Cognitive Evaluation Research Articles

Factors Affecting Attachment Behaviors, Cognitive and Emotional Evaluations on Facebook Live streams

Factors Affecting Attachment Behaviors, Cognitive and Emotional Evaluations on Facebook Live streams

Real-Time Attention Regulation and Cognitive Monitoring Using a Wearable EEG-based BCI.

Attention regulation is an essential ability in daily life that affects learning and work efficiency and is closely related to mental health. The effectiveness of brain-computer interface (BCI) systems in attention regulation has been proven, but most of these systems rely on bulky and expensive equipment and are still in the experimental stage. This study proposes a wearable BCI system for real-time attention regulation and cognitive monitoring. The BCI system integrates a wearable singlechannel electroencephalogram (EEG) headband with wireless data streaming for real-time analysis. Twenty healthy subjects participated in the long-term attention regulation experiment and were evenly divided into an experimental group and a control group based on the presence of realtime neurofeedback. The neurofeedback is represented by output value of attention, which calculated from singlechannel EEG data. Before and after the regulation sessions, baseline assessments were conducted for each subject, incorporating multi-channel EEG data analysis and cognitive behavioral evaluations, to verify the effectiveness of system for attention regulation. The online experimental results indicate that the average attention level in the experimental group increased from 0.625 to 0.812, while no significant improvement was observed in the control group. Further comparative analysis revealed the reasons for the enhancement of attention regulation ability in terms of both brain network patterns and cognitive performance. The proposed wearable BCI system is effective at improving attention regulation ability and could be a promising tool for assisting people with attention disorders.

Hyperbolic graph embedding of MEG brain networks to study brain alterations in individuals with subjective cognitive decline.

An expansive area of research focuses on discerning patterns of alterations in functional brain networks from the early stages of Alzheimer's disease, even at the subjective cognitive decline (SCD) stage. Here, we developed a novel hyperbolic MEG brain network embedding framework for transforming high-dimensional complex MEG brain networks into lower-dimensional hyperbolic representations. Using this model, we computed hyperbolic embeddings of the MEG brain networks of two distinct participant groups: individuals with SCD and healthy controls. We demonstrated that these embeddings preserve both local and global geometric information, presenting reduced distortion compared to rival models, even when brain networks are mapped into low-dimensional spaces. In addition, our findings showed that the hyperbolic embeddings encompass unique SCD-related information that improves the discriminatory power above and beyond that of connectivity features alone. Notably, we introduced a unique metric-the radius of the node embeddings-which effectively proxies the hierarchical organization of the brain. Using this metric, we identified subtle hierarchy organizational differences between the two participant groups, suggesting increased hierarchy in the dorsal attention, frontoparietal, and ventral attention subnetworks among the SCD group. Last, we assessed the correlation between these hierarchical variations and cognitive assessment scores, revealing associations with diminished performance across multiple cognitive evaluations in the SCD group. Overall, this study presents the first evaluation of hyperbolic embeddings of MEG brain networks, offering novel insights into brain organization, cognitive decline, and potential diagnostic avenues of Alzheimer's disease.

Risk factors for cognitive dysfunction amongst patients with cardiovascular diseases.

The impact of cardiovascular diseases on cognition raises important research questions. The study aimed to investigate the relationship between demographic data, cardiovascular diseases, kidney disease and depressive symptoms on cognition. A cross-sectional study of patients with cardiovascular diseases was performed. The Montreal Cognitive Assessment (MoCA) was applied for cognitive evaluation. Based on MoCA three groups were defined: preserved cognition, mild, and advanced cognitive dysfunction (CD). Data were analyzed using Cronbach alpha (Cα) and McDonald's ω (Mω) for internal consistency. The Chi-square test, Cramer's V test, and correlation analyses were also applied. Of 628 patients, 55.2% had mild CD, and the mean age was 67.95 (SD 9.53) years. Cα and Mω were 0.7, indicating good internal consistency. We found a moderate positive correlation between depression and the severity of CD (r = 0.25, p = 0.0001). A weak association between CD and female gender (p = 0.016), atrial fibrillation (p = 0.03), stroke (p = 0.009), and a moderate association for age group (p < 0.0001), education level (p < 0.0001), smoking (p < 0.0001), and renal dysfunction (p < 0.0001) was found. Age ≥ 70 years, eGFR 30-59 mL/min/1.73m2 significantly increased the likelihood for mild and advanced CD, while smoking and > 9 classes decreased it. Female gender, history of atrial fibrillation, and stroke significantly increased the likelihood of advanced CD. Mild CD was the most common in patients with cardiovascular diseases. Older age, lower education, being a non-smoker, and renal dysfunction were risk factors for both mild and advanced CD. Female gender, previous diagnosis of atrial fibrillation, and stroke are risk factors for advanced CD.

