vorapun senanarong | Mahidol University (original) (raw)

Papers by vorapun senanarong

Frontiers in Neurology, 2021

Background: The determination of brain volumes using visual ratings is associated with an inheren... more Background: The determination of brain volumes using visual ratings is associated with an inherently low accuracy for the diagnosis of Alzheimer's disease (AD). A support-vector machine (SVM) is one of the machine learning techniques, which may be utilized as a classifier for various classification problems. This study exploratorily investigated the accuracy of SVM classification models for AD subjects using brain volume and various clinical data as features.Methods: The study was designed as a retrospective chart review. A total of 201 eligible subjects were recruited from the Memory Clinic at Siriraj Hospital, Thailand. Eighteen cases were excluded due to incomplete MRI data. Subjects were randomly assigned to a training group (AD = 46, normal = 46) and testing group (AD = 45, normal = 46) for SVM modeling and validation, respectively. The results in terms of accuracy and a receiver operating characteristic curve analysis are reported.Results: The highest accuracy for brain vo...

Background Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebr... more Background Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Methods Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5,701) and classified into i) stroke/transient ischemic attack (TIA), ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. ResultsThe prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3 %). Bandang Indonesia showed the highest prevalence of WML, adjusted for age, sex, education and disease groups. Hypert...

IEEE Transactions on Instrumentation and Measurement, 2021

In the status quo, dementia is yet to be cured. Precise diagnosis prior to the onset of the sympt... more In the status quo, dementia is yet to be cured. Precise diagnosis prior to the onset of the symptoms can prevent the rapid progression of the emerging cognitive impairment. Recent progress has shown that Electroencephalography (EEG) is the promising and cost-effective test to facilitate the detection of neurocognitive disorders. However, most of the existing works have been using only resting-state EEG. The efficiencies of EEG signals from various cognitive tasks, for dementia classification, have yet to be thoroughly investigated. In this study, we designed four cognitive tasks that engage different cognitive performances: attention, working memory, and executive function. We investigated these tasks by using statistical analysis on both time and frequency domains of EEG signals from three classes of human subjects: Dementia (DEM), Mild Cognitive Impairment (MCI), and Normal Control (NC). We also further evaluated the classification performances of two features extraction methods: Principal Component Analysis (PCA) and Filter Bank Common Spatial Pattern (FBCSP). We found that the working memory related tasks yielded good performances for dementia recognition in both cases using PCA and FBCSP. Moreover, FBCSP with features combination from four tasks revealed the best sensitivity of 0.87 and the specificity of 0.80. To our best knowledge, this is the first work that concurrently investigated several cognitive tasks for dementia recognition using both statistical analysis and classification scores. Our results yielded essential information to design and aid in conducting further experimental tasks to early diagnose dementia patients.

BMC Geriatrics

Background Cognitive age-related decline is linked to dementia development and gait has been prop... more Background Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate between the three cognitive status groups. Methods Ninety-three older adults were screened and classified into three groups; mild cognitive impairment (MCI) (n = 32), dementia (n = 31), and a cognitively intact (n = 30). Spatiotemporal gait variables were assessed under single- and dual-tasks using an objective platform system. Effects of cognitive status and walking task were analyzed using a two-way ANCOVA. Sub-comparisons for between- and within-group were performed by one-way ANCOVA and Paired t-tests. Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was used to discriminate between three groups on gait variables. Results There were significant effects (P < 0.05) of cognitive status during both single and dual-task walk...

Alzheimer's & Dementia, 2021

Subjective and objective cognitive impairments were prevalent in patients with Parkinson’s diseas... more Subjective and objective cognitive impairments were prevalent in patients with Parkinson’s disease (PD), but there is no data on longitudinal cognitive change in these patients in Thailand. We aimed to evaluate the cognition, perception of cognitive decline, and the diagnosis of cognitive impairment in Thai patients with PD after 1‐2 follow‐up.

