Cancellation Test Research Articles

Quantification of myelination in children with attention-deficit/hyperactivity disorder: a comparative assessment with synthetic MRI and DTI.

Evaluation of myelin content is crucial for attention-deficit/hyperactivity disorder (ADHD). To estimate myelin content in ADHD based on synthetic MRI-based method and compare it with established diffusion tensor imaging (DTI) method. Fifth-nine ADHD and fifty typically developing (TD) children were recruited. Global and regional myelin content (myelin volume fraction [MVF] and myelin volume [MYV]) were assessed using SyMRI and compared with DTI metrics (fractional anisotropy and mean/radial/axial diffusivity). The relationship between significant MRI parameters and clinical variables were assessed in ADHD. No between-group differences of whole-brain myelin content were found. Compared to TDs, ADHD showed higher mean MVF in bilateral internal capsule, external capsule, corona radiata, and corpus callosum, as well as in left tapetum, left superior fronto-occipital fascicular, and right cingulum (all PFDR-corrected < 0.05). Increased MYV were found in similar regions. Abnormalities of DTI metrics were mainly in bilateral corticospinal tract. Besides, MVF in right retro lenticular part of internal capsule was negatively correlated with cancellation test scores (r = -0.41, P = 0.002), and MYV in right posterior limb of internal capsule (r = 0.377, P = 0.040) and left superior corona radiata (r = 0.375, P = 0.041) were positively correlated with cancellation test scores in ADHD. Increased myelin content underscored the important pathway of frontostriatal tract, posterior thalamic radiation, and corpus callosum underlying ADHD, which reinforced the insights into myelin quantification and its potential role in pathophysiological mechanism and disease diagnosis. Prospectively registered trials number: ChiCTR2100048109; date: 2021-07.

Standardization of apple cancellation test for neglect patients in Korea: An observational study.

Neglect can be divided into two types using apple cancellation test (apple test): Egocentric neglect (EN) and allocentric neglect (AN). However, in South Korea, apple test results and decision criteria are still largely dependent on tests by foreign countries. To establish a new South Korea standard and improve the accuracy of neglect assessment, the apple experiment was standardized in this study. This study was conducted on 223 healthy subjects for a total of 7 mo from August 2021 to February 2022. Standardization was carried out using the original apple test developed by Bickerton in 2011. In scoring for the apple test, total omission error refers to the number of missed targets (full apple) in the entire test sheet (left, middle, and right area). The score for EN is the difference between the cor-rect number of right area and the correct number of left area (excluding the middle area). For AN, the score is difference between the number of left opening apples and number of right opening apples (including the middle area). Linear regression analysis was used for standardization using the general characteristics of subjects and the results of the apple test. The cut-off score, which is the standard value indicating the pathological condition by combining the results of all subjects, is as follows: Total omission error (5), error for EN (2), and error for AN (2). Also, differences in cut-off score according to age were found. This study will be helpful in facilitating a more accurate differential diagnosis of neglect.

Standardization of apple cancellation test for neglect patients in Korea: An observational study

In recent years, because of the growing desire to improve the noninvasiveness and safety of tumor treatments, sonodynamic therapy has gradually become a popular research topic. However, due to the complexity of the therapeutic process, the relevant mechanisms have not yet been fully elucidated. One of the widely accepted possibilities involves the effect of reactive oxygen species. In this review, the mechanism of reactive oxygen species production by sonodynamic therapy (SDT) and ways to enhance the sonodynamic production of reactive oxygen species are reviewed. Then, the clinical application and limitations of SDT are discussed. In conclusion, current research on sonodynamic therapy should focus on the development of sonosensitizers that efficiently produce active oxygen, exhibit biological safety, and promote the clinical transformation of sonodynamic therapy.

