Cognitive Subdomains Research Articles

Evidence for a multidimensional account of cognitive and affective theory of mind: A state-trace analysis

Theory of mind (ToM) has been argued to be a multidimensional construct, with ToM inferences depending on distinct processes across affective and cognitive ToM tasks and across first-order cognitive and second-order cognitive ToM tasks. Behavioural evidence for a multidimensional account has primarily depended on dissociations identified via analysis of variance, a statistical approach insufficient for assessing dimensionality. Instead, state-trace analysis (STA) is a more appropriate statistical technique to uncover dimensionality. The current study first applied STA to two summary datasets that had previously identified key dissociations between cognitive and affective ToM; these reanalyses did not support a multidimensional account of ToM. Next, STA was applied to a more detailed dataset to reveal whether ToM is based on multiple processes in a sample of 115 older adults aged 60–85 years (M = 68.5, SD = 5.92, 61.7% female) with higher or lower emotion perception ability. Participants made ToM judgements about different social exchanges (e.g., sarcasm or lying). STA results supported a multidimensional account of ToM across first-order cognitive, second-order cognitive, and affective ToM subdomains. These results lay a more rigorous foundation for subsequent studies to further examine the dimensionality of ToM and to apply formal modelling, progressing the field’s understanding and measurement of the cognitive processes driving ToM judgements.

Association of Age-Related Spontaneous Internal Jugular Vein Reflux with Cognitive Impairment and Incident Dementia.

It remains unclear whether changes in the venous circulation contribute to cognitive decline. This study aimed to clarify whether the spontaneous jugular vein reflux (JVR) is associated with cognitive impairment and incident dementia. Patients with any evidence of cerebral vessel disease on magnetic resonance imaging (MRI) were consecutively enrolled between October 2015 to July 2019. We employed carotid duplex sonography to measure the internal jugular vein (IJV). The subjects were classified into two groups based on the degree of JVR on either side: none, mild (JVR(-) group) and moderate, severe (JVR (+) group) JVR. They underwent both the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment-Japanese (MoCA-J) global tests. Their cognitive status was prospectively assessed until March 2023. 302 patients with an MMSE score ≥24 underwent duplex sonography of the IJV. Among them, 91 had spontaneous JVR on either side. Both MMSE and MoCA-J were significantly lower in patients with JVR (+) group than in the JVR (-) group. After the adjustment for risk factors and MRI findings, intergroup differences in MoCA-J remained significant. Among the cognitive subdomains, median executive function and memory scores were significantly lower in the JVR (+) group than in the JVR (-) group. During the median 5.2-year follow-up, 11 patients with incident dementia were diagnosed. Patients with severe JVR were significantly more likely to be diagnosed with dementia (log-rank test, p = 0.031). Spontaneous IJV reflux especially severe JVR, was associated with global cognitive function, and potentially with incident dementia.

A review of the effect of alcohol hangover on attention and memory

Alcohol hangover (AH) refers to adverse mental and physical symptoms after a heavy consumption of alcoholic drinks, which had a significant effect on socioeconomic development and drew a huge amount of interest among psychologists in recent years. Studies found that AH mainly affected peoples cognitive performances, especially memory and attention functioning, while the findings in this field were controversial. This paper aimed to review the articles and examine the effects of AH on attention and memory by focusing on their cognitive subdomains and different study designs to find explanations for their inconsistent results. The review article showed that among attention functioning, psychologists found consistent damaging effects of AH on selective attention and sustained attention behaviors whereas the effects of divided attention performance were inconsistent. Moreover, insufficient attentional resources were regarded as the mechanism of divided attention deficit during the AH state. Among studies of memory functioning, the encoding phase was believed to be a significant factor for impaired retrospective memory performance during the AH state compared with the retrieval phase, while the effect of the memory retrieval process was not clearly tested during AH. In addition, the AH state also negatively affected the prospective memory ability to implement behaviors at a specific future time or place. The distinct study methodologies (laboratory vs. naturalistic studies; within-subject vs. between-subject design; student vs. non-student sample) were suggested to be the contributors to these conflicting results.

