Attention Processing Speed Research Articles

Associations between brain structure and dual decline in gait and cognition

Dual decline in gait and cognition is associated with an increased risk of dementia, with combined gait and memory decline exhibiting the strongest association. To better understand the underlying pathology, we investigated the associations of baseline brain structure with dual decliners using three serial gait speed and cognitive assessments in memory, processing speed-attention, and verbal fluency. Participants (n=267) were categorized based on annual decline in gait speed and cognitive measures. Lower gray and white matter volume and higher white matter hyperintensity volume increased the risk of being a dual decliner in gait and both the memory and processing speed-attention groups (all p < 0.05). Lower hippocampal volume (p = 0.047) was only associated with dual decline in gait and memory group. No brain structures were correlated with dual decline in gait and verbal fluency. These results suggest that neurodegenerative pathology and white matter hyperintensities are involved in dual decline in gait and both memory and processing speed-attention. Smaller hippocampal volume may only contribute to dual decline in gait and memory.

Anticholinergic and sedative medication use in older patients with cognitive concerns.

Anticholinergic (AC) and sedative medications are a risk factor for cognitive impairment. This study sought to characterize AC and sedative use in older patients seen for outpatient neuropsychological evaluation and evaluate their associations with different cognitive domains. We hypothesized that AC and sedative use would be associated with worse attention/processing speed (AP), executive functioning (EF), and memory. We conducted a cross-sectional chart review of 392 patients (mean [M] age = 72 ± 7.7 years, range = 54-91). Medications were characterized by number of AC medications (≥1 on the Anticholinergic Cognitive Burden Scale [ACB]), number of sedative medications, and polypharmacy (≥5 daily medications). Demographically adjusted composites were calculated for AP, EF, and memory. Bivariate Pearson correlations assessed relationships between medication use and cognition. Multivariate linear regressions evaluated significant medication-cognition associations, controlling for total medications, medical comorbidities, and estimated premorbid cognitive functioning. Polypharmacy was common (80%; n = 314). Most patients (70%; n = 275) used ≥1 sedative medications (range = 0-9). Over half (63%; n = 248) used ≥1 AC drugs (range = 0-7), yet ACB scores were ≤2 in 74% of patients. Sedative use was negatively correlated with AP (r = -0.134, p = 0.008) and EF (r = -0.105, p = 0.04). ACB scores were negatively correlated with AP (r = -0.106, p = 0.037). Sedatives and a priori covariates significantly predicted AP performance (R2 = 0.127, p < 0.001); using more sedative medications was uniquely associated with worse AP (β = -0.426, p = 0.049). No significant associations were found with memory. AC and sedative medications and polypharmacy were prevalent in this sample of older patients. Though both drug classes had negative relationships with AP and EF, sedatives had a particularly negative association with AP. Contrary to our hypotheses, memory was not associated with medication use; however, anticholinergic burden was low within the sample, and AP and EF deficits may masquerade as memory problems.

A89: Experimental Study on Effects of ‘Micro-Exercise’ on Pupils' Attention and Performance

Purpose: Extended periods of desk-based study in schools often result in diminished attention and reduced learning efficiency among students. This study aims to investigate exercise methods and implementation approaches that can enhance the attention and academic performance of primary school students. Methods: This study randomly selected 90 students（44 in the experimental group and 46 in the control group）from two classes of Grade 3 in Shenxhen Yantian Foreign Language primary School Donghe Branch. The students from the experimental group received two rounds of 12-week 10 minutes of micro-exercise every day. The attention index (D2) and the academic performance (Chinese, Math, and English) of the experimental group and the control group before and after the experiment were compared and analyzed. Results: Before the experiment, there was no significant difference between the experimental group and the control group. After the experiment, there was a significant difference in the attention index between the experimental group and the control group (tTN=7.274, PTN &lt; 0.01). There was a positive correlation between students' math performance and attention index of the experimental group before and after the experiment (rE1=-0.413, PE1= 0.005 &lt; 0.01; rE2=-0.423, PE2=0.003 &lt; 0.01). Conclusion: The current research indicates that incorporating ten minutes of micro-exercise between classes can activate students' attention systems, enhance attention processing speed, and elevate overall attention levels. Consistent implementation of micro-exercises during breaks has been found to enhance students' computational skills, logical thinking, and other cognitive abilities, leading to improvements in their academic performance, particularly in math. The sustained use of micro-exercises between classes emerges as an effective strategy for cultivating students' attention levels and boosting academic performance.

