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Nygren, Ingela
Publications (10 of 14) Show all publications
Feresiadou, A., Nilsson, K., Ingelsson, M., Press, R., Kmezic, I., Nygren, I., . . . Burman, J. (2019). Measurement of sCD27 in the cerebrospinal fluid identifies patients with neuroinflammatory disease. Journal of Neuroimmunology, 332, 31-36
Open this publication in new window or tab >>Measurement of sCD27 in the cerebrospinal fluid identifies patients with neuroinflammatory disease
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2019 (English)In: Journal of Neuroimmunology, ISSN 0165-5728, E-ISSN 1872-8421, Vol. 332, p. 31-36Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Laboratory tests to assist in the diagnosis and monitoring of neuroinflammatory diseases are scarce. The soluble form of the CD27 molecule (sCD27) is shed in high concentrations by activated T cells and can be detected in the cerebrospinal fluid. The aim of this study was to investigate whether CSF quantitation of sCD27 could discriminate between inflammatory and non-inflammatory neurological diseases.

METHODS: The concentration of sCD27 was measured using a commercially available ELISA in 803 well-defined subjects from a study cohort comprised of 338 patients with neuroinflammatory disease, 338 with non-inflammatory neurological disease and 127 controls without neurological disease.

RESULTS: The median value of cerebrospinal fluid sCD27 was 64 pg/mL (IQR 0-200) in controls, 58 pg/mL (IQR 0-130) in patients with non-inflammatory disease and 740 pg/mL (IQR 230-1800) in patients with inflammatory disease. The likelihood ratio of having an inflammatory disease was 10 (sensitivity 74% and specificity 93%) if the sCD27 concentration was >250 pg/mL. In patients with a known inflammatory condition, the likelihood ratio of having an infection was 10 (sensitivity 40% and specificity 96%) if the sCD27 concentration was >2500 pg/mL.

CONCLUSIONS: The likelihood of having an inflammatory neurological condition is increased with elevated concentrations of sCD27 in cerebrospinal fluid. Rapid tests of sCD27 should be developed to assist clinicians in diagnosis of neuroinflammatory disease.

National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-381319 (URN)10.1016/j.jneuroim.2019.03.015 (DOI)000470940600004 ()30928869 (PubMedID)
Available from: 2019-04-26 Created: 2019-04-26 Last updated: 2020-01-08
Jakobsson Larsson, B., Ozanne, A. G., Nordin, K. & Nygren, I. (2017). A prospective study of quality of life in amyotrophic lateral sclerosis patients. Acta Neurologica Scandinavica, 136(6), 631-638
Open this publication in new window or tab >>A prospective study of quality of life in amyotrophic lateral sclerosis patients
2017 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 136, no 6, p. 631-638Article in journal (Refereed) Published
Abstract [en]

OBJECTS: The aim of this prospective and longitudinal study was to describe individual quality of life in patients with amyotrophic lateral sclerosis (ALS) and its correlations with physical function and emotional well-being from diagnosis and over time.

MATERIALS AND METHODS: Thirty-six patients were included in the study. Individual quality of life was measured with the Schedule of Evaluation of Individual Quality of Life-Direct Weighting (SEIQoL-DW), illness severity was assessed using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALS FRS-R), and emotional distress was measured using the Hospital Anxiety and Depression Scale (HADS). Data were collected from diagnosis and thereafter, every six months for a period of two years. Twelve patients completed the 24-month follow-up.

RESULTS: Family, friends and own physical health were important for overall quality of life, from diagnosis and during the disease progression. Most patients had good quality of life, which remained stable, despite changed physical functions. Several patients scored above the cut-off score for doubtful and clinical anxiety and depression early on after diagnosis, and there was a significant decrease in anxiety over time. Soon after diagnosis, there was a correlation between depression and quality of life.

CONCLUSION: The family, social relations and own physical health are important for overall quality of life in patients with ALS. Thus, supporting the family and facilitating so that patients can continue to stay in contact with friends are important aspects during the disease. Conducting an early screening for depression can be important for preventing decreased quality of life.

