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Thomas Bak

University of Edinburgh, School of Philosophy, Psychology and Language Sciences, Faculty Member

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Born and raised in Cracow, Poland, Dr Thomas H Bak studied medicine and worked as a clinician in psychiatry and neurology in Bern, Berlin, Cambridge and Edinburgh. 2010-2018 he was the president of the World Federation of Neurology Research Group on Aphasia, Dementia and Cognitive Disorders (WFN RG ADCD).
His main interest is the relationship between language, brain and mind, with a recent focus on the impact of language learning and multilingualism on cognitive functions across the lifespan and in brain diseases such as dementia and stroke. He has teaching experience in 7 languages and conducts his research in a wide range of populations across the world.

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Konrad Szewczyk-królikowski

Sonia Maria Dozzi Brucki

University of Sao Paulo

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Dorothée Lulé

Rossano Fiorelli

UNIRIO - Universidade Federal do Estado do Rio de Janeiro

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Papers by Thomas Bak

The association between performance on a test of motor sequencing and language abilities in neurodegenerative disorders

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis

Neuropathology and Applied Neurobiology, Aug 28, 2019

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral scle... more Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis Aims: Clusterin is a topologically dynamic chaperone protein with the ability to participate in both intraand extacellular proteostasis. Clusterin has been shown to be upregulated in the spinal cord of patients with amyotrophic lateral sclerosis (ALS) and has been shown to protect against TDP-43 protein misfolding in animal and cell models. Previous studies have demonstrated an association between the pathological burden of TDP-43 misfolding and cognitive deficits in ALS, demonstrating high specificity, but correspondingly low sensitivity owing to a subset of individuals with no evidence of cognitive deficits despite a high burden of TDP-43 pathology, called mismatch cases. Methods: Hypothesizing that differences in the ability to cope with protein misfolding in these cases may be due to differences in expression of protective mechanisms such as clusterin expression, we assessed the spatial expression of clusterin and another chaperone protein, HspB8, in post mortem brain tissue of mismatch cases. We employed a modified in situ hybridization technique called BaseScope, with single cell, single transcript resolution. Results: Mismatch cases demonstrated differential spatial expression of clusterin, with a predominantly neuronal pattern, compared to cases with cognitive manifestations of their TDP-43 pathology who demonstrated a predominantly glial distribution of expression. Conclusions: Our data suggest that, in individuals with TDP-43 pathology, predominantly neuronal expression of clusterin in extra-motor brain regions may indicate a cell protective mechanism delaying clinical manifestations such as cognitive dysfunction.

Impairment of Visual Cognition in Progressive Multiple Sclerosis

Journal of Multiple Sclerosis, 2015

Background: Impairment of visual cognition occurs in up to 25% of patients with MS, however data ... more Background: Impairment of visual cognition occurs in up to 25% of patients with MS, however data on progressive disease is limited and the neural basis remains unknown. Objective: To evaluate the influence of multifocal inflammatory CNS white matter demyelination burden on visual cognition in equivalent SPMS and PPMS cohorts. Methods: 59 SPMS and 27 PPMS patients matched for demographic and disease characteristics were evaluated using visuospatial and visuoperceptual components of the Addenbrooke's cognitive examination-revised (ACE-R) battery. Factors influencing performance were then identified by logistic regression. Exploratory logistic models were also used to determine the predictive value of deficits in attention, working memory, and arithmetic abilities. Finally, comparison of deficits between equivalent primary (PPMS) and secondary (SPMS) progressive disease groups was used to evaluate a potential dose-response for cumulative multifocal inflammatory CNS white matter demyelination. Results: The overall prevalence of impairment in visual cognition was 14.0% (95%CI=6.4 to 21.4%) with no difference between disease groups. Qualitatively, the observed deficits in visual cognition were subtle, and patients were not able to predict them. Impairment was more common in women (OR 3.2; 95% CI=0.8 to 13.2), and subjects with a Beck depression inventory II score ≥ 25 (OR 5.2; 95% CI=1.1 to 24.2). No effect was seen for: age, years in full-time education, disease duration, clinical evidence of anterior visual pathway dysfunction, or motor disability. Exploratory analyses showed no predictive association with deficits in attention or working memory, however impairment of basic arithmetic skills was a highly significant predictor of impaired visual cognition (OR 29.4, 95% CI 3.0 to 291.9). Allowing for all significant predictors, secondary and primary progressive disease groups had equivalent rates of impairment (OR 1.6, 95% CI 0.4 to 7.1; p=0.538). Conclusions: Impairment of visual cognition in progressive MS is more common in women and patients with high levels of depressive symptomatology, but occurs independently from anterior visual pathway dysfunction and the cumulative burden of inflammatory CNS white matter demyelination. These findings suggest that the site rather than the absolute quantity of brain pathology is crucial, with the strong association observed to impairment of basic arithmetic skills implicating possible localization to the intraparietal sulcus.

Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment

Dementia and geriatric cognitive disorders, 2017

Increasing evidence suggests that life course factors such as education and bilingualism may have... more Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; ...

Chapter 1 Why the mythical “native speaker” has mud on its face

De Gruyter eBooks, Nov 8, 2021

The mythical native speaker has mud on its face

De Gruyter eBooks, Nov 8, 2021

The terms “native speaker” (NS) and “non-native speaker” (NNS) continue to be widely used in appl... more The terms “native speaker” (NS) and “non-native speaker” (NNS) continue to be widely used in applied linguistics and foreign language learning and teaching despite a growing wave of criticism about the difficulty in defining them accurately, the (neo)racist ideology they reflect and the deficit view they perpetuate among foreign language learners and teachers. These issues are explored in more detail, focusing on the history of the terms NS/NNS and their enduring perverse social consequences. We consider alternative views and explain the reasoning behind the development of a new terminology: “L1 user versus LX user” (Dewaele 2018). We conclude that the field needs to abandon the toxic terms “NS/NNS” and adopt neutral terms that emphasise the equal status of first and foreign language users – which can often be the same person

Interference suppression in bilingualism: Stimulus-Stimulus vs. Stimulus-Response conflict

Bilingualism: Language and Cognition, 2021

Studies examining the potential effects of bilingualism on interference suppression show inconsis... more Studies examining the potential effects of bilingualism on interference suppression show inconsistent results. Our study approaches this topic by distinguishing two potential subcomponents within interference suppression (i.e., Stimulus-Stimulus and Stimulus-Response conflict). We investigated the two subcomponents through their operationalisation in different tasks and examined the role of language proficiency in modulating it. A sample of 111 young adult participants performed four non-linguistic cognitive tasks measuring both visual and auditory domains of cognitive control. Bilinguals outperformed monolinguals in tasks involving Stimulus-Stimulus conflict, but showed comparable performance in tasks involving Stimulus-Response conflict. Specific effects of language proficiency on cognitive control were observed: group differences in auditory inhibition and visual orienting were only observed between high-proficient bilinguals and monolinguals. Taken together, types of conflicts i...

From Bilingualism to Bilingualisms: Bilingual experience in Edinburgh and Singapore affects attentional control differently

Bilingualism: Language and Cognition, 2018

Recent theories propose that language-switching in bilinguals influences executive control. We in... more Recent theories propose that language-switching in bilinguals influences executive control. We investigated whether switching behaviour, shaped by the bilingual's interactional context as well as personal preferences impacted attentional control. We compared four groups – (i) Edinburgh monolinguals, (ii) Edinburgh non-switching late bilinguals, (iii) Edinburgh non-switching early bilinguals, and (iv) Singapore switching early bilinguals – on two tasks of attentional control. Effects of interactional context were observed, with Singapore bilinguals performing better on conflict resolution in the Attention Network Task and Edinburgh late bilinguals on attentional switching in the Elevator reversal (Test of Everyday Attention) subtest. Our results suggest that the interactional context of bilinguals could impact attentional control differently.

Cognitive effects of Gaelic medium education on primary school children in Scotland

International Journal of Bilingual Education and Bilingualism, 2018

Research has shown that learning more than one language may have beneficial effects on executive ... more Research has shown that learning more than one language may have beneficial effects on executive functions, such as focused attention, inhibitory control, and switching between tasks. Evidence demonstrating these effects comes from studies with infants, children and adults from a range of language combinations. Much less direct evidence of such effects exists with regard to the bilingual experience of children acquiring regional minority languages. This study addresses the question of whether English-speaking children attending Gaelic Medium Education in Scotland exhibit differences of executive function compared with English-speaking children attending English Medium Education. Primary Five pupils from English-medium and Gaelic-medium schools in two Scottish towns were tested on three tasks of attentional control. One task, requiring verbal response inhibition, provided evidence of a significant positive effect for Gaelic-medium pupils. The results suggest that the cognitive effects of attending Gaelic Medium Education are specific to certain tasks and are affected by the characteristics of this particular bilingual setting (i.e. acquiring the second language in a domain-specific context with one dominant language). This supports the notion that the context of the bilingual experience is an important factor in shaping the cognitive effects which may be gained through exposure to more than one language.

