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5. Effects of neurological music therapy on behavioural and emotional recovery after traumatic brain injury: A randomized controlled cross-over trial.

Author

Siponkoski, Sini-Tuuli, Koskinen, Sanna, Laitinen, Sari, Holma, Milla, Ahlfors, Mirja, Jordan-Kilkki, Päivi, Ala-Kauhaluoma, Katja, Martínez-Molina, Noelia, Melkas, Susanna, Laine, Matti, Ylinen, Aarne, Zasler, Nathan, Rantanen, Pekka, Lipsanen, Jari, and Särkämö, Teppo

Abstract

Traumatic brain injury (TBI) causes deficits in executive function (EF), as well as problems in behavioural and emotional self-regulation. Neurological music therapy may aid these aspects of recovery. We performed a cross-over randomized controlled trial where 40 persons with moderate-severe TBI received a 3-month neurological music therapy intervention (2 times/week, 60 min/session), either during the first (AB, n = 20) or second (BA, n = 20) half of a 6-month follow-up period. The evidence from this RCT previously demonstrated that music therapy enhanced general EF and set shifting. In the current study, outcome was assessed with self-report and caregiver-report questionnaires performed at baseline, 3-month, 6-month, and 18-month stages. The results showed that the self-reported Behavioural Regulation Index of the Behaviour Rating Inventory of Executive Function (BRIEF-A) improved more in the AB than BA group from baseline to 3-month stage and the effect was maintained in the 6-month follow-up. No changes in mood or quality of life questionnaires were observed. However, a qualitative content analysis of the feedback revealed that many participants experienced the intervention as helpful in terms of emotional well-being and activity. Our results suggest that music therapy has a positive effect on everyday behavioural regulation skills after TBI. [ABSTRACT FROM AUTHOR]

Published
2022
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6. Resting-State Network Plasticity Induced by Music Therapy after Traumatic Brain Injury

Author

Martínez-Molina, Noelia, primary, Siponkoski, Sini-Tuuli, additional, Kuusela, Linda, additional, Laitinen, Sari, additional, Holma, Milla, additional, Ahlfors, Mirja, additional, Jordan-Kilkki, Päivi, additional, Ala-Kauhaluoma, Katja, additional, Melkas, Susanna, additional, Pekkola, Johanna, additional, Rodríguez-Fornells, Antoni, additional, Laine, Matti, additional, Ylinen, Aarne, additional, Rantanen, Pekka, additional, Koskinen, Sanna, additional, Cowley, Benjamin Ultan, additional, and Särkämö, Teppo, additional

Published
2021
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7. Effects of neurological music therapy on behavioural and emotional recovery after traumatic brain injury: A randomized controlled cross-over trial

Author

Siponkoski, Sini-Tuuli, primary, Koskinen, Sanna, additional, Laitinen, Sari, additional, Holma, Milla, additional, Ahlfors, Mirja, additional, Jordan-Kilkki, Päivi, additional, Ala-Kauhaluoma, Katja, additional, Martínez-Molina, Noelia, additional, Melkas, Susanna, additional, Laine, Matti, additional, Ylinen, Aarne, additional, Zasler, Nathan, additional, Rantanen, Pekka, additional, Lipsanen, Jari, additional, and Särkämö, Teppo, additional

Published
2021
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8. Resting-state network plasticity induced by music therapy after traumatic brain injury

Author

Martínez-Molina, Noelia, primary, Siponkoski, Sini-Tuuli, additional, Kuusela, Linda, additional, Laitinen, Sari, additional, Holma, Milla, additional, Ahlfors, Mirja, additional, Jordan-Kilkki, Päivi, additional, Ala-Kauhaluoma, Katja, additional, Melkas, Susanna, additional, Pekkola, Johanna, additional, Rodriguez-Fornells, Antoni, additional, Laine, Matti, additional, Ylinen, Aarne, additional, Rantanen, Pekka, additional, Koskinen, Sanna, additional, Cowley, Benjamin Ultan, additional, and Särkämö, Teppo, additional

Published
2020
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9. Music Therapy Enhances Executive Functions and Prefrontal Structural Neuroplasticity after Traumatic Brain Injury: Evidence from a Randomized Controlled Trial