Keywords
amyotrophic lateral sclerosis, emotional well-being, physical function, quality of life
National Category
Clinical Medicine
Identifiers
urn:nbn:se:uu:diva-327077 (URN)10.1111/ane.12774 (DOI)000414488000007 ()28523721 (PubMedID)
Available from: 2017-08-02 Created: 2017-08-02 Last updated: 2018-02-19Bibliographically approved
Al-Chalabi, A., Andersen, P. M., Chandran, S., Chio, A., Corcia, P., Couratier, P., . . . van den Berg, L. H. (2017). July 2017 ENCALS statement on edaravone. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 18(7-8), 471-474
Open this publication in new window or tab >>July 2017 ENCALS statement on edaravone
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2017 (English)In: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, ISSN 2167-8421, E-ISSN 2167-9223, Vol. 18, no 7-8, p. 471-474Article in journal (Other academic) Published
National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-343156 (URN)10.1080/21678421.2017.1369125 (DOI)000415817900001 ()28975816 (PubMedID)
Available from: 2018-02-26 Created: 2018-02-26 Last updated: 2018-02-26Bibliographically approved
Jakobsson Larsson, B., Nordin, K. & Nygren, I. (2016). Coping with amyotrophic lateral sclerosis; from diagnosis and during disease progression. Journal of the Neurological Sciences, 361, 235-242
Open this publication in new window or tab >>Coping with amyotrophic lateral sclerosis; from diagnosis and during disease progression
2016 (English)In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 361, p. 235-242Article in journal (Refereed) Published
Abstract [en]

To evaluate coping strategies among patients with Amyotrophic lateral sclerosis starting with diagnosis and during the disease progression, as well as investigate changes and correlations between coping strategies, emotional well-being and physical function. A total of 36 patients participated in the study. The patients filled out the Hospital Anxiety and Depression Scale and the Motor Neuron Disease Coping Scale. Physical function was measured using the revised ALS functional rating scale. Data were collected regularly from diagnosis and over a two years period. As a way to cope with the disease patients relied on both problem focused and emotional focused strategies. The use of coping strategies remained stable. Both physical disabilities and emotional well-being was related to some coping strategies, with some variation during the disease progression. Moreover, some coping strategies were related to symptoms of anxiety and depression. Irrespective of whether the coping strategies affect the emotional well-being or vice versa, the results show the importance of early and continuous evaluation of coping and emotional well-being to ease the emotional distress and provide support to the patient so that he/she can cope with the disease during the disease progression.

National Category
Neurosciences
Identifiers
urn:nbn:se:uu:diva-275272 (URN)10.1016/j.jns.2015.12.042 (DOI)000370093400044 ()26810549 (PubMedID)
Available from: 2016-02-02 Created: 2016-02-02 Last updated: 2018-01-10Bibliographically approved
Larsson, B. J., Fröjd, C., Nordin, K. & Nygren, I. (2015). Relatives of patients with amyotrophic lateral sclerosis: Their experience of care and support. Palliative & Supportive Care, 13(6), 1569-1577
Open this publication in new window or tab >>Relatives of patients with amyotrophic lateral sclerosis: Their experience of care and support
2015 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 6, p. 1569-1577Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The purpose of this study was to describe relatives' experience of patient care and the support they themselves received during the course of disease progression.

METHOD: A total of 15 relatives were included from two neurology clinics in Sweden: 7 wives, 4 husbands, and 4 daughters. Data were collected through qualitative interviews 6 to 12 months after the patient had died. Content analysis was performed to analyze the interviews.

RESULT: The results showed that patient care was experienced as positive and as being based on the patient's needs and desires. Treatment from the staff, support and help, knowledge, availability, and continuity among the team were important reasons for the relations to feel secure. In addition, support for relatives was available, but different factors influenced its use. Most relatives did not think about their own needs but focused on the patient.

SIGNIFICANCE OF RESULTS: It is important that care and support for both patients and relatives be based on individual needs. The staff members responsible for providing this care and support must have knowledge and experience of the disease and its specific care. If they do not belong to an ALS (amyotrophic lateral sclerosis) team, they may require further education and support. The relatives focus on the patient's situation and do not think of their own needs. It is therefore important that health professionals be observant of the relatives and offer them help and support to better manage their situation.

