Jan 22 0

How to Avoid Winter Depression?

Posted by One Vision Health Team

Psychotherapist, Stelios Kiosses explores how natural light, and the lack of it in the winter, can affect our psychological health

Do you feel slowed down and have difficulty waking up in the morning?

Do you feel you want to eat more through the dark days of winter, and do you find it hard to focus at work and socialise while at the same time feeling depressed?

If you answered yes to one or more of these questions you may be one of the millions of people around the world who have problems with the changing seasons and you may suffer from a condition now widely accepted by the medical community and the public at large as Seasonal Affective Disorder or SAD.

Seasonal Affective Disorder is a depression brought on by a lack or deficit of natural light (i.e. sunlight). According to the Diagnostic and Statistical Manual of Mental Disorders DSM-5, criteria for depression with a seasonal pattern include having depression that begins and ends during a specific season every year (with full remittance during other seasons) for at least two years and having more seasons of depression than seasons without depression over a lifetime.

The term ‘Seasonal Affective Disorder’ was coined in the 1980s by Norman Rosenthal, MD, a psychiatrist and research scientist who studied mood and biological rhythm disorders at the National Institutes of Mental Health. In his best-selling book Winter Blues, he revealed his struggle with SAD.

Many of us now recognise that our moods change with the revolving years and seasons. However, the effect of the seasons on our moods has long been a subject of discussion through the centuries with artists, poets, and philosophers. As in the classic Shakespearean writing remark “a sad tale is best for winter”.

My favourite myth is how the Greek Gods suffered during the winter months: Persephone was banished to the underworld every winter, while Boreas ushered in the cool winter winds and his nasty temper.

The human body responds to daylight: we rise when the sun comes up and we go to bed once it’s gone down. And this is not just in our modern times. As humans, we are attuned to the patterns of light and dark to maintain our circadian rhythms. (Circadian rhythms regulate many of our body’s functions, including our appetites and our moods).

It is thought that insufficient sunlight has a direct effect upon the part of the brain that contains the hypothalamus. The hypothalamus is a region of the forebrain that controls the body’s autonomic nervous system and the pituitary gland. This, in turn, may affect the production of the hormone melatonin in the body.When working normally, this hormone makes us feel tired, but when it is sunlight-deprived, more melatonin than usual may be produced, making us feel more tired, more often. The production of serotonin may also be affected by insufficient sunlight. This hormone affects mood, sleep patterns and appetite and if our bodies do not produce enough serotonin, we often begin to feel depressed. Lower levels of sunlight exposure affects the natural rhythm of our bodies and any disruption to your body’s clock can result in suffering some symptoms of SAD.

Further, with less outdoor exposure to sunlight on the skin in winter, people with SAD may produce less Vitamin D. As Vitamin D is believed to play a role in serotonin activity, Vitamin D deficiency and insufficiency have been associated with clinically significant depressive symptoms. Causal links between serotonin, melatonin, circadian rhythms, Vitamin D, and SAD have not yet been confirmed. However, associations among these key factors are present and are continuing to be researched.

Who is affected by SAD?

Depression can strike anyone at any time, but some groups are more susceptible to developing SAD than others. These groups can be categorised as follows:

1. 20-40 year old age group;
2. women in their 20s and 30s;
3. and women rather than men.

Some individuals may experience a milder form of SAD known as subsyndromal or S-SAD, or most commonly known as ‘winter blues’.

Those living farthest from the equator in Northern latitudes are most susceptible. For example, in the United States, 1% of those who live in Florida and 9% who live in Alaska experience SAD. In Canada, 15% of the population experience winter blues and 2 to 6% experience SAD. In the United Kingdom, 20% experience winter blues and 2% experience SAD.

However, pinpointing prevalence is difficult as the disorder may go unreported and consequently under- diagnosed. Furthermore, SAD can cooccur with other depressive issues like bipolar, attention deficit, alcoholism, and eating disorders, making it difficult to diagnose. The symptoms of SAD tend to be the typical symptoms of depression, including:

• increased sleep,
• increased appetite and carbohydrate cravings,
• weight gain,
• irritability,
• interpersonal difficulties (especially rejection sensitivity),
• a heavy, leaden feeling in the arms or legs,
• feelings of despondency and hopelessness characteristic of depression,
• lack of energy, and difficulty carrying out a normal routine; inactivity,
• increased appetite and a tendency to overeat, leading to weight gain,
• withdrawal from friends, family and social activities,
• feelings of anxiety and an inability to cope,
• difficulties in concentration; frustration and irritability,
• and feelings of worthlessness and guilt.

It is important for the health and aesthetic practitioner, if they suspect that a patient may suffer from SAD, that they do an initial screen of the patient using the Seasonal Pattern Assessment Questionnaire (SPAQ). The SPAQ is a retrospective, self- administered tool that screens for the existence of SAD and S-SAD.

It is freely available in the public domain and can be downloaded from http://www.guilford.com/add/forms/ rosenthal2.pdf. No training is required to use the tool.

