Assessment Of Cognitive Function Research Articles

Serum Homocysteine, Vitamin B12, Folate, and Their Association with Mild Cognitive Impairment and Subtypes of Dementia.

Although elevated levels of homocysteine (Hcy) are associated with cognitive impairment and dementia, the relevance of Hcy, vitamin B12, and folate levels to subtypes of dementia are still unknown. To investigate the changes of Hcy, vitamin B12, and folate levels in mild cognitive impairment (MCI) and subtypes of dementia including Alzheimer's disease (AD), vascular dementia (VaD), frontotemporal dementia (FTD), and Lewy body dementia (LBD), and their relationships with cognitive function and magnetic resonance imaging (MRI) markers. We measured serum levels of Hcy, vitamin B12, and folate in 257 subjects. Each subject underwent cognitive function assessment and brain MRI test. The Fazekas and temporal lobe atrophy (MTA) visual rating scales were used to assess the degree of white matter hyperintensities and MTA, respectively. Serum levels of Hcy was higher and vitamin B12 was lower in AD, VaD, FTD, and LBD groups than cognitively normal controls. No significant differences of folate levels were found among 6 groups. Hcy levels were positively correlated with MTA total score in AD (r = 0.448, p < 0.001). Vitamin B12 levels were positively correlated with MoCA in VaD (r = 0.497), and negatively correlated with MTA total score in AD (r = - 0.325) (ps < 0.05). Hyperhomocysteinemia may increase the risk of AD (OR = 2.744), VaD (OR = 3.600), and FTD (OR = 3.244) in the adjusted model (ps < 0.05). Hcy and vitamin B12 levels are associated with MTA in AD. Vitamin B12 levels are associated with general cognition in VaD. Hyperhomocysteinemia is a risk factor for not only AD and VaD but also FTD.

EVALUATION OF ROLE OF FICUS BENGALENSIS IN MODULATION OF COGNITIVE IMPAIRMENT AND OXIDATIVE STRESS IN DIABETIC RATS

Objectives: Our objective was to study the effects of Ficus benghalensis on cognitive behavior and oxidative stress in diabetic rats and to compare with vitamin C and glimepiride. Methods: Wistar rats of either sex randomized into five groups of diabetic rats by streptozocin (STZ), five groups of non-diabetic rats (distilled water) (n=10). Subgroup division (F. benghalensis dose I and II, i.e., 50 mg/kg and 100 mg/kg; Vitamin C 100 mg/kg and glimepiride 0.5 mg/kg) were done. Each drug was given to one diabetic and one non-diabetic group. Other set served as control. Assessment of blood glucose, cognitive function (using continuous avoidance apparatus and Morris water maze test), and oxidative stress (measuring Malondialdehyde (MDA), reduced glutathione (GSH) levels) were done on Day 0 and 30. The acquisition phase of cognitive behavior tests was assessed on 0, 14, and 29 days and retention phase was assessed on 1, 15, and 30 day. Results: As compared to control group, F. benghalensis dose I, dose II, and glimepiride showed significant decrease (p&lt;0.001) in blood glucose. F. benghalensis dose I, dose II, vitamin C, and glimepiride group showed significant decrease in acquisition and retention of transfer latency on 29 and 30 days. Significant increase in retention of step-down latency on 30 day was shown by both the doses of F. benghalensis. Both doses of F. benghalensis, vitamin C and glimepiride group showed significant increase in retention of Quadrant-time in comparison to control on 30 days. Significant decrease in brain MDA levels while a significant increase in brain GSH levels was observed in all groups except control. Conclusion: F. benghalensis reverses behavioral and biochemical changes induced by STZ and effects are comparable with that of vitamin C and glimepiride.

Exploring Brain Connectivity of Single-Digit and Double-Digit in Familiar and Unfamiliar Numerals: A Functional MRI Study