Disrupted Small-World Networks in Children with Drug-Naïve Attention-Deficit/Hyperactivity Disorder: A DTI-Based Network Analysis

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, while the potential neurological mechanisms are poorly understood. To explore the alterations in the white matter (WM) structural connectome in children with drug-naïve ADHD, forty-nine ADHD and 51 age- and gender-matched typically developing (TD) children aged 6–14 years were enrolled. WM structural connectivity based on deterministic diffusion tensor imaging (DTI) was constructed in 90 cortical and subcortical regions, and topological parameters of the resulting graphs were calculated. Network metrics were compared between two groups. The concentration index and the total cancellation test scores of digit cancellation test were used to evaluate clinical symptom severity in ADHD. Then, a partial correlation analysis was performed to explore the relationship between significant topologic metrics and clinical symptom severity. Compared to TD group, ADHD showed an increase in the characteristic path length (Lp), normalized clustering coefficient (γ), small worldness (σ), and a decrease in the global efficiency (Eglob) (all p < 0.05). Furthermore, ADHD showed reduced nodal centralities mainly in the regions of default mode network (DMN), central executive network (CEN), basal ganglia, and bilateral thalamus (all p < 0.05). After performing Benjamini-Hochberg’s procedure, only the left orbital part of superior frontal gyrus and the left caudate were statistically significant (p < 0.05, FDR-corrected). In addition, the concentration index of ADHD was negatively correlated with the nodal betweenness of the left orbital part of the middle frontal gyrus (r = −0.302, p = 0.042). Our findings revealed an ADHD-related shift of WM network topology toward “regularization” pattern, characterized by decreased global network integration, which is also reflected by changed nodal centralities involving DMN, CEN, basal ganglia, and bilateral thalamus. ADHD could be understood by examining the dysfunction of large-scale spatially distributed neural networks.

Practical (un)cancellability

Cancellability is an essential feature of implicatures. However, its reliability has been challenged by several cases and examples in which conversational implicatures seem to be hard or even impossible to cancel. Should it then be concluded that not all implicatures are cancellable, and therefore Grice's cancellability test should be weakened or abandoned? The present paper addresses this problem by drawing a distinction between theoretical and practical cancellability, where the latter concept captures the (un)reasonableness of explicit or contextual cancellation. By analyzing three legal cases of misleading advertising, I show how the indefensibility of an interpretation can account for the practical uncancellability of an implicature. To explain and account for the reasonableness of an interpretation, the presumptive inferences involved must be reconstructed and evaluated considering different dimensions, such as the conversational context and the associated presumptions.

The impact of yoga on stress, metabolic parameters, and cognition of Indian adolescents: A cluster randomized controlled trial

BackgroundThis project aimed to assess the impact of yoga on stress, metabolic parameters and cognition (attention & concentration) in adolescents, aged 13–15 years from public and private schools in two cities (Chennai and New Delhi) in India. MethodsThe study recruited 2000 adolescents from 24 schools in a cluster randomized controlled trial design. The yoga group participants underwent 17 yoga sessions, which included: pranayama, basic asanas, meditation and relaxation exercises. Yoga sessions, were held in the school premises once a week. A total of five awareness talks on healthy lifestyle were delivered once a month to the education group. ADOlescence Stress Scale (ADOSS), salivary cortisol, metabolic and clinical parameters and Letter Cancellation Test (LCT) score were measured at baseline and post-intervention (5–6 months). ResultsThe yoga group showed statistically significant differences in the mean ADOSS score, metabolic parameters, salivary cortisol, and LCT scores compared to the education group. In the intention- to- treat analysis, a significant reduction [5.11, 95% CI (4.78, 5.36), p = 0.001] in ADOSS score was seen in the yoga group compared to education. ConclusionImplementation of a 17-week standardized yoga program at the school level significantly decreased stress, improved attention and concentration, metabolic and clinical parameters in Indian adolescents. Trial registrationThis trial was registered at Clinical Trials Registry, India (CTRI/2017/08/009203).