Journal of stroke and cerebrovascular diseases : official publication of the National Stroke Association, 2000

Generalised weakness from neuropathy, requiring respiratory support combined with slow nerve cond... more Generalised weakness from neuropathy, requiring respiratory support combined with slow nerve conduction velocity, is usually concomitant with acute inflammatory demyelinating polydiculoneuropathy (AIDP). In AIDP, the weakness usually reaches its peak within two to four weeks. The clinical symptoms and the measurable abnormalities in nerve conduction studies (NCS) take several weeks to resolve. We describe a case misdiagnosed as AIDP where the patient's rapidly progressive weakness and slow nerve conduction studies (NCS) take several weeks to resolve. We describe a case misdiagnosed as AIDP where the patient's rapidly progressive weakness and slow nerve conduction velocity reversed spontaneously to a near normal state within one week. From a literature review, this case was found to be similar to the tetrodotoxication and saxitoxin poisoning case reported. However, there was no evidence to support intoxication in this case.

Dementia & Neuropsychologia, 2020

Owing to advancement of medical technology and current knowledge, the population has a longer lif... more Owing to advancement of medical technology and current knowledge, the population has a longer life expectancy, leading to an increase in the proportion of elderly. Objective: The study aimed to investigate the effect of action observation (AO) combined with gait training on gait and cognition in elderly with mild cognitive impairment (MCI). Methods: Thirty-three participants were randomly allocated to action observation with gait training (AOGT), gait training (GT), and control (CT) groups. The AOGT and GT groups received a program of observation and gait training protocol with the same total duration of 65 min for 12 sessions. For the observation, the AGOT group watched a video of normal gait movement, while the GT group watched an abstract picture and the CT group received no training program. All participants were assessed for gait parameters during single-and dual-tasks using an electronic gait mat system and were assessed for cognitive level using the Montreal Cognitive Assessment (MoCA) at baseline, after training and at 1-month follow-up. Results: The results showed that the AOGT group had significant improvements in gait speeds during single-and dual-tasks, as well as better MoCA score, while the GT group had significant improvement only in gait speed. Conclusion: The adjunct treatment of AO with gait training provides greater benefits for both gait and cognitive performances in elderly with MCI.

Alzheimer's & Dementia, 2019

International journal of Alzheimer's disease, 2017

Alzheimer's & Dementia, 2015

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The combination of decreased cerebrospinal fluid (CSF) levels of beta-amyloid (1-42) and increase... more The combination of decreased cerebrospinal fluid (CSF) levels of beta-amyloid (1-42) and increased levels of phosphorylated tau (ptau-181) or total tau protein are known to be biomarkers ofAlzheimer's disease (AD). These biomarkers can also be used as predictors of disease progression in persons with mild cognitive impairment. Utilizing biomarkers to differentiate Alzheimer's disease (AD) against non-Alzheimer dementia (non-AD) needs to be explored. To evaluate the clinical use ofCSF biomarker: beta-amyloid (1-42), phosphorylated tau (ptau-181) and total tau protein for distinguishing Alzheimer's disease (AD) from non-Alzheimer dementia (non-AD) in Thai patients. Thirty patients diagnosed of dementia during 2005-2007 at Siriraj hospital were offered CSF analysis for beta-amyloid (1-42), phosphorylated tau (ptau-181) and total tau protein. Diagnosis of dementia was performed by a concensus diagnostic group utilizing a standard criteria for diagnosis of AD and other dement...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006

The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Techni... more The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Technitium L, L-ethyl cysteinate dimer Single Photon Emission Computer Tomography (99-Tc ECD SPECT) between mild and moderate to severe dementia. The authors reported a retrospective study in the Memory Clinic, Siriraj Hospital between January 2001 and October 2003 including only patients with Alzheimer's disease, vascular dementia, and mixed dementia. Clinical dementia rating (CDR) was used to document dementia severity. Patterns of hypoperfusion were classified into no definite hypoperfusion, regional hypoperfusion, and diffused hypoperfusion. One hundred and seven patients were included in the present study. Only mean Thai Mental State Examination (TMSE) score was different between the two groups. There was no significant correlation between pattern of hypoperfusion in brain SPECT and severity of dementia. The authors cannot demonstrate the pattern of hypoperfusion of 99-Tc ECD SPECT am...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

