Sleep disorders are very common in Parkinson's disease (PD), being associated with several other conditions, mainly psychiatric disorders. The present study was designed to assess sleep quality in Brazilian patients with PD and to evaluate whether sleep changes are associated with clinical variables, especially neuropsychiatric symptoms in PD. Patients diagnosed with PD were subjected to a comprehensive clinical evaluation that included the assessment of motor, cognitive and psychiatric symptoms. Our study showed that sleep complaints are frequent in PD and worse sleep quality is associated with depressive and anxious symptoms, poorer cognitive performance and greater severity of PD symptoms. In the multivariate analysis, older age, greater severity of anxiety and PD remained as significant predictors of worse sleep quality. In conclusion, sleep complaints, depressive and anxiety symptoms are frequent in PD patients. Older age, disease severity and anxiety symptoms are significant predictors of poorer sleep quality in PD patients.

Background and PurposeExcessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson's disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD.MethodsThis cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS.ResultsWe found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD.ConclusionsNighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.

RESUMO Objetivo O estudo propôs-se a avaliar diferentes domínios das funções executivas em adolescentes como preditores ao uso de álcool e cigarro. Métodos Utilizou-se um delineamento transversal. A amostra foi composta por 239 adolescentes com idade média de 15,34 (±2,32). Os testes Alcohol Use Disorders Identification Test (AUDIT) e Fagerstrom Test for Nicotine Dependence (FTND) avaliaram o uso de álcool e cigarro respectivamente. O Self-Reporting Questionnaire (SRQ-20) foi utilizado para rastreio de saúde mental. Os testes Iowa Gambling Task (IGT), Wisconsin Card Sorting Test (WCST) e Continuous Performance Task (CPT) avaliaram os domínios executivos. Foi utilizado o estimador Odds Ratio adjusted (ORa). Resultados Os modelos logísticos ajustados demonstraram associação entre os domínios controle inibitório (ORa = 1.043; IC de 95% = 1,013-1,069; p = 0,001), flexibilidade cognitiva (ORa = 1.069; IC de 95% = 1,01-1,11; p = 0,001) e a tomada de decisão (ORa = 1.025; IC de 95% = 0,258-0,867; p < 0,014) e o uso de álcool. Também houve associação entre os domínios controle inibitório (ORa = 1.053; IC de 95% = 1,017-1,041; p = 0,003) e flexibilidade cognitiva (ORa =1.047; IC 95% = 1,004-1,250; p = 0,001) e o uso de cigarro. A faixa dos 14 aos 16 anos com 1,065 (ORa = 1.065; IC de 95% = 1,05-1,95; p = 0,010) razão de chances maiores para o uso de álcool e 1,067 (ORa = 1.067; IC de 95% = 0,156-1,453; p = 0,016) razão de chances para o uso de cigarro. Conclusão Os domínios cognitivos das funções executivas são fatores preditores associados ao uso de álcool e cigarro por adolescentes. Adolescentes com piores desempenhos nos domínios das funções executivas possuem maiores chances de fazer o uso de álcool ou cigarro.

Objective: Schizophrenia is a complex and chronic psychiatric disorder. In recent years, studies have found glutamatergic system participation in its etiopathogenesis, especially through aberrant NMDA receptors functioning. Thus, drugs that modulate this activity, as amantadine and memantine, could theoretically be used in its treatment. To perform a systematic literature review about memantine and amantadine use as adjunct in schizophrenia treatment. Methods: A systematic review of papers published in English indexed in the electronic database PubMed ® using the terms "memantine", "amantadine" and "schizophrenia" published until October 2016. Results: We found 144 studies, 8 selected for analysis due to meet the objectives of this review. Some of these have shown benefits from such drug use, especially in symptoms measured by PANSS and its subdivisions, while others do not. Discussion: The data in the literature about these drugs use for schizophrenia treatment is still limited and have great heterogeneity. Thus, assay with greater robustness are needed to assess real benefits of these drugs as adjuvant therapy.

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Introduction. Health problems in elderly individuals are diverse. The use of cigarettes, a potentially addictive substance, has been increasing in the elderly population age group, affecting the cognitive and elderly domains, and becoming an important global public health problem. Objective. This study aimed to investigate the relationship between tobacco consumption by the elderly, as well as different levels of nicotine dependence and cognitive domains of executive functions. Method. It is a case-control study composed by 58 individuals aged ≥ 60 years, with 29 participants in the clinical group and 29 in the control group. The case-control sample was paired in subgroups by sex, socioeconomic status, schooling, and sample isonomy with the clinical group. We used the Shapiro-Wilk normality test, the Mann-Whitney test, the student T-test, and the Cohen d-estimator. Results. The control group performed better compared to the clinical group with the median grade in the inhibitory control of the executive domain with Cohen’s d 1.00 in the five-digit test and Cohen’s 1.5 in the Stroop test. The control group compared with the high-grade clinical group presented better performance with Cohen’s working memory of 1.56 d, Cohen’s inhibition of 1.06 d in the five-digit test, and Cohen’s of 1.17 d in the Stroop test. Discussion and conclusion. The detection of the level of nicotine dependence is associated with the degree of cognitive impairment in the specific executive domain, which provides a possibility of differential diagnosis, both in the clinical and population contexts, directed at the rehabilitation of executive domains most affected by smoking in the elderly.

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