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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.
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.