Learning and memory are closely related in a way that the ability to learn new information is done through working memory and the retrieval of the learned information is done through long-term memory [1]. Over the years, a keen interest in investigating the functional network and interaction in the brain regions during processing number magnitudes has increased among cognitive neuroscientists [2]. The majority of studies related to brain connectivity, especially on numeral cognition focus on children as these investigations could provide insight into neurodevelopmental performance [3].&#x0D; &#x0D; In the current study, we aim to explore brain connectivity associated with familiar and unfamiliar numerals of single-digit and double-digit among young adults. Figure 1 demonstrates the conceptual framework of the current study. This is a quantitative experimental design study that uses a combination of cognitive performance assessment and task-based fMRI block design to measure brain connectivity during learning and retrieval of the acquired information. Fifteen healthy young Malaysian adults in the age range of 18-30 years old who meet the inclusion criteria will be recruited via convenience sampling. Participants will be in one group performing two categories of tasks namely familiar (Chinese) and unfamiliar (Arabic) with two conditions each (single-digit and double-digit). A 3-Tesla MRI Philips Achieva (Philips Medical Systems, Best, Netherlands) scanner with a 32-channel SENSE head coil will be used for data acquisition.&#x0D; Descriptive statistics will be used to summarise the socio-demographic characteristics of subjects. The mean difference in reaction time and accuracy of answers for single and double-digit in familiar and unfamiliar numerals will be analysed using two-way repeated-measures ANOVA and reported. The pre-processing of the fMRI images will be carried out using MATLAB software, Statistical Parametric Mapping 12, and CONN toolbox. The identification and comparison of the brain's functional connectivity will be done using the GIFT toolbox and Statistical Parametric Mapping 12. Results will be reported in the form of figures and tables.&#x0D; &#x0D; Both familiar and unfamiliar numerals are expected to activate the fronto-parietal-occipital networks by extracting the network from the cognitive-control domain, sub-cortical domain, and visual domain but with different connectivity values. Unfamiliar numerals are anticipated to have higher connectivity values than familiar numerals. Similar findings are expected to double and single digits, whereby higher connectivity values in double digits than in the single digits. The limited studies on functional connectivity show the main regions involved in mathematic processing are the inferior frontal gyrus (IPG), intraparietal sulcus (IPS), and inferior temporal gyrus (ITG) [4]. The outcome of this study would be beneficial as it could provide baseline data to investigate abnormalities of brain connectivity in learning and memory-related to numerical cognition among the young adult population.&#x0D;

Functional Neuroimaging as an Assessment Tool in Critically Ill Patients.

Little is known about residual cognitive function in the earliest stages of serious brain injury. Functional neuroimaging has yielded valuable diagnostic and prognostic information in chronic disorders of consciousness, such as the vegetative state (also termed unresponsive wakefulness syndrome). The objective of the current study was to determine if functional neuroimaging could be efficacious in the assessment of cognitive function in acute disorders of consciousness, such as coma, where decisions about the withdrawal of life-sustaining therapies are often made. A hierarchical functional magnetic resonance imaging (fMRI) approach assessed sound perception, speech perception, language comprehension, and covert command following in 17 critically ill patients admitted to the intensive care unit (ICU). Preserved auditory function was observed in 15 patients (88%), whereas 5 (29%) also had preserved higher-order language comprehension. Notably, one patient could willfully modulate his brain activity when instructed to do so, suggesting a level of covert conscious awareness that was entirely inconsistent with his clinical diagnosis at the time of the scan. Across patients, a positive relationship was also observed between fMRI responsivity and the level of functional recovery, such that patients with the greatest functional recovery had neural responses most similar to those observed in healthy control participants. These results suggest that fMRI may provide important diagnostic and prognostic information beyond standard clinical assessment in acutely unresponsive patients, which may aid discussions surrounding the continuation or removal of life-sustaining therapies during the early post-injury period. ANN NEUROL 2023;93:131-141.

PMON279 Variability in Cognitive Performance by Sexual Orientation among US Older Adults: Findings from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014

Abstract Aim Previous evidence suggests that some fields of cognitive function are man dominated while others are woman dominated. Recent research has additionally associated sexual orientation with cognitive function. However, data on the effect of sexual orientation on various cognitive subdomains are limited. We aim to explore the variability in a range of cognitive subdomains (working memory, language, attention, processing speed, and executive functioning) by cis-gender hetero versus homo sexual orientation. Methods We combined NHANES 2011–2012 and NHANES 2013–2014 datasets to study the individuals (60-69 years old) with both sexual health and cognitive assessment data. We analyzed the data to assess the performance of heterosexual and homosexual men and women on various cognitive function assessments. We used 1) word learning and recall modules from the Consortium to Establish a Registry for Alzheimer's disease (CERAD) to examine new verbal learning, immediate and delayed memory; 2) the Animal Fluency test (AFT) to evaluate verbal sematic fluency and 3) the Digital Symbol Substitution test (DSST) to assess attention and processing speed. Mentally impaired individuals or participants who were unable to understand or read English, Spanish, Korean, Vietnamese, traditional or simplified Mandarin, or Cantonese were not asked questions regarding sexual orientation and hence, were excluded from final analysis. Simple Linear regression models were used to quantify the association of sexual orientation and cognitive function. Statistical significant was specified at P &amp;lt; 0.05. Results Our study population consists of 61 homosexual adults (39 men and 22 women) and 3087 heterosexual adults (1486 men and 1601 women). Comparison of heterosexual men and women demonstrated differences typically found between the genders, with heterosexual women performing significantly better on all cognitive function assessments. Homosexual men scored significantly higher than heterosexual men on all cognitive function assessments and performed in the direction of heterosexual women in all cognitive domains. In fact, mean scores for homosexual men were even higher than for heterosexual women in the four of the six cognitive domains tested (CERAD 2 and delayed recall, AFT and DSST). Homosexual women did not differ from heterosexual women and homosexual men on any of the measures of cognitive performance. Therefore, as expected, homosexual women scored higher points than heterosexual men on most cognitive assessments (CERAD 1,3 and delayed recall, and DSST). Conclusion Homosexual men were gender-atypical and performed in the direction of heterosexual women in cognitive domains related to working memory, language, attention, processing speed, and executive functioning. Homosexual women were sex-typical with cognitive skills similar to heterosexual women. These findings underscore the need for further studies to understand the association of sexual orientation with cognitive functioning. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