How to Avoid Winter Depression – Light therapy

Treatment approaches typically include combinations of antidepressant medication, light therapy, Vitamin D, and counselling.

There are some self-care steps you can take all year long that may help reduce your risk of SAD, too. They include exercising regularly, maintaining healthy sleep habits and a predictable sleep/wake cycle, eating a healthy diet and limiting the amount of sugary foods you eat.

Also, going outside on sunny days can make a difference. Exposure to natural sunlight can help ease SAD. Light box therapy is also particularly useful. Light boxes mimic outdoor light by emitting a broad-spectrum ultraviolet light. The most common prescription is 30 minutes of light box use at the beginning of every morning, with the box 12 to 24 inches away.

The intensity of the light box is recorded in lux, which is a measure of the amount of light you receive at a specific distance from a light source. The recommended intensity of the light typically is 10,000 lux.

For light therapy to work, the light must enter a patient’s eyes indirectly – this does not mean staring directly into a light box, rather the box must be facing the person while they work, read, or relax.

Sunrise alarm clocks have become increasingly popular in recent months, especially among people who experience SAD. The clocks come with gentle sunrise and sunset features, allowing users to wake up and go to sleep in a setting that mimics natural light.

How to Avoid Winter Depression – Psychotherapy

A combination of lig and CBT has been shown to significantly reduce symptoms in sufferers, both in the short and long-term. Cognitive Behavioural Therapy (CBT) is a psychological treatment which helps to change the way you think, feel and behave.

Although SAD has been shown to have a biological basis, it is often accompanied by negative automatic thoughts, pessimistic attitudes, withdrawal from social activities, and rumination; thus, CBT can be particularly helpful in targeting these negative thoughts and behaviours.

Finally. there are some simple steps anyone can try that may help improve symptoms:

• Get as much natural sunlight as possible.
• Make your work and home environments as light and airy as possible.
• Sit near the windows when you’re indoors.
• Take plenty of regular exercise, particularly outdoors and in daylight.
• Eat a healthy, balanced diet.
• Manage your stress levels.
• A winter holiday to a sunny location can also do wonders for your state of mind, and some people suffering from SAD truly consider it a health requirement.
• Some SAD sufferers manage their symptoms with vitamin D supplements in the autumn and winter months.
• Snacking on the right kinds of carbohydrates can relieve some of the symptoms of SAD such as popcorn, shredded wheat squares or low-fat biscuits.
• Research has suggested that SAD is less common in those

who consume more omega-3 fatty acids. Take a supplement with a high concentration of fish oil.

The good thing is that winter isn’t forever and, the moment spring returns, the symptoms of SAD fade away.

Furthermore, there is no need to suffer in silence. If SAD is impacting the quality of your life, make lifestyle changes to ease symptoms and consider seeking out a treatment that helps you manage your symptoms and continue living your life. Managing Seasonal Affective Disorder is possible.

References

• R. Anglin, Z. Samaan, S. Walter, and S. McDonald, “Vitamin D deficiency and depression in adults: systematic review and meta-analysis,” British Journal of Psychiatry, vol. 202, no. 2, pp. 100–107, 2013.
• American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM- 5), American Psychiatric Association, Arlington, Va, USA, 2013. • S. Penckofer, J. Kouba, M. Byrn, and C. E. Ferrans, “Vitamin D and depression: where is all the sunshine,” Issues in Mental Health Nursing, vol. 31, no. 6, pp. 385–393, 2010.
• D. C. Kerr, D. T. Zava, W. T. Piper, S. R. Saturn, B. Frei, and A. F. Gombart, “Associations between vitamin D levels and depressive symptoms in healthy young adult women,” Psychiatry Research, vol. 227, no. 1, pp. 46–51, 2015.
• M. Kjærgaard, K. Waterloo, C. E. A. Wang et al., “Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case-control study and randomised clinical trial,” British Journal of Psychiatry, vol. 201, no. 5, pp. 360–368, 2012.
• Rohan KJ, Meyerhoff J, Ho SY, Evans M, Postolache TT, and Vacek PM. Outcomes One and Two Winters Following Cognitive- Behavioral Therapy of Light Therapy for Seasonal Affective Disorder. The American Journal of Psychiatry. 2015.

Oct 29 0

Caring for Someone with Dementia

Posted by One Vision Health Team

When somebody is diagnosed with dementia, it often impacts on their loved one too – especially if you are going to be caring for them.

There are different types of dementia, including vascular dementia and Alzheimer’s disease, but symptoms typically involve varying degrees of memory loss, declining cognitive function, confusion and mood changes, and people with dementia may gradually lose their independence or ability to carry out day-to-day tasks.

Although there is no cure for dementia, getting an accurate diagnosis as early as possible, along with the right support and treatments, can make a big difference.

At Dementech Neurosciences, the dementia specialists at our Neurology Clinic can provide a number of diagnostic tests and assessments, as well as tailored treatment plans and advice to suit your individual needs. It’s very important that carers are provided with information and support too and this is something we are happy to help with.