Neurocognitive outcome in children with sickle cell disease after myeloimmunoablative conditioning and haploidentical hematopoietic stem cell transplantation: a non-randomized clinical trial.

Due to the risk of cerebral vascular injury, children and adolescents with high-risk sickle cell disease (SCD) experience neurocognitive decline over time. Haploidentical stem cell transplantation (HISCT) from human leukocyte antigen-matched sibling donors may slow or stop progression of neurocognitive changes. The study is to determine if HISCT can ameliorate SCD-associated neurocognitive changes and prevent neurocognitive progression, determine which specific areas of neurocognitive functioning are particularly vulnerable to SCD, and determine if there are age-related differences in neurocognitive functioning over time. We performed neurocognitive and neuroimaging in SCD recipients following HISCT. Children and adolescents with high-risk SCD who received parental HISCT utilizing CD34+ enrichment and mononuclear cell (T-cell) addback following myeloimmunoablative conditioning received cognitive evaluations and neuroimaging at three time points: pre-transplant, 1 and 2 years post-transplant. Nineteen participants (13.1 ± 1.2 years [3.3-20.0]) received HISCT. At 2 years post-transplant, neuroimaging and cognitive function were stable. Regarding age-related differences pre-transplantation, older children (≥13 years) had already experienced significant decreases in language functioning (p < 0.023), verbal intelligence quotient (p < 0.05), non-verbal intelligence quotient (p < 0.006), and processing speed (p < 0.05), but normalized post-HISCT in all categories. Thus, HISCT has the potential to ameliorate SCD-associated neurocognitive changes and prevent neurocognitive progression. Further studies are required to determine if neurocognitive performance remains stable beyond 2 years post-HISCT.Clinical trial registration: The study was conducted under an investigator IND (14359) (MSC) and registered at clinicaltrials.gov (NCT01461837).

An Ensemble Learning Algorithm for Cognitive Evaluation by an Immersive Virtual Reality Supermarket.

Early screening for Mild Cognitive Impairment (MCI) is crucial in delaying cognitive deterioration and treating dementia. Conventional neuropsychological tests, commonly used for MCI detection, often lack ecological validity due to their simplistic and quiet testing environments. To address this gap, our study developed an immersive VR supermarket cognitive assessment program (IVRSCAP), simulating daily cognitive activities to enhance the ecological validity of MCI detection. This program involved elderly participants from Chengdu Second People's Hospital and various communities, comprising both MCI patients (N=301) and healthy elderly individuals (N=1027). They engaged in the VR supermarket cognitive test, generating complex datasets including User Behavior Data, Tested Cognitive Dimension Game Data, Trajectory Data, and Regional Data. To analyze this data, we introduced an adaptive ensemble learning method for imbalanced samples. Our study's primary contribution is demonstrating the superior performance of this algorithm in classifying MCI and healthy groups based on their performance in IVRSCAP. Comparative analysis confirmed its efficacy over traditional imbalanced sample processing methods and classic ensemble learning voting algorithms, significantly outperforming in metrics such as recall, F1-score, AUC, and G-mean. Our findings advocate the combined use of IVRSCAP and our algorithm as a technologically advanced, ecologically valid approach for enhancing early MCI detection strategies. This aligns with our broader aim of integrating realistic simulations with advanced computational techniques to improve diagnostic accuracy and treatment efficacy in cognitive health assessments.

Lessons From the Coronavirus Disease Experience: Research Participant and Staff Satisfaction With Remote Cognitive Evaluations.