CHARACTERISTICS OF CEREBRAL ENERGY METABOLISM IN ELDERLY PEOPLE WITH IMPAIRED COGNITIVE FUNCTIONS

Background. In old age, there is a change in personality, behavior and the rate of cognitive processes due to age-related changes in the central nervous system. Therefore, there is a need to identify those neurophysiological predictors that may indicate the development of pathology or indicate normal aging.&#x0D; Purpose. Investigate the features of cerebral energy metabolism in elderly people (60+) with cognitive impairments of varying severity.&#x0D; Materials and methods. The study involved 30 people aged 60 to 85 years with mild and pronounced manifestations of cognitive impairment. The study of the level of cognitive decline was conducted using the Montreal Cognitive Function Assessment Scale (MoCA). To identify the level of neurometabolic activity of the brain, the method of neuroenergocarting (NEC) was used. The levels of brain activation and functional state were determined by the method of dynamic omegametry.&#x0D; Results. In the group of people with moderate cognitive impairments, there was exceeding the level of constant potentials of the brain by 2-3 times compared with the normative values, a rigid reaction to the load, a delayed recovery of indicators in the post-loading period. It can be concluded that all patients have hypoxic changes accompanied by acidification of brain tissue and oxidative stress. In the group with severe cognitive deficits, there is a general decrease in neuroenergy exchange and activation of the cerebral cortex, which indicates the depletion of the reserve adaptive mechanisms of the nervous system.&#x0D; Conclusion. Thus, pronounced changes in indicators of neurometabolism and brain activity were revealed in elderly people with a decrease in cognitive functions. The data obtained can be used to diagnose the initial manifestations of dementia in old age and to develop therapeutic and preventive measures.

Impact of glucagon-like peptide 1 analogs on cognitive function among patients with type 2 diabetes mellitus: A systematic review and meta-analysis.

Diabetes is an independent risk factor for cognitive impairment. However, little is known about the neuroprotective effects of glucagon-like peptide 1 (GLP-1) analogs on type 2 diabetes mellitus (T2DM). Herein, we assessed the impact of GLP-1 analogs on the general cognitive functioning among patients with T2DM. Relevant studies were retrieved from PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov databases from their inception till June 30, 2022, without any language restrictions. For continuous variables, the mean and standard deviation (SD) were extracted. Considering the heterogeneity in general cognitive functioning assessments among the pooled studies, the standardized mean differences (SMDs) with corresponding 95% confidence intervals (CIs), were calculated. Five studies including 7,732 individuals with T2DM were selected for the meta-analysis. The use of GLP-1 analogs exerted no significant effects on the general cognitive functioning in self-controlled studies (SMD 0.33, 95% CI -0.03 to 0.69). Subgroup analyses among the self-controlled studies based on age and history of cardio-cerebrovascular disease showed that GLP-1 analogs significantly improved the general cognitive functioning in T2DM patients younger than 65 years (SMD 0.69, 95% CI 0.31 to 1.08) or those without cardio-cerebrovascular diseases (SMD 0.69, 95% CI 0.31 to 1.08). Similarly, differences in the general cognitive functioning for GLP-1 analogs between treated and non-treated patients with T2DM were significant in subgroups with patients younger than 65 years (SMD 1.04, 95% CI 0.61 to 1.47) or those with no history of cardio-cerebrovascular diseases (SMD 1.04, 95% CI 0.61 to 1.47). Limited evidence suggests that the use of GLP-1 analogs exerts no significant effects on general cognitive functioning but may be beneficial for patients with T2DM younger than 65 years or those without a history of cardio-cerebrovascular diseases. Further prospective clinical studies with large sample sizes are needed to validate these findings. www.inplasy.com, identifier 202260015.

Mindfulness Training for Depressed Older Adults Using Smartphone Technology: Protocol for a Fully Remote Precision Clinical Trial.

