Effects of Cha-Cha dance training on fall-related physical performance and cognitive function in patients with Parkinson's disease: A feasibility study.

Previous studies demonstrate that the difference between motor imagery and actual tasks (estimation error) is related to cognitive and physical functions and that a large estimation error (LE) is related to motor imagery ability, including cognitive and physical functions in healthy subjects. The purpose of this study investigated whether estimation error is related to physical and cognitive function in patients with stroke. The study included 60 patients with stroke. The Timed Up and Go Test (TUGT) was employed to assess estimation error. First, the imagined TUGT (iTUGT) was performed; thereafter, the actual TUGT was performed. The estimation error was calculated by subtracting TUGT from iTUGT, with conversion to the absolute value. The patients were classified into the small estimation error (SE) and LE groups, with comparisons of various clinical scores (Mini-Mental State Examination, Berg Balance Scale, 10-m walking speed, Brunnstrom Recovery Stage, and Functional Independence Measure). As a result, the estimation error was significantly larger in the LE group than in the SE group. Cognitive function and balance ability were significantly lower in the LE group than in the SE group. In conclusion, the estimation error was related to physical and cognitive functions in patients with stroke.

This study aimed to investigate the association between sarcopenia and cognitive function in Chinese patients with Parkinson's disease (PD). This cross-sectional study included 148 patients with PD aged 60 years or older. Sarcopenia, nutritional status, and cognitive functioning were assessed using the 2019 Asian sarcopenia guidelines, the Mini Nutritional Assessment (MNA) scale, and the Montreal Cognitive Assessment (MoCA) scale, respectively. The relationship between sarcopenia and cognitive functioning was examined using multivariable logistic regression, receiver operating characteristic (ROC) analysis, and threshold effect analysis to identify the inflection point. Additionally, mediation analysis was performed to examine potential mediating variables. Subgroup analyses were also conducted to assess the robustness of the results across different populations. In the fully adjusted model, higher MoCA scores were significantly associated with lower odds of sarcopenia (OR = 0.78, 95% CI: 0.69-0.88, p = 0.0001), whereas higher Hamilton Anxiety Inventory (HAMA) scores (OR = 1.11, 95% CI: 1.02-1.21, p = 0.0133) and Hamilton Depression Inventory (HAMD) scores (OR = 1.16, 95% CI: 1.06-1.27, p = 0.0011) were significantly associated with higher odds of sarcopenia. This association was more pronounced in older participants and those with higher HAMA scores. In addition, the multivariable model adjusted for age, gender, BMI, and MoCA showed better discriminative ability for sarcopenia than MoCA alone (AUC: 0.828vs. 0.778). E-value analysis suggested that the observed association was relatively robust to potential unmeasured confounding. Lower MoCA scores were independently associated with higher odds of sarcopenia in patients with PD. This association was more pronounced in older participants and those with higher anxiety scores. These findings suggest that cognitive assessment may help identify PD patients at increased likelihood of sarcopenia.