A-54 Increased Symptoms During a Post-Concussion Neuropsychological Evaluation are Associated with Intraindividual Cognitive Variability and Anxiety

Abstract Purpose To examine the relationship between self-reported affect, cognitive functioning, and increased symptoms during a post-concussion neuropsychological evaluation. Methods 46 collegiate athletes (M=34, F=12) completed a comprehensive neuropsychological evaluation within 14 days of concussion, including measures of depression (Beck Depression Inventory-Fast Screen (BDI-FS)) and anxiety (NEO Five Factor Inventory (NEO-FFI) Anxiety Subscale). Suggested cutoffs for significant depression (BDI-FS ≥4) and anxiety (NEO-FFI Anxiety Subscale ≥10) symptomatology were utilized. The 21-item Post-Concussion Scale (PCS) was administered at the beginning (Pre-PCS) and end (Post-PCS) of testing. A difference score was calculated by subtracting Post-PCS from Pre-PCS. Composites of mean neuropsychological performance and two intraindividual variability (IIV) indices (average standard deviation and maximum discrepancy score) were created separately for two domains: memory and attention/processing speed (APS). Results Cognitive functioning explained a significant amount of the variance in Pre-Post PCS difference scores, F(6,39)=5.13, p&amp;lt;.001, R2=.44. Both IIV indices for memory and APS (all p’s&amp;lt;.02) significantly predicted difference scores, with cognitive variability increasing as Pre-Post PCS difference scores increased, but traditional mean composites did not (p’s&amp;gt;.05). Athletes who reported significant anxiety symptomatology (M=-4.33, SD=4.41) were significantly more likely than those who did not (M=.21, SD=3.75) to experience an increase in PCS symptoms, t(37)=2.66, p=.01, 95% CI [1.09,8.00]. There were no significant Pre-Post PCS symptom changes between athletes reporting significant depression symptomatology (M=.43, SD=5.19) or not (M=-.15, SD=4.61). Conclusions Higher IIV in cognitive functioning and worse anxiety symptomatology, but not traditional mean differences in cognitive functioning or depression symptomatology, were associated with an increase in symptoms during a post-concussion evaluation.

Longitudinal cognitive changes in patients with early Parkinson's disease and neuropsychiatric symptoms.

In this study, we aimed to investigate the effect of neuropsychiatric symptoms (NPS) on the rate of cognitive decline for both global cognition and specific cognitive domains in a cohort of patients from the Parkinson's Progression Markers Initiative (PPMI). Prospectively longitudinal data were obtained from the PPMI cohort. NPS, including depression, anxiety, apathy, psychosis, impulse control disorders (ICDs), and cognition ability, were evaluated by a series of questionnaires. Linear mixed-effects models were used to investigate the relationship between NPS and the rate of cognitive decline. Generalized estimating equations (GEEs) were used to investigate the relationship between NPS and the occurrence of mild cognitive impairment (MCI). In total, 423 patients with Parkinson's disease (PD) were recruited at baseline and 395, 378, 366, 346, and 315 participants were followed up at 1, 2, 3, 4, and 5 years, respectively. Depression, anxiety, apathy, and psychosis were associated with global cognitive decline. Except for those with ICDs, patients with psychosis, depression, anxiety, and apathy were more likely to meet the criteria for MCI. Patients with depression and anxiety showed a progressive decline in four major cognitive domains. Apathy and ICDs were separately associated with a progressive decline in processing speed-attention and memory, respectively. Neuropsychiatric symptoms, including psychosis, depression, anxiety, and apathy, could be used to predict future cognitive decline in patients with PD.