Precision medicine, optimized interventions, and access to care are catchphrases for the future of behavioral treatments. Progress has been slow due to the dearth of clinical trials that optimize interventions' benefits, individually tailor interventions to meet individual needs and preferences, and lead to rapid implementation after effectiveness is demonstrated. Two innovations have emerged to meet these challenges: fully remote trials and precision clinical trials. This paper provides a detailed description of Mindful MyWay, a study designed to test online mindfulness training in older adults with depression. Consistent with the concept of fully remote trials using a smartphone app, the study requires no in-person contact and can be conducted with participants anywhere in the United States. Based upon the precision medicine framework, the study assesses participants using high-frequency assessments of symptoms, cognitive performance, and patient preferences to both understand the individualized nature of treatment response and help individually tailor the intervention. Mindful MyWay is an open-label early-phase clinical trial for individuals 65 years and older with current depression. A smartphone app was developed to help coordinate the study, deliver the intervention, and evaluate the acceptability of the intervention, as well as predictors and outcomes of it. The curriculum for the fully remote intervention parallels the mindfulness-based stress reduction curriculum, a protocolized group-based mindfulness training that is typically provided in person. After consent and screening, participants download The Healthy Mind Lab mobile health smartphone app from the Apple App Store, allowing them to complete brief smartphone-based assessments of depressive symptoms and cognitive performance 4 times each day for 4 weeks prior to and after completing the intervention. The intervention consists of an introduction video and 10 weekly mindfulness training sessions, with the expectation to practice mindfulness at home daily. The app collects participant preference data throughout the 10-week intervention period; these high-frequency assessments identify participants' individually dynamic preferences toward the goal of optimizing the intervention in future iterations. Participant recruitment and data collection began in March 2019. Final end point assessments will be collected in May 2022. The paper describes lessons learned regarding the critical role of early-phase testing prior to moving to a randomized trial. The Mindful MyWay study is an exemplar of innovative clinical trial designs that use smartphone technology in behavioral and neuropsychiatric conditions. These include fully remote studies that can recruit throughout the United States, including hard-to-access areas, and collect high-frequency data, which is ideal for idiographic assessment and individualized intervention optimization. Our findings will be used to modify our methods and inform future randomized controlled trials within a precision medicine framework. ClinicalTrials.gov NCT03922217; https://clinicaltrials.gov/ct2/show/NCT03922217. DERR1-10.2196/39233.

Psycholinguistic Assessment of Cognitive Function in Breast Cancer Survivors.

To gather preliminary data on correlations among psycholinguistic measures, self-report of cognitive function, and performance on neurocognitive tests in breast cancer survivors. Participants were breast cancer survivors who reported issues with cognitive function after completion of chemotherapy. This secondary analysis used data from participants in parent studies at two National Cancer Institute-designated cancer centers. Qualitative interview transcripts (N = 52) underwent psycholinguistic analyses for grammatical and semantic complexity. Relationships among six psycholinguistic variables, self-report of cognitive function, and performance on neurocognitive tests were examined. Three grammatical complexity variables had a significant positive correlation to self-report of cognitive function. One semantic complexity variable had a significant positive correlation to delayed recall neurocognitive tests. Results suggest that psycholinguistic analysis may be used to assess cognitive function among breast cancer survivors. Confirmatory studies are needed to establish the correlation between psycholinguistic measures, self-report of cognitive function, and domain-specific tests of neurocognitive performance, as well as to evaluate longitudinal sensitivity to change.

The role of comorbidity in the development of Long-COVID

Introduction. Elimination of intracellular energy deficit and "smoldering" systemic inflammation, as well as elimination of water-electrolyte and metabolic disorders can be singled out as the main directions of therapy for the long-term consequences of Long COVID.&#x0D; The aim: to study and analyze the results of treatment with a pathogenetically justified combination of drugs Xavron, Tivorel and Xylat in patients with asthenic manifestations in the framework of Long-COVID.&#x0D; Materials and methods. During 2021, a clinical and neurological examination of 50 patients aged 47 to 76 years with a diagnosis of chronic cerebral ischemia (CMI) and an asthenic syndrome that persisted for more than 3 months after a laboratory-confirmed SARS-CoV-2 infection was carried out. The diagnosis was confirmed by the results of a clinical-neurological and neuropsychological examination using scales for the assessment of cognitive function (MMSE), emotional status (DASS-21), fatigue (FAS) and the neurological deficit assessment scale (MOND) developed by us. 20 patients additionally received a 10-day course of infusions of a combination of Xavron drugs in a dose of 30 mg No. 10, Tivorel 100.0 No. 5, and Xylate 200.0 No. 5 every other day, respectively. Thus, 50 patients were divided into two groups: the first - 20 people and the second - 30 people.&#x0D; Results. Correlation analysis revealed a strong positive correlation between the CIRS-G comorbidity score and the MOND score. A positive correlation coefficient between comorbidity and asthenic syndrome, assessed on the FAS scale, was also expressed - 0.699 (p=&lt;0.001).&#x0D; A somewhat weaker negative relationship was found between anxiety and the number of points on the CIRS-G scale – -0.474 (p=0.035). At the same time, the assessment of other parameters on the DASS-21 scale, such as depression and stress, did not show a reliably significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbid diseases. There was also a positive correlation coefficient between comorbidity and asthenic syndrome as assessed by FAS - 0.699 (p=&lt;0.001). A weaker negative correlation was seen between anxiety and CIRS-G - -0.474 (p=0.035). However, other DASS-21 scores, such as depression and stress, did not show a significant correlation effect. Also, the severity of cognitive deficits in this group did not depend on the number of comorbidities. All patients who received treatment with a combination of Xavron, Tivorel and Xylat noted an improvement in general well-being and a decrease in the severity of neurological symptoms. Changes in the severity of neurological deficit in 30 patients with Long-COVID (MOND) of the second group after the completion of the treatment course were significantly lower than in the first research group (P&lt;0.05).&#x0D; Conclusions. The combination of Xavron, Tivorel and Xylat is pathogenetically primed and safe for the treatment of patients with long-covid. the use of this drug combination leads to reduction of asthenic syndrome, which, in turn, positively influences the reduction of cognitive manifestations of long-covid in the form of "brain fog".