Keywords
Amyotrophic lateral sclerosis; Palliative care; Care; Support; Relatives
National Category
Nursing
Identifiers
urn:nbn:se:uu:diva-256591 (URN)10.1017/S1478951515000188 (DOI)000365665500008 ()25772516 (PubMedID)
Available from: 2015-06-24 Created: 2015-06-24 Last updated: 2017-12-04Bibliographically approved
Elf, K., Shevchenko, G., Nygren, I., Larsson, L., Bergquist, J., Askmark, H. & Artemenko, K. (2014). Alterations in muscle proteome of patients diagnosed with amyotrophic lateral sclerosis. Journal of Proteomics, 108, 55-64
Open this publication in new window or tab >>Alterations in muscle proteome of patients diagnosed with amyotrophic lateral sclerosis
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2014 (English)In: Journal of Proteomics, ISSN 1874-3919, E-ISSN 1876-7737, Vol. 108, p. 55-64Article in journal (Refereed) Published
Abstract [en]

Amyotrophic lateral sclerosis (ALS) is a motor neuron disease characterized by progressive muscle paralysis. Currently clinical tools for ALS diagnostics do not perform well enough and their improvement is needed. The objective of this study was to identify specific protein alterations related to the development of ALS using tiny muscle biopsies. We applied a shotgun proteomics and quantitative dimethyl labeling in order to analyze the global changes in human skeletal muscle proteome of ALS versus healthy subjects for the first time. 235 proteins were quantified and 11 proteins were found significantly regulated in ALS muscles. These proteins are involved in muscle development and contraction, metabolic processes, enzyme activity, regulation of apoptosis and transport activity. In order to eliminate a risk to confuse ALS with other denervations, muscle biopsies of patients with postpolio syndrome and Charcot Marie Tooth disease (negative controls) were compared to those of ALS and controls. Only few proteins significantly regulated in ALS patients compared to controls were affected differently in negative controls. These proteins (BTB and kelch domain-containing protein 10, myosin light chain 3, glycogen debranching enzyme, transitional endoplasmic reticulum ATPase), individually or as a panel, could be selected for estimation of ALS diagnosis and development. Biological significance ALS is a devastating neurodegenerative disease, and luckily, very rare: only one to two people out of 100,000 develop ALS yearly. This fact, however, makes studies of ALS very challenging since it is very difficult to collect the representative set of clinical samples and this may take up to several years. In this study we collected the muscle biopsies from 12 ALS patients and compared the ALS muscle proteome against the one from control subjects. We suggested the efficient method for such comprehensive quantitative analysis by LC-MS and performed it for the first time using human ALS material. This gel- and antibody-free method can be widely applied for muscle proteome studies and has been used by us for revealing of the specific protein alterations associated with ALS.

Keywords
Amyotrophic lateral sclerosis (ALS), Dimethyl labeling quantitative proteomics, Mass spectrometry (MS), Muscle biopsy
National Category
Biochemistry and Molecular Biology
Identifiers
urn:nbn:se:uu:diva-230939 (URN)10.1016/j.jprot.2014.05.004 (DOI)000340315400004 ()
Available from: 2014-09-04 Created: 2014-09-01 Last updated: 2017-12-05Bibliographically approved
Jakobsson Larsson, B., Nordin, K., Askmark, H. & Nygren, I. (2014). Coping strategies among patients with newly diagnosed amyotrophic lateral sclerosis. Journal of Clinical Nursing, 23(21-22), 3148-3155
Open this publication in new window or tab >>Coping strategies among patients with newly diagnosed amyotrophic lateral sclerosis
2014 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 21-22, p. 3148-3155Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To prospectively identify different coping strategies among newly diagnosed amyotrophic lateral sclerosis patients and whether they change over time and to determine whether physical function, psychological well-being, age and gender correlated with the use of different coping strategies.

