Browsing by Author "Pavlović, Aleksandra M. (7003808508)"

Introduction Cerebral ischemic small-vessel disease (SVD), causing lacunar infarcts and white matter hyperintensities on brain magnetic resonance imaging (MRI), is a progressive disease associated with an increased risk of stroke, dementia and death. Increased arterial stiffness has been associated with ischemic stroke and cerebral SVD independently of common vascular risk factors. Objective The aim of the study was to analyze arterial stiffness in our patients with symptomatic SVD. Methods In a cross-sectional study design we included 30 patients with clinical and MRI evidence of cerebral SVD and 30 age-, gender- and risk factor-matched control subjects with no neurological diseases. Patients were evaluated at the Ultrasound Laboratory at the Neurology Clinic, Clinical Center of Serbia in Belgrade, during a three-month period (from September 1st to December 1st 2012). Baseline demographic and vascular risk factors were recorded. All patients underwent standard carotid ultrasound scans with measuring of intima-media thickness (IMT) and analysis of atheromatous plaques. Internal carotid artery stiffness was evaluated with the use of e-tracking option as beta stiffness index (BSI) value. Results There were no differences between study groups in regard to degree of carotid stenosis and type of carotid plaques (p>0.05). Patients in SVD group had significantly higher mean IMT (p=0.0093) and mean BSI (p<0.0001) than subjects in the control group. No significant correlation was detected between IMT and BSI in SVD group (r=0.168; p=0.376). Brain lesions severity correlated with BSI (r=0.733; p<0.0001). Conclusion Arterial stiffness is increased in symptomatic patients with SVD, independently of vascular risk factors and IMT. © 2016, Serbia Medical Society. All rights reserved.

Background/Aim. Aging entails a wide range of cognitive processes that are not independent of one another. It leads to changes in physical-motor characteristics and sometimes to disability. The aim of this study was to examine the association between multiple cognitive performances in elderly subjects and their physical-motor abilities. Method. The study included 98 elderly participants (60+) (16 males and 82 females). Cognitive abilities were assessed by the Montreal Cognitive Assessment (MoCA)/Serbian version, and physical measures were assessed by the Senior Fitness Test with its five subtests, supplemented by the Walking Speed Test. Results. Several MoCA items demonstrated relatively low variability, i.e., they proved to be too easy for most of the participants. The participants exhibited the lowest performance on the memory relating to other domains, followed by executive functions, visuospatial skills, attention, concentration, and working memory domains, with the highest performance on temporal and spatial orientation relating to other domains. Executive functions and language correlated most significantly with physical strength. Agility and dynamic balance, lower- and upper-body strength, and aerobic endurance correlated moderately and positively. Conclusion. This study underlines the positive correlation between physical fitness and cognitive level in the elderly and emphasizes the importance of physical fitness for cognitive functions, especially those of executive type in elderly subjects. Clinicians should consider the association between cognitive function and physical-motor performances when dealing with functioning improvement in the elderly. The importance of designing the most efficient exercise programs to achieve maximal somatic and cognitive effects is emphasized. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with loss of balance, sensation of spinning in the space or around self, and is exaggerated with changes of the head and body position; no other neurological deficit is present. Some medications may also cause vertigo. Depending on the cause of the vertigo, drugs with different mechanisms of action, physical therapy, psychotherapy, as well as surgery may be used to combat this disabling malady. Symptomatic treatment has a particularly important role, regardless of the etiology of vertigo. We reviewed the current medications recommended for patients with vertigo, their mechanisms of action and their most frequent side effects. © 2015 Neurology India | Published by Wolters Kluwer - Medknow.