To study the effect of Galantamine on sleep quality in Thai Alzheimer's disease (AD) patients... more To study the effect of Galantamine on sleep quality in Thai Alzheimer's disease (AD) patients with or without cerebrovascular disease. A 6 month, multicenter open-label, uncontrolled trial was undertaken in 75 mild to moderate Alzheimer's disease patients with or without cerebrovascular disease. Eligible patients received a flexible-dose of Galantamine 16 or 24 mg/day for 24 weeks. The Pittsburgh Sleep Quality Index (PSQI) with self-analysis questionnaires were used to evaluate sleep quality. Analyses were based on the intent-to-treat population. Seventy-five eligible patients with mild to moderate Alzheimer's disease with or without cerebrovascular disease (male:female = 32:43, age range 74.5 +/- 0.9) were included and 58 patients (79%) completed the present study. The global PSQI scores showed some improvement over baseline (week 0 = 5.10 +/- 3.08, week 4 = 4.37 +/- 2.48, week 8 = 4.65 +/- 2.71, week 24 = 3.70 +/- 2.12) but were not yet statistical significant. In cont...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009

The purpose of this study was to explore factors that influence the clinical safety and tolerabil... more The purpose of this study was to explore factors that influence the clinical safety and tolerability associated with galantamine administration in Thai Alzheimer's disease patients with or without cerebrovascular disease and vascular dementia. This was an analysis of previous study. Tolerability and safety profile were analyzed according to sex, age, body weight, Thai mental state examination (TMSE) score, Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) score, and Alzheimer's disease cooperative study/activities of daily living (ADCS/ADL) score. The most common adverse events were nausea, dizziness, and weight loss which more often occurred during the dose-escalation phase. Mean body weight lost at week 24 was 0.9 kg. Sex, age, body weight, and ADAS-cog score did not influence the incidence of any adverse events. Dizziness was more likely to occur in patients with low TMSE and high ADCS/ADL score (p = 0.02 and p = 0.050, respectively). Patients with TM...

Scientific Reports, 2021

Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small ve... more Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5701) and classified into (i) stroke/transient ischemic attack (TIA), (ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or (iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. The prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3%). Bandung Indonesia showed the highest prevalence of WML, adjusted for age, sex, education, disease groups, and imaging modality. Hypertension...

Alzheimer's & Dementia, 2012

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006

The validity ofHachinski Ischemic Score (HIS) in differentiating between Alzheimer's disease ... more The validity ofHachinski Ischemic Score (HIS) in differentiating between Alzheimer's disease (AD) and Vascular dementia (VaD) has been questioned and compared with the gold standard autopsy. To confirm that the HIS can be used to differentiate related VaD from AD in a Thai population. A prospective study of 398 patients who were attending the Memory Clinic, at Siriraj Hospital between January 2001 and October 2003. The 214 patients, with a mean age of 71.15 + 10.20 years, were classified as AD, VaD or mixed dementia (AD with cerebrovascular disease) in proportion of 60.2%, 30.4%, and 9.3% respectively. The authors propose HIS at 5 as a cut off point to differentiate patients with AD and those with VaD or AD with cerebrovascular disease with sensitivity of 85.3% and specificity of 72.9%. The HIS can be applied to differentiate dementia related vascular etiology from AD in a Thai population.

BMC Neurology, 2013

Background: A strong inverse relationship of functional limitation and socioeconomic status has b... more Background: A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods: The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004-2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results: The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r 2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap (indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white matter lesions.

Journal of The Neurological Sciences, 2009

Frontiers in Neurology, 2021

Background: The determination of brain volumes using visual ratings is associated with an inheren... more Background: The determination of brain volumes using visual ratings is associated with an inherently low accuracy for the diagnosis of Alzheimer's disease (AD). A support-vector machine (SVM) is one of the machine learning techniques, which may be utilized as a classifier for various classification problems. This study exploratorily investigated the accuracy of SVM classification models for AD subjects using brain volume and various clinical data as features.Methods: The study was designed as a retrospective chart review. A total of 201 eligible subjects were recruited from the Memory Clinic at Siriraj Hospital, Thailand. Eighteen cases were excluded due to incomplete MRI data. Subjects were randomly assigned to a training group (AD = 46, normal = 46) and testing group (AD = 45, normal = 46) for SVM modeling and validation, respectively. The results in terms of accuracy and a receiver operating characteristic curve analysis are reported.Results: The highest accuracy for brain vo...