Enhancing Intrinsic Capacity and Related Biomarkers in Community-Dwelling Multimorbid Older Adults Through Integrated Multidomain Interventions: Ancillary Findings From the Taiwan Integrated Geriatric (TIGER) Trial

ObjectiveThis study aimed to evaluate the efficacy of integrated multidomain interventions and primary health care on intrinsic capacity (IC) and related biomarkers. DesignAn ancillary analysis from the Taiwan Integrated Geriatric Care (TIGER) study: a randomized controlled trial. Setting and ParticipantsA total of 398 community-dwelling older adults aged ≥65 years with ≥3 chronic conditions. MethodsParticipants were randomized into the 12-month pragmatic multidomain intervention or usual care groups. The primary outcome was the change in IC and its subdomains (locomotion, cognition, vitality, psychological, and sensory) at baseline and 3-, 6-, 9-, and 12-month follow-ups. Generalized linear mixed models were used to evaluate the multidomain intervention effects on these changes. ResultsThe intervention arm had greater improvement in IC than the usual care arm (overall difference 1.5; 95% CI 0.5–2.5; P = .005), mainly from subdomains of locomotion (overall difference 1.4; 95% CI 0.5–2.4; P = .004) and cognition (2.9; 95% CI 2.1–3.7; P < .001). Changes in neutrophil-to-lymphocyte ratio (NLR −2.4; 95% CI −3.9 to −0.8, P = .003), serum levels of albumin (35.1; 95% CI 23.1–47.2; P < .001), dehydroepiandrosterone sulfate (DHEA-S 2.8; 95% CI 1.9–3.8; P < .001), free androgen index (FAI 1.5; 95% CI 1.1–1.9; P < .001), and vitamin D (4.0; 95% CI 2.0–6.1; P < .001) were associated with changes in IC over time. Conclusions and ImplicationsThe incorporation of multidomain interventions into primary health care significantly enhanced IC over the 12-month program. Changes in NLR, FAI, and serum levels of albumin, DHEA-S, vitamin D were associated with changes in IC over time. Trial registrationClinicalTrials.gov Identifier: NCT03528005.

Effects of dance therapy on cognitive and mental health in adults aged 55 years and older with mild cognitive impairment: a systematic review and meta-analysis

BackgroundIndividuals with mild cognitive impairment are at high risk of developing dementia. Dance therapy has promising applications in delaying cognitive decline. However, the effectiveness of dance therapy for older adults with mild cognitive impairment is unclear. The objective of this review was to evaluate the effectiveness of dance therapy on global cognitive function, specific cognitive subdomains, quality of life, and mental health in older adults with mild cognitive impairment to enrich health management strategies for dementia.MethodsElectronic databases and grey literature were searched from inception up to September 23, 2023. The language was limited to English and Chinese. Relevant studies were screened and assessed for risk of bias. A meta-analysis and subgroup analyses stratified by measurement instrument, dance type, intervention duration, and frequency were conducted using the STATA 16.0 software. This review was conducted in accordance with the PRISMA guidelines.ResultsTen studies involving 984 participants aged 55 years and over who met the eligibility criteria were included. Dance therapy significantly improved global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). However, the effects of dance therapy on processing speed, visuospatial ability, and quality of life in older adults with mild cognitive impairment remain inconclusive. Moreover, dance interventions of longer duration (> 3 months) improved global cognition more than shorter interventions.ConclusionThis review reported that dance therapy was effective in improving global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). Hence, it may be an effective non-pharmacological complementary treatment for older adults with mild cognitive impairment.

Functional Impairment, Attachment, and Affective Temperaments in Euthymic Patients with Bipolar Disorder.

Functional impairment in euthymic patients with bipolar disorder is a compelling issue, and revealing unknown related factors with functional impairment is a substantial topic. We aimed to assess the effects of clinical factors, affective temperaments, and attachment on overall functioning in euthymic patients with bipolar disorder. Sixty-three patients with bipolar disorder and 61 healthy controls participated in this study. The assessment involved Hamilton Depression Rating Scale; Young Mania Rating Scale; Relationship Scales Questionnaire; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego; and Functioning Assessment Short Test. Secure attachment scores were significantly higher in the control group than in the bipolar disorder group. Depressive, anxious, and cyclothymic temperament scores were significantly higher in the bipolar disorder group. In the bipolar disordergroup higher occupational, cognitive, autonomy, interpersonal relationships, and leisure subdomain and overall functional impairment scores were found than in the healthy control group. Secure attachment scores were significantly and negatively correlated with anxious and depressive temperaments. Secure attachment scores were positively and significantly correlated with hyperthymic temperament scores. Years of education; subclinical depressive symptoms; secure attachment; and cyclothymic, irritable, depressive, hyperthymic, and anxious temperaments were all significantly correlated with the overall functional impairment in the patient group. The cyclothymic and anxious temperament positively predicted the overall functional impairment in the bipolar group, while the secure attachment negatively predicted the overall functional impairment in the regression analysis. The results suggest that, when following up the patients with bipolar disorder in relation to functional impairment, secure attachment, cyclothymic, and anxious temperaments should be taken into consideration.