Neuroanatomical substrates of attention processing speed in early dementia with Lewy bodies (DLB): A white‐matter voxel‐based morphometry and diffusion tensor imaging study

AbstractBackgroundBased on a previous study (Botzung et al., 2019) that revealed the importance of grey matter (GM) integrity in the striatum for attention processing speed, the purpose of this study was now to examine, in early DLB patients, the relationship between impaired attentional speed performances and white matter changes.MethodWe administered the Trail Making Test A (TMTA) to 73 prodromal to moderate DLB patients (mean MMSE = 26.4) and 30 control subjects (mean MMSE = 28.9) to assess attention processing speed. Three‐dimensional (3D) MRI and Diffusion‐weighted images (DTI) were acquired for all participants and correlational analyses were performed in the patient group using WM‐VBM, fractional anisotropy (FA) and mean diffusivity (MD).ResultBehavioral results showed significantly impaired performances in patients in comparison to control subjects (p = .004). In addition, correlational analyses using WM‐VBM revealed negative WM correlations in the anterior corpus callosum and in the anterior cingulum (p &lt; .05 FDR). Using DTI (p &lt; .05 FDR), correlated with TMTA scores, we found reduced FA in bilateral frontal and posterior regions, and increased MD in bilateral anterior and posterior networks.ConclusionWM‐VBM analysis revealed the involvement of anterior corpus callosum and cingulum, which could indicate a disruption of the loops connecting striatal regions and the prefrontal cortex. Changes in both FA and MD also correlate with impaired attentional speed: further DTI analyses are still ongoing to question the degree of which white matter tracts are disrupted between the striatum and cortical anterior and posterior networks, respectively.

Short breaks at school: effects of a physical activity and a mindfulness intervention on children's attention, reading comprehension, and self-esteem.

Although breaks are essential to restoring cognitive and psychological conditions for learning, short breaks within school lessons are not established and the specificity of effects has not often been investigated. Therefore, the effects of a physical activity (Study 1) and a mindfulness intervention (Study 2) were investigated. By an intervention-control group design, the effects of daily 10-min physical activity (Study 1: N=162, 4th grade) and mindfulness breaks (Study 2: N=79, 5th grade) were implemented within regular school lessons over a 2-week time period to research the impact on attention, reading comprehension, and self-esteem. In the physical activity intervention children's attention improved (attention-processing speed: p < .004, ηp2=.05, attention-performance: p < .025, ηp2=.03), and in the mindfulness intervention reading comprehension improved (p < .012, ηp2=.08) compared to the controls. Results further indicated that self-esteem moderated the relationship between groups and attention improvement in study 1. Classroom-based short physical and mindfulness breaks could support attention and reading comprehension, which are known to support overall academic success.

A-14 Mechanisms and Neuropsychological Correlates of Sleep Disruption in Concussed College Athletes

Abstract Objective First, to explore demographic/injury characteristics associated with increased sleep disruption post-concussion. Second, to examine the association between sleep disruption post-concussion and symptom reporting and cognitive variability. Method 124 athletes (M = 103, F = 21) completed neuropsychological testing within 14 days of concussion. Athletes were categorized as sleep-disrupted (n = 52) or not sleep-disrupted (n = 72). Athletes in the sleep-disrupted group endorsed one or more of the following from the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) Post-Concussion Symptom Scale (PCSS): trouble falling asleep, sleeping more than usual, and sleeping less than usual. Loss of consciousness (LOC) and concussion history were explored. Two neurocognitive variability measures were derived from the neuropsychological battery: intraindividual standard deviation (ISD) and maximum discrepancy score (MDS). Variability in memory and attention/processing speed (APS) composites were explored. Total PCSS symptom score, without sleep items, was calculated. Results A significantly greater proportion of sleep-disrupted athletes experienced LOC (30%) compared to not sleep-disrupted athletes (13%), χ2(1,N = 118) = 4.99, p &amp;lt; 0.03, φ = 0.21. Sleep-disrupted athletes reported more symptoms, t(122) = −5.42, p &amp;lt; 0.001, d = 0.98, and demonstrated more memory variability (memory ISD, t(122) = −2.22, p = 0.03, d = 0.40, and memory MDS, t(122) = −2.29, p = 0.02, d = 0.41) than not sleep-disrupted athletes. Groups did not differ in APS variability or concussion history. Conclusions Given the higher rate of LOC in sleep-disrupted athletes, it is possible that LOC is a mechanism leading to post-concussion sleep difficulties. Furthermore, sleep disruption following concussion results in more variable memory performance and higher symptom reporting. Symptom reporting and/or return to baseline cognitive functioning are often decision-making tools in concussion management. The difficulties experienced by sleep-disrupted athletes may complicate recovery.