Postural instability and gait disorder and cognitive dysfunction are common symptoms of Parkinson's disease (PD). Scale assessment is frequently used in the clinic to evaluate PD, but this technique is limited by its lack of sensitivity to changes in disease progression and its difficulty in capturing subtle movements and changes in cognitive function. It is currently believed that high-frequency repetitive transcranial magnetic stimulation (rTMS) can improve motor and cognitive dysfunction in patients with PD, though it remains controversial. Therefore, it is imperative to monitor and dynamically identify changes in postural instability and gait disorder, as well as those in cognitive dysfunction, in PD to develop targeted interventions. In this study, we observed the effect of high-frequency rTMS on gait disorders and cognitive functions in patients with PD by comparing data from wearable devices and eye-tracking devices before and after treatment. A total of 159 patients with PD were included in this study. A GYENNO MATRIX wearable gait analyzer was used to monitor the objective gait data (including the timed up-and-go, narrow-track, and turning tests), the Eyeknow eye-tracking evaluation system was used to monitor the patient's eye movement cognition data (including the smooth pursuit, pro-saccade, and anti-saccade tests), and gait and cognitive function-related scales, including the Tinetti Balance Scale, Tinetti Gait Scale, Berg Balance Scale, Mini-Mental State Examination, and Montreal Cognitive Assessment (MoCA), were evaluated at the same time before and after high-frequency rTMS treatment. The mean step length, mean stride velocity, stride length, and mean step frequency of patients with PD in the timed up-and-go test all increased compared with those before rTMS treatment, whereas the mean stride time and double support decreased. In the narrow-track test, the mean stride velocity increased and the mean stride time decreased. In the turning test, the turning left duration, turning right duration, mean duration, mean number of steps, and average step duration decreased, while the mean angular velocity increased after rTMS treatment. Compared with those before rTMS treatment, the latency period of patients with PD in overlapping saccades decreased, the completion time of overlapping saccades decreased, and the average saccade speed increased. In the anti-saccade test, the completion time decreased and the average saccade speed increased after rTMS treatment. Compared with those before rTMS treatment, the Tinetti Balance Scale, Tinetti Gait Scale, Berg Balance Scale, Mini-Mental State Examination, and MoCA scores increased, and the MoCA sub-items improved in terms of visual-spatial and executive function, language, abstraction, delayed recall, and orientation after rTMS treatment. High-frequency rTMS may be an effective therapy for improving gait disorders and cognitive functions in patients with PD.

Background Evidence regarding the relationship between body mass index (BMI) and cognitive function was limited. Therefore, the objective of this research is to investigate whether BMI is independently related to cognitive function in Chinese patients with atrial fibrillation after adjusting for other covariates. Methods The present study is a cross-sectional study. A total of 281 patients with atrial fibrillation who were hospitalized at the Affiliated Hospital of Jining Medical University in Shandong Province from January 2021 to November 2021 were included in the study. The target independent variable and the dependent variable were BMI and cognitive function in patients with atrial fibrillation, respectively. The patients' general information, BMI, past history, medication history, and other disease-related data were collected. The Montreal cognitive assessment scale (MoCA) was used to evaluate cognitive function. Results A total of 244 patients with atrial fibrillation were collected in this study, with an average age of (67.28 ± 10.33) years, of whom 55.3% were male. The average BMI was (25.33 ± 4.27) kg/m2, and the average cognitive function score was (19.25 ± 6.88) points. The results of the smooth curve fitting and threshold effect tests showed that there was a curve correlation between BMI and cognitive function score, and its inflection point was 24.56 kg/m2. To the left of the inflection point, the relationship was significant; the effect size and the confidence interval were 0.43 and 0.01–0.85, respectively. To the right of the inflection point, there was no significant correlation between BMI and cognitive function (P=0.152). Conclusion When BMI is lower than 24.56 kg/m2, the cognitive function score increases by 0.43 points for each unit increase in BMI in patients with atrial fibrillation. An increase in BMI at this time is a protective factor for cognitive function. Within the normal range of BMI, the higher the BMI in atrial fibrillation patients, the higher the cognitive function score. We encourage atrial fibrillation patients with normal BMI to maintain their current weight.

Objective: To study the relationship between emotional apathy and motor symptoms, sleep, and cognitive function in patients with early Parkinson's disease (PD). Methods: One hundred and twenty-nine early PD patients who were treated in the Second Affiliated Hospital of Soochow University from June to October 2020 were included, including 82 male and 47 female patients. The emotional apathy was assessed by modified apathy rating scale (MAES). The above 129 patients were divided into 67 patients in the PD with emotional apathy group (MAES>14 points) and 62 patients in the PD without emotional apathy group (MAES≤ 14 points). Age, gender, course of disease and levodopa equivalent dose were also collected. Hoehn-Yahr stage and unified Parkinson's disease rating scale PartⅢ(UPDRS-Ⅲ), Pittsburgh Sleep Quality Index (PSQI), polysomnography, and Montreal Cognitive Assessment Scale (MoCA) were used to evaluate the motor symptoms, sleep and cognitive functions of patients with early PD, and the clinical characteristics of patients with early PD with apathywere determined. Results: Compared with PD patients without apathy, those with apathy had longer disease duration [M(Q1,Q3)][5.0 (3.0, 7.0) years vs 3.0 (2.0, 5.0) years, P=0.006] and severer motor symptoms [20.0 (10.0, 28.0) vs 14.0 (8.5, 23.0), P=0.047]. There was no significant difference in PSQI score between the two groups. Among the 33 patients who completed polysomnography, compared with PD patients without apathy (n=16), those with apathy (n=17) had a longer rapid eye movement (REM) sleep latency [150 (124, 184) min vs 87 (57, 133) min, P=0.035)] and more frequent periodic limb movements in the REM phase(P=0.042).The REM sleep ratio (r=0.373, P=0.042), apnea-hypopena index (AHI)(r=0.374, P=0.046) and oxygen deficit index (r=0.409, P=0.025) were positively correlated with the degree of apathy in PD patients. PD patients with apathy had relatively poorer performance in cognition assessment than those without apathy and total MoCA score was inversely correlated with the degree of apathy (r=-0.231, P=0.017). Conclusion: Early PD patients with apathy have objective sleep disorders dominated by REM sleep disorders, which can have a negative impact on cognitive function.