Altered connectivity in the cognitive control-related prefrontal cortex in Parkinson's disease with rapid eye movement sleep behavior disorder.

Rapid eye movement sleep behavior disorder (RBD) frequently occurs in Parkinson's disease (PD), however, the exact pathophysiological mechanism is not clear. The prefrontal cortex (PFC), especially ventrolateral prefrontal cortex (VLPFC), dorsolateral prefrontal cortex (DLPFC), and inferior frontal gyrus (IFG) which may play roles by regulating cognitive control processes. The purpose of this study was to investigate whether there is abnormal functional connectivity (FC) maps and volume changes in PD with RBD(PD-RBD). We recruited 20 PD-RBD, 20 PD without RBD (PD-nRBD), and 20 normal controls (NC). We utilized resting-state functional Magnetic Resonance Imaging (rs-MRI) to explore FC changes based on regions of interest (VLPFC, DLPFC, and IFG), and used voxel-based morphology technology to analyze whole-brain volumes by 3D-T1 structural MRI. Except the REM sleep behavioral disorders questionnaire (RBDSQ), the PD-RBD showed lower visuospatial/executive and attention scores than the NC group. The RBDSQ scores were significantly positively correlated with zFC of right DLPFC to bilateral posterior cingulate cortex (PCC) (P = 0.0362, R = 0.4708, AlphaSim corrected) and also significantly positively correlated with zFC of left VLPFC to right inferior temporal (P = 0.0157, R = 0.5323, AlphaSim corrected) in PD-RBD group. Furthermore, abnormal correlations with zFC values were also found in some cognitive subdomains in PD-RBD group. The study may suggest that in PD-RBD patients, the presence of RBD may be related to the abnormal FC of VLPFC and DLPFC, meanwhile, the abnormal FC of DLPFC and IFG may be related to the mechanisms of cognitive impairment.

Parental investment, school choice, and the persistent benefits of an early childhood intervention

We present evidence from a randomised experiment testing the impacts of a six-month early childhood home-visiting program on child outcomes and parental investment behaviour at school entry. Two and a half years after completion of the program, we find large persistent effects on parental investment at home, as well as large effects on preschool enrolment. Children in treatment villages were enrolled earlier and in higher quality preschools, the latter reflecting a shift in preferences over preschool attributes towards quality. Finally, we find evidence that the program increased child working memory, but do not find strong evidence of impacts on other cognitive sub-domains or on non-cognitive skills of children at school entry.

The development and evaluation of a self-efficacy enhancement program for older adults with mild cognitive impairment

ObjectiveThe aims of this study were to develop a self-efficacy enhancement program and to evaluate its effect on cognitive function, dementia knowledge, self-efficacy, depression, and dementia preventive behaviors in older adults (age ≥ 65 years) with mild cognitive impairment (MCI). MethodsThis equivalent control group pretest-posttest study was conducted at a tertiary hospital in Seoul, South Korea. Older adults with MCI were randomly allocated to an experimental (EG, n = 16) or control group (CG, n = 16). The EG underwent an 8-week intervention (weekly 60-min session) utilizing self-efficacy enhancement strategies; the CG received usual care. The intervention was comprised of physical, cognitive, and emotional activities and was followed by 4-week maintenance during which both groups engaged in self-learning at home with a dementia preventive guidebook. Outcome data were evaluated at the pretest and 8, 10, and 12 weeks later. This study adhered to the CONSORT guidelines. ResultsThere were significant differences in cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors, but not in depression between the two groups over the time. Regarding cognitive function subdomains, significant differences were observed in visuospatial/executive, attention, language, and delayed recall. ConclusionThe integrated intervention consisting of physical, cognitive, and emotional activities was effective in improving cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors. This suggests that this program can be utilized as an educational program to prevent dementia in older adults with MCI in dementia support centers, public health centers, clinics, and hospitals. Trial registrationKCT0006094 in the Clinical Research Information Service. Retrospectively registered 23 April 2021, https://cris.nih.go.kr/cris/search/listDetail.do

Does occupational therapy improve activities of daily living and/or cognitive abilities in stroke patients with cognitive impairment? A Cochrane Review summary with commentary.