Author

Siponkoski, Sini-Tuuli, primary, Martínez-Molina, Noelia, additional, Kuusela, Linda, additional, Laitinen, Sari, additional, Holma, Milla, additional, Ahlfors, Mirja, additional, Jordan-Kilkki, Päivi, additional, Ala-Kauhaluoma, Katja, additional, Melkas, Susanna, additional, Pekkola, Johanna, additional, Rodriguez-Fornells, Antoni, additional, Laine, Matti, additional, Ylinen, Aarne, additional, Rantanen, Pekka, additional, Koskinen, Sanna, additional, Lipsanen, Jari, additional, and Särkämö, Teppo, additional

Published
2020
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19. Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People

Author

Nurmela, Kirsti, Mattila, Aino, Heikkinen, Virpi, Uitti, Jukka, Ylinen, Aarne, Virtanen, Pekka, Nurmela, Kirsti, Mattila, Aino, Heikkinen, Virpi, Uitti, Jukka, Ylinen, Aarne, and Virtanen, Pekka

Abstract

The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this Depression identification pattern' with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services.

Published
2018
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22. Aivovammojen ali- ja ylidiagnostiikka

Author

Liimatainen, Suvi, Rellman, Johanna, Luoto, Teemu, Wäljas, Minna, Ylinen, Aarne, Clinicum, and Neurotieteiden osasto

Subjects
Brain Injuries, +diagnosis, Accidents, +complications, Accidents, Traffic, Cognition Disorders, +rehabilitation, 3112 Neurotieteet
Abstract

•Jokainen pään vamman saanut potilas ansaitsee asianmukaisen ja yhtenäisen diagnostiikan oikean hoidon ja kuntoutuksen saamiseksi. •Akuuttivaiheessa aivovammojen alidiagnostiikan riski on suurentunut erityisesti suurienergiaisissa ­tapaturmissa, joissa potilaan muut vakavat vammat vievät terveydenhuollon toimijoiden huomion. •Ylidiagnostiikkaa nähdään aivovammojen jälkitilojen arvioinnissa, kun potilaan oirekuvaa pidetään merkittävän aivovamman aiheuttamana riippumatta akuuttivaiheen tapahtumatiedoista ja muista selittävistä tekijöistä. •Kun diagnoosi on tehty alkuvaiheessa oikein, lievän aivovamman saaneista valtaosa toipuu ennalleen ja palaa töihin. Keskivaikea aivovamma voi aiheuttaa pitkittyneitä tai pysyviäkin toimintakykyä rajoittavia oireita, ja potilaat tarvitsevat kuntoutusta. Sitä vaikeamman aivovamman saaneet eivät yleensä kykene palaamaan työelämään.

Published
2016

26. The use of F-response in defining interstimulus intervals appropriate for LTP-like plasticity induction in lower limb spinal paired associative stimulation

Author

University of Helsinki, Department of Neurosciences, University of Helsinki, Neuroscience Center, University of Helsinki, Kliinisen neurofysiologian yksikkö, University of Helsinki, BioMag Laboratory, University of Helsinki, Clinicum, Shulga, Anastasia, Lioumis, Pantelis, Kirveskari, Erika, Savolainen, Sarianna, Mäkelä, Jyrki, Ylinen, Aarne, University of Helsinki, Department of Neurosciences, University of Helsinki, Neuroscience Center, University of Helsinki, Kliinisen neurofysiologian yksikkö, University of Helsinki, BioMag Laboratory, University of Helsinki, Clinicum, Shulga, Anastasia, Lioumis, Pantelis, Kirveskari, Erika, Savolainen, Sarianna, Mäkelä, Jyrki, and Ylinen, Aarne

Abstract

Background In spinal paired associative stimulation (PAS), orthodromic volleys are induced by transcranial magnetic stimulation (TMS) in upper motor neurons, and antidromic volleys by peripheral nerve stimulation (PNS) in lower motor neurons of human corticospinal tract. The volleys arriving synchronously to the corticomotoneuronal synapses induce spike time-dependent plasticity in the spinal cord. For clinical use of spinal PAS, it is important to develop protocols that reliably induce facilitation of corticospinal transmission. Due to variability in conductivity of neuronal tracts in neurological patients, it is beneficial to estimate interstimulus interval (ISI) between TMS and PNS on individual basis. Spinal root magnetic stimulation has previously been used for this purpose in spinal PAS targeting upper limbs. However, at lumbar level this method does not take into account the conduction time of spinal nerves of the cauda equina in the spinal canal. New method For lower limbs spinal PAS, we propose estimating appropriate ISIs on the basis of F-response and motor-evoked potential (MEP) latencies. The use of navigation in TMS and ensuring correct PNS electrode placement with F-response recording enhances the precision of the method. Results Our protocol induced 186 ± 17% (mean ± STE) MEP amplitude facilitation in healthy subjects, being effective in all subjects and nerves tested. Comparison with existing method We report for the first time the individual estimation of ISIs in spinal PAS for lower limbs. Conclusions Estimation of ISI on the basis of F and MEP latencies is sufficient to effectively enhance corticospinal transmission by lower limb spinal PAS in healthy subjects. Keywords Paired associative stimulation; Neuronal plasticity; Transcranial magnetic stimulation; Electrical stimulation therapy; F-response