In New York City in 2020 the pandemic shut down in-person research. Icahn School of Medicine's Alzheimer's Disease Research Center transitioned longitudinal evaluations from in-person to telephone to enhance equity of access. We assessed diverse research participants' and clinical research coordinators' (CRC) satisfaction with remote evaluation and examined sociodemographic, cognitive, and behavioral factors that might impact satisfaction. Data collected: 241 participants with Clinical Dementia Rating (CDR) = 0/0.5 (3/2020 to 6/2021). A Telehealth Satisfaction Questionnaire for CRCs and participants was administered at the end of remote evaluations. We compared Telehealth Satisfaction Questionnaire items by CDR and Geriatric Depression Scale. Participants' mean age was 78.4, 61.4% were females, 16.2% were Hispanic, 17.1% Asian, 15.8% were non-Hispanic black, and 72.6% CDR = 0. Participant satisfaction was high [14.1 ± 1.4 (out of 15)] but was lower among those with depression. CRC satisfaction was high [16.9 ± 1.8 (out of 18)] but was lower concerning the ability to explain the test battery and interact with participants with CDR = 0.5. Telephone research assessments provide flexibility in a hybrid model. They offer equitable access to research participation for those who do not use computer technology and may promote the retention of diverse elderly research participants.

Hidden cases of epilepsy in cognitive impairment clinics: Exploring the use of a portable device for simplified electroencephalography testing

Late-onset epilepsy, particularly focal impaired awareness seizures, often present without convulsions and can cause memory impairment. This can lead patients to initially seek consultation at memory clinics, potentially delaying referral to epilepsy specialists. We report on three patients, aged 40s to 70s, admitted for cognitive evaluation who were finally diagnosed with epileptic seizures as the underlying cause of their symptoms. Notably, all initially presented to local clinics with symptoms suggesting cognitive impairment. Despite initial diagnostic uncertainty, all patients exhibited epileptic activity on electroencephalography (EEG) and responded positively to antiepileptic drugs, suggesting epileptic mechanisms were involved in their symptoms. Both traditional clinical EEG systems and newly developed, one-minute portable EEG devices were used in their evaluations. The portable device, medically approved in Japan, successfully captured sharp-waves like activities with the same durations, amplitudes, and shapes as traditional devices. This highlights its potential to improve epilepsy diagnosis and future screening due to its portability and ease of use. Implementing portable EEG devices could promote timely and appropriate treatment, preventing misdiagnosis of neurological conditions.

Early postoperative cognitive decline—are there any preventive strategies for surgical patients in the emergency setting?

Postoperative neurocognitive impairments following surgery are a growing concern, especially in the elderly population, since it is associated with a significantly increased risk of morbi-mortality in the postoperative period. Among them, delirium or the early postoperative cognitive decline is associated with a further risk of prolonged cognitive dysfunction and it may quicken long-term cognitive impairment or postoperative cognitive dysfunction (POCD). The current knowledge regarding preventive strategies for delirium is not focused anymore only on pharmacological and behavioral management strategies in the postoperative period, but also supports the preoperative cognitive training programs. Since preoperative cognitive evaluation and proactive interventions to optimize surgical patient outcomes are rather impossible in the emergency setting, what are the appropriate preventive strategies that can be implemented in day-to-day practice? In this review, we try to highlight the most recent experimental and clinical strategies, and outline the most relevant recommendations for clinicial practicioners based on the available data.

Evaluación de la adaptabilidad intercultural del inglés y realización de la enseñanza desde la perspectiva de la deconstrucción filosófica

Abstract: Since its emergence, philosophical deconstructionism has been regarded as an unconventional and anti-dogmatic ideology, which has strong reference significance for the reform of English courses in Chinese universities. China is in a critical period of transformation, which requires university English education to fundamentally change traditional educational concepts and carry out comprehensive English teaching reforms. At the same time, issues, such as cross-cultural adaptability and communication in Chinese English teaching, have gradually attracted people’s attention. The academic community in China has been discussing issues related to English education for many years, but few people have placed English education from a philosophical perspective. In response to the issues of insufficient understanding of cultural differences and incomplete cognitive evaluation systems in current English cross-cultural teaching, this article aims to improve people’s cross-cultural abilities through a deconstructive perspective, thereby better understanding cultural differences, respecting multiculturalism, promoting students’ diverse development and deepening English education. Therefore, this article attempts to explore the cross-cultural adaptability of English from the perspective of philosophical deconstruction and how to achieve English teaching reform in China, which has important practical significance for related fields. Through the study of English cross-cultural communication from the perspective of philosophical structure, it can be concluded that applying structuralism to English cross-cultural teaching helps to better understand cultural differences, respect multiculturalism, advocate dialogue and communication, and rebuild a new cognitive system.

