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All Journal MNJ (Malang Neurology Journal) Universa Medicina Jurnal Abdi Insani Jurnal Kesehatan Masyarakat
Sri Budhi Rianawati, Sri Budhi
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Agriculture, Biological Sciences & Forestry Civil Engineering, Building, Construction & Architecture Computer Science & IT Economics, Econometrics & Finance Education Engineering Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Mathematics Medicine & Pharmacology Neuroscience Public Health

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THE CORRELATION OF COGNITIVE FUNCTION TO BRAIN GYM IN THE ELDERLY Rianawati, Sri Budhi; Harahap, Herpan Syafii; Raisa, Neila; Setianto, Catur Ari; Nikmahtustsani, Mulika Ade Fitria; Maliga, Helnida Anggun
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): 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.2024.010.02.06

Abstract

Background: A decline in cognitive function is often considered normal in the elderly, but the advanced stages of cognitive decline can decrease the ability to perform functional activities. Brain gym is one of the physical activity therapies that is proven to improve cognitive function. The purpose of this study is to know the effect of brain gym on cognitive function. Objective: This study aims to determine the correlation of cognitive function to brain gym in elderly. Methods: This is a queasy experimental study in 70 respondent with a pre and post-test group design. The subjects were elderly who were examined with Montreal Cognitive Assessment Indonesian (MoCA-Ina) and Visual Reproduction Test (VRT) on the first day and given brain gym 13 times, which was done 2 times in 1 week and re-examined MoCA-Ina and VRT after the intervention. Results: The research results show improvement in the MoCA-Ina and VRT pre and post-examinations after being given intervention. In the MoCA-INA examination, the mean score of the pretest was 23.30 and the mean score of the post-test was 24.50, while in the VRT examination, the mean score of the pretest was 10.08, and the post-test mean score was 10.83. However, there was no significant difference between MoCA-Ina or VRT in pre- and post-interventional brain gym (p>0.05). Conclusion: There is a relationship between cognitive function which is marked by an increase in the results of Moca INA and VRT with brain gym in the elderly at Balearjosari Malang
THE OUTCOME OF COGNITIVE THERAPY IN PATIENTS WITH FIRST-EVER STROKE AND RECURRENT STROKE Rianawati, Sri Budhi; Wardani, Rachmawati
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): 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.2024.010.02.20

Abstract

Background: Vascular dementia (VaD) is the second most prevalent type of dementia that impacts elderly adults, succeeding Alzheimer's disease. In contrast to Alzheimer's disease, Vascular Dementia (VaD) presents a wide range of cognitive changes, which are greatly influenced by the specific neural regions that are impacted by vascular pathology. The incidence of dementia in adults with a prior history of stroke is 30%, demonstrating a frequency that is 3-5 times more than those without any discernible stroke-related impairments. In addition, the intensity or frequency of strokes may contribute to a decrease in cognitive reserve in persons with vascular dementia. Case Report: We presented two cases of VaD. The first case was a 62-year-old man with a history of ischemic stroke without sequelae a year before the complaints of frequent forgetfulness and cognitive impairment. Neuropsychological examination showed neurocognitive disturbances in orientation, attention, memory, and visuospatial domain with impaired daily activities function. The MRI result showed senile brain atrophy with chronic infarction on the right temporoparietooccipital lobe, left side mesencephalon, right side pons accompanied by cortical laminar necrosis on the right frontal lobe and left temporoparietal lobe. The second case was a 79-year-old man with history of recurrent ischemic stroke (three times since 2021-2022) with sequelae of left hemiparesis and complaints of frequent forgetfulness and cognitive impairment in the last 1 year. Neuropsychological examination showed neurocognitive disturbances in orientation, attention, and visuospatial domain with impaired daily activities function. The MRI result showed subacute multiple lacunar infarctions in right insular cortex, right frontotemporal lobe cortex, right corona radiata, with multiple chronic infarcts on the right frontotemporoparietal lobe, right corona radiata, right internal genu capsule, right lateral periventricular anterior horn, pons, right left cerebellum, also senile brain atrophy. Both patients were diagnosed as VaD and given donepezil 1x10mg and memantine 1x5mg to treat the cognitive impairment. Both cases showed improvements after 6 months of therapy with MMSE from 17 to 28, MoCA-INA from 12 to 22 and MMSE from 19 to 23, MoCA-INA from 14 to 21 respectively. Discussion: The probability of acquiring vascular dementia (VaD) was strongly associated with the incidence and frequency of strokes. The prevalence of newly developed dementia after the initial stroke is approximately 10%, which increases to 30% with recurrent strokes. The likelihood of experiencing cognitive impairment and dementia after a stroke is primarily determined by the specific attributes of the stroke. While pharmacological therapy largely focuses on cognitive impairment, other factors, such as the stroke's characteristics, might contribute to neuronal and molecular abnormalities that result in cognitive loss. Two instances were shown, both demonstrating enhancements, with the initial instance, involving primary strokes, exhibiting a superior outcome compared to the subsequent instance with recurring strokes. A more profound or recurring stroke has the potential to reduce cognitive reserve, hence potentially heightening vulnerability to neurodegenerative disorders, either directly or by means of modifications in social contacts or lifestyle, which can subsequently affect cognitive performance. Conclusion: Recurrent stroke plays a role in reducing cognitive reserve and increasing the risk of dementia. Patients with VaD have shorter life expectancy, thus the severity of VaD is best managed by providing optimum acute stroke care and recurrent stroke prevention.
THE THE POTENTIAL ROLE OF NRF2 AS A TARGET SITE FOR THERAPEUTIC INTERVENTIONS IN ALZHEIMER'S DISEASE Rivarti, Arina Windri; Harahap, Herpan Syafii; Saputri, Legis Ocktaviana; Suryani, Dini; Rianawati, Sri Budhi
MNJ (Malang Neurology Journal) Vol. 11 No. 2 (2025): 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.2025.011.02.10