Here’s a look at some points to keep in mind when it comes to caring for someone with dementia at home:

1] Don’t forget to look after yourself too

It’s easy for carers to put their own needs last, but it’s very important to prioritise your own wellbeing too and make time for regular respite. Whether it’s exercise, doing something fun, socialising or all of the above, these are vital tools for keeping yourself resilient and energised. As the saying goes – you can’t pour from an empty cup – so taking breaks really isn’t selfish, it’s healthy for everyone.

2] Tell family and friends what’s happening

If you’re caring for someone with dementia, it’s not uncommon to feel isolated and alone, and possibly even frustrated if you feel nobody really understands what you’re dealing with. Telling those close to you what’s going on can be very helpful; often they won’t know if you’re finding things hard unless you tell them. If you are still working, it might be a good idea to tell your employer too, so they’re aware of any additional pressures and support you may need.

3] Ask for help

Caring for someone with dementia at home can be challenging. Don’t feel you have to shoulder everything alone though, as there may be a number of options or means of additional support available. This might include external carer support, hiring a cleaner to help take the weight off at home, or looking into community resources that could provide outside support and respite. Charities such as Alzheimer’s Society, Dementia UK and Age UK can be useful sources of information.

If you are looking after somebody with progressive dementia, their needs may change as time goes on. They may also need help with personal care and be less able to manage around the house. An occupational therapist can help assess their needs at home and suggest helpful solutions.

4] Embrace carer support

Support for dementia carers is available too, and is something we also provide through our Neurology Clinic. Carer support might mean talking things through with a trained professional, or joining a local support group where you can let off steam or talk about your experiences with others in similar positions. Knowing you’re not alone can be extremely reassuring, and you might find useful information and ideas.

5] Focus on positives

Caring for someone with dementia can sometimes feel all-consuming and, in some cases, a thankless task. Focusing on the positives can really help. After all, you are doing a wonderful thing for somebody you care about. Is it still possible to enjoy quality time doing nice things with the person you’re caring for? Perhaps days out, visiting favourite cafes or galleries – keeping up those positive connections can be therapeutic for both the person with dementia and their carer. If you do find getting out and about an increasing struggle, perhaps ask a good friend or another relative to join you too.

6] Go easy on yourself

Everybody will have tough days, and feeling angry, sad and resentful on occasions is completely normal. Don’t beat yourself up – you are not a robot and you are allowed to express these feelings. In fact, doing so can be very healthy and help you find ways to move forwards. You are doing a great job and making a big positive difference to somebody’s life.

Dementech specialises in diagnosing and treating neurological disorders like dementia. For more information contact our experienced and friendly team.

Sep 10 Comments Off

Common Mental Health Conditions

Posted by Dementech

Common Mental Health Conditions

In a previous blog we discussed depression, anxiety and stress, which are the most commonly recognised mental health conditions. However, there are other mental health conditions that we treat regularly at Dementech Neurosciences.

Bipolar Disorder

Bipolar disorder causes extreme mood swings ranging from highs (mania or hypomania) to lows (depression).

Find out more about bipolar disorder in this short video.

Symptoms of bipolar include:

Depression – feeling hopeless or sad, losing interest in most activities.
Mania/Hypomania (a less extreme type of mania) – irritability, euphoria, feeling energised.

The condition can affect the ability to think clearly as well as affect judgement, behaviour, energy levels, activity and sleep. It cannot be cured however treatments are available that can help you to manage the symptoms.

Treatment options for bipolar disorder:

Cognitive behavioural therapy focuses on identifying unhelpful or negative behaviours and beliefs and replacing them with positive and healthy ones. It may be helpful in identifying triggers for episodes of bipolar and developing strategies to help you cope with your condition.
Interpersonal and social rhythm therapy aims to stabilise daily routines and create a more consistent pattern of sleep, exercise and diet.
Family therapy can help family members to understand more about the condition and how to recognise and manage the early signs.

Chronic Fatigue Syndrome

This is a complex disorder that cannot be explained by an underlying medical condition. The symptoms include extreme fatigue which does not improve with rest. Scientists are unclear what causes chronic fatigue syndrome although it is believed to be triggered by a combination of factors which may include psychological stress and viral infections.

Symptoms include:

Extreme exhaustion which does not improve with rest or sleep
Loss of memory or concentration
Headaches and/or muscular or joint pain

Treatment options:

Cognitive training involves talking to a counsellor to help you feel more in control of your life. This can help as chronic fatigue brings with it many restrictions and uncertainties. You may also benefit from gentle exercises which you can build up gradually.

Phobias

A phobia is a fear of a specific thing, situation or animal. People can have phobias about a whole range of things, from heights to needles and the symptoms of a phobia can occur suddenly and without warning.