Analysis and Optimization of the Effectiveness of College Physical Education Courses Based on Fuzzy Cognitive Evaluation

Abstract Cognitive diagnostic theory can provide a comprehensive and detailed objective evaluation of individual macro learning ability, thus providing an effective reference for targeted teaching and learning. In this paper, a fuzzy cognitive diagnostic model is used to evaluate the degree of mastery of a college student on the physical education course, calculate the probability of mastery of each attribute, and statistically analyze the degree of mastery of the attributes of the individual as well as the class as a whole. Then, a learning effect evaluation standard is constructed to evaluate the learning effects of the physical education course for all students. The empirical results show that the mean value of the evaluation of the students’ cognition of physical education in School X is 0.6587, and the average probability of mastery of physical education emotion is 0.6021, both of which have reached the degree of good mastery. The average probability of mastering sports operations was 0.5909, which indicates that university students have an average level of mastery in all sports skills through the physical education program. The outcome is in line with the current situation, which can serve as a reference for teachers to make targeted teaching decisions. The study has both theoretical value and practical significance in promoting the development of wisdom education.

Assessment of Cerebral Hypoxemia and Its Impact on Cognitive and Psychological Functions in Patients With Obstructive Sleep Apnea Syndrome

Background and Objective The precise pathophysiology of cognitive impedance and mental illness in obstructive sleep apnea (OSA) patients remains elusive. Therefore, there is a need for studies on novel diagnoses and therapeutic strategies for cognitive impairment in OSA patients. This work aimed to evaluate cerebral hypoxemia, its consequences on brain metabolism, and local and systemic inflammation, and their subsequent impact on cognitive and psychological functioning.Methods This cross-sectional case-control study was conducted on 30 eligible OSA patients and 20 age/sex-matched healthy controls. All the participants underwent one-night polysomnography, and cognitive evaluation was done using the Mini-Mental State Examination, Montreal Cognitive Assessment, Brief Kingston Standardized Cognitive Assessment, D2 Test of Consideration (to evaluate attention problems), and Wisconsin card sorting test. The psychiatric assessment included the Arabic form of the Hamilton Depression Rating Scale and Beck Depression Inventory-II. A radiology assessment was done using proton magnetic resonance spectroscopy. Neurophysiological assessment was done using the potential cortical (N20) latency and amplitude of somatosensory evoked potential. Laboratory examinations included serum levels of NF-κB, HMGB1, and HIF-1α.Results Polysomnography demonstrated noteworthy increase in the apnea-hypopnea index, respiratory disturbance index, arousal index, snoring index, and wake after sleep onset. It also showed diminished sleep efficiency, total sleep time, and SaO2 nadir in the OSA group. Neuropsychological scales demonstrated poor performance in global cognitive tests, particular cognitive domains impedance, and depression in the OSA group, with noteworthy differences within the group. Magnetic resonance spectroscopy highlighted that OSA patients had a noteworthy bilateral decrement in N-acetylaspartate (NAA) peak, creatine peak, and NAA/choline proportion and an increment in choline peak, lipid peak, lactate peak, choline/creatine proportion, and NAA/creatine proportion in the frontal white matter, hippocampus, and parieto-occipital cortex. Moreover. OSA patients had either missing or decreased amplitude and delayed latency of N20. There was a noteworthy rise of serum inflammatory marker NF-κB, HMGB1, and oxidative stress marker HIF-1α in OSA patients.Conclusions Chronic intermittent hypoxia with resulting amplified inflammatory and oxidative stress in OSA patients may affect brain metabolism; consequently, leading to cognitive and psychological dysfunctions.