Abstract

Alzheimer's Disease (AD) is the most common form of dementia, characterized by progressive neurodegeneration leading to cognitive decline and memory impairment, affecting various cognitive functions. AD pathology involves the accumulation of neurotoxic substances such as amyloid beta (Aβ) and tau proteins, mitochondrial dysfunction, oxidative stress, and chronic neuroinflammation, resulting in synaptic loss and neuronal apoptosis. The transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) has emerged as a pivotal regulator of cellular defense mechanisms, including antioxidant response, autophagy, and inflammation. NRF2 not only inhibits Aβ synthesis and enhances tau protein clearance via autophagy but also reduces neuroinflammation by modulating microglial activation and cytokine production. Additionally, NRF2 activation preserves mitochondrial function by attenuating reactive oxygen species (ROS) production and sustaining mitochondrial biogenesis. Recent studies highlight the therapeutic potential of NRF2 activators, such as sulforaphane and echinacoside, in preclinical AD models, demonstrating reductions in Aβ and tau pathologies and improved cognitive outcomes. These findings underscore the multifaceted role of NRF2 in mitigating AD progression and its promise as a target for developing novel therapeutic interventions. By integrating NRF2-based strategies, future treatments may offer more effective approaches to combat the complex pathophysiology of AD.
EDUKASI MENGENAI PENYAKIT PARKINSON PADA PENGUNJUNG POLI NEUROLOGI DI RS UNIVERSITAS MATARAM Prayitno, Oktavianus; Gunawan, Stephanie Elizabeth; Rianawati, Sri Budhi; Putra, Rifki Ahmad Eka; Savitri, Gaida Gita; Rizki, Dira Kurnia; Nabiilah, Annisa Yumna; Suryantini, Ni Kadek Mega; Akmal, Ardhitio Musthafa
Jurnal Abdi Insani Vol 12 No 4 (2025): Jurnal Abdi Insani
Publisher : Universitas Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/abdiinsani.v12i4.2391