Symptoms can include:

Breathing difficulties or shortness of breath
Rapid heartbeat
Pain or tightness in the chest
Trembling
Sweating
Headaches, nausea or dizziness
Panic attack

Some of the most common phobias include:

Arachnophobia (fear of spiders)
Ophidiophobia (fear of snakes)
Acrophobia (fear of heights)
Aerophobia (fear of flying)
Cynophobia (fear of dogs)
Social Phobia (fear of being in a social situation)
Agoraphobia (fear of public places)
Mysophobia (fear of dirt or germs)

Treatment options for phobias:

Phobias produce a fear response which can be extreme and may interfere with daily living, resulting in anxiety and, in some cases, depression. Psychotherapy has been shown to be effective for phobias and panic disorders and may be used alongside prescribed medication and self-help techniques like meditation and mindfulness.

Fibromyalgia

Fibromyalgia is a condition that is characterised by pain throughout the body, accompanied by fatigue, sleep and memory problems and mood swings. It is believed to be caused by a change in the way the brain processes pain signals, leading to pain sensations becoming amplified.

The condition may begin after some kind of physical trauma, psychological stress, infection or surgery. In some people symptoms develop gradually over time.

Symptoms include:

Pain throughout the body that is experienced as a dull ache
Fatigue
Sleep disorders including sleep apnoea and restless legs syndrome
Difficulty concentrating

The condition may be accompanied by other disorders such as irritable bowel syndrome, migraine and cystitis.

Treatment

Fibromyalgia is a painful and distressing condition. There is no single effective treatment. However, doctors may prescribe medication to relieve pain and to help promote sleep. CBT, mindfulness and counselling may also help people to deal more effectively with the stress of the condition.

To find out what the best treatment is for fibromyalgia for you, it is best to speak to a specialist who can assess your symptoms and offer advice on how to manage the condition.

Dementech specialises in diagnosing and treating neurological disorders including all types of mental health conditions. For more information contact our experienced and friendly team.

Aug 22 0

Common Mental Health conditions and how to treat them

Posted by Dementech

Mental health problems are becoming increasingly common, but why is this and what can be done about it?

Causes of mental health problems

There is no single cause for the growth in mental health disorders over the last 10 years. We believe there may be many different contributory factors. There are more demands on people now compared to previous generations, fuelled by the pressures of social media and instant news. The pace of life has accelerated to such an extent that people are at greater risk of burnout than ever before. Our cognitive and emotional workload is increasing, and many people are finding it harder and harder to find any downtime or to relax in the short amount of leisure time they may have. The result is rising levels of anxiety, depression and stress.

Why is mental illness on the rise? Mr Stelios Kiosses explains in this video.

Depression

Depression is very different to feeling low or unhappy. When someone is depressed it can impact every aspect of their lives and they may feel unable to cope with everyday activities. It may affect their physical and mental health, resulting in a loss of interest in things that previously they enjoyed. They may lose their appetite or find themselves unable to sleep.

Anxiety

Anxiety is a natural human response to a perceived threat. It is what we feel when we are worried or tense about things that might happen, particularly if we are facing stressful events or major life changes.

Anxiety becomes a problem if it starts to have a significant detrimental impact on your life. You may be diagnosed as having anxiety if you have felt anxious for a long time or your fears are disproportionate to the situation. You may be experiencing distressing symptoms such as panic attacks, or you may find it hard to go about your normal life.

Stress

Stress is normally related to our reaction to feeling under pressure. This is very individual and what one person finds stressful, another may take in their stride. Stress can become particularly acute when we feel we don’t have control over what is happening to us or we become overwhelmed. Stress isn’t a psychiatric diagnosis however it can trigger mental health problems like anxiety or depression. Conversely, mental health problems can lead to stress.

Stress can also cause physical symptoms including tiredness, headaches and gastrointestinal problems. When we are stressed our bodies produce high levels of hormones such as cortisol and adrenaline which are responsible for the body’s fight, flight or freeze response. When we are unable to release these hormones as our ancestors would have done (by running away or fighting, for example) they remain in our bodies and can cause unpleasant physical symptoms.

Treatment for anxiety and depression

The right treatment for mental health problems, such as anxiety and depression, varies from one person to the next, depending on the type and extent of the problem and the person’s individual thoughts, beliefs and preferences.

Medication may be prescribed to deal with certain problems, such as anxiety or problems sleeping, but this will not get to the root of the problem. A therapeutic approach such as Cognitive Behavioural Therapy (CBT) can be effective in tackling some of the psychological issues that lie at the heart of a person’s depression.

CBT for mental health

CBT works on a person’s behaviour first. This is because when someone becomes depressed, they may stop doing things that they used to enjoy. They may lose motivation and become tired and listless. The focus of CBT is to try and increase the person’s activity levels first, so they begin to experience some of the things they used to enjoy and start to feel better. Once this is in place, the therapist may help the person to work on any negative thoughts or rumination.

How does mindfulness reduce depression?

Mindfulness-based CBT brings together mindfulness techniques such as meditation, stretching and breathing exercises and combines this with elements of CBT. It can be effective in helping to break the negative thought patterns that are a symptom of recurrent depression.