Mixed Reality Prototype of Multimodal Screening for Early Detection of Cognitive Impairments in Older Adults: Protocol Development and Usability Study.

BackgroundThe early diagnosis of cognitive impairments is an important step in the adequate management of dementia. The project “Smart Cognition & Behaviour Screening powered by Augmented Reality” (SCOBES-AR) aims to develop a multimodal screening tool (MST) for the early detection of cognitive impairments using augmented and virtual reality. The first project phase selected validated assessments for combination with the MST and tested it in 300 healthy older adults.ObjectiveThis study established a protocol for the implementation and usability of a mixed reality (MR)–enhanced multidisciplinary screening tool for the early detection of cognitive impairments in older adults. The developed MST will be partially enhanced by MR, which is a combination of augmented reality (AR) and virtual reality (VR). This MR-enhanced prototype of the screening tool (MR-MST) will be tested and compared to the previously developed MST. The usability of the prototype will also be examined.MethodsThis single-center observational crossover design study screens 100 healthy participants (aged 60-75 years) for cognitive decline using a specially developed MST (assessment of cognitive functions, olfactory sensitivity, nutritional preferences, gait parameters, reaction times, and activities of daily living) and an MR-enhanced MST in which the assessments of cognitive functions, reaction time, activities of daily living, and gait will be performed using tailor-made software and AR and VR hardware. The results of the MR-enhanced MST will be compared to those without MR. The usability of the developed MR-enhanced MST will be tested on 10 investigators and 10 test participants using observed summative evaluation and the codiscovery method, and on 2 usability experts using the codiscovery and cognitive walkthrough methods.ResultsThis study was funded by the Austrian Research Promotion Agency (grant 866873) and received approval from the ethics committee of the Medical University of Graz. The MR-MST and the experimental protocol for this study were developed. All participants gave written informed consent. As of July 15, 2022, a total of 70 participants have been screened. Data analysis and dissemination are scheduled for completion by September 2023.ConclusionsThe development and testing of the MR-MST is an important step toward the establishment of the best practice procedure for the implementation of AR and VR in the screening of cognitive declines in older adults. It will help improve our knowledge of the usability and applicability of the developed prototype and promote further advancement in AR and VR technologies to be used in therapeutic settings.International Registered Report Identifier (IRRID)DERR1-10.2196/39513

Iodine Intake and Related Cognitive Function Impairments in Elementary Schoolchildren.