The Association Between Physical Activity Intensity, Cognition, and Brain Structure in People With Type 2 Diabetes.

Physical inactivity is a risk factor for type 2 diabetes (T2D) and dementia. However, it is unknown if physical activity (PA) intensity is associated with brain health in people with T2D. Therefore, this study aimed to determine (i) associations between PA intensity and step count with both cognition and brain structure and (ii) if apolipoprotein E-ε4 or insulin therapy modifies any associations. Participants were people with T2D (n = 220; aged 55-86 years). An accelerometer worn over the right hip was used to obtain step count and moderate-to-vigorous PA (MVPA) averaged over 7 days. Cognition in 7 domains was obtained using a battery of neuropsychological tests. Brain structure was measured by Magnetic Resonance Imaging. Linear regression models were used to examine associations between step count, MVPA and each cognitive and Magnetic Resonance Imaging measure. Apolipoprotein E-ε4 × PA and insulin therapy × PA product terms were added to the models to examine effect modification. The mean age of participants was 67.9 (SD = 6.3). Higher step count was associated with greater hippocampal volume (β = 0.028, 95% CI = 0.005, 0.051). Insulin therapy modified the association between MVPA and attention-processing speed, such that associations were significant in people receiving insulin therapy (p for interaction = .019). There were no other significant associations. Higher step count and greater time spent in MVPA may be associated with better hippocampal volume and attention-processing speed, respectively, in people with T2D. People with greater diabetes severity (receiving insulin therapy) may get more cognitive benefit from MVPA.

Attention processing speed impairment in early dementia with Lewy bodies correlates with white matter damage on volumetric and diffusion tensor imaging

AbstractBackgroundAttentional deficit is a prominent and distinguishing neuropsychological feature of Dementia with Lewy Bodies (DLB) since the prodromal stages. Our group recently highlighted, using voxel based morphometry (VBM), the importance of the basal ganglia grey matter (GM) integrity for attention processing speed, however, one can hypothesize that white matter (WM) would also be affected. Accordingly, this study aimed at investigating, in early DLB patients, the relationship between impaired attention processing speed and white matter changes using WM‐VBM and diffusion tensor imaging (DTI).MethodSeventy‐three prodromal to moderate DLB patients (mean MMSE = 26.4) and thirty healthy elderly subjects (mean MMSE = 28.9), matched in terms of age and educational level, were selected to participate in the study. The Trail Making Test A (TMTA) was used to assess attention processing speed. Behavioral performances were compared between patients and control subjects. Three‐dimensional (3D) MRI and diffusion tensor images (DTI) were acquired and correlational analyses were performed in the patient group using GM‐ and WM‐VBM, fractional anisotropy (FA) and mean diffusivity (MD) DTI.ResultAs expected, DLB patients took significantly more time to achieve completion of the TMTA in comparison to control subjects (p = .004), indicating an impairment in speed of processing. Correlational analyses using VBM revealed negative GM correlations in the basal ganglia bilaterally (p &lt; .001), and negative WM correlations in a bilateral but left‐predominant cluster including mainly the corpus callosum and the anterior cingulate region and a smaller cluster in the right anterior cingulum (p &lt; .05 FDR corrected). Using DTI in correlation with TMTA scores (p &lt; .05 FDR corrected), we found reduced FA in bilateral frontal and posterior regions, and increased MD in widespread lateral and medial anterior and posterior regions.ConclusionWM‐VBM analysis revealed the involvement of the anterior corpus callosum and cingulum in processing speed, which could indicate a disruption of the loops connecting striatal regions and the prefrontal cortex. Changes in both FA and MD were also found: their distribution suggest that attention processing speed might be particularly dependent on the integrity of white matter connections throughout the brain.