Evidence suggests that mindfulness-based CBT can reduce the risk of relapse of people who experience recurrent depression by as much as 43%. It is recommended by NICE for the prevention of relapse in such people.

Dementech specialise in diagnosing and treating neurological disorders including mental health conditions and can suggest the best treatment plan for you. For more information contact our experienced and friendly team.

Jul 19 0

Treatment for Aphasia

Posted by Dementech

To continue to raise awareness for National Aphasia Month, and to follow on from our previous article about Types of Aphasia, we look at the various aphasia treatment approaches.

Aphasia Treatment

Aphasia is a communication disorder that affects a person’s ability to process language. It may develop after a stroke or brain injury or as a result of a neurological disorder or infection. People with aphasia may struggle to speak, understand language, read or write.

Speech and language therapy

Treatment will depend on which type of aphasia a person has and how severely they are affected. If the brain damage is mild, the individual may recover their language skills without needing to have specialist treatment. However, most people with aphasia have some kind of speech and language therapy to help them to recover their language skills as much as possible and develop other ways of communicating.

It is unusual to regain pre-injury levels of communication even after treatment, however certain factors appear to affect treatment outcomes. Starting soon after the brain injury has been shown to be effective, according to some studies, and working in a group environment with other people affected by aphasia may also help. Computer-assisted therapy is increasingly being used to help people to relearn word sounds.

Aphasia treatment approaches

Aphasia treatment falls into two main categories. It is likely that most people with aphasia will be treated using both. As the condition develops, the treatment will be adjusted to ensure it remains effective.

Impairment-based therapies

Impairment-based therapies are designed to stimulate listening, speaking, reading and writing. The aim is to improve language function over time by attempting to repair the damaged areas. A speech-language pathologist may set particular tasks that enable the person to understand and speak as well as they are able. Computer software may be used to improve word-finding, comprehension and day-to-day problems.

Among the types of impairment-based therapies are:

Constraint-induced therapy – this follows similar principles to physical therapies for paralysis which restrict or constrain functional parts of the body in order to force the damaged areas to work. In constraint-induced therapy, people with aphasia may be constrained from using gesture to communicate in order to encourage them to use their impaired speech. The therapy is done in short bursts – usually two or three hours a day for a period of two weeks. It is normally done alongside communication-based therapy which encourage people with aphasia to use whatever abilities remain available to them in order to communicate.
Tele-rehabilitation – this is a new approach currently in the early stages of development. It uses webcam and the internet to enable the person with aphasia and the therapist to be able to interact remotely.
Melodic intonation therapy – this is based on the principle that certain types of aphasia leave people able to sing but not speak. This therapy uses melody to enable people with the condition to construct sentences. It is suited to people who have a good level of understanding of speech and some ability to express themselves.

Communication-based therapies

Communication-based therapies are designed to help people with aphasia to manage the day-to-day challenges of their condition by learning how to communicate using any means. The aim is to overcome frustration by helping people to make themselves understood.

Among the types of communication-based therapies are:

Supported conversation – this approach uses volunteers who engage in conversations with people who have aphasia. Supported conversations help to enhance the confidence of people who have lost their natural ability to communicate and have conversations.
PACE (Promoting Aphasics’ Communicative Effectiveness) therapy – this introduces elements of conversation into a simple picture-naming procedure.
Conversational coaching – this aims to increase the confidence of someone with aphasia by scripting conversation. A computer programme called AphasiaScripts features a virtual therapist who helps and supports the person with aphasia.

Dementech specialise in diagnosing and treating neurological disorders including all types of aphasia. Following diagnosis, we can discuss the most appropriate treatment approach for you. For more information contact our experienced and friendly team.

Jun 24 0

Understanding Types of Aphasia

Posted by Dementech

To mark National Aphasia Awareness Month, we are looking at what aphasia is, the different types of aphasia and how you can communicate more effectively with people who have the condition. In a separate post, we will be considering the treatments available for people with aphasia.

What causes aphasia?

Aphasia is an acquired communication disorder that impairs a person’s ability to process language but does not affect their intelligence.

People are not born with aphasia, but they may develop it after a stroke, brain injury, infection or as a result of a neurological disorder. Aphasia may cause people to struggle to understand language, to speak, read or write.

The disorder can vary in severity. In its most severe form, it can be almost impossible for someone with the condition to make themselves understood, while other types of aphasia may affect the ability to remember particular words or to construct a sentence. Sometimes, someone may lose the ability to read.

Often people with aphasia may experience impairment in several different forms of communication but may still have some ability to communicate. Treatment for the condition tends to focus on determining how much function remains and enhancing those channels that are still available.

Aphasia versus dysphasia

Aphasia is sometimes confused with dysphasia. While aphasia and dysphasia have the same causes and symptoms, dysphasia tends to involve moderate language impairments whereas aphasia is more severe, potentially resulting in a complete loss of speech and the ability to understand speech. Some health professionals use the terms interchangeably, which can be confusing.