Simple SummaryThis is the first survey to show throughout the application of Wechsler Intelligence Scale for Children complete form, how the adverse effects of moderate iodine-deficiency negatively impair cognitive function in schoolchildren. The results obtained suggest differences in the cognitive profile of the children with moderate iodine-deficiency, denouncing several changes in specific mental functions which could attaining their full intellectual potential, resulting in a differentiated profile of intellectual development and may have some clinical value. Working memory, in our study seriously compromised in moderate iodine-deficient schoolchildren, is used to process, and store information during complex and demanding activities and it supports many activities that iodine-deficient children usually engage in at school. Given the heavy working memory demands of classroom instructions and daily activities, it is perhaps unsurprising that one of the key characteristics of the schoolchildren with moderate iodine-deficiency is poor educational attainment, thereby; iodine deficiency represents a significant risk factor for poor educational progress. For policy makers and governments, it is imperative to act against this iodine-deficiency epidemiology in the most urgent terms. Cognitive impairments represent huge costs for the region, affecting local productivity, economy, and the region´s development and economic potential.Iodine deficiency, the most common cause of preventable mental impairment worldwide, has been linked to poorer intellectual function in several studies. However, to our knowledge, no studies have been performed in moderate iodine-deficient schoolchildren using the complete form of Wechsler Intelligence Scale for Children (WISC-III; Portuguese version). The main purpose of this study was to ascertain whether moderate iodine deficiency would affect the cognitive function of schoolchildren (7–11 years old; 3rd and 4th grades). Raven’s Colored Progressive Matrices (CPM; Portuguese version) were used for measuring the intelligence quotient (IQ) of the total population (n = 256; median UIC = 66.2 μg/L), and the WISC-III was used to study two selected subgroups: one moderately iodine-deficient (n = 30) and the other with adequate iodine intake (n = 30). WISC-III was shown to be the prime instrument for cognitive function assessment among moderate iodine-deficient schoolchildren; this subgroup had a Full-Scale IQ 15.13 points lower than the adequate iodine intake subgroup, with a magnitude effect of d = 0.7 (p = 0.013). Significant differences were also registered in 6 of the 13 Verbal-Performance IQ subtests. Moderate iodine deficiency has a substantial impact on mental development and cognitive functioning of schoolchildren, with significant impairment in both Performance IQ and Verbal IQ spectrum, adversely impacting their educational performance.

Transcranial direct current stimulation modulates working memory and prefrontal-insula connectivity after mild-moderate traumatic brain injury.

Background: Persistent posttraumatic symptoms (PPS) may manifest after a mild-moderate traumatic brain injury (mmTBI) even when standard brain imaging appears normal. Transcranial direct current stimulation (tDCS) represents a promising treatment that may ameliorate pathophysiological processes contributing to PPS.Objective/Hypothesis: We hypothesized that in a mmTBI population, active tDCS combined with training would result in greater improvement in executive functions and post-TBI cognitive symptoms and increased resting state connectivity of the stimulated region, i.e., left dorsolateral prefrontal cortex (DLPFC) compared to control tDCS.Methods: Thirty-four subjects with mmTBI underwent baseline assessments of demographics, symptoms, and cognitive function as well as resting state functional magnetic resonance imaging (rsfMRI) in a subset of patients (n = 24). Primary outcome measures included NIH EXAMINER composite scores, and the Neurobehavioral Symptom Inventory (NSI). All participants received 10 daily sessions of 30 min of executive function training coupled with active or control tDCS (2 mA, anode F3, cathode right deltoid). Imaging and assessments were re-obtained after the final training session, and assessments were repeated after 1 month. Mixed-models linear regression and repeated measures analyses of variance were calculated for main effects and interactions.Results: Both active and control groups demonstrated improvements in executive function (EXAMINER composite: p < 0.001) and posttraumatic symptoms (NSI cognitive: p = 0.01) from baseline to 1 month. Active anodal tDCS was associated with greater improvements in working memory reaction time compared to control (p = 0.007). Reaction time improvement correlated significantly with the degree of connectivity change between the right DLPFC and the left anterior insula (p = 0.02).Conclusion: Anodal tDCS improved reaction time on an online working memory task in a mmTBI population, and decreased connectivity between executive network and salience network nodes. These findings generate important hypotheses for the mechanism of recovery from PPS after mild-moderate TBI.

Can machine learning identify childhood characteristics that predict future development of bipolar disorder a decade later?

Early identification of bipolar disorder may provide appropriate support and treatment, however there is no current evidence for statistically predicting whether a child will develop bipolar disorder. Machine learning methods offer an opportunity for developing empirically-based predictors of bipolar disorder. This study examined whether bipolar disorder can be predicted using clinical data and machine learning algorithms. 492 children, ages 6–18 at baseline, were recruited from longitudinal case-control family studies. Participants were assessed at baseline, then followed-up after 10 years. In addition to sociodemographic data, children were assessed with psychometric scales, structured diagnostic interviews, and cognitive and social functioning assessments. Using the Balanced Random Forest algorithm, we examined whether the diagnostic outcome of full or subsyndromal bipolar disorder could be predicted from baseline data. 45 children (10%) developed bipolar disorder at follow-up. The model predicted subsequent bipolar disorder with 75% sensitivity, 76% specificity, and an Area Under the Receiver Operating Characteristics of 75%. Predictors best differentiating between children who did or did not develop bipolar disorder were the Child Behavioral Checklist Externalizing and Internalizing behaviors, the Child Behavioral Checklist Total t-score, problematic school functions indexed through the Child Behavioral Checklist School Competence scale, and the Child Behavioral Checklist Anxiety/Depression and Aggression scales. Our study provides the first quantitative model to predict bipolar disorder. Longitudinal prediction may help clinicians assess children with emergent psychopathology for future risk of bipolar disorder, an area of clinical and scientific importance. Machine learning algorithms could be implemented to alert clinicians to risk for bipolar disorder.