Neurocognitive Profile in Children with Attention Deficit/Hyperactivity Disorder and Dyslexia

Objective: The current study aimed to examine the neurocognitive deficits of children with ADHD and/or Developmental Dyslexia (DD) using neurocognitive tests. Material and Methods: The participants of the study consisted of children diagnosed with Dyslexia (N=33), ADHD (N=32), and DD+ADHD (N=37) who applied to the Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ankara University. The control group consists of 30 primary school children aged 7-11 with similar sociodemographic data. K-SADS-PL is used for the DSM-5 diagnoses of the patients and the control group. Stroop Test, Trail Making Test, Verbal Cancellation Test, and Wechsler Intelligence Scale for Children-Revised (WISC-R) were used to evaluate the cognitive functions of the groups in detail. Results: Children with ADHD and/or Dyslexia were evaluated to have significant deficits in all neurocognitive measures such as reaction inhibition, selective attention, sustained attention, shifting attention, and visuospatial short-term memory compared to the healthy control group (p&lt;0.001). Children with ADHD-only revealed the most significant weaknesses in reaction inhibition, and visuospatial short-term memory measures (p&lt;0.001). The comorbid group exhibited significant weakness on almost all neurocognitive measures compared with the control group, but did not perform significantly lower than the ADHD-only and Dislexia-only groups. Conclusion: It has been shown that children with ADHD and/or Dyslexia have multiple neurocognitive deficits, and our study supports the multiple cognitive deficit hypothesis.

Comparing the effects of dietary sugars on cognitive performance and reaction time: A randomized, placebo- controlled and double-blind experimental trial

The aim of the study was to compare the effects of acute intake dietary sugars on cognitive performance and reaction time. This study was, randomized, placebo-controlled, double-blind experimental design, conducted with 75 healthy adults. At the beginning of the study, the participants (36 male, 39 female; 21.6 ± 1.3 years of age; body mass index: 21.59 ± 1.94 kg/m2) were randomly divided into equal five groups (n:15) (glucose (10 g), fructose (10 g), sucrose (10 g), saccharin (0.24 g), placebo), and received dietary sugars dissolved in 200 mL of water. Cognitive performance was determined with Cancelation Test, and the Simple Response Time and Ruler Drop Tests were used in order to response and reaction time of participants, respectively. General score of cognitive performance (0.93 ± 0.1), reaction (295 ± 20 ms), and response (204 ms) were highest in glucose and lowest in placebo (0.63 ± 0.1; 368 ± 22 ms; 251 ms, respectively) (p < .001). Saccharin groups had a higher reaction (312 ± 22 ms) and response (216 ms) time score compared to consumed fructose (316 ± 39; 227 ms), sucrose (354 ± 26; 246 ms), and placebo (368 ± 22; 251 ms) groups, respectively (p < .001). These findings show that differences in the absorption pattern and sweetness levels of sugar types may have different effects on cognitive performance and reaction time.

Neuropsychological measures of post-COVID-19 cognitive status.

COVID-19 may result in persistent symptoms in the post-acute phase, including cognitive and neurological ones. The aim of this study is to investigate the cognitive and neurological features of patients with a confirmed diagnosis of COVID-19 evaluated in the post-acute phase through a direct neuropsychological evaluation. Individuals recovering from COVID-19 were assessed in an out-patient practice with a complete neurological evaluation and neuropsychological tests (Mini-Mental State Examination; Rey Auditory Verbal Test, Multiple Feature Target Cancellation Test, Trial Making Test, Digit Span Forward and Backward, and Frontal Assessment Battery). Pre- and post-COVID-19 global and mental health status was assessed along with the history of the acute phase of infection. Post-COVID-19 cognitive status was modeled by combining persistent self-reported COVID-related cognitive symptoms and pathologic neuropsychological tests. A total of 406 individuals (average age 54.5 ± 15.1 years, 45.1% women) were assessed on average at 97.8 ± 48.0 days since symptom onset. Persistent self-reported neurological symptoms were found in the areas of sleep (32%), attention (31%), and memory (22%). The MMSE mean score was 28.6. In total, 84 subjects (20.7%) achieved pathologic neuropsychological test results. A high prevalence of failed tests was found in digit span backward (18.7%), trail making (26.6%), and frontal assessment battery (10.9%). Cognitive status was associated with a number of factors including cardiovascular disease history, persistent fatigue, female sex, age, anxiety, and mental health stress. COVID-19 is capable of eliciting persistent measurable neurocognitive alterations particularly relevant in the areas of attention and working memory. These neurocognitive disorders have been associated with some potentially treatable factors and others that may stratify risk at an early stage.