BACKGROUND: Amyotrophic lateral sclerosis is a fatal disease with impact on both physical function and psychological well-being. Different coping strategies are used to manage symptoms and disease progression, but knowledge about coping in newly diagnosed amyotrophic lateral sclerosis patients is scarce.

DESIGN: This was a prospective study with a longitudinal and descriptive design.

METHODS: A total of 33 patients were included and evaluation was made at two time points, one to three months and six months after diagnosis. Patients were asked to complete the Motor Neuron Disease Coping Scale and the Hospital Anxiety and Depression Scale. Physical function was estimated using the revised Amyotrophic Lateral Sclerosis Functional Rating Scale.

RESULTS: The most commonly used strategies were support and independence. Avoidance/venting and information seeking were seldom used at both time points. The use of information seeking decreased between the two time points. Men did not differ from women, but patients ≤64 years used positive action more often than older patients. Amyotrophic Lateral Sclerosis Functional Rating Scale was positively correlated with positive action at time point 1, but not at time point 2. Patients' psychological well-being was correlated with the use of different coping strategies.

CONCLUSIONS: Support and independence were the most used coping strategies, and the use of different strategies changed over time. Psychological well-being was correlated with different coping strategies in newly diagnosed amyotrophic lateral sclerosis patients.

RELEVANCE TO CLINICAL PRACTICE: The knowledge about coping strategies in early stage of the disease may help the nurses to improve and develop the care and support for these patients.

National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-219767 (URN)10.1111/jocn.12557 (DOI)000343835300016 ()24476534 (PubMedID)
Available from: 2014-03-11 Created: 2014-03-05 Last updated: 2017-12-05Bibliographically approved
Feresiadou, A., Eriksson, U., Larsen, H.-C., Raininko, R., Nygren, I. & Melberg, A. (2014). Recurrence of Susac Syndrome following 23 Years of Remission. Case Reports in Neurology, 6(2), 171-175
Open this publication in new window or tab >>Recurrence of Susac Syndrome following 23 Years of Remission
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2014 (English)In: Case Reports in Neurology, ISSN 1662-680X, E-ISSN 1662-680X, Vol. 6, no 2, p. 171-175Article in journal (Refereed) Published
Abstract [en]

Susac syndrome is an autoimmune microangiopathy affecting the brain, retina and inner ear (cochlea and semicircular canals), leading to encephalopathy, branch retinal artery occlusions (BRAOs) and asymmetric neurosensory hearing loss, respectively. The natural history and long-term prognosis are variable as the disease has been shown to be monophasic and self-limiting, polycyclic or chronic continuous. We describe a 35-year-old woman who presented with a sudden hearing loss in the left ear in the 37th week of her second pregnancy. She subsequently developed BRAO in the right eye 2.5 months after having given birth. MRI findings included round lesions in the corpus callosum which are pathognomonic for Susac syndrome. Previous patient records documented encephalopathy, sudden deafness of the right ear and visual field defects in the left eye at the age of 12, followed by permanent hearing and visual defects. We expand on the variability in the course of Susac syndrome as recurrence may occur after as long as 23 years. Cases of monophasic self-limiting Susac syndrome may in fact turn polycyclic with an interval of more than 2 decades between the bouts of the disease. In these cases, suspecting the development of exacerbation early is important in order to start the treatment promptly.

National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-231588 (URN)10.1159/000362868 (DOI)24987361 (PubMedID)
Available from: 2014-09-09 Created: 2014-09-09 Last updated: 2017-12-05Bibliographically approved
Elf, K., Askmark, H., Nygren, I. & Punga, A. R. (2014). Vitamin D deficiency in patients with primary immune-mediated peripheral neuropathies. Journal of the Neurological Sciences, 345(1-2), 184-188
Open this publication in new window or tab >>Vitamin D deficiency in patients with primary immune-mediated peripheral neuropathies
2014 (English)In: Journal of the Neurological Sciences, ISSN 0022-510X, E-ISSN 1878-5883, Vol. 345, no 1-2, p. 184-188Article in journal (Refereed) Published
Abstract [en]

PURPOSE: T cells are important in the immunopathology of immune-mediated peripheral neuropathies (PNP) and activated vitamin D regulates the immune response through increasing the amount of regulatory T cells. An association between vitamin D deficiency and polyneuropathy has been stipulated; hence we assessed whether patients with primary immune-mediated PNP have low vitamin D [25(OH)D] levels.