Published
2015

27. Identification of major depressive disorder among the long-term unemployed.

Author

Nurmela, Kirsti, Mattila, Aino, Heikkinen, Virpi, Uitti, Jukka, Ylinen, Aarne, and Virtanen, Pekka

Subjects
DIAGNOSIS of mental depression, UNEMPLOYED people, MENTAL health services, SUICIDAL behavior, MEDICAL care, PSYCHOLOGY, LONG-term unemployment, UNEMPLOYMENT & psychology, MENTAL depression, COMPARATIVE studies, MARITAL status, RESEARCH methodology, MEDICAL cooperation, RESEARCH, EVALUATION research
Abstract

Purpose: Depression is a common mental health disorder among the unemployed, but research on identifying their depression in health care is scarce. The present study aimed to explore the identification of major depressive disorder (MDD) in health care on long-term unemployed and find out if the duration of unemployment correlates with the risk for unidentified MDD.Methods: The study sample consisted the patient files of long-term unemployed people (duration of unemployment 1-35 years, median 11 years), who in a screening project diagnosed with MDD (n = 243). The MDD diagnosis was found in the health care records of 101. Binomial logistic regression models were used to explore the effect of the duration of unemployment, as a discrete variable, to the identification of MDD in health care.Results: MDD was appropriately identified in health care for 42% (n = 101) of the participants with MDD. The odds ratio for unidentified MDD in health care was 1.060 (95% confidence interval 1.011; 1.111, p = 0.016) per unemployment year. When unemployment had continued, for example, for five years the odds ratio for having unidentified MDD was 1.336. The association remained significant throughout adjustments for the set of background factors (gender, age, occupational status, marital status, homelessness, criminal record, suicide attempts, number of health care visits).Conclusions: This study among depressed long-term unemployed people indicates that the longer the unemployment period has lasted, the more commonly these people suffer from unidentified MDD. Health services should be developed with respect to sensitivity to detect signs of depression among the long-term unemployed. [ABSTRACT FROM AUTHOR]

Published
2018
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32. MR Volumetry of the Entorhinal, Perirhinal, and Temporopolar Cortices in Drug-Refractory Temporal Lobe Epilepsy

Author

Jutila, Leena, Ylinen, Aarne, Partanen, Kaarina, Alafuzoff, Irina, Mervaala, Esa, Partanen, Juhani, Vapalahti, Matti, Vainio, Pauli, and Pitkänen, Asla

Subjects
Adult, Cerebral Cortex, Male, Adolescent, Drug Resistance, Brain, Middle Aged, Hippocampus, Magnetic Resonance Imaging, Epilepsy, Temporal Lobe, Entorhinal Cortex, Humans, Female, Epilepsies, Partial, Atrophy, Dominance, Cerebral
Abstract

BACKGROUND AND PURPOSE: The occurrence of damage in the entorhinal, perirhinal, and temporopolar cortices in unilateral drug-refractory temporal lobe epilepsy (TLE) was investigated with quantitative MR imaging. METHODS: Volumes of the entorhinal, perirhinal, and temporopolar cortices were measured in 27 patients with unilateral drug-refractory TLE, 10 patients with extratemporal partial epilepsy, and 20 healthy control subjects. All patients with TLE were evaluated for epilepsy surgery and underwent operations. RESULTS: In left TLE, the mean volume of the ipsilateral entorhinal cortex was reduced by 17% (P < .001 compared with control subjects) and that of the ipsilateral temporopolar cortex by 17% (P < .05). In right TLE, the mean ipsilateral entorhinal volume was reduced by 13% (P ≤ .01), but only in patients with hippocampal atrophy. Asymmetry ratios also indicated ipsilateral cortical atrophy. When each patient was analyzed individually, the volume of the ipsilateral hippocampus was reduced (≥ 2 SD from the mean of controls) in 63% and that of the entorhinal cortex in 52% of patients with TLE. Furthermore, ipsilateral entorhinal (left: r = 0.625, P < .001; right: r = 0.524, P ≤ .01), perirhinal (left: r = 0.471, P < .05), and temporopolar (right: r = 0.556, P < .01) volumes correlated with ipsilateral hippocampal volumes. There was no association, however, with clinically or pathologically identified causes of epilepsy, duration of epilepsy, or age at onset of epilepsy. Mean cortical volumes were unaffected in extratemporal partial epilepsy. CONCLUSION: Subpopulations of patients with unilateral TLE have ipsilateral damage in the entorhinal and temporopolar cortices. The damage is associated with hippocampal damage.

