Susanna Vestberg
Lund University, Deptartment of Psychology, Faculty Member
OBJECTIVE To explore associations between four methods assessing long-term neurocognitive outcome after out-of-hospital cardiac arrest and early hypoxic-ischemic neuronal brain injury assessed by the biomarker serum neurofilament light... more
OBJECTIVE To explore associations between four methods assessing long-term neurocognitive outcome after out-of-hospital cardiac arrest and early hypoxic-ischemic neuronal brain injury assessed by the biomarker serum neurofilament light (NFL), and to compare the agreement for the outcome methods. METHODS An explorative post-hoc study was conducted on survivor data from the international Target Temperature Management after Out-of-hospital Cardiac Arrest trial, investigating serum NFL sampled 48/72-hours post-arrest and neurocognitive outcome 6 months post-arrest. RESULTS Among the long-term surviving participants (N = 457), serum NFL (n = 384) was associated to all outcome instruments, also when controlling for demographic and cardiovascular risk factors. Associations between NFL and the patient-reported Two Simple Questions (TSQ) were however attenuated when adjusting for vitality and mental health. NFL predicted results on the outcome instruments to varying degrees, with an excellent area under the curve for the clinician-report Cerebral Performance Category (CPC 1-2: 0.90). Most participants were classified as CPC 1 (79%). Outcome instrument correlations ranged from small (Mini-Mental State Examination [MMSE]-TSQ) to strong (CPC-MMSE). CONCLUSIONS The clinician-reported CPC was mostly related to hypoxic-ischemic brain injury, but with a ceiling effect. These results may be useful when selecting methods and instruments for clinical follow-up models.
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Before adding cerebrospinal fluid (CSF) biomarkers to the diagnostic workup of Alzheimer disease, it needs to be determined whether CSF biomarkers analyzed in routine clinical practice can reliably predict cortical β-amyloid (Aβ)... more
Before adding cerebrospinal fluid (CSF) biomarkers to the diagnostic workup of Alzheimer disease, it needs to be determined whether CSF biomarkers analyzed in routine clinical practice can reliably predict cortical β-amyloid (Aβ) deposition. To study whether CSF biomarkers, analyzed consecutively in routine clinical practice during 2 years, can predict cortical Aβ deposition and to establish a threshold for Aβ42 abnormality. This cross-sectional study (The Swedish BioFINDER [Biomarkers For Identifying Neurodegenerative Disorders Early and Reliably] Study) was conducted at 3 memory clinics. It involved consecutively referred, nondemented patients with mild cognitive symptoms (original cohort, n = 118; validation cohort, n = 38). Amyloid positron emission tomography imaging with 18F-flutemetamol. Analyses of CSF Aβ42, total tau, and phosphorylated tau using an enzyme-linked immunosorbent assay (INNOTEST) in clinical samples. The agreement between Aβ classification with CSF Aβ42 and 18...
Research Interests: Cognitive Science, Mild Cognitive Impairment, Medicine, Cerebrospinal Fluid, Brain, and 15 moreHumans, Cerebral Cortex, Female, Male, Clinical Sciences, Aged, Middle Aged, Memory Clinic, Odds ratio, Cross Sectional Studies, Alzheimer Disease, Early Diagnosis, Neurosciences, aniline Compounds, and Cohort Studies
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The aim of this study was to evaluate cognitive impairment, psychiatric symptoms and cerebral blood flow (CBF) patterns in middle-aged (35–64 years) and younger old patients (65–74 years) with subjective experience of memory deficits. The... more
The aim of this study was to evaluate cognitive impairment, psychiatric symptoms and cerebral blood flow (CBF) patterns in middle-aged (35–64 years) and younger old patients (65–74 years) with subjective experience of memory deficits. The study group was heterogeneous with patients fulfilling criteria for dementia, as well as patients with mild cognitive impairment (MCI) and with non-verified cognitive impairment (non-MCI). Seventy per cent of the non-MCI patients reported long-lasting experiences of psychosocial stress tentatively causing the memory problems. The MCI patients were subdivided into two groups: MCI type 1 included patients with isolated memory impairment, while MCI type 2 included patients with memory impairment together with slight verbal and/or visuospatial impairments. CBF measurements comparing the two MCI groups with the non-MCI group were performed. The MCI type 2 showed reduced CBF in the left anterior medial temporal lobe as well as in parts of the posterior c...