Lise Öğrencilerinde Akıllı Telefon Bağımlılığının Dikkat Düzeyi Üzerine Etkisi

Introduction: Smartphones are electronic devices that have an important place in our lives today and provide many conveniences. However, it can cause many problems such as distraction and social isolation. The aim of this study is to investigate the effect of smartphone use on attention levels in high school students.&#x0D; Material-Methods: In the study, the smartphone addiction scale and Mesulam's cancellation tests were applied to 100 students, 68 women, and 32 men. Statistical analyzes were made with the obtained data.&#x0D; Results: As the duration of smartphone use has increased, phone addiction has increased. Phone addiction is more common in males than in females. In addition, according to attention tests results, it was determined that as the phone use time increases, there is a distraction and the distraction is more in males.&#x0D; Discussion and Conclusion: The use of smartphones may have a negative effect on the level of attention of high school students, who are the target audience of the smartphone market and are preparing for an important exam. Limiting smartphone use, especially social media, which increases smartphone addiction, can have a positive effect on the level of attention.

The Influence of Vertical Illuminance on Cognitive Performance and Subjective Evaluations during Simulated Conditions of Polar-Night Specificity

ABSTRACT The natural light environment in polar regions is different in that there are midnight sun and polar night rather than a regular year-round alternation of day and night. Existing research has reported that the scientific modulation of interior light parameters can reduce the negative effects on the circadian rhythm and improve brain functions of the staff members at polar stations, from basic physiological mechanisms to higher cognitive functions, such as perception, learning, memory, and thinking. Currently, the appropriate balance of visual and nonvisual aspects that allow lighting conditions to be applied in a manner conducive to human well-being, health and functioning is still to be investigated, and accurate analysis of the influence rules of functional lighting’s vertical illuminance at eye level on cognitive performance remains an unresolved and important issue. This study analyses the effects of the vertical illuminance at eye level of functional lighting on the cognitive performance indicators toward the target population through simple reaction time task, cancellation test, and stroop test, and concludes that vertical illuminance levels of 260 ~ 300 lx at eye level contributed to improved cognitive performance. The study also verifies that comfort and satisfaction indices of subjective perceptions are significantly and strongly correlated with cognitive function indicators, and slightly better than the relaxation index. However, the attention index is not significantly correlated with cognitive function indicators. This study can provide data reference for the light design and operational decisions of buildings in Antarctica and the Arctic to promote wider application and impact.

Long-term neurodevelopment in children with resected congenital lung abnormalities.

To determine whether children who underwent resection of a congenital lung abnormality (CLA) are at higher risk for neurodevelopmental impairments than peers in the general population. The study population consisted of children born between 1999-2018 who underwent resection of a symptomatic CLA. Neurocognitive development (intelligence, memory, attention, visuospatial processing, executive functioning) and motor function of this population are monitored through our structured, prospective longitudinal follow-up program at the ages of 30months, 5, 8, and 12years. We compared study population scores with Dutch norm values using one-sample t-tests and one-sample binominal proportion tests. Forty-seven children were analyzed. The 8-year-olds showed significant impairments in sustained attention through the Dot Cancellation Test (mean z-scores -2.4; [-4.1; -0.8], p = 0.006 and -7.1; [-12.8; -1.4], p = 0.02 for execution speed and fluctuations respectively). Visuospatial memory was impaired at 8years, though only in 1 out of 3 assessment tools (Rey Complex Figure Test z-scores (-1.0; [-1.5; -0.5], p < 0.001). Further neurocognitive outcomes were unimpaired at all tested ages. Regarding motor function outcomes, mean z-scores of total motor functioning were unimpaired across assessed ages. However, at 8years, significantly more children than expected had definite motor problems (18% vs 5%, 95% CI [0.052; 0.403], p = 0.022). Conclusion: This evaluation reveals impairment in some subtests of sustained attention, visuospatial memory and motor development. However, globally, normal neurodevelopmental outcomes were found throughout childhood. We recommend testing for neurodevelopmental impairments in children who underwent surgery for CLA only if associated morbidities are present or if caregivers express doubts about their daily functioning. What is Known: • In general, surgically managed CLA cases seldom suffer from long-term surgery-related morbidity and show favorable lung function. What is New: • Long-term neurocognitive and motor function outcome appear unimpaired within surgically managed CLA cases. We recommend testing for neurodevelopmental impairments in children who underwent surgery for CLA only if associated morbidities are present or if caregivers express doubts about their daily functioning.

