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All Journal Neurona Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Acta Neurologica Indonesia
Dyah Tunjungsari, Dyah
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Health Professions Medicine & Pharmacology Neuroscience Public Health

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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.
MANIFESTASI KLINIS DAN DIAGNOSIS MIGREN VESTIBULAR Sitorus, Freddy; Rida Ariarini, Ni Nengah; Tunjungsari, Dyah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 2 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i2.108

Abstract

CLINICAL MANIFESTATION AND DIAGNOSIS OF VESTIBULAR MIGRAINEABSTRACTVestibular migraine (VM) is the most common cause of recurrent spontaneous vertigo on outpatient dizziness clinics. Clinical manifestation of VM is highly variable. Patient may present symptoms like vertigo, dizziness, tinnitus, visual disturbance, phonophobia, photophobia, aural fullness, paresthesia, nausea, and vomiting. Most VM patients have normal physical examination between attacks. Diagnostic criteria of this disease based on joint consensus of the International Headache Society (IHS) together the Barany Society published in 2012. The Differential diagnosis of this disease are benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and acute ischemic attack. Moreover, vestibular migraine treatment is almost the same as for migraine.Keywords: Clinical manifestation, diagnosis, vestibular migraineABSTRAKMigren vestibular (MV) merupakan penyebab tersering vertigo spontan berulang pada pasien di poliklinik spesialis yang menangani rasa goyang. Manifestasi klinis dari migren vestibular sangat bervariasi. Pasien dapat mengeluhkan gejala seperti vertigo, pusing, tinitus, gangguan penglihatan, fonofobia, fotofobia, aural fullness, parestesi, mual, dan muntah. Pemeriksaan fisik pada pasien MV biasanya normal di antara serangan. Penegakan diagnosis penyakit ini berdasarkan konsensus bersama antara International Headache Society (IHS) dan Barany Society pada tahun 2012. Diagnosis diferensial penyakit ini adalah benign paroxysmal positional vertigo (BPPV), penyakit Meniere, dan serangan iskemik akut. Sampai saat ini, terapi untuk migren vestibular hampir sama dengan terapi migren pada umumnya.Kata kunci: Diagnosis, manifestasi klinis, migren vestibular
Nosocomial COVID-19 Infection in Acute Neurological Diseases at the Indonesian National Referral Hospital Mesiano, Taufik; Tunjungsari, Dyah; Budikayanti, Astri; Ramli, Yetty
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.6

Abstract

Introduction: Neurological diseases elevate the susceptibility to respiratory tract ailments. This study aims to evaluate the incidence of nosocomial coronavirus disease 2019 (COVID-19) among non-COVID neurology inpatients and identify associated risk factors. Objective: To assess nosocomial COVID-19 infection in non-COVID neurology inpatients and identify associated risk factors. Material and Methods: A prospective cohort study was conducted during the initial wave of the COVID-19 pandemic, encompassing all non-COVID neurology inpatients at Dr. Cipto Mangunkusumo Hospital from May to September 2020. Clinical data were collected, and bivariate and multivariate analyses were employed to examine risk factors. Result and Discussion: Among 308 subjects, 31 (10.6%) experienced nosocomial COVID-19 infection. Suspect cases constituted 77.4%, probable cases 16.1%, and confirmed cases 6%. Predominant neurological diseases included cerebrovascular disease (36.7%), CNS neoplasm (18.8%), and traumatic brain injury (15.6%). Comorbid diseases increased the infection risk by 6.53 times (95% CI 1.52-28.0), particularly non-CNS malignancy (12.37, 3.7-41.00), chronic pulmonary TB (12.29, 2.7-55.89), and hypertension (3.8, 1.3-11.4). Loss of consciousness and nasogastric tube (NGT) usage elevated the risk by 2.92 (1.37-6.21) and 4.68 (1.95-11.24) times. This study reinforces existing evidence that hospitalized patients with neurological diseases are more susceptible to COVID-19, particularly due to loss of consciousness and NGT usage. The risk is amplified with comorbidities such as non-CNS malignancy, chronic pulmonary TB, and hypertension. Conclusion: Individual neurological diseases alone did not heighten the risk of COVID-19 infection. Notably, factors like loss of consciousness, NGT usage, and comorbid diseases significantly correlate with nosocomial COVID-19 infection in non-COVID neurology inpatients.
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.
Co-Authors Asmoro, Anastasia Budikayanti, Astri Candra, Putri Nabilah Gunawan, Andrie Hildaria, Margareth Jody, Abraham Al Kathy Putri Sari, Christine Mesiano, Taufik Ramli, Yetty Rida Ariarini, Ni Nengah Sitorus, Freddy Tiksnadi, Amanda