Vertigo is a common symptom in everyday clinical practice. The treatment depends on the specific etiology. Vertigo may be secondary to inner ear pathology, or any existing brainstem or cerebellar lesion but may also be psychogenic. Central vertigo is a consequence of a central nervous system lesion. It is often associated with a focal neurological deficit. Peripheral vertigo is secondary to dysfunction of the peripheral vestibular system and is usually characterized by an acute vertigo with loss of balance, sensation of spinning in the space or around self, and is exaggerated with changes of the head and body position; no other neurological deficit is present. Some medications may also cause vertigo. Depending on the cause of the vertigo, drugs with different mechanisms of action, physical therapy, psychotherapy, as well as surgery may be used to combat this disabling malady. Symptomatic treatment has a particularly important role, regardless of the etiology of vertigo. We reviewed the current medications recommended for patients with vertigo, their mechanisms of action and their most frequent side effects. © 2015 Neurology India | Published by Wolters Kluwer - Medknow.

[No abstract available]

Objectives: The aim of the article is to determine the relationship between homocysteine in the plasma, vitamin D (VitD) in the serum and cognitive abilities in persons with mild intellectual disability (ID) in different age groups. Methods: In a cross-sectional, observational study including younger and older participants with mild ID, a cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA), and blood samples were taken to assess plasma homocysteine and serum VitD levels. Results: A total of 60 persons with mild ID were included in the study, of whom 30 were aged 9–16 and 30 were aged 35–62 years old. Increased plasma homocysteine values were detected in 85% of cases and reduced serum VitD levels in 90% of cases. Older participants had significantly higher homocysteine values than younger ones (t(58) = −4.19; p = 0.00; d = 1.082), while younger participants had significantly more pronounced VitD deficiency than older ones (t(58) = −3.91; p = 0.00; d = 1.011). A significant correlation between cognition and VitD values was found in older participants (r = −0.424, p = 0.020). Conclusions: A substantial proportion of individuals with ID, both children and adults, have increased total homocysteine (tHcy) plasma levels and insufficient VitD serum, but the clinical significance of these findings remains to be determined. Homocysteine and VitD have not been found to have a protective effect on cognition among persons with mild ID. © 2024 The British Society of Developmental Disabilities.

Objectives: The aim of the article is to determine the relationship between homocysteine in the plasma, vitamin D (VitD) in the serum and cognitive abilities in persons with mild intellectual disability (ID) in different age groups. Methods: In a cross-sectional, observational study including younger and older participants with mild ID, a cognitive assessment was performed using the Montreal Cognitive Assessment (MoCA), and blood samples were taken to assess plasma homocysteine and serum VitD levels. Results: A total of 60 persons with mild ID were included in the study, of whom 30 were aged 9–16 and 30 were aged 35–62 years old. Increased plasma homocysteine values were detected in 85% of cases and reduced serum VitD levels in 90% of cases. Older participants had significantly higher homocysteine values than younger ones (t(58) = −4.19; p = 0.00; d = 1.082), while younger participants had significantly more pronounced VitD deficiency than older ones (t(58) = −3.91; p = 0.00; d = 1.011). A significant correlation between cognition and VitD values was found in older participants (r = −0.424, p = 0.020). Conclusions: A substantial proportion of individuals with ID, both children and adults, have increased total homocysteine (tHcy) plasma levels and insufficient VitD serum, but the clinical significance of these findings remains to be determined. Homocysteine and VitD have not been found to have a protective effect on cognition among persons with mild ID. © 2024 The British Society of Developmental Disabilities.

The blood–brain barrier (BBB) is formed by continuous, closely connected endothelial cells, enveloped in the basal lamina, pericytes, and foot extensions of astrocytes. BBB has a vital role in brain metabolism and protects the brain parenchyma from harmful agents present in the systemic circulation. Damage to the BBB and an increase in its permeability have an important role in many neurodegenerative diseases. This paper aims to review the literature on the impact of the BBB damage on psychiatric illness, a largely neglected and under-researched area. Links between BBB impairment and specific neuropsychiatric disorders are described including schizophrenia, affective disorders, dementias with behavioral disorders, and alcohol use disorder, with comparison to typical hereditary small vessel diseases affecting the BBB such as cerebral autosomal dominant arteriopathy with subcortical infarction and leukoencephalopathy and mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes. The authors critically summarize possible pathogenic mechanisms linking BBB damage and these common disorders. © 2022, Serbia Medical Society. All rights reserved.