Effects of Twins Therapy on Egocentric and Allocentric Neglect in Stroke Patients: A Feasibility Study.

(1) Background: Existing treatment methods for neglect are concentrated on egocentric neglect and may lead to various problems such as cost/space constraints and portability. Therefore, this study seeks to determine how a new treatment (also known as twins therapy, TT) for stroke patients can improve an existing problem associated with neglect. (2) Method: A pre/post-test control group research design was used and both groups continued to receive existing rehabilitation treatment, whilst TT intervention was only added to the experimental group. TT intervention was conducted for a total of 20 sessions (1 session for 30 min/day, 5 days/week, for 4 weeks). (3) Result: There was no significant difference in the manual function test (MFT) and the Korean version of the Modified Barthel Index (K-MBI) items (p > 0.05) before and after the TT intervention. However, the score and execution time of the apple cancellation test showed a significant reduction only in the experimental group (p < 0.05). (4) Conclusion: TT not only improved egocentric neglect, but also allocentric neglect symptoms in stroke patients.

The Single-Matrix Digit Cancellation Test, a Screener for Selective Attention Deficits: Standardization in an Italian Population Sample and Clinical Usability in Acute Stroke Patients

Introduction: This study aimed at validating and providing Italian norms for the Single-Matrix Digit Cancellation Test (SMDCT), a cancellation task to screen for selective attention deficits, as well as providing clinical usability evidence for it in acute stroke patients. Methods: The SMDCT stimulus is a specular, 4-quadrant, horizontally oriented matrix, across which target distribution is homogeneous. Both accuracy (-A) and time (-T) outcomes were computed. N = 263 healthy participants (HPs) and N = 76 acute stroke patients were recruited. N = 108 HPs also underwent the Mini-Mental State Examination, Frontal Assessment Battery (FAB), and Trail-Making Test (TMT), while patients were further assessed by the Mental Performance in Acute Stroke (MEPS). Regression-based norms were derived (equivalent scores). Construct and factorial validity, as well as case-control discrimination, were tested. Results: The matrix was underpinned by a two-component structure reflecting left and right hits. The SMDCT-T and -A were associated with TMT and FAB scores, respectively. Education predicted the SMDCT-A/-T, whereas age predicted the SMDCT-T only. In patients, the SMDCT converged with the MEPS, also accurately discriminating them from HPs. An index of right-left difference differentiated right- from left-damaged patients. Conclusions: The SMDCT is a valid and normed screener for selective attention deficits, encompassing measures of both accuracy and time, whose adoption is encouraged in acute stroke patients. Relatedly, the horizontal disposition of its matrix does allow for the qualitative report of either leftward of rightward biases due to underlying visual or attentional-representational deficits in this population.

The Effect of Circadian Photoreceptors Stimulation on the Stress Response of Subjects with High Anxiety: A Pilot Study

The circadian and stress-realizing systems are interconnected, and the balance of their interaction determines the state of human health. The objective of this study was to investigate the modulating effect of activating the circadian system on heart rate variability in female medical students with high anxiety while performing a cognitive task. After 20 min of adequate stimulation of circadian photoreceptors with a monochromatic blue light, the cognitive task performance resulted in a decrease in sympathetic impact. During the session of monochromatic blue light exposure, a trend of increasing heart rate variability was observed in a state of relative rest (especially in the first 5 min). A comparative analysis of the parameters of the letter cancellation test before and after light exposure revealed a statistically significant increase in the indexes reflecting mental productivity, work accuracy, and concentration of attention. The results suggest an essential physiological role of the human circadian system in modulating the autonomic and psycho-emotional conditions, as well as cognitive functions of individuals with high anxiety. Our findings indicate the possibility of quickly correcting the balance in human systemic regulatory mechanisms using the activation of retinal circadian photoreceptors by blue light.

