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Persistent symptoms post-mild traumatic brain injury (mTBI) includes autonomic dysregulation (AD). The composite autonomic symptoms score, (COMPASS-31), was developed to quantify AD symptom severity in the last year, which limits clinical utility. The primary aim was to determine validity of a modified-COMPASS-31 measuring symptoms in the last month compared to the original, secondarily to compare both original and modified versions to the Neurobehavioral Symptom Inventory (NSI), and tertiarily to detect change post-treatment of the modified-COMPASS-31 compared to NSI and headache intensity (HI). Thirty-three military personnel with persistent headache post-mTBI. Total and domain scores for COMPASS-31 (original vs. modified) NSI and HI at baseline. Change in modified-COMPASS-31. NSI, and HI. Baseline COMPASS-31 versions were comparable and highly correlated (r = 0.72, p < 0.001), they were moderately correlated at best to the NSI (r < 0.6), which may suggest differences in measurement metrics. The mean change in modified-COMPASS-31 scores (15.4/100, effect size 0.8) was mild to moderately correlated to the change in HI (r = 0.39) score, but not to NSI (r = 0.28). The modified-COMPASS-31 appears to be valid, can measure change of AD symptom severity, and is recommended as an outcome measure. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the differences in patient/caregiver characteristics, their treatment needs, and the attending physician's understanding of those treatment needs according to the duration after diagnosis of dementia with Lewy bodies (DLB). Methods: This was a post hoc analysis of a multicenter, cross‐sectional, questionnaire survey study. A total of 263 patient–caregiver pairs were reclassified into two groups according to the median duration after diagnosis of DLB as follows: short (<24 months; S‐group) and long (≥24 months; L‐group) post‐DLB diagnosis duration. Treatment need was defined as the symptom domain that caused the patient or caregiver the most distress. Concordance rates between patient–physician and caregiver–physician were calculated for physicians' understanding of treatment needs. Results: In this analysis, 126 pairs (32 physicians) and 137 pairs (34 physicians) were classified as the S‐ and L‐groups, respectively. Patient and caregiver characteristics were broadly similar between groups (mean age for patients 78.7 ± 6.6 vs. 79.8 ± 6.7, for caregivers 64.7 ± 12.9 vs. 64.9 ± 12.8; number of male/female for patients 61/65 vs. 67/70, for caregivers 34/92 vs. 38/99), but the prevalence of parkinsonism (82.5% vs. 66.7%) and autonomic dysfunction (49.6% vs. 33.3%), severity of parkinsonism (MDS‐UPDRS Part III total scores, 29.2 ± 22.6 vs. 18.0 ± 16.4; Part II total score, 14.6 ± 12.0 vs. 7.6 ± 7.9), and caregiver burden (J‐ZBI_8 score, 9.1 ± 6.7 vs. 7.5 ± 5.8) were higher in the L‐group than the S‐group. Regarding treatment needs, the invalid answer rates for patients were 34.9% and 46.8%, and those for caregivers were 28.6% and 34.9% in the S‐ and L groups, respectively. Patients' treatment needs did not significantly differ (p = 0.056), but S‐group patients were more likely to select cognitive impairment (p = 0.045) as their treatment need, whereas L‐group patients were more likely to select parkinsonism (p = 0.003). Caregivers' treatment needs significantly differed (p = 0.032) between groups. S‐group caregivers were more likely to select cognitive impairment (p = 0.001), whereas L‐group caregivers were more likely to select other symptom domains such as parkinsonism (S‐group vs. L‐group: 10.3% vs. 16.7%), psychiatric symptoms (20.6% vs. 24.6%), sleep‐related disorder (4.0% vs. 7.1%), and autonomic dysfunction (4.8% vs. 9.5%). Concordance rates between patient–physician and caregiver–physician were low in both groups. Conclusions: There were some differences in characteristics according to the duration after diagnosis of DLB. Cognitive dysfunction may be a particular concern for patients and caregivers soon after diagnosis of DLB. Treatment needs of patients and caregivers for parkinsonism, psychiatric symptoms, sleep‐related disorder, or autonomic dysfunction were different according to the duration after diagnosis of DLB. Physicians' perception of patients'/caregivers' treatment needs was poor regardless of the duration after diagnosis of DLB. Clinical trial registration: UMIN Clinical Trials Registry (UMIN000041844). Key points: This multicenter, cross‐sectional observational study collected survey data from 263 patient–caregiver pairs and 66 physicians to investigate how the duration after diagnosis of dementia with Lewy bodies (DLB) influences clinical symptoms, prescribed medications, and caregiver burden, and how perception of treatment needs differs among patients, their caregivers, and their physicians.Presence of parkinsonism and autonomic dysfunction, severity of parkinsonism, and caregiver burden were all found to be higher in patients with more than 24 months duration.Although patient treatment needs did not differ significantly between patients by post‐diagnosis duration (<24 vs. ≥ 24 months), patients with short (<24 months) post‐diagnosis duration were more likely to select cognitive impairment as treatment need; while those with long (≥24 months) post‐diagnosis duration were more likely to select parkinsonism.Caregivers for patients with short post‐diagnosis duration were more likely to select cognitive impairment as the greatest treatment need, whereas caregivers for patients with long post‐diagnosis duration were more likely to select other symptom domains such as parkinsonism, psychiatric symptoms, sleep‐related disorder, and autonomic dysfunction as the greatest treatment need.Physicians' perception of patients' and caregivers' treatment needs was poor, regardless of the duration after diagnosis of DLB. [ABSTRACT FROM AUTHOR]

Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19. To evaluate the effects of a 36-session WBV protocol on the risk of falls, balance, mobility and heart rate variability (HRV). A randomized clinical trial. 13 patients affected by COVID-19, trained with WBV, 3×/week on alternate days, totaling 36 sessions, were evaluated before and after the intervention. WBV training at 2 mm and 4 mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p = 0.023), with effect size of 0.530. No changes were observed for mobility and balance outcomes (p = 0.127) or for any of the HRV variables (p = 0.386). WBV training reduced the risk of falls in post-COVID patients. No changes were observed regarding balance and mobility, nor for HRV. [ABSTRACT FROM AUTHOR]

Autonomic nerve dysfunction is a common non-motor symptom of Parkinson's disease (PD). It has a high incidence and involves multiple organ system disorders with various manifestations, seriously affecting the quality of life. Autonomic nerve dysfunction can be a major symptom of advanced PD and a major cause of disability. Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced PD, and its improvement of motor symptoms in PD patients has been widely recognized. However, the effect of STN - DBS on the symptoms of autonomic nerve dysfunction in PD patients is still unclear. Here, the efficacy of STN - DBS on PD autonomic nerve dysfunction is briefly reviewed. Therefore, we should pay more attention to the symptoms of autonomic nerve dysfunction in PD patients, and conduct preoperative evaluation of DBS in PD patients, so as to comprehensively consider the postoperative efficacy, target selection, stimulus parameter setting, drug adjustment, develop an individualized treatment plan. [ABSTRACT FROM AUTHOR]