To investigate the bidirectional relationship between depression and activities of daily living (ADL) in Parkinson's disease (PD) patients and explore the mediating role of cognitive function over time. Data from 892 PD patients from the Parkinson's Progression Markers Initiative (PPMI) database were included in this study, and depression, cognitive function, and ADL were measured using the Geriatric Depression Scale (GDS-15), Montreal Cognitive Assessment Scale (MoCA), and Unified Parkinson's Disease Rating Scale, Part II (UPDRS II) respectively. The cross-lagged panel model (CLPM) was employed to analyze the reciprocal relationship between depression and ADL. Then, we explored the mediating role of cognitive function in the bidirectional relationship between depression and ADL in patients with PD, and the mediation effect test was carried out using a bias-corrected nonparametric percentile bootstrap approach. Depression in patients with PD predicted their subsequent ADL (β = 0.079, p < 0.01), and ADL also predicted their subsequent depression (β = 0.069, p < 0.05), In addition, Bootstrap analysis showed that cognitive function played a significant mediating role in prediction of depression to ADL in patients with PD (β = 0.006, p = 0.074, 95%CI = 0.001 ~ 0.014), and cognitive function also played a significant mediating role in prediction of depression to ADL (β = 0.006, p = 0.067, 95%CI = 0.001 ~ 0.013). There is a bidirectional relationship between depression and ADL in patients with PD. Furthermore, we found that cognitive function mediates the relationship that exists between depression and ADL in patients with PD. Interventions aimed at enhancing cognitive function could potentially lessen the vicious cycle of depression and ADL in PD, thus improving patient quality of life (QOL).

Objective To investigate the change and its related risk factors of cognitive function of patients with Parkinson's disease(PD). Methods The cognitive function of 70 idiopathic PD patients were assessed with Montreal cognitive assessment scale (MoCA), and other PD related neuropsychological test batteries were used to evaluate their movement symptoms and non-movement symptoms such as depression and anxiety.Patients’ personal information were collected at the same time. They were reassessed after 2 years. Results As the disease progressed, the MoCA score of the PD patients significantly reduced from (24.79±4.07) points to (21.69±5.22) points (P<0.01). Seven subdomains of MoCA were attenuated, and 5 of them reached statistical significance. Motor subtype was a main predictor of the outcome of the cognitive impairment in PD. Scores of MoCA total score, naming, language, abstract and directional domains reduced more notably in patients with postural instability gait difficulty(PIGD) than those in the tremor dominant(TD) patients. Conclusion Cognitive function of PD patients decreases obviously after 2 years. The patients' cognitive impairment should be identified and intervened as soon as possible, especially the patients with PIGD. Key words: Parkinson's disease; Cognitive impairment; Follow-up; MoCA