The Nairobi Declaration—Reducing the burden of dementia in low‐ and middle‐income countries (LMICs): Declaration of the 2022 Symposium on Dementia and Brain Aging in LMICs

Alzheimer's & Dementia

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Learning from History-FTD, ALS and Behaviour

Rinsho Shinkeigaku, 2010

Correspondence to

A cognitive bedside assessment beyond the MMSE: the

Arctic Explorers in Their Own Words: Interviews, Mental Health & Cognition

Chapter 12. The impact of bilingualism on cognitive ageing and dementia

Studies in Bilingualism, 2017

A Mixed-Methods Approach in the Arctic Archipelago of Svalbard: Studying the Cognition, Mental Health, and Lived Experiences of Small Teams in Isolation and Confinement

The Edinburgh cognitive and behavioural ALS Screen (ECAS): The effect of age, education and IQ

Harmonization and innovation of cognitive, behavioural and functional assessment in neurodegenerative dementias

The aim of this project was to provide guidelines for harmonization and innovation of assessment ... more The aim of this project was to provide guidelines for harmonization and innovation of assessment tools to be applied to research in neurodegenerative dementias (NDD), with a special focus on longitudinal cohort studies. A consensus was achieved on the general recommendations to be followed in developing procedures and tools for neuropsychological assessment. The context, the target population, the cognitive/behavioural variable to evaluate and the exact clinical questions to be answered, should be considered as the main preliminary aspects to address. Validity and reliability are two main psychometric properties that must be known before using a test. Sensitivity, specificity and predictive value are particularly important in the context of NDD, to define normal vs. abnormal conditions and for the purpose of differential diagnosis. The working group particularly focused on unmet needs and provided specific recommendations on how to design studies that can provide empirical evidence for selecting between methods for diagnosis and monitoring of NDD. These issues refer to the assessment of global functions, memory, language, visual-spatial abilities, executive function, functional abilities, motor and behavioural symptoms. A central issue is represented by the lack of standardized norms for the tests to be used in the different European countries. Another important aspect is the need to improve knowledge about the sensitivity, specificity and predictive value of the currently used tools. For each single domain a consensus was also achieved on the practical recommendations of the assessment tools.

Well-Being at the Polish Polar Station, Svalbard: Adaptation to Extreme Environments

The Interconnected Arctic — UArctic Congress 2016, 2017

While the psychological well-being of Antarctic crews has been investigated previously, Arctic cr... more While the psychological well-being of Antarctic crews has been investigated previously, Arctic crews have received little attention. Antarctic stressors include the permanent darkness of polar night, cramped quarters and harsh weather conditions which demand that the crews work together to survive. These stressors are also present for Arctic crews with the addition of dangerous polar bears. In this study, these psychological stressors were explored at the Polish Polar Station, Svalbard. Nine crew members three of whom were women, took part in the study. They filled in the Profile of Mood States (POMS) and the Symptom Checklist 90-Revised (SCL-90-R) after their arrival, at equinox, during polar night, in spring and during the midnight sun. Depression and hostility were highest in the spring following the isolation of polar night. Vigor reached its lowest point in spring and remained low until mission completion. Confusion continued to decline throughout the mission. The Polish crew adapted by monitoring their feelings to work together and ensure survival. Up until and during the polar night, negative feelings were low. Following the isolation period, depression and hostility increased while vigor declined. This suggests adaptation paradigm wherein the participants stopped to monitor their own feelings as closely after the polar night. 21.1 Introduction Research in the polar social sciences has often taken one of these two approaches: research on isolated and confined environments (ICE) at Antarctic stations, and research on Arctic indigenous peoples. The doctoral research outlined in this article

Clinical Trials in Neurodegeneration

Neurodegenerative Disorders, 2016

Significant progress made over the last few decades in the management and treatment of many neuro... more Significant progress made over the last few decades in the management and treatment of many neurodegenerative diseases. However, successful translation of effective therapeutic compounds from animal models to humans has been disappointing. This chapter provides an overview of the current models of drug development and clinical trial design along with a summary of the advantages and limitations of each model. The chapter also discusses the challenges of performing clinical trials in neurodegenerative disorders, including the selection of appropriate biomarkers of disease activity and the appropriate definition of meaningful clinical outcomes, and identifies promising new approaches towards the development of efficacious disease modifying therapeutics.

