Tele-neuropsychological evaluation in Alzheimer’s disease: an experimental study

Carotenuto, Anna (2014) Tele-neuropsychological evaluation in Alzheimer’s disease: an experimental study. PhD thesis, SCHOOL OF ADVANCED STUDIES - Doctoral course in Environmental sciences and Public Health - PhD Programme in E-Health and telemedicine (XXVI cycle).

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BACKGROUND: Telemedicine consists in the use of telecommunication technologies to provide healthcare services overcoming geographic, temporal, social, and cultural barriers. Today telemedicine is a developed field, which includes about 50 different subspecialties: neuropsychology is one of them. Its main application consists in the early diagnosis of cognitive disorders of adult onset ,and particularly in the assessment of individuals potentially affected by degenerative conditions, such as Alzheimer disease (AD). These individuals would benefit significantly by an assessment by telemedicine. This study was aimed to assess the feasibility by telemedicine of two widely used neuropsychological test: the MMSE and the ADAS_COG test. While for the first some data are available in the literature, no study has investigated, to our knowledge, the ADAS_COG administration by videoconference in subjects with AD. We aimed thus to compare the results obtained by the “face to face” condition to those obtained by videoconference. MATERIALS AND METHODS: The ADAS_Cog and the MMSE test were administered to 28 subjects (8M) in two conditions: the face-to-face condition and the video-conference modality. Subjects were all participating to the randomized, double blind, placebo controlled ASCOMALVA study. The administration was done at the enrollment of the patients in the study, baseline, and after 6, 12, 18 and 24 months. Subjects were randomized in two groups. Group A subjects were submitted to the ADAS_Cog and the MMSE test by the face-to-face modality first; two weeks later the same tests were administered via telemedicine by videoconferencing. Group B were submitted vice-versa to the videoconference modality first, and then to the face to face. A two-tailed Student "t" test was done to evaluate the differences between the two modality. RESULTS: There was no significant difference in MMSE scores and ADAS_Cog scores (p<.05) administered by telehealth versus face to face modality. In patient with moderate AD the administration via telemedicine gives worse results on average than the face to face mode CONCLUSIONS: The most employed tool to assess and measure the cognitive functions in subjects potentially affected by degenerative dementia are the MMSE and the ADAS_Cog. Both are required in the clinical trials to assess the severity of the damage and the effectiveness of new drugs. Their employ by videoconference should be very useful. We found that both the MMSE and the ADAS Cog test may be applied in subjects with mild to moderate Alzheimer disease, and that the scores obtained by videoconference are related to those obtained by the face to face condition. Videoconference may be very useful to reach patients with cognitive damages, to assess their stability or progression, to measure the efficacy of therapies.

Item Type:Tesi (PhD)
Informazioni aggiuntive:Tutor: Prof. Francesco Amenta Papers published during the research activity 2011 to 2014 1. R Rea, A Carotenuto, AM Fasanaro, E Traini, and F. Amenta. Apathy in Alzheimer’s Disease: Any Effective Treatment? The Scientific World Journal Volume 2014 (2014), Article ID 421385, 9 pages. 2. R Rea, A Carotenuto, E Traini, AM Fasanaro, V Manzo, F Amenta. Apathy treatment in Alzheimer disease. Results of the ASCOMALVA Trial. In press 3. F Amenta, A Carotenuto, AM Fasanaro, R Rea, E Traini. The ASCOMALVA (Association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease) trial. Interim results after 2 years of treatment. Journal of Alzheimer’s disease. In press. 4. A. Carotenuto, AM Fasanaro, I Molino, F Sibilio, A Saturnino, E Traini, F. Amenta. The Psychological General Well-Being Index (PGWBI) for assessing stress of seafarers on board merchant ships. Int Marit Health. 2013;64(4):215-20. 5. A. Carotenuto, I. Molino, A.M. Fasanaro, F. Amenta Psychological stress in seafarers: a review Int Marit Health 2012; 63, 4: 188–194 6. S. Carpi, A. Carotenuto, L. Colucci, A.R. Ziello, V. Manzo, F. Amenta and A. M. Fasanaro. Non motor symptoms in Parkinson’s disease. Current Neurobiology International Journal of Neuroscience. 2013 Volume 4 Issue 1&2. ISSN 0975-9042 pp:53-65 7. F. Amenta, A. Carotenuto, AM Fasanaro, A. Lanari, R. Rea, E. Traini. Preliminary results of ASCOMALVA trial on the association of donepezil and choline alphoscerate in Alzheimer’s disease with associated cerebrovascular injury G Gerontol 2011;59:1-10 8. A Carotenuto, R Rea, L Colucci, AR Ziello, I Molino, S Carpi, E Traini, F Amenta, A M Fasanaro. Late and early onset dementia: What is the role of vascular factors? A retrospective study. J Neurol Sci. 2012 Nov 15;322(1-2):170-5 9. F Amenta, A Carotenuto, AM Fasanaro, R Rea, E Traini. The ASCOMALVA trial: Association between the cholinesterase inhibitor donepezil and the cholinergic precursor choline alphoscerate in Alzheimer's disease with cerebrovascular injury: Interim results. J Neurol Sci. 2012 Nov 15;322(1-2):96-101. 10. F. Amenta, A. Carotenuto, I. Grappasonni, F. Mazzucchi, I. Molino, C. Trevi, H. Vatev HEALTHY SHIP: An Innovative Project for Health Care Improvement and Health Promotion On Board Ships. Med-e-Tel 2011 Electronic Proceedings: The International eHealth, Telemedicine and Health ICT Forum for Educational, Networking and Business Editors: Malina Jordanova, Frank Lievens ISSN 1818 – 9334 11. D Grossi, A Carotenuto, L Trojano, V Manzo, A M Fasanaro. Do frontal dysfunctions play a role in Visual Hallucinations in Alzheimer’s as in Parkinson’s Disease? A comparative study. Psychology & Neuroscience, 2011, 4, 3, 385 – 389 12. A Carotenuto, R Rea, I Molino, A R Ziello, E Traini, F Amenta, V Andreone, A M Fasanaro. Malattia di Alzheimer: quanti sono i casi “misti”? Il Giornale dello Stroke. Giugno 2011. pp. 12-15. 13. R Rea, A Carotenuto, A M Fasanaro. Associazione fra Malattia di Alzheimer e danno vascolare: i casi di AD puro e misto. EXEL 20-23. 2011
Settori scientifico-disciplinari:SCIENZE BIOLOGICHE > BIO/16 Anatomia umana
ID Code:710
Depositato da:Dr. Cristina Soave
Depositato su:13 May 2014 16:19
Last Modified:13 May 2014 16:19

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