Cognitive Impairment (CI) after stroke is frequent and often persistent, and is associated with poor functional outcome. Occupational therapy (OT) is aimed at restoring functioning also by addressing CI. Commentary on the review by Gibson et al. (2022) updating a previous Cochrane Review (Hoffmann et al., 2010) to investigate the effectiveness of OT on CI after stroke. This review included randomised and quasi-randomised controlled trials evaluating OT for adults with clinically defined stroke and confirmed CI. Outcomes included basic activities of daily living (BADL) (primary), instrumental ADL (IADL), community integration and participation, global cognitive function and specific cognitive abilities. Overall, 24 trials from 11 countries including 1142 participants. For BADL, a small effect below the minimal clinically important difference (MCID) was found immediately after intervention and at six months' follow-up (low certainty evidence), but not at three months follow-up (insufficient evidence). For IADL, the evidence was very uncertain about an effect, while for community integration, there was insufficient evidence of an effect. For global cognitive performance, there was an improvement of clinical importance after the intervention (low-certainty). There was some effect for attention overall, and for executive functional performance overall (very low-certainty). Of the cognitive subdomains, there was evidence of effect of possible clinical importance, immediately after intervention, only for sustained visual attention (moderate certainty), for working memory (low certainty), and thinking flexibly (low certainty), while there was only low or very low certainty or insufficient evidence of an effect for other cognitive domains/subdomains;CONCLUSION:The authors concluded that the body of evidence for the effectiveness of OT interventions has improved since their first review. However, although their findings provide some support for the potential benefits of OT (mostly based on low certainty evidence), OT effectiveness for stroke patients remains unclear.

Cognitive and executive impairments in Parkinson’s disease psychosis: a Bayesian meta-analysis

BackgroundCognitive and executive deficits lead to worsening of quality of life and are a risk factor for developing dementia in people with Parkinson’s disease (PD) with psychosis (PDP). However, which...

The longer-term impact of the COVID-19 pandemic on wellbeing and subjective cognitive functioning of older adults in Belgium

In earlier survey research, we observed a severe impact of the first peak of the COVID-19 pandemic on the subjective wellbeing, sleep and activity of adults aged 65 years or older in Flanders, Belgium. The impact on subjective cognitive functioning, however, was limited. Since then, periods of lockdown and periods with less strict regulations alternated, but social distancing remained, especially for older adults. To study the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning, we re-assessed the older adults from the first measurement moment (May–June 2020) in a second (June–July 2020) and third (December 2020) wave of the survey (n = 371, M = 72 years old, range 65–97 years old). Results indicated that wellbeing fluctuated with the severity of the pandemic. Results for self-reported cognitive functioning were mixed. While participants indicated a slightly better general subjective cognitive functioning at the end of the study, experienced problems with most cognitive subdomains significantly increased over time. The presence of depressive and anxiety symptoms were related to the longer-term impact of the pandemic on wellbeing and subjective cognitive functioning. Our study shows the long-lasting impact of the pandemic on the wellbeing and subjective cognitive functioning of older adults, without full recovery from the first wave.

The Presence and Severity of NAFLD are Associated With Cognitive Impairment and Hippocampal Damage.