Historical background

Dementia with Lewy Bodies and Parkinson’s Disease Dementia, 1988

The association between performance on a test of motor sequencing and language abilities in neurodegenerative disorders

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis

Neuropathology and Applied Neurobiology, Aug 28, 2019

Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral scle... more Neuronal clusterin expression is associated with cognitive protection in amyotrophic lateral sclerosis Aims: Clusterin is a topologically dynamic chaperone protein with the ability to participate in both intraand extacellular proteostasis. Clusterin has been shown to be upregulated in the spinal cord of patients with amyotrophic lateral sclerosis (ALS) and has been shown to protect against TDP-43 protein misfolding in animal and cell models. Previous studies have demonstrated an association between the pathological burden of TDP-43 misfolding and cognitive deficits in ALS, demonstrating high specificity, but correspondingly low sensitivity owing to a subset of individuals with no evidence of cognitive deficits despite a high burden of TDP-43 pathology, called mismatch cases. Methods: Hypothesizing that differences in the ability to cope with protein misfolding in these cases may be due to differences in expression of protective mechanisms such as clusterin expression, we assessed the spatial expression of clusterin and another chaperone protein, HspB8, in post mortem brain tissue of mismatch cases. We employed a modified in situ hybridization technique called BaseScope, with single cell, single transcript resolution. Results: Mismatch cases demonstrated differential spatial expression of clusterin, with a predominantly neuronal pattern, compared to cases with cognitive manifestations of their TDP-43 pathology who demonstrated a predominantly glial distribution of expression. Conclusions: Our data suggest that, in individuals with TDP-43 pathology, predominantly neuronal expression of clusterin in extra-motor brain regions may indicate a cell protective mechanism delaying clinical manifestations such as cognitive dysfunction.

Impairment of Visual Cognition in Progressive Multiple Sclerosis

Journal of Multiple Sclerosis, 2015

Background: Impairment of visual cognition occurs in up to 25% of patients with MS, however data ... more Background: Impairment of visual cognition occurs in up to 25% of patients with MS, however data on progressive disease is limited and the neural basis remains unknown. Objective: To evaluate the influence of multifocal inflammatory CNS white matter demyelination burden on visual cognition in equivalent SPMS and PPMS cohorts. Methods: 59 SPMS and 27 PPMS patients matched for demographic and disease characteristics were evaluated using visuospatial and visuoperceptual components of the Addenbrooke's cognitive examination-revised (ACE-R) battery. Factors influencing performance were then identified by logistic regression. Exploratory logistic models were also used to determine the predictive value of deficits in attention, working memory, and arithmetic abilities. Finally, comparison of deficits between equivalent primary (PPMS) and secondary (SPMS) progressive disease groups was used to evaluate a potential dose-response for cumulative multifocal inflammatory CNS white matter demyelination. Results: The overall prevalence of impairment in visual cognition was 14.0% (95%CI=6.4 to 21.4%) with no difference between disease groups. Qualitatively, the observed deficits in visual cognition were subtle, and patients were not able to predict them. Impairment was more common in women (OR 3.2; 95% CI=0.8 to 13.2), and subjects with a Beck depression inventory II score ≥ 25 (OR 5.2; 95% CI=1.1 to 24.2). No effect was seen for: age, years in full-time education, disease duration, clinical evidence of anterior visual pathway dysfunction, or motor disability. Exploratory analyses showed no predictive association with deficits in attention or working memory, however impairment of basic arithmetic skills was a highly significant predictor of impaired visual cognition (OR 29.4, 95% CI 3.0 to 291.9). Allowing for all significant predictors, secondary and primary progressive disease groups had equivalent rates of impairment (OR 1.6, 95% CI 0.4 to 7.1; p=0.538). Conclusions: Impairment of visual cognition in progressive MS is more common in women and patients with high levels of depressive symptomatology, but occurs independently from anterior visual pathway dysfunction and the cumulative burden of inflammatory CNS white matter demyelination. These findings suggest that the site rather than the absolute quantity of brain pathology is crucial, with the strong association observed to impairment of basic arithmetic skills implicating possible localization to the intraparietal sulcus.

Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment

Dementia and geriatric cognitive disorders, 2017

Increasing evidence suggests that life course factors such as education and bilingualism may have... more Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; ...

Chapter 1 Why the mythical “native speaker” has mud on its face

De Gruyter eBooks, Nov 8, 2021

The mythical native speaker has mud on its face

De Gruyter eBooks, Nov 8, 2021

The terms “native speaker” (NS) and “non-native speaker” (NNS) continue to be widely used in appl... more The terms “native speaker” (NS) and “non-native speaker” (NNS) continue to be widely used in applied linguistics and foreign language learning and teaching despite a growing wave of criticism about the difficulty in defining them accurately, the (neo)racist ideology they reflect and the deficit view they perpetuate among foreign language learners and teachers. These issues are explored in more detail, focusing on the history of the terms NS/NNS and their enduring perverse social consequences. We consider alternative views and explain the reasoning behind the development of a new terminology: “L1 user versus LX user” (Dewaele 2018). We conclude that the field needs to abandon the toxic terms “NS/NNS” and adopt neutral terms that emphasise the equal status of first and foreign language users – which can often be the same person

Interference suppression in bilingualism: Stimulus-Stimulus vs. Stimulus-Response conflict

Bilingualism: Language and Cognition, 2021

Studies examining the potential effects of bilingualism on interference suppression show inconsis... more Studies examining the potential effects of bilingualism on interference suppression show inconsistent results. Our study approaches this topic by distinguishing two potential subcomponents within interference suppression (i.e., Stimulus-Stimulus and Stimulus-Response conflict). We investigated the two subcomponents through their operationalisation in different tasks and examined the role of language proficiency in modulating it. A sample of 111 young adult participants performed four non-linguistic cognitive tasks measuring both visual and auditory domains of cognitive control. Bilinguals outperformed monolinguals in tasks involving Stimulus-Stimulus conflict, but showed comparable performance in tasks involving Stimulus-Response conflict. Specific effects of language proficiency on cognitive control were observed: group differences in auditory inhibition and visual orienting were only observed between high-proficient bilinguals and monolinguals. Taken together, types of conflicts i...

From Bilingualism to Bilingualisms: Bilingual experience in Edinburgh and Singapore affects attentional control differently

Bilingualism: Language and Cognition, 2018

Recent theories propose that language-switching in bilinguals influences executive control. We in... more Recent theories propose that language-switching in bilinguals influences executive control. We investigated whether switching behaviour, shaped by the bilingual's interactional context as well as personal preferences impacted attentional control. We compared four groups – (i) Edinburgh monolinguals, (ii) Edinburgh non-switching late bilinguals, (iii) Edinburgh non-switching early bilinguals, and (iv) Singapore switching early bilinguals – on two tasks of attentional control. Effects of interactional context were observed, with Singapore bilinguals performing better on conflict resolution in the Attention Network Task and Edinburgh late bilinguals on attentional switching in the Elevator reversal (Test of Everyday Attention) subtest. Our results suggest that the interactional context of bilinguals could impact attentional control differently.

Cognitive effects of Gaelic medium education on primary school children in Scotland

International Journal of Bilingual Education and Bilingualism, 2018

Research has shown that learning more than one language may have beneficial effects on executive ... more Research has shown that learning more than one language may have beneficial effects on executive functions, such as focused attention, inhibitory control, and switching between tasks. Evidence demonstrating these effects comes from studies with infants, children and adults from a range of language combinations. Much less direct evidence of such effects exists with regard to the bilingual experience of children acquiring regional minority languages. This study addresses the question of whether English-speaking children attending Gaelic Medium Education in Scotland exhibit differences of executive function compared with English-speaking children attending English Medium Education. Primary Five pupils from English-medium and Gaelic-medium schools in two Scottish towns were tested on three tasks of attentional control. One task, requiring verbal response inhibition, provided evidence of a significant positive effect for Gaelic-medium pupils. The results suggest that the cognitive effects of attending Gaelic Medium Education are specific to certain tasks and are affected by the characteristics of this particular bilingual setting (i.e. acquiring the second language in a domain-specific context with one dominant language). This supports the notion that the context of the bilingual experience is an important factor in shaping the cognitive effects which may be gained through exposure to more than one language.