Dietary patterns and cognitive decline among older adults: Findings from Sydney Memory and Aging Study

AbstractBackgroundEvidence suggested dietary patterns that may protect against cognitive decline among older adults, are mostly plant‐based, rich in poly‐/mono‐ unsaturated fatty acids, and low in processed foods. We aim to examine associations between diet with cognition and cognitive decline among older adults over a 6‐year period in Sydney Memory and Aging Study.MethodCommunity dwelling participants (n=1037) were non‐demented and aged 70‐90 years at baseline. Diet was assessed using the 80‐item Cancer Council of Victoria FFQ at baseline, Mediterranean diet scores and DASH diet scores were generated based on dietary intake for individuals. Using PCA we have derived a‐posterori patterns. Neuropsychological tests assessed global cognition and 6 cognitive domains for 4 times, at baseline and followed up every two years. Linear mixed model analyses were conducted to examine the relationship between dietary scores, cognitive health, and cognition change over time, with adjustment for age, gender, education, BMI, cardiovascular risk factors, history of stroke, smoking, depression and APOE ε4 genotype.ResultNo significance was found between adherence to Mediterranean diet or DASH diet, and cognitive decline over 6 years. However, a total intake of legumes and nuts, was positively associated with better overall performance in cognitive domains including language (β=0.058; 95% CI: 0.028, 0.113; P=0.040), visuospatial (β=0.048; 95% CI: 0.008, 0.089; P=0.019) and global cognition (β=0.059; 95% CI:0.005, 0.112; P=0.033). The prudent healthy diet pattern was associated with cognitive health in women over time, in domains of memory (β=0.332; 95% CI: 0069, 0.596 ; P=0.014), verbal memory (β=0.313; 95% CI:0.056 ,0.569 ; P=0.017), visuospatial (β=0.271; 95% CI: 0.005,0.440; P=0.009), executive (β=0.352; 95% CI:0.073, 0.631; P=0.014), attention processing speed (β=0.273; 95% CI: 0.039,0.507 ; P=0.022) and global cognition (β=0.426; 95% CI: 0.141,0.711 ; P=0.004).ConclusionIn this longitudinal analysis, a prudent healthy diet and high total intake of legumes and nuts, were associated with better cognitive performance over 6 years in various domains among older adults. Adherence to Mediterranean or DASH diet was not associated with cognitive change overtime.

Using a multidimensional model of attention to predict low-income preschoolers' early academic skills across time.

The current study examines the organization of attention skills across the preschool year before kindergarten, and tests how distinct attention subcomponents predict early academic skills in a sample of low-income children (n=99). Children completed well-validated attention tasks in fall at 4.5 years old and spring at 5 years old, capturing the abilities to selectively focus, sustain attention, and employ executive control. Exploratory factor analyses at both time points support a 2-factor model differentiating selective and sustained attention from attention processing speed and executive attention, suggesting that attention in low-income preschoolers may have a simpler organization than the 3-factor structure found in adulthood. Multiple regression models find children's ability to selectively focus and sustain attention serves as a robust concurrent and longitudinal predictor of academic skills. These results highlight the role of selective and sustained attention processes in supporting school readiness for economically vulnerable children.