Types of aphasia

There are various different types of aphasia depending on the location and extent of the brain injury. These include:

Global aphasia is the most severe form of the condition. Patients understand little or no spoken language, can produce few recognisable words and cannot read or write. It can occur immediately after a stroke but may improve quite quickly if the extent of brain damage is not too severe.
Broca’s or non-fluent aphasia severely impacts speech. People may not be able to utter more than a few words and the formation of sounds may be laborious. The ability to read and understand speech remains intact, however, although the ability to write may also be affected.
Mixed non-fluent aphasia is form of aphasia where the person will have very limited speech (as with Broca’s aphasia) and may also struggle to understand speech. Reading and writing may be very limited.
Wernicke’s or fluent aphasia affects the ability to understand speech. The person may still able to speak themselves, although the meaning might be unclear and sentence structure can often be jumbled. Reading and writing may be severely impaired.
Anomic aphasia affects the ability to recall nouns and verbs which can make speech and writing vague and difficult to understand. Those affected can understand speech well and read adequately.

Primary progressive aphasia

Unlike other forms of aphasia, which are the result of stroke or brain injury, primary progressive aphasia is caused by neurodegenerative diseases such as Alzheimer’s Disease or Frontotemporal Lobar Degeneration.

The deterioration of brain tissue associated with speech and language causes this type of aphasia to worsen over time. Initial symptoms might include problems with speech and language but other issues such as memory loss may develop later.

Communicating with someone with aphasia

There are some simple ways to improve communication with someone who is suffering from aphasia:

Be patient. Allow the person plenty of time to process what you are saying and respond.
Talking in a quiet place without too many distractions can help.
Do not patronise. Remember, the condition does not affect a person’s intelligence.
It can be frustrating for the person with aphasia to try and communicate. Using an iPad, pen and paper or gestures may help them to express themselves more easily.

Dementech specialises in diagnosing and treating neurological disorders including all types of aphasia. For more information contact our experienced and friendly team.

May 28 0

Parkinson’s Disease: What To Expect

Posted by Dementech

Parkinson’s disease is a progressive and incurable disorder of the nervous system. It affects movement and is characterised by tremors, stiffness and slowing down of movement.

Early symptoms may be barely noticeable. The condition often starts with a slight tremor in one hand and a feeling of stiffness in the body, but as the disease develops the symptoms become more pronounced.

Symptoms of Parkinson’s disease

Symptoms of Parkinson’s disease may vary from person to person. Some of the early signs include:

Tremors or shaking – this often begins in the hands or fingers and you may notice tremors in the hand even when it is resting.
Slowed movement (bradykinesia) – Parkinson’s disease causes a slowing of movement which may make even everyday tasks, such as walking or getting up out of a chair, more difficult and time-consuming.
Speech changes – you may start to slur or hesitate before speaking. Your speech may lose its normal inflections and become more monotone.
Muscle stiffness – muscles may become stiff and painful, limiting your range of movement.
Changes in posture – you may start to stoop or have problems balancing.
Loss of automatic movement – movements that you perform without thinking about them, such as swinging your arms when you walk or smiling, may become more difficult.
Writing changes – you may find it more difficult to write and your writing may become illegible.

In addition, you may also develop:

Depression, anxiety or loss of motivation.
Problems chewing, eating or swallowing – these tend to occur as the condition develops.
Sleep problems.
Bladder problems.
Constipation due to a slower digestive tract.
Problems with your sense of smell including difficulty distinguishing between different odours.
Pain.

What are the 5 stages of Parkinson’s disease?

Doctors have identified five stages to Parkinson’s disease, known as the Hoehn and Yahr Scale. This scale is used to classify patients in research studies.

Stage 1: the earliest stage with mild symptoms only on one side of the body and little or no functional impairment.
Stage 2: Symptoms have spread to both sides of the body and may now include loss of facial expression and speech abnormalities. This may come months or years after stage 1.
Stage 3: By this stage you may have loss of balance and slowness of movement. However, you will still be able to dress, eat and wash by yourself.
Stage 4: You may be able to walk and stand unassisted, but you have become increasingly disabled and can no longer perform daily activities without assistance.
Stage 5: The most advanced stage of the disease. You can no longer get out of a chair or bed without help. You may fall frequently when standing and stumble when walking. You need round the clock assistance and you may have hallucinations.

Causes of Parkinson’s disease

Scientists are not absolutely sure what causes Parkinson’s disease, but it is linked to the death of nerve cells in the brain and a fall in level of dopamine levels which causes abnormal brain activity. If it is accompanied by changes in the Lewy bodies of the brain, dementia may also develop.

Certain factors seem to be associated with an increased risk of developing Parkinson’s disease. These include:

Age – the disease is most common in people aged 60 and over.
Hereditary – if you have a close family member with the disease, you are more likely to develop it.
Sex – A French study in 2015 found that men are 50% more likely to develop Parkinson’s disease than women. However, the risk for women increases with age.
Environmental factors – studies suggest ongoing exposure to certain pesticides may slightly increase your risk of Parkinson’s.

