Eugene Lai

Publications of Eugene Lai

• Cognitive rehabilitation for executive dysfunction in Parkinson's disease: application and current directions.

  Authors: Jessica Calleo, Cristina Burrows, Harvey Levin, Laura Marsh, Eugene Lai, Michele K York

  Parkinson's disease. 01/2012; 2012:512892.

  Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills,Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits.

• Through with the looking glass: Escape responses to implicit mirror exposure.

  Authors: Christopher T Burris, Eugene Lai

  Consciousness and cognition. 12/2011; 21(1):464-70.

  Based on the assumption that confrontation with one's physical reflection can be aversive, we explored the appeal of possible "escape routes" when incidentally exposed to one's mirror image. ComparedBased on the assumption that confrontation with one's physical reflection can be aversive, we explored the appeal of possible "escape routes" when incidentally exposed to one's mirror image. Compared to their no-exposure peers, individuals who felt less chronically "trapped" in their bodies showed increased interest in flow experiences and decreased interest in experiences involving low-level thinking or a subjective sense of meaning when exposed to their reflection. Mirror exposure also increased overall interest in "pure consciousness events," wherein the transcendence of space and time figures centrally. The aversive effects of even implicit confrontation with one's reflection therefore seem more diverse than anticipated based on existing frameworks such as Objective Self-Awareness theory, so additional theoretical development seems warranted.

• Evaluation of a new device to prevent falls in persons with Parkinson's disease.

  Authors: Mon Bryant, Diana Rintala, Eugene Lai, Mary Raines, Elizabeth Protas

  Disability and rehabilitation. Assistive technology. 07/2009;

  Purpose. To compare walking characteristics of individuals with Parkinson's disease (PD) using a new walking aid, the WalkAbout, with usual walking. Method. Fifteen subjects with PD were recruited.Purpose. To compare walking characteristics of individuals with Parkinson's disease (PD) using a new walking aid, the WalkAbout, with usual walking. Method. Fifteen subjects with PD were recruited. Subjects walked in their usual fashion and then walked again in the WalkAbout. Gait parameters, 5-min walk, and oxygen consumption were recorded. Results. Stride lengths were shorter when using the WalkAbout. On an average, the distance walked in 5 min and the oxygen uptake was not different when walking with the WalkAbout compared with the usual walk. Eight subjects (responders) walked further with the WalkAbout compared to their usual walk (164.90 +/- 55.72 m vs. 140.82 +/- 55.94 m). Seven subjects (non-responders) walked a shorter distance while using the WalkAbout compared to their usual walk (241.79 +/- 73.06 m vs. 281.24 +/- 82.83 m). Compared to non-responders, responders were older, had more severe disability, and were more likely to use an assistive device for walking. Responders walked more slowly, had a shorter stride length, and walked shorter distances in 5 min than non-responders. Conclusion. The WalkAbout may help persons with PD who have more severe disability to walk farther. These data could be beneficial in selecting a helpful walking aid for persons with PD.

• Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson's Disease.

  Authors: Connie Veazey, Karon Cook, Melinda Stanley, Eugene Lai, Mark Kunik

  Journal of clinical psychology in medical settings. 05/2009;

  Parkinson's disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications isParkinson's disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD.

• Identifying incident cases of parkinsonism among veterans using a tertiary medical center.

  Authors: Donna White, Suzanne Moore, Stephen Waring, Karon Cook, Eugene Lai

  Movement disorders : official journal of the Movement Disorder Society. 05/2007; 22(7):915-23.

  To better understand the impact of incident Parkinson's disease (PD) on the Veteran's Health Administration (VHA) and to develop methods applicable to future epidemiological research, we performed aTo better understand the impact of incident Parkinson's disease (PD) on the Veteran's Health Administration (VHA) and to develop methods applicable to future epidemiological research, we performed a medical record review study at a tertiary referral VHA medical center. Searching the local data base, we identified 782 veterans with diagnostic codes for PD or secondary parkinsonism (SP) between 1998 and 2000. Based on structured medical record review, a movement disorders specialist confirmed diagnoses for incident parkinsonism cases. Among the 782, 191 incident parkinsonism cases were identified (100 PD, 75 SP, and 16 Parkinson's Plus). Incident PD cases were older at diagnosis (74.5 vs. 70.4 yr; P < 0.05) and more likely to be white (81% vs. 62; P < 0.07) than incident SP cases. Diagnostic codes were insufficient to distinguish between incident PD and SP (positive predictive value, 57% and 39%, respectively), and VHA sources failed to identify 21% of confirmed deaths among the incident PD cohort by November 2004. Although the large number of incident cases identified suggests PD is an important cause of disability among elderly VHA users, observed limitations of VHA sources for identifying incident PD cases and determining their vital status should be considered when designing future studies.