The Effect of Visual Acuity Corrections on the Determination of Unilateral Neglect when Conducting the Apple Cancellation Test

This study examined the effects of visual acuity corrections on the diagnosis of unilateral neglect (UN) in elderly subjects. Nineteen subjects between the ages of 61 and 86 participated in this study. For the assessment of UN, the frequency of subjects diagnosed as UN, the number of correct responses, and the time spent completing the test were examined under three conditions; naked eye state, with distance-correction glasses, and with near-correction glasses, in order to determine whether or not the subjects had UN using the apple cancellation sheet. The frequency of subjects diagnosed with UN decreased when wearing both distance- and near-correction glasses, and the number of correct responses showed a significant increase while wearing near-correction glasses (p &lt; 0.05). In addition, the time spent completing the test was significantly reduced while wearing near-correction glasses (p &lt; 0.05). For elderly subjects, near visual acuity correction can improve near visual perception, reading ability, and concentration, acting as a positive factor in the apple cancellation test, which is tested at near distance, and prevent the misdiagnosis of UV.

Breath Phase Durations, Affect, and Attention: A Pilot Randomized Crossover Trial.

Previously, yoga volitional breathing with low inspiration to expiration ratios (i/e) (as in bhramari pranayama) improved cognition and reduced state anxiety. This study compared the effects of low, high and equal i/e ratio breathing on affect and attention. Affect, vigor and attention were assessed in forty healthy participants (group mean age± SD; 22.58±3.83; M:F= 2.33:1) while breathing with three different i/e regulated by a visual metronome on separate days viz., (i) low i/e (28:72), (ii) equal i/e (50:50), (iii) high i/e (72:28) compared to control, without conscious breath modification. Assessments were: (i) brief mood introspection scale (BMIS), (ii) global vigor and affect scale (GVAS), (iii) Spielberger's state trait anxiety inventory-state (STAI-S) and a six letter cancellation test to assess sustained attention. Data were analyzed with repeated measures analysis of variance with Bonferroni adjusted post-hoc tests. Pleasant feelings increased after low and equal i/e. Low i/e also increased positive feelings whereas equal i/e decreased scores in the cancellation test for sustained attention. All three breathing practices and the control session decreased state anxiety and increased vigor. High i/e breathing alone did not decrease negative feelings. For all the breath ratios the breath frequency cue was set at twelve breaths per minute. In summary, varying breath phase ratios influenced positive and pleasant feelings but did not influence state anxiety or vigor. Understanding the mechanisms underlying the findings would be improved with concurrent physiological assessments.

Decreased serum allopregnanolone and progesterone levels in male patients with bipolar disorder and their effects on cognitive functions

The progression of bipolar disorder (BD) is characterized by recurrent episodes of depression, mania, and hypomania, thus affecting the daily functionality of individuals. Previous studies have shown that a large proportion of patients diagnosed with BD who are in clinical remission experience significant functional disorders. The present study aimed to investigate the relationships between cognitive impairment and serum progesterone, allopregnanolone and BDNF levels in male bipolar disorder patients who are in the euthymic period. Our study included 41 euthymic male patients with bipolar disorder and 40 age, sex, body mass index (BMI) and smoking-matched male healthy control subjects. Neuropsychiatric tests such as the Stroop Test TBAG Form, Auditory Verbal Digit Span Test- Form B (VADS-B) and Cancellation Test were administered to all participants, and 5-7ml of peripheral venous blood sample was taken from all participants. Serum allopregnanolone, progesterone and BDNF levels were also measured in all participants. Serum allopregnanolone and progesterone levels were found to be lower in bipolar patients, and it was observed that the serum level of allopregnanolone decreased as the disease duration increased. The serum BDNF levels were similar between groups. The cognitive functions assessed using the Stroop, VADS-B and cancellation tests were found to be better in healthy subjects. The neurocognitive test performances of all participants were strongly positively correlated with allopregnanolone levels. The present study supports the hypothesis that allopregnanolone acts as an endogenous mood stabilizer.