Background - There are still dilemmas about the vasodilating effect of vinpocetine, a synthetic ethyl alkaloid vincamine. The method of measuring cerebral vasomotor reactivity (VMR) by transcranial Doppler (TCD) technique before and after administration of the medication was used to estimate the degree of arterioles vasodilatation. The aim of this study was to test of the vasodilating effect of vinpocetine in patients with cerebral small vessel disease (SVD) by measuring cerebral VMR. Material and methods - Thirty patients with SVD were on 3-month-long oral treatment with 15 mg vinpocetine daily. Cerebral VMR was determined by breath holding test. The breath holding index (BHI) was calculated in standard manner and values >0.69 were considered normal. At the baseline, before treatment (I), BHI, modified Rankin scale (mRS) score, Mini Mental State Examination (MMSE) score were determined. One month later (II) BHI was assessed again, while after 3 months of treatment (III) we analyzed BHI, mRS score and AAMSE score. Results - The average age of patients was 61.4± 11.5 years (range 40 to 77 years), 18 (60%) female and 12 (40%) males. Values of BHIs were increased during treatment at the right MCA (I) 1.18±0.53, (II) 1.26±0.54, (III) 1.37±0.41, with statistical significance between I and III measurement (p<0.05). An increase was noted on the left MCA (I) 1,25±0.53, (II) 1.31 ±0.55 and (III) 1.32±0.42, but it did not reach statistical significance (p>0.05). Mean MMSE score significantly increased from baseline 27.4±2.3 to 28.5±2.0 after three months of treatment (p<0.001). Functional status showed a statistically significant improvement with mRS score increasing from 2.1 ±1.0 to 1.1 ±0.6 (p<0.001). Conclusion - This pilot study showed that 3-month-long oral treatment with vinpocetine 15 mg daily had tendency to increase BHI, indicating improvement of cerebral VMR. It is possible that higher doses of vinpocetine are needed to achieve substantial increase of VMR.

Objectives - Patients with cerebral small vessel disease often present with various motor, cognitive, and emotional changes, including gait disturbances, parkinsonism, and depression. Substantia nigra hyperechogenicity, brain stem raphe hypoechogenicity, ventricle diameters, and sonographic characteristics of other brain structures on transcranial sonography have been increasingly used as biomarkers in a range of neurologic diseases. We aimed to explore the frequency and clinical correlates of transcranial sonographic findings in symptomatic patients with small vessel disease. Methods - In a cross-sectional study, neurologic, cognitive, and emotional statuses and transcranial sonographic and magnetic resonance imaging findings were compared between 102 patients with small vessel disease and 45 healthy age- and sex-matched control participants. Results - Compared to healthy controls, small vessel disease cases had more frequent brain stem raphe hypoechogenicity (55.9% versus 11.1%; P <.0001), substantia nigra hyperechogenicity (30.4% versus 11.1%; P =.022), and enlarged third ventricles (P <.0001). Substantia nigra hyperechogenicity correlated with gait disturbances, extrapyramidal features, and cognitive impairment. Brain stem raphe hypoechogenicity was associated with the diagnosis of depression. Enlargement of the third and lateral ventricles was more frequent in patients with cognitive impairment. Pathologic substantia nigra hyperechogenicity and enlarged ventricles were associated with the severity of cerebral ischemic lesions. Conclusions - Transcranial sonography shows pathologic findings in a substantial number of patients with small vessel disease, probably reflecting disruption of frontostriatal pathways. © 2015 by the American Institute of Ultrasound in Medicine.