The Nairobi Declaration—Reducing the burden of dementia in low‐ and middle‐income countries (LMICs): Declaration of the 2022 Symposium on Dementia and Brain Aging in LMICs

Alzheimer's & Dementia

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Learning from History-FTD, ALS and Behaviour

Rinsho Shinkeigaku, 2010

Correspondence to

A cognitive bedside assessment beyond the MMSE: the

Arctic Explorers in Their Own Words: Interviews, Mental Health & Cognition

Chapter 12. The impact of bilingualism on cognitive ageing and dementia

Studies in Bilingualism, 2017

A Mixed-Methods Approach in the Arctic Archipelago of Svalbard: Studying the Cognition, Mental Health, and Lived Experiences of Small Teams in Isolation and Confinement

The Edinburgh cognitive and behavioural ALS Screen (ECAS): The effect of age, education and IQ

Harmonization and innovation of cognitive, behavioural and functional assessment in neurodegenerative dementias

The aim of this project was to provide guidelines for harmonization and innovation of assessment ... more The aim of this project was to provide guidelines for harmonization and innovation of assessment tools to be applied to research in neurodegenerative dementias (NDD), with a special focus on longitudinal cohort studies. A consensus was achieved on the general recommendations to be followed in developing procedures and tools for neuropsychological assessment. The context, the target population, the cognitive/behavioural variable to evaluate and the exact clinical questions to be answered, should be considered as the main preliminary aspects to address. Validity and reliability are two main psychometric properties that must be known before using a test. Sensitivity, specificity and predictive value are particularly important in the context of NDD, to define normal vs. abnormal conditions and for the purpose of differential diagnosis. The working group particularly focused on unmet needs and provided specific recommendations on how to design studies that can provide empirical evidence for selecting between methods for diagnosis and monitoring of NDD. These issues refer to the assessment of global functions, memory, language, visual-spatial abilities, executive function, functional abilities, motor and behavioural symptoms. A central issue is represented by the lack of standardized norms for the tests to be used in the different European countries. Another important aspect is the need to improve knowledge about the sensitivity, specificity and predictive value of the currently used tools. For each single domain a consensus was also achieved on the practical recommendations of the assessment tools.

Well-Being at the Polish Polar Station, Svalbard: Adaptation to Extreme Environments

The Interconnected Arctic — UArctic Congress 2016, 2017

While the psychological well-being of Antarctic crews has been investigated previously, Arctic cr... more While the psychological well-being of Antarctic crews has been investigated previously, Arctic crews have received little attention. Antarctic stressors include the permanent darkness of polar night, cramped quarters and harsh weather conditions which demand that the crews work together to survive. These stressors are also present for Arctic crews with the addition of dangerous polar bears. In this study, these psychological stressors were explored at the Polish Polar Station, Svalbard. Nine crew members three of whom were women, took part in the study. They filled in the Profile of Mood States (POMS) and the Symptom Checklist 90-Revised (SCL-90-R) after their arrival, at equinox, during polar night, in spring and during the midnight sun. Depression and hostility were highest in the spring following the isolation of polar night. Vigor reached its lowest point in spring and remained low until mission completion. Confusion continued to decline throughout the mission. The Polish crew adapted by monitoring their feelings to work together and ensure survival. Up until and during the polar night, negative feelings were low. Following the isolation period, depression and hostility increased while vigor declined. This suggests adaptation paradigm wherein the participants stopped to monitor their own feelings as closely after the polar night. 21.1 Introduction Research in the polar social sciences has often taken one of these two approaches: research on isolated and confined environments (ICE) at Antarctic stations, and research on Arctic indigenous peoples. The doctoral research outlined in this article

Clinical Trials in Neurodegeneration

Neurodegenerative Disorders, 2016

Significant progress made over the last few decades in the management and treatment of many neuro... more Significant progress made over the last few decades in the management and treatment of many neurodegenerative diseases. However, successful translation of effective therapeutic compounds from animal models to humans has been disappointing. This chapter provides an overview of the current models of drug development and clinical trial design along with a summary of the advantages and limitations of each model. The chapter also discusses the challenges of performing clinical trials in neurodegenerative disorders, including the selection of appropriate biomarkers of disease activity and the appropriate definition of meaningful clinical outcomes, and identifies promising new approaches towards the development of efficacious disease modifying therapeutics.

Historical background

Dementia with Lewy Bodies and Parkinson’s Disease Dementia, 1988