Objective To investigate the correlation between the expression of microRNA-16, mircoRNA-124 and mircoRNA-195 in peripheral blood of schizophrenic patients and their cognitive and social functions. Methods From January 2016 to December 2018, 112 schizophrenic patients admitted to the Second People's Hospital of Taizhou were selected as observation group, and 93 healthy examinees from the Second People's Hospital of Taizhou were selected as control group.The expression of mircoRNA-16, mircoRNA 124 and mircoRNA 195 in peripheral blood was detected by real-time quantitative fluorescent PCR.The cognitive function of patients was evaluated by Chinese version of Montreal Cognitive Assessment Scale (MoCA), and the social function of inpatients with mental illness was evaluated by SSPI. Results The expression of mircoRNA-16 (0.03±0.01) and mircoRNA 195(0.08±0.03) in peripheral blood of the observation group was lower than that of the control group[(0.12±0.02) and (0.27±0.06)], while the expression of mircoRNA 124 (14.63±3.24) of the observation group was higher than that of the control group (7.45±1.39), the differences were statistically significant(t=41.763, 19.898, 29.389, all P<0.05). The score of MoCA scale in the observation group[(22.17±3.45)points]was lower than that in the control group[(28.39±1.28)points](t=16.465, P<0.05). The SSPI score of the observation group[(26.58±5.16)points]was lower than that of the control group[(45.37±3.27)points](t=30.405, P<0.05). MicroRNA-16 and microRNA-195 were positively correlated with MoCA scale score and SSPI scale score (r=0.641, 0.724, SSPI scale score: r=0.801, 0.657, all P<0.05), while microRNA-124 was negatively correlated with MoCA scale score and SSPI scale score (r=-0.738, -0.769, all P<0.05). Conclusion The expression of mircoRNA-16 and mircoRNA-195 in peripheral blood of schizophrenic patients decreased, while the expression of mircoRNA-124 increased.The expressions of mircoRNA-16 and mircoRNA-195 were positively correlated with cognitive and social functions, while mircoRNA-124 was negatively correlated with cognitive and social functions. Key words: Schizophrenia; Healthy examinees; Peripheral blood; MicroRNA-16; MicroRNA-124; MicroRNA-195; Cognitive function; Social function; Relevance

BackgroundIn the past, researchers have observed a significant link between glycemia and dementia. Medial temporal atrophy (MTA) is regarded as a common marker of dementia. The correlation between glycemic variability and MTA is unclear, and it has not been determined whether glycemic variability can be utilized as a biomarker of MTA and cognitive performance.MethodsThe patients in a memory clinic who underwent brain MRI scans and cognitive assessments within the first week of their hospital visit, were enrolled. All participants underwent three fasting blood glucose and one HBA1c assessments on three self-selected days within 1 week of their first visit. The variability independent of the mean (VIM) was employed. Validated visual scales were used to rate the MTA results. The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales were employed to assess the cognitive functions of the participants. Spearman’s correlation and regression models were used to examine the relationship between the MMSE and MoCA scales, and also determine the link between the MRI characteristics and cognitive status, where vascular risk factors, educational status, age, gender, and mean glucose parameters served as covariates.ResultsFour hundred sixty-one subjects completed the MMSE scale, while 447 participants completed the MoCA scale. Data analysis revealed that 47.72% of the participants were men (220/461), and the median age of the patients was 69.87 ± 5.37 years. The findings of Spearman’s correlation analysis exhibited a strong negative relationship between the VIM and MMSE score (r = −0.729, P < 0.01), and the MoCA score (r = −0.710, P < 0.01). The VIM was regarded as an independent risk factor for determining cognitive impairment in both the MMSE and MoCA assessments. The results were unaffected by sensitivity analysis. In addition, a non-linear relationship was observed between the VIM and MTA scores.ConclusionThe variability in the blood glucose levels, which was presented as VIM, was related to the reduced cognitive function, which was reflected by MMSE and MoCA scales. The relationship between the VIM and the MTA score was non-linear. The VIM was positively related to the MTA score when the VIM was less than 2.42.