Objectives - Patients with cerebral small vessel disease often present with various motor, cognitive, and emotional changes, including gait disturbances, parkinsonism, and depression. Substantia nigra hyperechogenicity, brain stem raphe hypoechogenicity, ventricle diameters, and sonographic characteristics of other brain structures on transcranial sonography have been increasingly used as biomarkers in a range of neurologic diseases. We aimed to explore the frequency and clinical correlates of transcranial sonographic findings in symptomatic patients with small vessel disease. Methods - In a cross-sectional study, neurologic, cognitive, and emotional statuses and transcranial sonographic and magnetic resonance imaging findings were compared between 102 patients with small vessel disease and 45 healthy age- and sex-matched control participants. Results - Compared to healthy controls, small vessel disease cases had more frequent brain stem raphe hypoechogenicity (55.9% versus 11.1%; P <.0001), substantia nigra hyperechogenicity (30.4% versus 11.1%; P =.022), and enlarged third ventricles (P <.0001). Substantia nigra hyperechogenicity correlated with gait disturbances, extrapyramidal features, and cognitive impairment. Brain stem raphe hypoechogenicity was associated with the diagnosis of depression. Enlargement of the third and lateral ventricles was more frequent in patients with cognitive impairment. Pathologic substantia nigra hyperechogenicity and enlarged ventricles were associated with the severity of cerebral ischemic lesions. Conclusions - Transcranial sonography shows pathologic findings in a substantial number of patients with small vessel disease, probably reflecting disruption of frontostriatal pathways. © 2015 by the American Institute of Ultrasound in Medicine.

Vitamin B1 (aneurin, thiamine) is a water-soluble vitamin necessary for the normal function of the nervous system, visual system and heart and is part of important enzymes in the body. Thiamine enables the normal use of glucose, other carbohydrates and proteins, and enables the supply of energy to the organism. The main sources of thiamine are exogenous and small amounts are synthesized by microorganisms of the human intestinal microbiome. Vitamin B1 cannot accumulate in the body, so signs of deficiency are quickly manifested. Hypovitaminosis B1 is seen in chronic ethyl abuse, persistent vomiting (as in some pregnant women) or after bariatric surgical procedures, but in a mild form it is present in the general population. Normal daily needs for vitamin B1 depend on calorie intake, and 0.4 mg should be ingested for every 1000 kcal. © 2022, Serbia Medical Society. All rights reserved.

Objective: Although typically linked to aging, small vessel disease (SVD) is also observed in younger adult patients, with common vascular risk factors (RF). We aimed to investigate features of SVD occurrence at an early adult age. Patients and methods: Vascular RF, functional and cognitive status and severity of lesions on MRI expressed as total score on Age-Related White Matter Changes (ARWMC) scale were analyzed in 200 consecutive patients with cerebral SVD admitted to a tertiary neurological hospital. Variables were compared between younger (35-55 years) and older (>56 years) patients. Results: In this study, 63 (31.5%) of patients were 55 years or younger. Both age groups had comparable RF profiles, but smoking emerged as an independent predictor for SVD at a younger age (OR 2.9; 95% CI 1.5-5.5; p = 0.002). Younger patients had better functional (OR 1.8; 95% CI 1.3-2.5; p = 0.0001) and cognitive (χ 2 13.94; p = 0.0009) status compared to older patients. However, two thirds of younger patients had some degree of cognitive deficit. Total score on ARWMC scale was lower in younger patients (mean 12.3 in younger versus 15.2 in older, OR 1.11; 95% CI 1.0-1.18; p = 0.001). There was a strong correlation in both groups between functional score, cognitive status and ARWMC score (p < 0.0001). Conclusion: In our dataset, younger patients with SVD shared common vascular RF with older patients. In the group aged ≤55, better functional and cognitive status and less severe MRI changes were noted. However, a substantial number of younger SVD patients presenting with TIA or ischemic stroke had various deficits. © 2011 Elsevier B.V. All rights reserved.