A-145 Evaluating Attention and Processing Speed and Executive Functioning Abilities in Hispanic Traumatic Brain Injury Survivors and Healthy Adults

Abstract Objective We examined the effects of attention/processing speed (APS) and executive functioning (EF) in Hispanic and Caucasian traumatic brain injury (TBI) survivors and healthy comparison participants (HC). Method The sample consisted of 45 HC (21 Hispanics &amp; 24 Caucasian), 28 acute TBI (ATBI; 10 Hispanics &amp; 18 Caucasians), and 26 chronic TBI (CTBI; 9 Hispanics; 17 Caucasians) participants. ATBI participants were tested 6 months post-injury; CTBI participants were tested 12 months or more post-injury. Symbol Digit Modalities Test (SDMT) Oral, SDMT Written, Stroop Word, Stroop Color, and Trail Making Test (TMT) part A were used to create an APS composite (APSC) score. Stroop color-word, TMT part B, Delis-Kaplan Executive Function System verbal fluency composite score, and design fluency composite score were used to create an EF composite (EFC) score. Results ANOVAs were used to evaluate group differences. Main effects were found on APSC, p = .000, with HC and CTBI outperforming the ATBI group. Also, we found the HC group outperformed both TBI groups on EFC, p = .000. Furthermore, we found differences between racial/ethnic groups, with Caucasians outperforming Hispanics on EFC performance, p = .029. No interactions were found. Conclusion Overall, HC demonstrated better EF compared to both TBI groups, but only APS compared to the ATBI group. Also, CTBI survivors demonstrated better APS abilities compared to ATBI survivors. Our findings suggest improvement in APS during the later stages of TBI recovery. Finally, Caucasians demonstrated better EF compared to Hispanics.

Carbohydrate mouth rinse has no effects on behavioral or neuroelectric indices of cognition

Rinsing the mouth with a carbohydrate solution has been suggested as a means to enhance aspects of both physical and cognitive performance. However, evidence in support of these assertions is relatively weak. The purpose of this study was to investigate the effects of a carbohydrate mouth rinse solution on motor speed, inhibition, and sustained attention as indexed by both behavioral and neuroelectric measures. Using a double-blind, placebo-controlled, within-subjects crossover design, 50 college-aged young adults performed a battery of cognitive tasks both before and after rinsing their mouth for 10 s with 20 mL of either a carbohydrate mouth rinse solution or a sensory-matched placebo control solution. A simple tapping task was used as a measure of motor speed, a modified Eriksen flanker task was used to index inhibition, and a rapid visual information processing task was used as a measure of sustained attention. Participants demonstrated longer reaction times in the Flanker task after rinsing their mouths with the carbohydrate mouth rinse, relative to pretest. No differences in reaction time were observed for the placebo control condition. P3 latency in the Flanker task as an index of attentional processing speed was shorter at posttest than at pretest in the placebo control – but not the carbohydrate mouth rinse – condition. These results suggest that despite claims of cognitive enhancement, carbohydrate mouth rinses do not appear to alter motor speed, inhibition, or sustained attention as compared to a placebo control in non-physically-fatigued college-aged adults.

Pay attention to the basal ganglia: a volumetric study in early dementia with Lewy bodies