Although cognitive impairment in nonalcoholic fatty liver disease (NAFLD) has received attention in recent years, little is known about detailed cognitive functions in histologically diagnosed individuals. This study aimed to investigate the association of liver pathological changes with cognitive features and further explore the underlying brain manifestations. We performed a cross-sectional study in 320 subjects who underwent liver biopsy. Among the enrolled participants, 225 underwent assessments of global cognition and cognitive subdomains. Furthermore, 70 individuals received functional magnetic resonance imaging scans for neuroimaging evaluations. The associations among liver histological features, brain alterations, and cognitive functions were evaluated using structural equation model. Compared with controls, patients with NAFLD had poorer immediate memory and delayed memory. Severe liver steatosis (odds ratio, 2.189; 95% CI, 1.020-4.699) and ballooning (OR, 3.655; 95% CI, 1.419-9.414) were related to a higher proportion of memory impairment. Structural magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis exhibited volume loss in left hippocampus and its subregions of subiculum and presubiculum. Task-based magnetic resonance imaging showed that patients with nonalcoholic steatohepatitis had decreased left hippocampal activation. Path analysis demonstrated that higher NAFLD activity scores were associated with lower subiculum volume and reduced hippocampal activation, and such hippocampal damage contributed to lower delayed memory scores. We are the first to report the presence and severity of NAFLD to be associated with an increased risk of memory impairment and hippocampal structural and functional abnormalities. These findings stress the significance of early cognitive evaluation in patients with NAFLD.

Huntington's Disease with Small CAG Repeat Expansions.

Carriers of small cytosine-adenine-guanine (CAG) repeats below 39 in the HTT gene are traditionally associated with milder Huntington's disease, but their clinical profile has not been extensively studied. To study the phenotype of CAG36-38 repeat carriers. We included 35 patients and premanifest carriers of CAG36-38 repeats. We compared clinical and neuropsychological profiles of 11 CAG36-38 patients with 11 matched CAG40-42 patients. In addition, we analyzed 243 CAG36-38 individuals from the ENROLL study to complete the phenotype description. Global cognitive efficiency and performance in different cognitive subdomains were similar in small CAG36-38 and typically CAG40-42 expanded individuals. Chorea as the first symptom was significantly less frequent for CAG36-38 patients (P = 0.04) despite similar total motor scores at first visit. Total motor score at last visit was significantly lower in CAG36-38 carriers (P = 0.003). The similar cognitive and different motor profile of CAG36-38 (n = 243) and CAG40-42 (n = 4675) carriers was confirmed in the ENROLL database. Additionally, clinicians were significantly less confident in diagnosing Huntington's disease (P = 2.4e-8) and diagnosis happened significantly later in CAG36-38 (P = 2.2e-6) despite a similar age at symptom onset (P = 0.29). We showed that small CAG36-38 expansion carriers had a similar cognitive profile to those with the more common CAG40-42 expansions. These individuals may evade molecular diagnosis because of the absence of chorea rather than because of a low penetrance of symptoms. This finding should encourage neurologists to consider Huntington's disease in cognitively impaired elderly patients without typical chorea and anticipate consequences for genetic counseling in their offspring. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Sex differences in the association between sarcopenia and mild cognitive impairment in the older Korean population

BackgroundA link between sarcopenia and cognitive function has been proposed and is supported by several investigations. Nevertheless, the sex-linked relationship between these two diseases has been scarcely investigated. This cross-sectional study investigated sex differences in the association between sarcopenia and mild cognitive impairment.MethodsWe included all 286 participants aged 60 years or older with MCI who visited the Department of Neurology at Veterans Health Service Medical Center in South Korea from January to December 2021. The diagnosis of MCI was confirmed by two neurologists based on the participants’ neuropsychological test scores. Diagnosis of sarcopenia was based on the algorithm of Asian Working Group for Sarcopenia (AWGS) 2019 including bioelectrical impedance analysis and handgrip strength, and cognitive function was assessed using Seoul Neuropsychological Screening Battery Core (SNSB-C) test.ResultsAmong the 286 participants, 171 and 112 were men and women. After adjustment for potential covariates including APOE genotype, in women participants, there were significant associations between diagnosis of sarcopenia and MCI (OR = 4.72, 95%CI [1.39–15.97]), while there was no significant relationship in men participants. In eight subdomains of SNSB-C, we also found that women participants with sarcopenia demonstrated a significant memory decline (OR = 3.21, 95%CI [1.01–10.19]) as compared with the reference women group without sarcopenia after adjusting all covariates mentioned above. No significant association between any SNSB-C subdomain and MCI was demonstrated in men participants.ConclusionsWe demonstrated that there was a different relationship between sarcopenia and MCI by sex and that sarcopenia may affect the cognitive subdomain differently by sex. These results imply that, with regard to cognitive function, maintaining muscle function and muscle mass might be more crucial for women than for men.