Background Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebr... more Background Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Methods Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5,701) and classified into i) stroke/transient ischemic attack (TIA), ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. ResultsThe prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3 %). Bandang Indonesia showed the highest prevalence of WML, adjusted for age, sex, education and disease groups. Hypert...

IEEE Transactions on Instrumentation and Measurement, 2021

In the status quo, dementia is yet to be cured. Precise diagnosis prior to the onset of the sympt... more In the status quo, dementia is yet to be cured. Precise diagnosis prior to the onset of the symptoms can prevent the rapid progression of the emerging cognitive impairment. Recent progress has shown that Electroencephalography (EEG) is the promising and cost-effective test to facilitate the detection of neurocognitive disorders. However, most of the existing works have been using only resting-state EEG. The efficiencies of EEG signals from various cognitive tasks, for dementia classification, have yet to be thoroughly investigated. In this study, we designed four cognitive tasks that engage different cognitive performances: attention, working memory, and executive function. We investigated these tasks by using statistical analysis on both time and frequency domains of EEG signals from three classes of human subjects: Dementia (DEM), Mild Cognitive Impairment (MCI), and Normal Control (NC). We also further evaluated the classification performances of two features extraction methods: Principal Component Analysis (PCA) and Filter Bank Common Spatial Pattern (FBCSP). We found that the working memory related tasks yielded good performances for dementia recognition in both cases using PCA and FBCSP. Moreover, FBCSP with features combination from four tasks revealed the best sensitivity of 0.87 and the specificity of 0.80. To our best knowledge, this is the first work that concurrently investigated several cognitive tasks for dementia recognition using both statistical analysis and classification scores. Our results yielded essential information to design and aid in conducting further experimental tasks to early diagnose dementia patients.

BMC Geriatrics

Background Cognitive age-related decline is linked to dementia development and gait has been prop... more Background Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate between the three cognitive status groups. Methods Ninety-three older adults were screened and classified into three groups; mild cognitive impairment (MCI) (n = 32), dementia (n = 31), and a cognitively intact (n = 30). Spatiotemporal gait variables were assessed under single- and dual-tasks using an objective platform system. Effects of cognitive status and walking task were analyzed using a two-way ANCOVA. Sub-comparisons for between- and within-group were performed by one-way ANCOVA and Paired t-tests. Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was used to discriminate between three groups on gait variables. Results There were significant effects (P < 0.05) of cognitive status during both single and dual-task walk...

Alzheimer's & Dementia, 2021

Subjective and objective cognitive impairments were prevalent in patients with Parkinson’s diseas... more Subjective and objective cognitive impairments were prevalent in patients with Parkinson’s disease (PD), but there is no data on longitudinal cognitive change in these patients in Thailand. We aimed to evaluate the cognition, perception of cognitive decline, and the diagnosis of cognitive impairment in Thai patients with PD after 1‐2 follow‐up.

Journal of stroke and cerebrovascular diseases : official publication of the National Stroke Association, 2000

Generalised weakness from neuropathy, requiring respiratory support combined with slow nerve cond... more Generalised weakness from neuropathy, requiring respiratory support combined with slow nerve conduction velocity, is usually concomitant with acute inflammatory demyelinating polydiculoneuropathy (AIDP). In AIDP, the weakness usually reaches its peak within two to four weeks. The clinical symptoms and the measurable abnormalities in nerve conduction studies (NCS) take several weeks to resolve. We describe a case misdiagnosed as AIDP where the patient's rapidly progressive weakness and slow nerve conduction studies (NCS) take several weeks to resolve. We describe a case misdiagnosed as AIDP where the patient's rapidly progressive weakness and slow nerve conduction velocity reversed spontaneously to a near normal state within one week. From a literature review, this case was found to be similar to the tetrodotoxication and saxitoxin poisoning case reported. However, there was no evidence to support intoxication in this case.