Dr David Choluj discusses more about the causes of Parkinson’s disease.

Diagnosis of Parkinson’s disease

There is no specific test for Parkinson’s disease, and it may take some time to establish a definitive diagnosis. A neurologist will assess your medical history and review your signs and symptoms. You may be given an MRI, CT or ultrasound scan and/or blood tests to rule out other disorders. A dose of Parkinson’s disease medication may be administered to see if it improves your symptoms. This may help to confirm a diagnosis of Parkinson’s.

Parkinson’s disease treatment

Medication: There is no cure for Parkinson’s disease but there is a wide range of medications that have been shown to be effective in controlling symptoms, including medication to increase or provide a substitute for lost dopamine. Medication can improve problems with movement, tremoring and walking.
Surgery: People with advanced Parkinson’s disease who are no longer responding well to medication may be offered deep brain stimulation surgery. This implants electrodes into different parts of the brain that send pulses into the brain and may reduce symptoms.
Lifestyle changes: Certain lifestyle changes have been shown to reduce the symptoms of Parkinson’s disease. These include eating high fibre foods and drinking plenty of fluids to prevent constipation; eating a diet rich in omega-3 fatty acids; exercising to improve balance, flexibility and strength.

Interested to know more about how Parkinson’s disease can be treated?

Dementech specialise in diagnosing and treating neurological disorders like Parkinson’s disease. For more information contact our experienced and friendly team.

May 07 0

In The News: Dementech hosting AI trials with Medopad and Tencent

Posted by Dementech

One of the world’s largest technology firms, Tencent, is partnering with London based start-up Medopad on clinical trials of artificial intelligence (AI) programs which aim to diagnose patients with Parkinson’s disease, multiple sclerosis and psoriasis.

The Parkinson’s disease clinical trials will involve around 40 patients over the next few months and will take place at Dementech Neurosciences, state of the art private mental health clinic in central London. Clinical trials for multiple sclerosis and psoriasis will follow.

The move comes after Tencent were asked by the Chinese government to help facilitate and develop AI technology for diagnosing complex health conditions.

At Dementech we have always been at the forefront of neurological diagnosis and treatment and we are excited by the current project with Medopad and Tencent.

Keep up to date with the latest news and information from our projects on our website or social channels.

You can read more about project on the Financial Times website.

Apr 26 0

The dementech team’s multidisciplinary approach to patient care

Posted by Dementech

People with neurological disorders, such as Parkinson’s disease, Alzheimer’s and multiple sclerosis, benefit from a multidisciplinary approach combining pharmacological therapies with psychological interventions.

These are complex and frequently incurable conditions that present a range of different symptoms, both physical and psychological. In order to make the greatest difference, patients need an accurate diagnosis and holistic treatment plan that addresses the many different aspects of each disease.

Dementech Neurosciences – a private memory clinic based in London – was founded in August 2016 to provide just this. Our team includes healthcare experts and world-renowned scientific advisers who specialise in the diagnosis and treatment of particular neurological conditions.

Our Scientific Advisers include:

Professor K. Ray Chauduri who specialises in Parkinson’s disease and neurology and is Professor of Neurology/Movement Disorders at King’s College London. He is Medical Director of the National Parkinson Foundation International Centre of Excellence, Co-chairman of the appointments committee of the Movement Disorders Society and Chairman of the MDS Non-motor Study Group. Prof. Chauduri is co-editor in chief of Nature Parkinson’s Journal and chief editor of the first textbook on the non-motor aspects of Parkinson’s. In 2018, he received the Van Andel award for outstanding research contribution in the field of non-motor Parkinson’s.

Professor Dag Aarsland who is world-renowned in the field of Lewy Body Dementia and Parkinson’s disease and has contributed vastly to our understanding of old age psychiatry, Prof. Aarsland was professor of clinical dementia research at the Karolinska Intitutet before joining the Institute of Psychiatry, Psychology and Neuroscience in January 2016. As well as leading international research, Prof Aarsland sees patients and helps to train old age psychiatrists. He is a professor of geriatric psychiatry at the University of Oslo and director of research at the University of Stavanger’s Centre for Age-Related Medicine.

Specialist Healthcare Team

Dr Lucio D’Anna, Lead Neurologist who is a consultant in stroke medicine with a PhD in clinical neuroscience from King’s College London. He gained the Best PhD Award from the college in 2016 and featured on the front cover of Neurology magazine. Dr D’Anna is an associate member of the Royal College of Physicians with a particular interest in stroke, cryptogenetic stroke and atrial fibrillation. He has published numerous papers and been featured in a number of leading scientific journals.

Dr Areti Pavlidou, Lead Psychiatric Services who specialises in adult and liaison psychiatry. Dr Pavlidou works as lead consultant for inpatient and community mental health services within the NHS and has a particular interest in stress-related conditions and the mind/body connection, as well as chronic fatigue syndrome and fibromyalgia. She is experienced in treating all types of adult mental health problems, such as depression, bipolar affective disorder and psychotic illnesses.