M1-selective muscarinic allosteric modulation enhances cognitive flexibility and effective salience in nonhuman primates

Acetylcholine (ACh) in cortical neural circuits mediates how selective attention is sustained in the presence of distractors and how flexible cognition adjusts to changing task demands. The cognitive domains of attention and cognitive flexibility might be differentially supported by the M1 muscarinic acetylcholine receptor (mAChR) subtype. Understanding how M1 mAChR mechanisms support these cognitive subdomains is of highest importance for advancing novel drug treatments for conditions with altered attention and reduced cognitive control including Alzheimer's disease or schizophrenia. Here, we tested this question by assessing how the subtype-selective M1 mAChR positive allosteric modulator (PAM) VU0453595 affects visual search and flexible reward learning in nonhuman primates. We found that allosteric potentiation of M1 mAChRs enhanced flexible learning performance by improving extradimensional set shifting, reducing latent inhibition from previously experienced distractors and reducing response perseveration in the absence of adverse side effects. These procognitive effects occurred in the absence of apparent changes of attentional performance during visual search. In contrast, nonselective ACh modulation using the acetylcholinesterase inhibitor (AChEI) donepezil improved attention during visual search at doses that did not alter cognitive flexibility and that already triggered gastrointestinal cholinergic side effects. These findings illustrate that M1 mAChRpositive allosteric modulation enhances cognitive flexibility without affecting attentional filtering of distraction, consistent with M1 activity boosting the effective salience of relevant over irrelevant objects specifically during learning. These results suggest that M1 PAMs are versatile compounds for enhancing cognitive flexibility in disorders spanning schizophrenia and Alzheimer's diseases.

Amygdala Perfusion Is Associated with Persistent Affective Symptoms after Sports-Related Concussion (P8-1.003)

<h3>Objective:</h3> We evaluated PASL-based amygdala perfusion and symptom recovery after sports-related concussion (SRC). <h3>Background:</h3> Perfusion changes are well-documented in the pathophysiology of SRC. We have previously shown that rsfMRI-BOLD amygdala hyperconnectivity was associated with decreased acute symptoms, but increased chronic symptoms. We hypothesized that amygdala perfusion changes might correlate with symptoms after SRC and partly explain BOLD-connectivity findings. <h3>Design/Methods:</h3> We calculated PASL-based perfusion (mL/100g/min) at 3 timepoints after SRC (T1=1–4days, T2=10–14days, T3=2–3months) in collegiate athletes (N=31, female=14), as well as in-sport (ISC; N=29, female=15), and non-contact (NCC; N=35, female=14) controls. We assessed between- and within-group differences in four amygdala ROIs from the Brainnetome Atlas using ANOVA and Tukey’s HSD. Subject-level PASL values were correlated with SCAT-3 Graded Symptom Checklist (GSC) and Brief Symptom Inventory 18 (BSI-18) scores at each timepoint. <h3>Results:</h3> L medial and lateral amygdala (mAmy/lAmy) perfusion was elevated in SRC subjects compared to controls at T1, returning to control-level by T2 and T3. Among SRC subjects at T1, R lAmy perfusion positively correlated with BSI-18 depression subdomain; perfusion in all 4 amygdala ROIs positively correlated with BSI-18 anxiety subdomain and BSI-18 symptom total. Among ISC subjects at T1, R mAmy perfusion negatively correlated with GSC symptom total, GSC physical subdomain, and GSC cognitive subdomain; among NCC subjects, L mAmy perfusion negatively correlated with BSI-18 depression subdomain. Among SRC subjects at T2, L lAmy, L mAmy, and R lAmy perfusion positively correlated with BSI-18 depression subdomain, BSI-18 anxiety subdomain, and BSI-18 severity score. Among SRC subjects at T3, L lAmy perfusion positively correlated with all three BSI-18 subdomains and BSI-18 severity score. <h3>Conclusions:</h3> Increased amygdala perfusion after SRC positively correlated with affective symptoms; persistently elevated L lAmy perfusion was associated with increased chronic symptoms. Accounting for perfusion in analysis of BOLD-connectivity of the amygdala after SRC may improve prediction of affective symptom persistence. <b>Disclosure:</b> Mr. Sridharan has nothing to disclose. Mr. Sheridan has nothing to disclose. Mr. Hudson has nothing to disclose. Dr. Lipford has nothing to disclose. Dr. Bickart has nothing to disclose. Dr. Thibeault has received personal compensation for serving as an employee of NovaSignal Corp.. Dr. Thibeault has received stock or an ownership interest from NovaSignal Inc.. Dr. Giza has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Highmark Interactive. Dr. Giza has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis Pharmaceutical. Dr. Giza has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Lewitt, Hackman, Shapiro, Marshall &amp; Harlan. Dr. Giza has received stock or an ownership interest from Highmark Interactive. The institution of Dr. Giza has received research support from NCAA. The institution of Dr. Giza has received research support from US Department of Defense. The institution of Dr. Giza has received research support from UCLA: Brain Injury Research Center, Steve Tisch BrainSPORT Program, Easton Clinic for Brain Health. Dr. Giza has received publishing royalties from a publication relating to health care. Dr. Hamilton has received personal compensation for serving as an employee of NovaSignal Corp . Dr. Hamilton has received stock or an ownership interest from NovaSignal Corp. Dr. Hamilton has received intellectual property interests from a discovery or technology relating to health care. Dr. Choe has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Cases. The institution of Dr. Choe has received research support from NIH. The institution of Dr. Choe has received research support from AIR-P. Dr. Choe has a non-compensated relationship as a Board of Directors with NABIS that is relevant to AAN interests or activities. Dr. Choe has a non-compensated relationship as a Consultant with USA Swimming Concussion Task Force that is relevant to AAN interests or activities. Dr. Whitlow has nothing to disclose.