BackgroundCortical and subcortical cognitive impairments are usually found in dementia with Lewy bodies (DLB). Roughly, they comprise visuo-constructive/executive function and attention/processing speed impairments, whereas memory would remain relatively spared. In this study, we focused on the neuro-anatomical substrates of attention and processing speed, which is still poorly understood. For the purpose of the study, we examined the correlations between behavioral scores measuring the speed of processing and the degree of cerebral atrophy in patients with prodromal to moderate DLB.MethodsNinety-three prodromal to moderate DLB patients (mean MMSE = 25.5) were selected to participate in the study as well as 28 healthy elderly subjects (mean MMSE = 28.9), matched in terms of age and educational level. The Trail Making Test A (TMTA) and the Digit Symbol Substitution Test (DSST) were used to assess attention and processing speed. Behavioral performances were compared between patients and healthy control subjects. Three-dimensional MRI images were acquired for all participants, and correlational analyses were performed in the patient group using voxel-based morphometry (VBM).ResultsThe behavioral results on both the TMTA (p = .026) and the DSST (p < .001) showed significantly impaired performances in patients in comparison with control subjects. In addition, correlational analyses using VBM revealed for the TMTA negative correlations in the caudate nucleus (left cluster peak significant at .05 FWE corrected), the putamen, the left thalamus, and the subthalamic nuclei (p < .05 FDR corrected). Some positive correlations associated with the DSST were found in the right inferior frontal gyrus, the left thalamus, and the left cerebellum (p < .001 uncorrected).ConclusionsThe behavioral results are in line with the literature on the DLB cognitive profile and confirm the existence of attention and processing speed impairment. Interestingly, VBM analysis revealed the involvement of the basal ganglia, in particular, the left caudate nucleus, which is part of the attention cerebral network, suggesting an important role of this structure for attentional processing speed. This also suggests the clinical implication of damage in this region relatively early in the course of the disease.

Long-term leukoencephalopathy and neurocognitive functioning in childhood sarcoma patients treated with high-dose intravenous chemotherapy.

Knowledge is limited regarding the prevalence and persistence of chemotherapy-induced leukoencephalopathy in childhood sarcoma patients. This study explored the presence, clinical relevance, and potential risk factors of leukoencephalopathy in childhood bone and soft tissue sarcoma survivors, treated with intravenous chemotherapy. We acquired cross-sectional neurocognitive data in adult survivors (n=34) (median age at diagnosis[AaD] =13.32 years, age range=16-35 years) and healthy age-matched controls (n=34). Additionally, magnetic resonance imaging included T2-weighted FLAIR (leukoencephalopathy Fazekas rating), multiexponential T2 relaxation (MET2), and multishell diffusion MRI to estimate myelin integrity-related metrics and fluid movement restrictions. Finally, chemotherapy subgroups (methotrexate, alkylating agents, or combination), AaD, and Apoε and MTHFRC677T polymorphisms were explored as potential risk factors for leukoencephalopathy. At the group level, quality of life, working memory, processing speed, and visual memory were significantly lower in patients compared to controls. Furthermore, long-term leukoencephalopathy was observed in 27.2% of the childhood sarcoma survivors, which was related to attentional processing speed. Lesions were related to diffusion-derived, but not to myelin-sensitive metrics. A significant interaction effect between AaD and chemotherapy group demonstrated more lesions in case of high-dose methotrexate (HD-MTX) (F=3.434, P=.047). However, patients treated with alkylating agents (without HD-MTX) also showed lesions in younger patients. Genetic predictors were nonsignificant. This study suggests long-term leukoencephalopathy with possibly underlying changes in vasculature, inflammation, or axonal injury, but not necessarily long-term demyelination. Such lesions could affect processing speed, and as such long-term daily life functioning of these patients.

Pre-treatment attentional processing speed and antidepressant response to transcranial direct current stimulation: Results from an international randomized controlled trial

BackgroundTranscranial direct current stimulation (tDCS) has promising antidepressant effects, however, clinical trials have shown variable efficacy. Pre-treatment neurocognitive functioning has previously been identified as an inter-individual predictor of tDCS antidepressant efficacy. ObjectiveIn this international multicentre, sham-controlled study, we investigated this relationship while also assessing the influence of clinical and genotype (BDNF Val66Met and COMT Val158Met polymorphisms) factors as predictors of response to active tDCS. MethodsThe study was a triple-masked, parallel, randomized, controlled design across 6 international academic medical centers. Participants were randomized to active (2.5 mA) or sham (34 μA) tDCS for 30 min each session for 20 sessions. The anode was centered over the left dorsolateral prefrontal cortex at F3 (10/20 EEG system) and the cathode over the lateral right frontal area at F8. ResultsBetter pre-treatment attentional processing speed on the Ruff 2 & 7 Selective Attention Test (Total Speed: β = 0.25, p < .05) and concurrent antidepressant medication use (β = 0.31, p < .05) predicted antidepressant efficacy with active tDCS. Genotype differences in the BDNF Val66Metand COMT Val158Met polymorphisms were not associated with antidepressant effects. Secondary analyses revealed that only participants in the highest performing Ruff 2 & 7 Total Speed group at pre-treatment in both active and sham tDCS conditions showed significantly greater antidepressant response compared to those with lower performance at both the 2 and 4 week treatment time points (p < .05). ConclusionsThese results suggest that high pre-treatment attentional processing speed may be relevant for identifying participants more likely to show better tDCS antidepressant response to both high (2.5 mA) and very low (34 μA) current intensity stimulation. Clinical trials registrationwww.clinicaltrials.gov, NCT01562184.