Background and ObjectivesCarotid artery stenting (CAS) is an important therapeutic strategy for patients with carotid artery stenosis. However, the potential influence of CAS on cognitive function in patients with carotid artery stenosis and cerebral lacunar infarction has not been determined. This study investigated changes in cognitive function associated with CAS and the factors related to these changes.MethodsThis prospective cohort study comprised 579 Chinese patients with cerebral lacunar infarction and carotid artery stenosis for whom CAS was indicated, and a matched control group of 552 healthy individuals. Cognitive function before CAS and at scheduled intervals from 6 months to 3 years was assessed with instruments that included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scale. Potential factors that might affect cognitive function were analyzed via logistic regression.ResultsThe MMSE and MoCA scores of the patients before CAS were significantly lower than that of the control subjects. These scores were significantly higher 6 months after CAS and sustained or increased throughout the 3-year follow-up. Also significantly improved after CAS from baseline were scores for an alternating trail test, cube copying, clock-drawing, attention, and delayed recall in an auditory-verbal learning test. Logistic regression analyses showed that age greater than 65 y, little education, diabetes, and hypertension were independent risk factors for deteriorated MoCA scores 3 years after CAS.ConclusionCAS was associated with significantly improved cognitive function in cerebral lacunar infarction patients with severe stenosis.

<sec><title>Objective</title> To explore the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on depression, cognitive function and activities of daily living in patients with depression after cerebral infarction. </sec><sec><title>Methods</title> A total of 50 patients with depression after cerebral infarction from the departments of neurology and rehabilitation of the Second Affiliated Hospital of Chongqing Medical University from July 2018 to February 2020, which were randomly divided into the control group and the observation group, with 25 cases in each group. All of the patients received conventional drug therapy, rehabilitation training, and paroxetine antidepressant treatment. On this basis, the control group was given sham stimulation, the coil of magnetic stimulation was placed at 90 degrees perpendicular to the scalp, the stimulation frequency was 10.0 Hz, the stimulation intensity was 80%-90% resting motor threshold (RMT), and the stimulation intensity was adjusted from low to high according to the patients tolerance, two seconds per stimulus, 20 seconds interval, total pulses 1 200, once a day, five days a week, continous treatment for six weeks. The observation group was given high-frequency rTMS treatment, the stimulation site was the left dorsolateral prefrontal cortex (DLPFC), the center point of the coil was tangent to the patients scalp surface, and the treatment parameters and time were the same as those in the control group. Before treatment and after treatment for six weeks, the Montreal cognitive assessment scale (MoCA) was used to evaluate the overall cognitive function of patients; the Hamilton depression scale (HAMD) was used to evaluate the depression of patients; the modified Barthel index (MBI) was used to evaluate the activities of daily living of patients; the auditory event-related potential P300 was used to evaluate cognitive function and the adverse reactions of the two groups were compared. </sec><sec><title>Results</title> There were no significant differences in MoCA, HAMD, MBI scores and P300 between the two groups before treatment (<italic>P</italic>>0.05). Compared with before treatment, MoCA scores, subitem scores of MoCA (such as visuospatial/executive function, attention/calculation) and MBI score of both groups after treatment for six weeks were significantly higher (<italic>P</italic><0.05), HAMD score and P300 latency of both groups were significantly lower, the difference was statistically significant (<italic>P</italic><0.05). Compared with the control group, the MoCA scores and subitem scores of MoCA (such as attention/calculation and delayed memory) of the observation group were significantly higher (<italic>P</italic><0.05), and HAMD score and P300 latency were significantly lower, the difference was statistically significant (<italic>P</italic><0.05). There were no significant differences in MBI score and occurrence of adverse events between the two groups (<italic>P</italic>>0.05). </sec><sec><title>Conclusion</title> High frequency rTMS can effectively improve the depressive state and cognitive function of patients with post-stroke depression, which is worthy of clinical application. </sec>