Dementia & Neuropsychologia, 2020

Owing to advancement of medical technology and current knowledge, the population has a longer lif... more Owing to advancement of medical technology and current knowledge, the population has a longer life expectancy, leading to an increase in the proportion of elderly. Objective: The study aimed to investigate the effect of action observation (AO) combined with gait training on gait and cognition in elderly with mild cognitive impairment (MCI). Methods: Thirty-three participants were randomly allocated to action observation with gait training (AOGT), gait training (GT), and control (CT) groups. The AOGT and GT groups received a program of observation and gait training protocol with the same total duration of 65 min for 12 sessions. For the observation, the AGOT group watched a video of normal gait movement, while the GT group watched an abstract picture and the CT group received no training program. All participants were assessed for gait parameters during single-and dual-tasks using an electronic gait mat system and were assessed for cognitive level using the Montreal Cognitive Assessment (MoCA) at baseline, after training and at 1-month follow-up. Results: The results showed that the AOGT group had significant improvements in gait speeds during single-and dual-tasks, as well as better MoCA score, while the GT group had significant improvement only in gait speed. Conclusion: The adjunct treatment of AO with gait training provides greater benefits for both gait and cognitive performances in elderly with MCI.

Alzheimer's & Dementia, 2019

International journal of Alzheimer's disease, 2017

Alzheimer's & Dementia, 2015

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2011

The combination of decreased cerebrospinal fluid (CSF) levels of beta-amyloid (1-42) and increase... more The combination of decreased cerebrospinal fluid (CSF) levels of beta-amyloid (1-42) and increased levels of phosphorylated tau (ptau-181) or total tau protein are known to be biomarkers ofAlzheimer's disease (AD). These biomarkers can also be used as predictors of disease progression in persons with mild cognitive impairment. Utilizing biomarkers to differentiate Alzheimer's disease (AD) against non-Alzheimer dementia (non-AD) needs to be explored. To evaluate the clinical use ofCSF biomarker: beta-amyloid (1-42), phosphorylated tau (ptau-181) and total tau protein for distinguishing Alzheimer's disease (AD) from non-Alzheimer dementia (non-AD) in Thai patients. Thirty patients diagnosed of dementia during 2005-2007 at Siriraj hospital were offered CSF analysis for beta-amyloid (1-42), phosphorylated tau (ptau-181) and total tau protein. Diagnosis of dementia was performed by a concensus diagnostic group utilizing a standard criteria for diagnosis of AD and other dement...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006

The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Techni... more The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Technitium L, L-ethyl cysteinate dimer Single Photon Emission Computer Tomography (99-Tc ECD SPECT) between mild and moderate to severe dementia. The authors reported a retrospective study in the Memory Clinic, Siriraj Hospital between January 2001 and October 2003 including only patients with Alzheimer's disease, vascular dementia, and mixed dementia. Clinical dementia rating (CDR) was used to document dementia severity. Patterns of hypoperfusion were classified into no definite hypoperfusion, regional hypoperfusion, and diffused hypoperfusion. One hundred and seven patients were included in the present study. Only mean Thai Mental State Examination (TMSE) score was different between the two groups. There was no significant correlation between pattern of hypoperfusion in brain SPECT and severity of dementia. The authors cannot demonstrate the pattern of hypoperfusion of 99-Tc ECD SPECT am...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2008

To study the effect of Galantamine on sleep quality in Thai Alzheimer's disease (AD) patients... more To study the effect of Galantamine on sleep quality in Thai Alzheimer's disease (AD) patients with or without cerebrovascular disease. A 6 month, multicenter open-label, uncontrolled trial was undertaken in 75 mild to moderate Alzheimer's disease patients with or without cerebrovascular disease. Eligible patients received a flexible-dose of Galantamine 16 or 24 mg/day for 24 weeks. The Pittsburgh Sleep Quality Index (PSQI) with self-analysis questionnaires were used to evaluate sleep quality. Analyses were based on the intent-to-treat population. Seventy-five eligible patients with mild to moderate Alzheimer's disease with or without cerebrovascular disease (male:female = 32:43, age range 74.5 +/- 0.9) were included and 58 patients (79%) completed the present study. The global PSQI scores showed some improvement over baseline (week 0 = 5.10 +/- 3.08, week 4 = 4.37 +/- 2.48, week 8 = 4.65 +/- 2.71, week 24 = 3.70 +/- 2.12) but were not yet statistical significant. In cont...