METHODS: Plasma levels of 25(OH)D were analyzed in 26 patients with primary immune-mediated PNP, 50 healthy matched blood donors and 24 patients with motor neuron disease (MND). INCAT score was assessed in patients with Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy. ALSFRS-R score was applied to MND patients and the modified Rankin (mRankin) scale compared disability among patient groups.

RESULTS: Mean 25(OH)D value in PNP patients was 40±16nmol/l, compared to 69±21nmol/l in healthy blood donors (p<0.001). MND patients had a higher mean 25(OH)D than PNP patients (59±26nmol/L; p=0.006) and comparable levels to healthy blood donors (p=0.15). Mean 25(OH)D value was not higher in PNP patients with pre-existing vitamin D3 supplementation of 800IU/day (N=6; 35±18nmol/L) than in unsupplemented PNP patients (42±16nmol). INCAT score ranged from 0 to 10 (mean 3.5) and ALSFRS-R ranged from 11 to 44 (mean 31). mRankin score was more severe in MND patients (mean 3.5) compared to PNP patients (mean 2.1).

CONCLUSIONS: All patients with primary immune-mediated PNP were diagnosed with vitamin D deficiency and they had significantly lower 25(OH)D values than healthy control persons and MND patients. We suggest monitoring of vitamin D status in patients with autoimmune PNP, since immune cells are responsive to the ameliorative effects of vitamin D.

National Category
Neurology
Identifiers
urn:nbn:se:uu:diva-230891 (URN)10.1016/j.jns.2014.07.040 (DOI)000343689600030 ()25115500 (PubMedID)
Available from: 2014-09-01 Created: 2014-09-01 Last updated: 2017-12-05Bibliographically approved
Mattsson, P., Lönnstedt, I., Nygren, I. & Askmark, H. (2012). Physical fitness, but not muscle strength, is a risk factor for death in amyotrophic lateral sclerosis at an early age. Journal of Neurology, Neurosurgery and Psychiatry, 83(4), 390-394
Open this publication in new window or tab >>Physical fitness, but not muscle strength, is a risk factor for death in amyotrophic lateral sclerosis at an early age
2012 (English)In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 83, no 4, p. 390-394Article in journal (Refereed) Published
Abstract [en]

Background Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disorder mainly characterised by motor symptoms. Extensive physical activity has been implicated in the aetiology of ALS. Differences in anthropometrics, physical fitness and isometric strength measured at 18-19 years were assessed to determine if they are associated with subsequent death in ALS. Method Data on body weight and height, physical fitness, resting heart rate and isometric strength measured at conscription were linked with data on death certificates in men born in 1951-1965 in Sweden (n=809 789). Physical fitness was assessed as a maximal test on an electrically braked bicycle ergometer. Muscle strength was measured as the maximal isometric strength in handgrip, elbow flexion and knee extension in standardised positions, using a dynamometer. Analyses were based on 684 459 (84.5%) men because of missing data. A matched case control study within this sample was performed. The population was followed until 31 December 2006, and 85 men died from ALS during this period. Results Weight adjusted physical fitness (W/kg), but not physical fitness per se, was a risk factor for ALS (OR 1.98, 95% CI 1.32 to 2.97), whereas resting pulse rate, muscle strength and other variables were not. Conclusions Physical fitness, but not muscle strength, is a risk factor for death at early age in ALS. This may indicate that a common factor underlies both fitness (W/kg) and risk of ALS.

National Category
Medical and Health Sciences
Research subject
Neurology
Identifiers
urn:nbn:se:uu:diva-139500 (URN)10.1136/jnnp.2010.218982 (DOI)000301296600012 ()20852312 (PubMedID)
Available from: 2010-12-27 Created: 2010-12-27 Last updated: 2017-12-11Bibliographically approved
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