Objective To explore the cognition impairment of Parkinson's disease (PD) subtypes and the risk factors for cognitive dysfunction. Methods Totally56 patients with PD and 30 control subjects were selected. All patients were assessed by Mini-Mental State Examination (MMSE), the Montreal cognitive assessment scale (MoCA), digital span test scale (DS), block design test scale (BD). The cognition impairment status of PD subtype was compared between the two groups. Risk factors for cognitive impairment in Parkinson's disease were analyzed by the multiple regression analysis. Results The scores (or accuracy) of visuospatial / executive function, memory, repeat, attention, animal naming, understanding, calculation, orientation in PD patients and control group were (29.84±13.78) and (44.63±10.95), (17.64±3.00) and (21.93±2.12), (1.64±0.90) and (2.40±0.62), 64.29% and 86.67%, (2.25±0.77) and (2.70±0.47), (2.66±0.67) and (2.93±0.25), (3.98±1.17) and (4.93±0.25), (9.59±0.68) and (9.93±0.25) respectively, and there were statistically significant differences in above indictors between two groups (t=-5.080, -7.707, -4.571, -3.374, -2.710, -5.844, -3.367, respectively, χ2=4.86, all P<0.05). Pearson correlation analysis showed that the cognitive function had a positive correlation with education status, had negative correlations with duration of disease, Unified Parkinson's Disease Rating Scale (UPDRS)- Ⅲ, Hoehn and Yahr (H-Y) staging, Hamilton Anxiety Scale (HAMA), Hamilton Rating Scale for Depression (HRSD) (MMSE: r=0.488, -0.682, -0.478, -0.465, -0.611, -0.538, respectively, all P<0.05, MoCA: r=0.553, -0.583, -0.396, -0.384, -0.499, -0.444, respectively, all P<0.05), and had no correlation with gender, age, age of onset. Taking the duration of disease, education status, UPDRS- Ⅲ, H-Y grade, HAMA, HRSD as the independent variable, MMSE, MoCA as the dependent variable, multiple linear regression analysis showed that only the duration of disease and education status had effects on cognitive dysfunction in PD (MMSE: β=-0.042, 0.196, both P=0.000, MoCA: β=-0.052, 0.367, both P<0.05). Conclusions The key points of cognition impairment in PD patients are the impairments in visuospatial/executive function, memory, repeat, attention, animal naming, understanding, calculation and orientation. The duration of disease and low level of education are the risk factors for cognitive dysfunction in patients with Parkinson's disease. Key words: Parkinson disease; Cognition disorders

This study examines the impact of carotid artery stenting (CAS) on cognitive function in stroke patients, particularly in relation to hemodynamic depression (HD). Patients undergoing CAS between January 1, 2019 and June 1, 2023 were included in our study. Depending on whether hemodynamic depression happened, they were separated into two groups: HD and non-HD. Prior to surgery, one month, three months, six months, and a year following surgery, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment Scale (MoCA), and cognitive function scores were compared. 130 patients were included in the study, with an HD incidence rate of 51.54%. The comparison of MMSE and MoCA scores revealed that the HD group showed declining cognitive function post-surgery (P<0.05). Specifically, the MMSE and MoCA scores were significantly lower in the HD group compared to the non-HD group at 3, 6, and 12 months after CAS (P<0.05). Additionally, attention, computation, and memory were significantly lower in the HD group at these time points (P<0.05). The non-HD group demonstrated improvement in MMSE and MoCA scores compared to preoperative levels at 6- and 12-months post-surgery (P<0.05). Following CAS, patients' cognitive ability would briefly drop before returning to baseline and improving even more. Clinical focus should be given to HD prevention because its presence would exacerbate the cognitive function impairment and lengthen the recovery period.

The aim of this study was to explore the impact of sleep quality on cognitive function in patients with chronic subjective tinnitus. The Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment Scale (MoCA) were used to assess sleep quality and cognitive function in patients with chronic subjective tinnitus, sleep disorder patients (SD), and normal controls (NC). The tinnitus evaluation questionnaire (TEQ) and tinnitus loudness were used to assess the severity in patients with chronic subjective tinnitus. Tinnitus patients were divided into two groups based on PSQI results: "tinnitus with sleep disorder (TwSD)" and "tinnitus without sleep disorder (TnSD)." The MoCA scores in TwSD and TnSD groups were compared with those in SD and NC groups, and the correlation between PSQI, TEQ, tinnitus loudness, and MoCA scores in subjective tinnitus patients were analyzed. Whether TwSD group or TnSD group, the MoCA score was significantly lower than those in the NC group and SD group. Meanwhile, there was no significant difference between TwSD and TnSD groups in MoCA score, and PSQI, TEQ, and tinnitus loudness were not significantly correlated with MoCA. Subjective tinnitus may be an independent risk factor for cognitive impairment. The underlying neural mechanisms between subjective tinnitus, sleep disorders, and cognitive impairment need to be further explored and clarified.

P36-F Neurophysiological assessment of cognitive functions in patients with multiple sclerosis