Assessment of Neurodevelopment in Infants With and Without Exposure to Asymptomatic or Mild Maternal SARS-CoV-2 Infection During Pregnancy

Associations between prenatal SARS-CoV-2 exposure and neurodevelopmental outcomes have substantial public health relevance. A previous study found no association between prenatal SARS-CoV-2 infection and parent-reported infant neurodevelopmental outcomes, but standardized observational assessments are needed to confirm this finding. To assess whether mild or asymptomatic maternal SARS-CoV-2 infection vs no infection during pregnancy is associated with infant neurodevelopmental differences at ages 5 to 11 months. This cohort study included infants of mothers from a single-site prospective cross-sectional study (COVID-19 Mother Baby Outcomes [COMBO] Initiative) of mother-infant dyads and a multisite prospective cohort study (Epidemiology of Severe Acute Respiratory Syndrome Coronavirus 2 in Pregnancy and Infancy [ESPI]) of pregnant individuals. A subset of ESPI participants was subsequently enrolled in the ESPI COMBO substudy. Participants in the ongoing COMBO study were enrolled beginning on May 26, 2020; participants in the ESPI study were enrolled from May 7 to November 3, 2021; and participants in the ESPI COMBO substudy were enrolled from August 2020 to March 2021. For the current analysis, infant neurodevelopment was assessed between March 2021 and June 2022. A total of 407 infants born to 403 mothers were enrolled (204 from Columbia University Irving Medical Center in New York, New York; 167 from the University of Utah in Salt Lake City; and 36 from the University of Alabama in Birmingham). Mothers of unexposed infants were approached for participation based on similar infant gestational age at birth, date of birth, sex, and mode of delivery to exposed infants. Maternal symptomatic or asymptomatic SARS-CoV-2 infection. Infant neurodevelopment was assessed using the Developmental Assessment of Young Children, second edition (DAYC-2), adapted for telehealth assessment. The primary outcome was age-adjusted standard scores on 5 DAYC-2 subdomains: cognitive, gross motor, fine motor, expressive language, and receptive language. Among 403 mothers, the mean (SD) maternal age at delivery was 32.1 (5.4) years; most mothers were of White race (240 [59.6%]) and non-Hispanic ethnicity (253 [62.8%]). Among 407 infants, 367 (90.2%) were born full term and 212 (52.1%) were male. Overall, 258 infants (63.4%) had no documented prenatal exposure to SARS-CoV-2 infection, 112 (27.5%) had confirmed prenatal exposure, and 37 (9.1%) had exposure before pregnancy or at an indeterminate time. In adjusted models, maternal SARS-CoV-2 infection during pregnancy was not associated with differences in cognitive (β = 0.31; 95% CI, -2.97 to 3.58), gross motor (β = 0.82; 95% CI, -1.34 to 2.99), fine motor (β = 0.36; 95% CI, -0.74 to 1.47), expressive language (β = -1.00; 95% CI, -4.02 to 2.02), or receptive language (β = 0.45; 95% CI, -2.15 to 3.04) DAYC-2 subdomain scores. Trimester of exposure and maternal symptom status were not associated with DAYC-2 subdomain scores. In this study, results of a novel telehealth-adapted observational neurodevelopmental assessment extended a previous finding of no association between prenatal exposure to maternal SARS-CoV-2 infection and infant neurodevelopment. Given the widespread and continued high prevalence of COVID-19, these data offer information that may be helpful for pregnant individuals who experience asymptomatic or mild SARS-CoV-2 infections.