Research Interests: Cognitive Science, Geriatrics, Dementia, Audiology, Comparative Study, and 15 moreMedicine, Humans, Female, Male, Exploration, Clinical Sciences, Middle Aged, Cognitive impairment, Adult, Medial Temporal Lobe, Cerebral Blood Flow, Memory Disorders, Alzheimer Disease, Memory Impairment, and Cognition disorders
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☯ These authors contributed equally to this work. ‡DVW, JCLL and AFS also contributed equally to this work and are joint senior authors on this work. MDM and DJ are joint first authors on this work.
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The overall aim of this thesis was to enhance the understanding of patients with subjective memory complaints. The thesis is based on three empirical studies examining middle-aged and young old (< 70 years) non-demented patients... more
The overall aim of this thesis was to enhance the understanding of patients with subjective memory complaints. The thesis is based on three empirical studies examining middle-aged and young old (< 70 years) non-demented patients assessed at a memory clinic. In the first study the personality characteristics of the patients were compared with a Swedish normative sample. The patients scored higher on neuroticism and agreeableness and lower on extraversion. The female patients were in the majority and scored higher than the males on a scale assessing symptoms of anxiety and depression. Approximately half of the patients had objectively verified memory impairment (OMI) according to the neuropsychological assessment while the remaining patients were classified as having subjective memory impairment (SMI). No differences were revealed regarding personality characteristics or affective status between the OMI and SMI groups. In the second study about half of the patients reported signifi...
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Background: Inflammation may play an important role in development of mild cognitive impairment and also predict progression of cognitive diseases. Studies have shown that aerobic and strength training increases the ability to generate... more
Background: Inflammation may play an important role in development of mild cognitive impairment and also predict progression of cognitive diseases. Studies have shown that aerobic and strength training increases the ability to generate and secrete cytokines from the skeletal muscles (then named myokines) that might be protective. Objectives: This pilot study was intended to explore if it is possible to detect changes in cytokine/myokine levels in response to a single exercise test in patients with mild cognitive impairment before and after a training intervention. Participants and Methods: Participants with mild cognitive impairment (N=33) performed12 weeks aerobic and strength endurance training at moderate (n=13), at high intensity (n=12) or served as control group with no training (n=8). At baseline and after 12 weeks a single maximal exercise test was performed where 2 venous blood samples were collected respectively, one at rest and one at maximal workload. TNF-α, IL-6, IL-1β, ...
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Background This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted... more
Background This study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA. Methods This longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the sam...
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Objectives: The aim of this study was to assess the psychometric properties of a Swedish version of the Hayling test (HT-S) and its clinical utility in a group of patients with different frontotemporal dementia (FTD) syndromes. Early... more
Objectives: The aim of this study was to assess the psychometric properties of a Swedish version of the Hayling test (HT-S) and its clinical utility in a group of patients with different frontotemporal dementia (FTD) syndromes. Early diagnosis of FTD is a challenge and requires a broad arsenal of assessment methods, neuropsychological tests not the least. The Hayling test assesses executive functions including initiation, efficiency and response inhibition. Methods: Seventy-six healthy controls were included as well as patients with the behavioral variant FTD (bvFTD; n = 17), semantic dementia (SD, n = 6), and progressive supranuclear palsy (n = 12). The Color Word Interference Test was administered to examine the construct validity. Results: Age showed a correlation with better performances in younger participants whereas the importance of sex and education were less evident. The split half reliability and internal consistency were equal to, or better, than reported for the origina...