Remote assessment of cognitive dysfunction in hematologic malignancies using web-based neuropsychological testing.

Cognitive impairment is a frequent adverse effect of cancer and its therapies. As neuropsychological assessment is not often standard of care for patients with non-CNS disease, efficient, practical assessment tools are required to track cognition across the disease course. We examined cognitive functioning using a web-based cognitive testing battery to determine if it could detect differences between patients with cancer and controls. We enrolled 22 patients with multiple myeloma (MM) or non-Hodgkin lymphoma (NHL) and 40 healthy controls (mean age=56 ± 11 years, 52% male). Participants completed the BrainCheck cognitive testing battery and online versions of select measures from the Patient Reported Outcome Measures Information System (PROMIS) during a video conference. MANOVA was used to compare BrainCheck and PROMIS scores between groups controlling for age and sex. An exploratory linear regression analysis was conducted within the cancer group to determine potential contributors to cognitive functioning. All participants except for one control completed the online assessment measures without difficulty. Compared to controls, the cancer group demonstrated significantly lower scores in objective and subjective cognitive function, physical functioning, and social role performance and elevated fatigue scores. Corticosteroid treatment, immunotherapy, lower physical functioning, lower income, and older age significantly contributed to lower cognitive function (adjusted R2 = 0.925, F= 19.63, p= 0.002). Remote assessment of cognitive and psychosocial functioning is feasible with patients with cancer following treatments. The BrainCheck cognitive testing battery has the potential to detect differences in cognition between patients with cancer and controls.

Retraction Note: Cognitive learning performance assessment and analysis with CSCL applied on the NetGuru platform and CSPL applied on the TAoD platform for the network experiment class

Retraction Note: Cognitive learning performance assessment and analysis with CSCL applied on the NetGuru platform and CSPL applied on the TAoD platform for the network experiment class

Relationship between MMP-9 serum levels and tHcy levels and total imaging load and cognitive dysfunction

ObjectivesTo investigate the correlation and predictive value of serum matrix metalloproteinase-9 (MMP-9) level with cognitive dysfunction and total imaging load in patients with cerebral small vessel disease (CSVD). MethodsA total of 80 patients with CSVD who were admitted to the First Affiliated Hospital of Xinxiang Medical University between April 2019 and April 2020 were enrolled. All subjects underwent T1-weighted imaging (T1WI), T2WI, fluid-attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), serum sample collection, and assessment of cognitive function at a specific time-point after admission. According to the results of the neuropsychological test, subjects were divided into cognitive dysfunction group (n=40) and normal cognitive function group (n=40). The total imaging load was estimated according to the neuroimaging findings. Serum MMP-9 level was measured by an enzyme-linked immunosorbent assay (ELISA) kit. Beside, serum MMP-9 level and total imaging load were compared between the two groups. ResultsSerum levels of MMP-9 and plasma total homocysteine (tHcy) were negatively correlated with cognitive function (P<0.05). Serum MMP-9 level was found as a significant factor for diagnosing cognitive impairment due to CSVD (area under the curve (AUC), 0.756; sensitivity and specificity were 97.5% and 75.0%, respectively). THcy level was also found as significant factor for diagnosing cognitive impairment due to CSVD (area under the curve (AUC), 0.727; sensitivity and specificity were 97.5% and 75.0%, respectively). ConclusionSerum MMP-9 level and tHcy level were significantly correlated with cognitive function in patients with CSVD. Serum MMP-9 level has a specific correlation with the total imaging load in patients with CSVD. It plays an important role in diagnosing cognitive impairment in patients with CSVD.

Cognitive functioning and mental health in children with a primary mitochondrial disease