Predictors of Subjective Well-Being: Interpersonal Sensitivity, Close Relationship Experiences and Academic Self-Concept

The emphasis on well-being in mental health definitions and the impact of positive psychology studies, it is observed that the interest in the factors explaining the subjective well-being (happiness) of individuals is increasing day by day. Subjective well-being involves cognitive and emotional evaluation of life. These evaluations may vary from one area of life to another and may have positive or negative effects on happiness. For this reason, numerous studies have focused on the relationship between subjective well-being and various aspects of life domains including friendship, romantic relationships, and academic achievement. However, it is noteworthy that the extent and priority of how the dynamics of various life domains collectively contribute to individuals' subjective well-being have not yet to been sufficiently clarified. From this point of view, the present study aimed to investigate the predictive role of the subcomponents of university students' interpersonal sensitivity, academic self-perception and attachment-based experiences in close relationship in their subjective well-being and to determine the priority status of these factors. The participants of the study consisted of 410 (235 female, 175 male) university students between the ages of 18-25. As a result of the correlation analysis, statistically significant relationships were found between all of the sub-dimensions of interpersonal sensitivity, academic self and experiences in close relationship and subjective well-being. The results of the stepwise regression analysis revealed four statistically significant models to explain subjective well-being. At each stage, when the effects of the sub-dimensions included in the previous model were controlled, the explanatory levels of the variables included in the model for subjective well-being were 30% for lack of social self-confidence, 12% for academic effort, 3% for interpersonal anxiety and dependency, and 4% for non-assertive behaviors, respectively. The findings were discussed and supported by the explanations and findings in the literature.

Research on the Double-edged Sword Effect of Electronic Performance Monitoring in Workplace

In the digital era, in order to improve organizational performance and achieve high-quality development, more and more modern enterprises begin to use electronic performance monitoring, and the accompanying work pressure directly affects employees' role behavior. However, the existing research on electronic performance monitoring is still in the stage of its concept definition, theoretical basis and influencing factors, especially the research on the influence mechanism of electronic performance monitoring on employee role behavior is very scarce. Based on the work resource-requirement model and stress cognitive evaluation theory, this paper discusses the double-edged sword effect of two dimensions of electronic performance monitoring on employees' role behavior, and analyzes the mediating role of work stress perception and the regulating role of monitoring transparency. Through a questionnaire survey of 330 employees, a total of 308 valid questionnaires were collected. The empirical results show that: (1) Developmental electronic performance monitoring has a significant positive impact on employees' role behavior; (2) Preventive electronic performance monitoring has a significant positive impact on employees' in-role behavior and a significant negative impact on employees' out-of-role behavior. (3) Challenging pressure plays an intermediary role between developmental electronic performance monitoring and employees' in-role behavior. (4) Obstructive stress plays an intermediary role between preventive electronic performance monitoring and employee role behavior; (5) Monitoring transparency positively regulates the relationship between developmental electronic performance monitoring and challenging pressure; (6) Monitoring transparency negatively regulates the relationship between preventive electronic performance monitoring and obstructive stress. The research results verify the double-edged sword effect of electronic performance monitoring on employees' role behavior.

Examining the impact of perceived psychological distances of quitting and continuing tobacco smoking on antismoking intention: a cross-sectional study

To date, little research has been conducted to understand the role of psychological distances on smoking behaviour. Construal Level Theory posits that individuals mentally construe events, objects, or ideas based on their perceived distance in terms of spatial, temporal, social, and hypothetical dimensions, influencing their judgments and decision-making processes. The aim of the current study was (1) to provide a comprehensive exploration of psychological distances of costs and benefits of tobacco smoking and antismoking intention and (2) to examine whether smoking can be attributed to rational behaviour based on the psychological distance weighted balance of perceived costs and benefits of quitting and continuing smoking. Mediation models delineating the relationships among temporal and hypothetical psychological distances, personal relevance and antismoking intention were tested on cross-sectional survey data of 1486 smokers (880 men, Mage = 39.9 years, SD = 13.36). Psychological distances were shown to be important factors in the cognitive evaluation process of smoking behaviour. Perceived temporal distance to smoking continuation/cessation was related to personal importance and hypothetical psychological distances, which were associated with anti-smoking intention. Furthermore, antismoking intention was related to the psychological distance-weighted gain-cost balance of quitting and continuing smoking. The current findings enhance our knowledge of the cognitive evaluation of the outcomes of smoking, indicating that the choice of not quitting smoking may be partially based on a biased rational decision-making process.