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2009

The purpose of this study was to explore factors that influence the clinical safety and tolerabil... more The purpose of this study was to explore factors that influence the clinical safety and tolerability associated with galantamine administration in Thai Alzheimer's disease patients with or without cerebrovascular disease and vascular dementia. This was an analysis of previous study. Tolerability and safety profile were analyzed according to sex, age, body weight, Thai mental state examination (TMSE) score, Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog) score, and Alzheimer's disease cooperative study/activities of daily living (ADCS/ADL) score. The most common adverse events were nausea, dizziness, and weight loss which more often occurred during the dose-escalation phase. Mean body weight lost at week 24 was 0.9 kg. Sex, age, body weight, and ADAS-cog score did not influence the incidence of any adverse events. Dizziness was more likely to occur in patients with low TMSE and high ADCS/ADL score (p = 0.02 and p = 0.050, respectively). Patients with TM...

Scientific Reports, 2021

Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small ve... more Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5701) and classified into (i) stroke/transient ischemic attack (TIA), (ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or (iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. The prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3%). Bandung Indonesia showed the highest prevalence of WML, adjusted for age, sex, education, disease groups, and imaging modality. Hypertension...

Alzheimer's & Dementia, 2012

Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2006

The validity ofHachinski Ischemic Score (HIS) in differentiating between Alzheimer's disease ... more The validity ofHachinski Ischemic Score (HIS) in differentiating between Alzheimer's disease (AD) and Vascular dementia (VaD) has been questioned and compared with the gold standard autopsy. To confirm that the HIS can be used to differentiate related VaD from AD in a Thai population. A prospective study of 398 patients who were attending the Memory Clinic, at Siriraj Hospital between January 2001 and October 2003. The 214 patients, with a mean age of 71.15 + 10.20 years, were classified as AD, VaD or mixed dementia (AD with cerebrovascular disease) in proportion of 60.2%, 30.4%, and 9.3% respectively. The authors propose HIS at 5 as a cut off point to differentiate patients with AD and those with VaD or AD with cerebrovascular disease with sensitivity of 85.3% and specificity of 72.9%. The HIS can be applied to differentiate dementia related vascular etiology from AD in a Thai population.

BMC Neurology, 2013

Background: A strong inverse relationship of functional limitation and socioeconomic status has b... more Background: A strong inverse relationship of functional limitation and socioeconomic status has been established in western ageing society. Functional limitation can be related to chronic diseases, disuse, cognitive decline, and ageing. Among chronic diseases in the Thai population, cerebrovascular diseases, diabetes, and arthritis are common. These factors are known to contribute to disability and poor quality of life in the elder population. Neuropsychiatric problems, cognitive decline, dementia, and cultural issues in elderly people also can alter the quality of life of the elderly. Methods: The Dementia and Disability Project in Thai Elderly (DDP) aims at comprehensively assessing community dwelling Thai elderly to understand the relationship between disability and motor function, neuropsychiatric symptoms, cognitive function, and chronic diseases. The DDP is the first study to look at the prevalence and etiology of dementia and of mild cognitive impairment (MCI) in Thai elders and to explore the relationship of cognition, disability, small vessel diseases and cortical degeneration with neuroimaging in Thai elderly people. 1998 Thai elders were screened in 2004-2006 and diagnosed as having MCI or dementia. 223 elders with MCI or dementia and cognitively normal elderly had brain magnetic resonance imaging (MRI) or at baseline. 319 elders from the 3 groups had blood tests to investigate the risks and possible etiologies of dementia including genotyping at baseline. Results: The mean age of elders in this study is 69.51(SD=6.71, min=60, max=95) years. 689(34.9%) are men and 1284(65.1%) are women. Mean body weight was 58.36(SD=11.20) kgs. The regression model reveals that performance on gait and balance and serum triglyceride predicts activity of daily living performance (adjusted r 2 = 0.280, f=2.644, p=0.003). The majority of abnormal gait in Thai elders was lower level gait disturbance. Only 1.5% (29/1952) had highest level gait disorders. 39.5% of 1964 subjects were free of chronic diseases. Treatment gap (indicating those who have untreated or inadequate treatment) of diabetes mellitus and hypertension in Thai elders in this study was 37% and 55.5% respectively. 62.6% of Thai elders have ApoE3E3 allele. Prevalence of positive ApoE4 gene in this study is 22.85%. 38.6% of Thai elders who had MRI brain study have moderate to severe white matter lesions.

Journal of The Neurological Sciences, 2009