Abstract

Penyakit Parkinson adalah gangguan neurodegeneratif progresif yang ditandai penurunan dopamin di substantia nigra, menyebabkan gejala motorik (tremor, kekakuan, bradikinesia) dan non-motorik (gangguan kognitif, depresi). Masyarakat sering menganggapnya sekadar "penyakit tremor", mengabaikan dampak multidimensinya. Kurangnya pemahaman tentang gejala awal, faktor risiko, dan penanganan holistik menghambat deteksi dini dan manajemen optimal. Penyuluhan tentang penyakit Parkinson memiliki peran penting dalam meningkatkan kesadaran masyarakat terkait gejala awal, faktor risiko, dan penanganan yang tepat, khususnya bagi pengunjung poli neurologi yang termasuk kelompok berisiko tinggi. Kegiatan ini bertujuan untuk menilai efektivitas edukasi mengenai penyakit Parkinson pada pengunjung poli neurologi di RS Universitas Mataram. Sebelum edukasi dilakukan, pengunjung akan diberikan pre-test terkait Penyakit Parkinson kemudian diberikan edukasi melalui penyuluhan dengan menggunakan presentasi visual dan sesi tanya jawab, dan dilanjutkan dengan pos-test. Evaluasi efektivitas dilakukan dengan membandingkan skor pre-test dan post-test. Tahap persiapan menghasilkan materi pelatihan, presentasi PowerPoint, serta soal pre-test dan post-test untuk peserta. Kegiatan dilaksanakan pada 13-15 November 2024 di RS Unram, dengan total 19 peserta selama tiga hari. Pelatihan menggunakan presentasi PowerPoint interaktif yang menyederhanakan topik kompleks dengan visual yang jelas. Pre- dan post-test menunjukkan peningkatan pengetahuan rata-rata dari 84,3% menjadi 99,03%. Hal ini menunjukkan efektivitas pelatihan dalam meningkatkan pemahaman peserta mengenai penyakit Parkinson, gejala, risiko, dan manfaat deteksi dini untuk kualitas hidup yang lebih baik.
Serum Clusterin Level Associated with Post-ischemic Stroke Cognitive Dysfunction Harahap, Herpan Syafii; Indriyana, Yanna; Rianawati, Sri Budhi; Arisetijono, Eko; Rivarti, Arina Windri
Jurnal Kesehatan Masyarakat Vol. 20 No. 3 (2025)
Publisher : Universitas Negeri Semarang in collaboration with Ikatan Ahli Kesehatan Masyarakat Indonesia (IAKMI Tingkat Pusat) and Jejaring Nasional Pendidikan Kesehatan (JNPK)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v20i3.4401

Abstract

The exploration of potential blood-based biomarkers that could be useful in the early detection of cognitive impairment associated with ischemic stroke is still being studied. The objective of this study was to examine the correlation between serum clusterin levels and the prevalence of cognitive impairment in individuals with ischemic stroke. A total of 86 outpatients with mild ischemic stroke within the first three months of its onset were recruited from three primary hospitals in Mataram, Indonesia. ELISA was used to measure the serum clusterin level. Patients’ sociodemographic and clinical data were also collected as covariates. The Montreal Cognitive Assessment-Indonesian version (MoCA-INA) instrument was used to evaluate cognitive status. The study used multivariate logistic regression analysis to investigate the effect of clusterin on the occurrence of cognitive impairment associated with ischemic stroke while controlling for other variables. Results: The multivariate logistic regression analysis revealed a significant correlation between elevated serum clusterin levels and a higher prevalence of cognitive impairment in ischemic stroke patients (odds ratio [OR] 3.56, 95% confidence interval [CI] 1.04-12.16, p = 0.043). Conclusion: Elevated serum clusterin levels have been associated with a higher occurrence of cognitive impairment in ischemic stroke patients.
Co-Authors Akmal, Ardhitio Musthafa Anak Agung Gede Sugianthara Anasrulloh, Anasrulloh Anastasia Novitasari, Anastasia Anggoro, Joko Annisa Nurul Arofah Asmiragani, Syaifullah Badrul Munir, Badrul Catur Ari Setianto, Catur Ari Chozin, Iin Noor Damayanti, Ria Darmaningrat, Cokorda Istri Agung Asvini Didi Candradikusuma Dini Suryani, Dini Dwi, Pratiwi Suryanti Eko Arisetijono F, Fahimma Fitria Nikmahtustsani, Mulika Ade Gunawan, Stephanie Elizabeth Habiba Aurora HARI PURNOMO Harun Al Rasyid Harun Al Rasyid Heri, Sutanto Herpan Syafii Harahap Indriyana, Yanna Made Ayu Hariningsih, Made Ayu Maliga, Helnida Anggun Masruroh Rahayu, Masruroh Mochammad Dalhar Mulyohadi Ali Nabiilah, Annisa Yumna Nikmahtustsani, Mulika Ade Fitria Nyoman Artha Megayasa, Nyoman Artha Ocktaviana Saputri, Legis Oktavianus Prayitno, Oktavianus Putra, Rifki Ahmad Eka Raisa, Neila Retty Ratnawati Rivarti, Arina Windri Rizki, Dira Kurnia Sartika Dewi Utami, Sartika Dewi Savitri, Gaida Gita Shahdevi Nandar Kurniawan, Shahdevi Nandar Suryantini, Ni Kadek Mega Susetya, Budi Tri Wahju Astuti, Tri Wahju Trisnawati, Ayu Wardani, Rachmawati Widodo Mardi Santoso, Widodo Mardi Yulia Nugrahanitya, Yulia