ZUHRIA PUSPITA Dessika Rahmawati Devi Annisa Devita Anggraeni Soeroso Dewi Permata Sari Dewi, Diana Evita Dheka Sapti Iskandar Dhelya Widasmara Didi Candradikusuma Dini Jatiya Anggraini, Dini Jatiya Dwi, Pratiwi Suryanti Dyah Kusuma Wardhani Edi Widjajanto Eko Arisetijono F, Fahimma Fahrani Yossa Prachika Farida Widyastuti Febriandha, Alfidha Muntaz Sobrina Fitria Nikmahtustsani, Mulika Ade Gerry Gunawan, Gerry Gyang Hanandita Gusti Putri Hanestya Oky Hermawan, Hanestya Oky Harbiyanti, Novita Titis Hardi Adiyatma Harun Al Rasyid Helena Era Millennie Heri, Sutanto Herwinda Brahmanti Husnul Khotimah Husnul Khotimah I Ketut Suada Irawan Satriotomo Irsyah Dwi Rohmayanti Izza Ayudia Hakim Izzaty, Adzura Qannita Chifka Janet, Karensa Abby Jatmiko, Sarazata Indi Rozaany Kadek Putri Paramita Abyuda Kartika Agustina Kinesya, Billi Lestari, Dwi Indriani Machlusil Husna Machlusil Husna, Machlusil Made Ayu Hariningsih Sunaga Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu, Masruroh Masykur, Umar Jundullah Maziya, Yulianda Mega Yulia Rusmayanti Michelle Anisa Misnasari, Putri Priela Mochammad Istiadjid Eddy Santoso Mokhamad Fahmi Rizki Syaban Mondiani, Yeni Quinta Muhammad Welly Dafif Nadia Artha Dewi Nadiya Elfira Bilqis, Nadiya Elfira Nasution, Ali Napiah Nata Sanjaya Nectarine Natasya Regitta Yasmin Nidia Suriani Nurvia Andriani Pramesti, Fathia Annis Pratiwi, Made Dinda Pringga, Gutama Arya Pudji, Rosalyna Purbasari, Bethasiwi Putri, Dwi Sandhi Aulia Pramesti Putri, Mutiara Kristiani Putri, Syarellia Safira R, Rahmad Rahma, Annisa Rahmasari, Herisa Rahmawati, Dessika Raisa, Neila Reza Rachmantoko Rislan Faiz Muhammad Rislan Faiz Muhammad Ristiawan Muji Laksono Rizki Rahamatullah Noer Rodhiyan Rakhmatiar Rulli Rosandi Safira Dita Arviana Sari, Diane Tantia Sari, Diane Tantia Sela Pricilia Siti Nurlaela Sri Budhi Rianawati Sri Budhi Rianawati, Sri Budhi Sri Budi Rianawati Sulistomo, Hikmawan Wahyu Suratmono, Mia Fajarningtyas Syafiatul Azizah Titin Andri Wihastuti Tri Wahju Astuti, Tri Wahju Vely Eva Meria Wa Ode Intan Nur Octina Wahyuni Ramadhani Suaib Widiatmoko, Arif Widodo Mardi Santoso Widodo Mardi Santoso, Widodo Mardi Wirathmawati, Andina Yudiansyah, Anggi Gilang Yuyun Yueniwati Zahradewi, Olympia Zamroni Afif