BackgroundStudies regarding cognitive and mental health functioning in children with mitochondrial disease (MD) are scarce, while both are important issues given their impact on QoL. Knowledge on these aspects of functioning and its relationship with disease parameters is essential to gather more insight in working mechanisms and provide recommendations for future research and patientcare. The aim of this study was to map the cognitive functioning and mental health in children with MD in relation to disease specific factors.MethodsPediatric patients (< 18 year) with a genetically confirmed MD were included. Demographic and disease specific factors (International Paediatric Mitochondrial Disease Scale) were assessed, as well as cognitive functioning (intelligence, attention, working memory (WM)), and mental health (psychological functioning and quality of life). Individual patient data was described.ResultsThirty-three children with MD were included. Intellectual functioning ranged from a clinically low IQ (36% of the patients, N = 12/33) to an average or above average IQ (39%, N = 13/33). A higher verbal versus performance IQ was observed (36% N = 5/14), a lower processing speed (43%, N = 6/14), attentional problems (50%, N = 7/14), and verbal WM problems (11%, N = 2/18). Regarding mental health, general behavioral problems were reported (45%, N = 10/22), and on subscale level, attention problems (45%, N = 10), withdrawn/depressed (36%, N = 8/22) and anxious/depressed behavior (14%, N = 3/22). Furthermore, QoL impairments were reported (42%, N = 5/12). The specific intelligence profiles, cognitive impairments, behavioral problems and QoL impairments occurred in every intelligence subgroup. Children with an average or above general intellectual functioning had a generally lower and less variability in IPMDS scores, less frequently epilepsy, vision and hearing problems, and a relatively later age of onset, as compared to patients with a clinically low intellectual functioning.ConclusionsDespite considerable heterogeneity, overall results showed a high rate of impairments in both cognitive and mental health functioning. Also in children with an average or above level of intellectual functioning, specific cognitive impairments were observed. Children with a clinically low intellectual functioning more often had disease related impairments compared to children with a higher intellectual functioning. The importance of structural assessment of cognitive functioning and mental health is warranted, also in children with mild disease related symptoms.

White Matter Microstructural Abnormalities and Cognitive Functions Assessment in First versus Multiple episodes of Euthymic Bipolar Cases

Background: Recently, several studies have detected cognitive impairment and microstructural anomalies of white matter (WM) in bipolar disorder type I (BD-I). It is still unclear if these structural and cognitive anomalies in BD are progressive or static. Subjects and Methods: We investigated Diffusion Tensor Imaging (DTI) derived fractional anisotropy (FA) and cognitive functions in 40 cases with euthymic BD I, who were subdivided into 20 cases with single episode and another 20 cases with multiple episodes, and were further compared with 20 healthy controls. Four tracts bilaterally (cingulum, inferior longitudinal fasciculus, superior longitudinal fasciculus, and uncinate fasciculus) and three areas (left rostral anterior cingulate, right inferior frontal area, and right subgenual anterior cingulate) were studied. The findings were further correlated with cognitive functions (memory, executive functions, and sustained attention), which were assessed using Trail Making Test A and B, Wisconsin Card Sorting Test, Wechsler Memory Scale, and Continuous Performance Test). Results: Cases with BD I either with a single episode or multiple episodes showed deficits than the control group in all the selected regions except right subgenual anterior cingulate in comparison to controls. Also, more deficits were found as regards cognitive functions. On the other hand, cases with many episodes had lower FA than those with a single episode regarding seven regions of interest (left and right inferior longitudinal fasciculus, left and right superior longitudinal fasciculus, left uncinate fasciculus, right cingulum, and right inferior frontal area) as well as more impairment in executive functions and sustained attention which correlated with these white matter abnormalities. Discussion and Conclusion: The present findings indicate that white matter microstructural abnormalities and cognitive functions deficits could serve as state and trait markers in cases with BD I. The detected abnormalities could affect the future in early diagnosis and intervention, thus facilitating functional recovery in cases with BD I.

The Magnitude of Hidden Hunger and Cognitive Deficits among Children Living in Orphanages in Kumasi, Ghana

This study assessed the magnitude of hidden hunger (micronutrient deficiencies) and cognitive deficits of 130 school-aged children (6–13 years old) living in three selected orphanages in Kumasi, Ghana. Sociodemographic data assessment, anthropometric assessment (BMI for age and height for age), dietary assessment (3-day repeated 24-hour dietary recall), urinary iodine level assessment, and cognitive performance assessment (Raven’s Coloured Progressive Matrices) were performed. Boys formed 50.8% of the study population, while girls formed 49.2%. The median age of participants was 10.50 years. About 12.3%, 7%, and 10.0% of participants were stunted, thin, and overweight/obese, respectively. The prevalence of mild iodine deficiency (i.e., 50–99 μg/L) was 16.2%. Iodine deficiency was significantly higher (23.6%) in participants who had lived for at least 7 years in the orphanage compared to those who had lived less than 7 years (10.7%) ( p = 0.047 ). About 17% of the participants performed poorly (&lt;50%) on the cognition test. Mean cognition test scores were significantly different among the orphanages ( p = 0.027 ). The majority of participants, 89.2%, 54.6%, 76.9%, and 77.7%, had adequate intake of iron, zinc, vitamin C, and folate, respectively, whereas intake of vitamins A and B12 was inadequate for the majority of participants (90.8% and 50.8%, respectively). There was no significant correlation between micronutrient intake and cognitive performance. However, mean cognition test scores were significantly different between participants with adequate and inadequate iron and vitamin A intake ( p = 0.007 and p &lt; 0.001 , respectively). The findings of this study warrant a closer look at nutritional intakes in orphanages to improve hidden hunger and cognitive performance.