Published
2001

49. [sup 18]F]FDG-PET Reveals Temporal Hypometabolism in Patients With Temporal Lobe Epilepsy Even When Quantitative MRI and Histopathological Analysis Show Only Mild Hippocampal Damage.

Author

Lamusuo, Salla, Jutila, Leena, Ylinen, Aarne, Kälviäinen, Reetta, Mervaala, Esa, Haaparanta, Merja, Jääskeläinen, Satu, Partanen, Kaarina, Vapalahti, Matti, and Rinne, Juha

Subjects
GLUCOSE, TEMPORAL lobe epilepsy, HIPPOCAMPUS diseases, METABOLISM, PATIENTS
Abstract

Background: The relationship between reduced glucose metabolism in positron emission tomography with fludeoxyglucose F 18 ([[sup 18]F]FDG-PET) and hippocampal damage (HD) in patients with temporal lobe epilepsy is still unclear. Objective: To determine whether the presence and severity of HD verified by quantitative magnetic resonance imaging (QMRI) and histopathological analysis affect the degree of hypometabolism. Patients and Methods: Sixteen patients with drug-resistant temporal lobe epilepsy underwent [[sup 18]F]FDG-PET and QMRI (hippocampal volumetry and T2 relaxometry) before surgery. Histopathological analysis of the hippocampus included measurements of neuronal loss, proliferation of glial cells, and mossy fiber sprouting. The asymmetry in glucose metabolism described the degree of hypometabolism. Results: Temporal hypometabolism was not related to severity of HD as measured by QMRI or histopathological analysis. The degree of hypometabolism did not differ in patients with mild, moderate, or severe HD. In addition, [[sup 18]F]FDG-PET revealed significant temporal hypometabolism even though hippocampal QMRI findings were normal or showed only mild HD. Thus, glucose consumption was reduced over and above the histopathological changes. Conclusions: [[sup 18]F]FDG-PET is sensitive for localizing the epileptogenic region in patients with temporal lobe epilepsy. However, it is insensitive to reflect the severity of HD. [ABSTRACT FROM AUTHOR]

Published
2001
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50. Long-term Study With Gabapentin in Patients With Drug-Resistant Epileptic Seizures

Author

Sivenius, Juhani, Ylinen, Aarne, Kälviäinen, Reetta, and Riekkinen, Paavo J.

Abstract

OBJECTIVE: To study the efficacy and safety of gabapentin in long-term treatment. DESIGN: A 4-year follow-up study of 25 patients with visits at 3-month intervals. SETTING: The patients were followed up in the outpatient unit of the University Hospital of Kuopio (Finland). PATIENTS: We treated 25 patients with drug-resistant complex partial seizures and secondarily generalized seizures in an open-label long-term study, using gabapentin as an additional means of therapy after a 3-month double-blind, placebo-controlled phase. Thirteen patients showed no benefit from gabapentin; the study medication was discontinued after 4 to 6 months of treatment. Of the 12 patients who responded enough to continue treatment, five were withdrawn due to different reasons, one because of loss of response. MAIN OUTCOME MEASURES: The number of patients receiving the study drug in the follow-up and reduction of seizure frequency from baseline level as analyzed by the Wilcoxon test. RESULTS: Seven patients received gabapentin therapy for more than 4 years. The median follow-up time was 54 months. There was a significant reduction in seizure frequency throughout the follow-up period. Five of seven patients had a greater than 50% seizure frequency reduction at 4 years, representing 20% of the 25 patients who entered the study. CONCLUSIONS: Gabapentin possesses good efficacy in long-term treatment of patients with partial and secondarily generalized epileptic seizures. It is safe to use, and it is fairly well tolerated even in long-term treatment.

Published
1994
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