Diabetes complications and cognitive function in young adults with youth-onset type 1 or type 2 diabetes: the SEARCH for Diabetes in Youth Study.

People with type 1 (T1D) or type 2 diabetes (T2D) who also have diabetes complications can have pronounced cognitive deficits. It remains unknown, however, whether and how multiple diabetes complications co-occur with cognitive dysfunction, particularly in youth-onset diabetes. Using data from the SEARCH for Diabetes in Youth study cohort, a prospective longitudinal cohort, we examined clustering of complications and their underlying clinical factors with performance on cognitive tests in young adults with youth-onset T1D or T2D. Cognition was assessed via the NIH Toolbox Cognition Battery. The main cognitive variables were age-corrected scores for composite fluid cognition and associated cognitive subdomains. Diabetes complications included retinopathy, microalbuminuria, and peripheral neuropathy (PN). Lipids, systolic blood pressure (SBP), hemoglobin A1c, and other clinical factors were included in the analyses. Clustering was applied separately to each group (T1D=646; T2D=165). A three-cluster(C) solution was identified for each diabetes type. Mean values and frequencies of all factors were compared between resulting clusters. The average age-corrected score for composite fluid cognition differed significantly across clusters for each group (p<0.001). People with T1D and the lowest average fluid cognition scores had the highest frequency of self-reporting at least one episode of hypoglycemia in the year preceding cognitive testing and the highest prevalence of PN. Persons with T2D and the lowest average fluid cognition scores had the highest SBP, the highest central systolic and diastolic blood pressures, and highest prevalence of PN. These findings highlight shared (PN) and unique factors (hypoglycemia in T1D; SBP in T2D) that could be targeted to potentially mitigate cognitive issues in young people with youth-onset diabetes.

Dietary pattern, food, and nutritional supplement effects on cognitive outcomes in mild cognitive impairment: a systematic review of previous reviews.

Nutritional interventions may benefit cognition in people with mild cognitive impairment (MCI). However, evidence is yet to be synthesized in a way that can inform recommendations for clinical and public health settings. To systematically review evidence on the effect of dietary patterns, foods, and nutritional supplements on cognitive decline in individuals with MCI. Guided by the Preferred Reporting items for Systematic Review and Meta-Analysis Protocols 2015 statement, the Medline, EMBASE, and CINAHL databases, the JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects were searched (publication years 2005 to 2020). Included studies were English-language systematic reviews and meta-analyses of randomized controlled trials and cohort studies reporting on the effectiveness of nutritional interventions on cognition of individuals with MCI. Two reviewers independently selected studies and extracted data on cognitive outcomes and adverse events. Review quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews-2). Primary study overlap was managed following Cochrane Handbook guidelines. Of the 6677 records retrieved, 20 reviews were included, which, in turn, reported on 43 randomized controlled trials and 1 cohort study that, together, addressed 18 nutritional interventions. Most reviews were limited by quality and the small number of primary studies with small sample sizes. Reviews were mostly positive for B vitamins, omega-3 fatty acids, and probiotics (including 12, 11 and 4 primary studies, respectively). Souvenaid and the Mediterranean diet reduced cognitive decline or Alzheimer's disease progression in single trials with <500 participants. Findings from studies with a small number of participants suggest vitamin D, a low-carbohydrate diet, medium-chain triglycerides, blueberries, grape juice, cocoa flavanols, and Brazil nuts may improve individual cognitive subdomains, but more studies are needed. Few nutritional interventions were found to convincingly improve cognition of individuals with MCI. More high-quality research in MCI populations is required to determine if nutritional treatments improve cognition and/or reduce progression to dementia. Open Science Framework protocol identifier DOI:10.17605/OSF.IO/BEP2S.