Feasibility of hemispatial neglect rehabilitation with virtual reality-based visual exploration therapy among patients with stroke: randomised controlled trial.

Hemispatial neglect (HSN) was diagnosed using a virtual reality-based test (FOPR test) that explores the field of perception (FOP) and field of regard (FOR). Here, we developed virtual reality-visual exploration therapy (VR-VET) combining elements from the FOPR test and visual exploration therapy (VET) and examined its efficacy for HSN rehabilitation following stroke. Eleven participants were randomly assigned to different groups, training with VR-VET first then waiting without VR-VET training (TW), or vice versa (WT). The TW group completed 20 sessions of a VR-VET program using a head-mounted display followed by 4 weeks of waiting, while the WT group completed the opposite regimen. Clinical HSN measurements [line bisection test (LBT), star cancellation test (SCT), Catherine Bergego Scale (CBS), CBS perceptual-attentional (CBS-PA), and CBS motor-explanatory (CBS-ME)] and FOPR tests [response time (RT), success rate (SR), and head movement (HM) for both FOP and FOR] were assessed by blinded face-to-face assessments. Five and six participants were allocated to the TW and WT groups, respectively, and no dropout occurred throughout the study. VR-VET considerably improved LBT scores, FOR variables (FOR-RT, FOR-SR), FOP-LEFT variables (FOP-LEFT-RT, FOP-LEFT-SR), and FOR-LEFT variables (FOR-LEFT-RT, FOR-LEFT-SR) compared to waiting without VR-VET. Additionally, VR-VET extensively improved FOP-SR, CBS, and CBS-PA, where waiting failed to make a significant change. The VR-VET made more improvements in the left hemispace than in the right hemispace in FOP-RT, FOP-SR, FOR-RT, and FOR-SR. The observed improvements in clinical assessments and FOPR tests represent the translatability of these improvements to real-world function and the multi-dimensional effects of VR-VET training. https://clinicaltrials.gov/ct2/show/NCT03463122, identifier NCT03463122.

Severe Obesity in Women Can Lead to Worse Memory Function and Iron Dyshomeostasis Compared to Lower Grade Obesity

Obesity is one of the modifiable risk factors for dementia. Insulin resistance, the abundance of advanced glycated end-products, and inflammation are some of the mechanisms associated with the lower cognitive performance observed in obesity. This study aims to evaluate the cognitive function of subjects with distinct degrees of obesity, comparing class I and II obesity (OBI/II) to class III obesity (OBIII), and to investigate metabolic markers that can distinguish OBIII from OBI/II. Study Design. This is a cross-sectional study, in which 45 females with BMI varying from 32.8 to 51.9 kg/m2 completed a set of 4 cognitive tests (verbal paired-associate test, stroop color, digit span, and Toulouse-Pieron cancellation test) and their plasma metabolites, enzymes, and hormones related to glycemia, dyslipidemia, and liver function, as well as the biomarkers of iron status, were concomitantly analyzed. OBIII showed lower scores in the verbal paired-associate test compared to OBI/II. In other cognitive tests, both groups showed similar performance. OBIII presented a lower iron status compared to OBI/II based on total iron binding capacity, degree of transferrin saturation, hemoglobin, mean corpuscular volume, and mean corpuscular hemoglobin. The levels of indicators for glycemia, liver function, and lipid metabolism were similar in both groups. Analysis of plasma metabolites showed that OBIII had lower levels of pyroglutamic acid, myoinositol, and aspartic acid and higher levels of D-ribose than OBI/II. Iron is an essential micronutrient for several metabolic pathways. Thus, iron dyshomeostasis observed in severe obesity may aggravate the cognitive impairment by altering metabolic homeostasis and enhancing oxidative stress. These findings can contribute to searching for biomarkers that indicate cognitive performance in the population with obesity.