Attention/Processing Speed Prospectively Predicts Social Impairment 18 Years Later in Mood Disorders

Cross-sectional studies suggest that cognitive deficits contribute to psychosocial impairment among individuals with mood disorders. However, studies examining whether cognition prospectively predicts psychosocial outcome are few, have used short follow-up periods, and have not demonstrated incremental validity (i.e., that cognition predicts future functioning even when controlling for baseline functioning). In a sample of 51 individuals with unipolar depression or bipolar disorder, we investigated whether attention/processing speed (APS) performance predicted social functioning 18 years later. Baseline APS predicted 18-year social functioning even after controlling for baseline social functioning and depressive symptoms, demonstrating incremental validity. Individuals with high baseline APS had stable social functioning over 18 years, whereas functioning deteriorated among those with low APS. This finding helps clarify the temporal order of cognitive and psychosocial deficits associated with mood disorders and suggests the clinical utility of cognitive measures in identifying those at risk of deterioration in social functioning.

Reabilitação da memória em idosos com queixas mnemônicas e sintomas depressivos: estudo piloto não controlado

O presente estudo piloto investigou o efeito terapêutico de um programa de reabilitação da memória (RM), com avaliações pré e pós-intervenção, em um grupo de idosos com queixas mnemônicas e sintomas sugestivos de depressão. A amostra foi composta por sete idosos entre 65 a 80 anos de idade, acima de sete anos de estudo formal. A RM consistiu de 24 sessões, realizadas duas vezes por semana, cada com duração de 90 minutos. Esta intervenção incluiu técnicas de aprendizagem explícita e implícita, com estratégias mnemônicas internas e externas. Comparou-se o desempenho cognitivo pré e pós-intervenção pelo Teste Wilcoxon. Houve redução nas queixas de memória e nos sintomas sugestivos de depressão, aumento da velocidade de processamento atencional e aprimoramento da memória de trabalho. Sugere-se que este estudo seja replicado em amostras maiores, em grupos com déficits objetivos de memória e depressão clinicamente diagnosticada, comparados a grupos controles.

The Influence of Individual Differences in Perceptual Performance on Pilot Perceptions of Head-Up Display Clutter

The objective of this study was to investigate the role of individual differences in pilot perceptual abilities on their experience of head-up display (HUD) clutter during a simulated instrument approach. Pilot contrast sensitivity, useful field of view (UFOV) and field dependence were assessed using standardized instruments. When these measures were included in a model of perceived clutter based on pilot subjective ratings of HUD configurations in terms of display clarity, contrast, density and similarity of elements, the predictive utility of the model modestly increased. Contrast sensitivity was found to be the most influential perceptual ability, with UFOV also being a predictor of perceived clutter. High contrast sensitivity for higher spatial frequencies was associated with higher ratings of overall clutter, while greater contrast sensitivity for moderate spatial frequencies was associated with lower ratings of clutter. Better performance on the UFOV measure of divided attention ability was associated with lower ratings of clutter, while better performance on the selective attention processing speed scale was related to higher clutter ratings. However, these variables had a much smaller degree of influence on clutter ratings than contrast sensitivity.