Find out about what makes Dementech different, according to Dr Areti Pavlidou

Mr. Stelios Kiosses, Lead Psychological Services who is an experienced consultant psychotherapist who works with adults and adolescents to help them to overcome personal issues. Mr Kiosses is a consultant psychotherapist who studied psychodynamic counselling and clinical supervision at the University of Oxford. He is a member of the British Association for Counselling & Psychotherapy and the British Psychological Society and will be a familiar household name to many, having appeared as a TV psychologist on Channel 4. He is involved in data review and decision-making, as well as training and supervising associate therapists and managing a team of experienced psychologists.

Find out more about Mr Stelios Kiosses’s role at Dementech

Dr David Choluj, Lead Neurologist for MS who is a consultant neurologist with a particular interest in stroke medicine and neurological rehabilitation. Dr Choluj trained and worked at one of the most prestigious teaching hospitals in middle Europe, the Motol University Hospital in Prague. He worked in the areas of neurological rehabilitation and disability management at Addenbrooke’s Hospital in Cambridge and the Royal Hospital for Neuro-disability in London. His specialist areas are neurology – MS, headache, dementia and Parkinson’s – and neurorehabilitation – prolonged disorders of consciousness, spasticity/complex neuro-disability management.

Find out about why Dr David Choluj thinks patients should choose Dementech

Joanna Rodrigues, Health Psychologist and Cognitive Behavioural Therapist who has more than 13 years’ experience working in the NHS and private settings. Among the conditions she treats are depression, anxiety, OCD, trauma and stress. She is part of a holistic condition management approach for people experiencing chronic health conditions and long-term pain.

Find out about what makes Dementech unique, according to Joanna Rodrigues

The Dementech team all understand why this holistic, multidisciplinary approach is so successful when it comes to diagnosing and treating neurological disorders, which is what makes us different and enables us to provide the highest level of personalised patient care in our field.

Apr 22 0

Diagnosing complex neurological conditions with tech

Posted by Dementech

Accurate diagnosis is critical for people with suspected neurological disorders in order to manage the condition appropriately. While, sadly, many neurological disorders are incurable, if sufferers are given the right medication and other forms of treatment, it can slow the progress of the disease and significantly improve quality of life.

But such conditions are complex and getting an accurate diagnosis can sometimes be challenging.

Diagnosing Neurological and Psychological Conditions

Dementech is a private clinic in the heart of London. Our internationally renowned team of healthcare experts, who cover a wide range of specialisms from neurology to speech therapy, provide diagnosis and treatment for patients with neurological and psychological conditions.

We particularly specialise in complex or intensive interventions for people who may not have benefitted from more usual approaches.

To support our diagnoses and improve accuracy we use a range of leading-edge technologies, including:

Parkinson’s KinetiGraph

The Parkinson’s KinetiGraph is a small device that is worn on the wrist by a patient with Parkinson’s Disease. It is used to collect data over a period of six to 10 days, which is then compiled into a report for the doctor.

This report reveals variations throughout the day in motor symptoms and complications of Parkinson’s Disease (such as tremors, stiffness and dyskinesias). Using this information, a doctor will be able to see how well people are functioning at home and whether the current medication dose needs to be altered or the medication itself needs to be changed.

The technology is also used to remind people when to take their prescribed medication and to capture information about daytime sleepiness and night-time disturbances.

Cantab

Cantab is an analytical computerised assessment software programme that is used to measure brain function and cognitive health in five key areas:

- Executive function (central control, planning, strategy, flexible thinking)
- Processing speed (the ability to perform mental tasks quickly and efficiently)
- Attention (the ability to concentrate and actively process information)
- Working memory (how we hold information while processing or acting on it)
- Episodic memory (memory of events and experiences, what happened, where and when)

An assessment using the software normally takes around 30 minutes and the results are adjusted for age, gender and education. They provide an accurate evaluation of a person’s cognitive performance and can be compared over time to assess for any decline.

Computerised Cognitive Rehabilitation and Psychotherapy

Computerised Cognitive Rehabilitation and Psychotherapy is a 12-session computer package of 12 challenging tasks designed to exercise specific cognitive functions in people with dementia. The skills learned can be transferred into real life situations with the support of a therapist.

The package is designed to build cognitive, emotional and societal skills as well as increasing awareness and understanding of their new self. Therapists use such computer-based interventions to help people develop skills for day-to-day living and to learn strategies to compensate for the loss of cognitive function. The technology uses a combined psychological and cognitive approach which addresses the interaction between people’s thoughts, feelings and behaviour.

Dementech is not limited to the above technologies but can also call upon leading neurologists, with their own specialised teams, to assist with the diagnosis and treatment of neurological conditions.

If you would like more information about using leading edge technologies in the diagnosis and management of complex neurological conditions, contact us.

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