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ABSTRACT Changes over time in information processing speed and executive functions (EFs) were studied in patients with suspected low-grade gliomas (LGG) 3 years after diagnosis. Using a person-oriented approach, the study aimed at... more
ABSTRACT Changes over time in information processing speed and executive functions (EFs) were studied in patients with suspected low-grade gliomas (LGG) 3 years after diagnosis. Using a person-oriented approach, the study aimed at focusing solely on two cognitive domains known to be significant in the understanding of the impact of white matter diseases. The Barkley’s hybrid model of EFs was used as a theoretical framework for the evaluation of EFs. The majority of the patients showed a decline in at least one of these two cognitive domains indicating that the progress of diffuse brain injury cannot be neglected in understanding neuropsychological changes over time in patients with LGG. In our sample, higher age and radiological signs of radiotherapy-induced brain atrophy were seen in patients with a decline in both domains.
To examine the psychometric properties of a modified version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), for a cardiac arrest population (IQCODE-CA). The IQCODE-CA, a 26-item observer-reported... more
To examine the psychometric properties of a modified version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), for a cardiac arrest population (IQCODE-CA). The IQCODE-CA, a 26-item observer-reported questionnaire, was completed by informants, defined as relatives or close friends, of 268 out-of-hospital cardiac arrest (OHCA) survivors who participated in the Target Temperature Management trial in a scheduled follow-up 180±14days after OHCA. Survivors completed the Mini Mental State Examination (MMSE), the Rivermead Behavioural Memory Test (RBMT) and the Hospital Anxiety and Depression Scale (HADS). An exploratory factor analysis was performed. Associations between IQCODE-CA results and demographic variables along with other instruments were calculated. Area under the curve (AUC) ratios were evaluated to examine discrimination. The IQCODE-CA measured one factor, global cognitive decline, with high internal consistency (ordinal α=0.95). Age, gender or educat...
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Research Interests: Behavior, Magnetic Resonance Imaging, Diffusion Tensor Imaging, Medicine, Multidisciplinary, and 15 moreNeurodegenerative Diseases, Humans, Cerebral Cortex, Female, Male, PLoS one, Aged, Middle Aged, Longitudinal Studies, White matter, Adult, Gray Matter, Case Control Studies, Severity of Illness Index, and Neuropsychological Tests
Research Interests: Nonparametric Statistics, Dementia, Mild Cognitive Impairment, Anxiety, Humans, and 15 moreFemale, Male, Cognitive Performance, Clinical Sciences, Aged, Middle Aged, Adult, Analysis of Variance, Chi Square Distribution, ANXIETY, Psychosocial Stress, Memory Disorders, Clinical Diagnosis, Psychiatric Status Rating Scales, and Neuropsychological Tests
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Before adding cerebrospinal fluid (CSF) biomarkers to the diagnostic workup of Alzheimer disease, it needs to be determined whether CSF biomarkers analyzed in routine clinical practice can reliably predict cortical β-amyloid (Aβ)... more
Before adding cerebrospinal fluid (CSF) biomarkers to the diagnostic workup of Alzheimer disease, it needs to be determined whether CSF biomarkers analyzed in routine clinical practice can reliably predict cortical β-amyloid (Aβ) deposition. To study whether CSF biomarkers, analyzed consecutively in routine clinical practice during 2 years, can predict cortical Aβ deposition and to establish a threshold for Aβ42 abnormality. This cross-sectional study (The Swedish BioFINDER [Biomarkers For Identifying Neurodegenerative Disorders Early and Reliably] Study) was conducted at 3 memory clinics. It involved consecutively referred, nondemented patients with mild cognitive symptoms (original cohort, n = 118; validation cohort, n = 38). Amyloid positron emission tomography imaging with 18F-flutemetamol. Analyses of CSF Aβ42, total tau, and phosphorylated tau using an enzyme-linked immunosorbent assay (INNOTEST) in clinical samples. The agreement between Aβ classification with CSF Aβ42 and 18...