The mediation effect of treatment fatigue in the association between memory and health-related quality of life in men with HIV who have sex with men

Approximately half of all adults living with the Human Immunodeficiency Virus (HIV) experience cognitive alterations related to difficulties in treatment adherence and, therefore, to a significant decrease in quality of life. In this sense, new studies are needed to identify potential mediators related to treatment in this association, such as treatment fatigue. This fact is especially important in at specific groups of individuals with HIV, namely men with HIV who have sex with men (MSM). The objective of this study was to analyze the association between cognitive functioning, Health-Related Quality of Life (HRQoL), and treatment fatigue in MSM with HIV. A cross-sectional study was developed with a sample of 70 MSM, from the Infectious Diseases Unit of the General University Hospital of Alicante (Spain). Participants completed questionnaires related to sociodemographic data, HRQoL, and treatment fatigue in an initial phase; in a second phase, they were administered a computerized cognitive evaluation. Our results demonstrate a significant relationship between a lower cognitive performance in the memory domain and worse HRQoL. Mediation analysis has revealed the total mediation effect of treatment fatigue, specifically, the treatment cynicism domain, on this relationship. This mediation effect remained significant after controlling the sociodemographic and clinical HIV-related variables in the model. No significant mediation effects of the rest of evaluated cognitive domains (attention, perception, reasoning, or coordination) were found in this relationship. The results of this study highlight how MSM with a significant deterioration of memory are at greater risk of developing high levels of treatment fatigue, and, therefore, a lower adherence to the same and a significant deterioration in their HRQoL.

THE COGNITION IN PRIMARY CARE PROGRAM: A STEP-BY-STEP CLINIC WORKFLOW PUTTING THE GSA KAER TOOLKIT INTO ACTION

Abstract In 2020 University of Washington (UW) Medicine began developing Cognition in Primary Care (CPC), a quality improvement program adapting the GSA KAER Toolkit to help primary care providers (PCPs) detect patients with cognitive impairment in their 16-clinic primary care network. The CPC consists of a 3-part training program to help PCPs diagnose, manage and counsel patients; a set of tools embedded into the electronic health record to facilitate cognitive evaluation; and an in-clinic workflow providing on-site support for providers within their own clinic setting. During this process we interviewed providers and developed a hybrid remote and in-person orientation for clinics to initiate a workflow to support improved cognitive evaluations. Utilizing pre-implementation input, the CPC in-clinic workflow was pilot-tested at two UW primary care clinics in 2021/2022. This presentation will describe content of the clinic orientation and implementation of CPC to include 1) the typical timeframe and content of orientation; 2) meetings with clinic leadership; 3) overview of provider/staff meetings; 4) in-person walk-through for placement of materials; 5) invitation to training; 6) a 12-page handbook outlining steps in the workflow; 7) other printed CPC materials, e.g., dementia warning signs, MoCA and AD8 forms, Alzheimer Association referral cards; and 8) follow-up focus group feedback. Evaluation of the pilot clinics following implementation found significant use of all tools by PCPs and an increase in diagnoses of mild cognitive impairment. This clinic workflow may be useful as a model for other health care systems to initiate cognitive evaluation programs in primary care.

ANNUAL WELLNESS VISITS (AWV) FOR RESIDENTS IN LOW-INCOME SENIOR HOUSING

Abstract Despite the known benefits, less than one-fifth of all eligible Medicare patients receive an Annual Wellness Visit (AWV). Consequently, we brought the AWV to the older residents in low-income senior housing. Across all four communities the residents are invited to receive an AWV during their birthday month via an individual invitation. Invitations are sent to the facility manager who places them in the residents’ mailboxes. As per Medicare requirements, the Annual Wellness Visit includes such things as medical and family history, review of providers and/or suppliers, height, weight, blood pressure monitoring, medication review, evaluations of health behaviors, cognition, immunizations, mood, safety, and health screenings. At the end of the review the resident is provided with a set of health goals for the year and a small token birthday gift from the team. Approximately half of those who were invited each month came to the clinic for their Annual Wellness Visit. None of the residents to date who have had a Welcome to Medicare Visit were aware of the opportunity. Goals have focused on better adherence to health behaviors, particularly medication adherence, diet and physical activity, and updating immunizations. Most reported adherence to appropriate age-related screenings, and monitoring of cardiovascular disease and screening for and assessment of diabetes and hypercholesteremia. Lastly, we have been able to encourage the completion of the Maryland Orders for Life Sustaining Treatment among many of the participants who were previously unaware of this form and/or not willing to address it.

Effect of MIND diet on cognitive function in elderly: a narrative review with emphasis on bioactive food ingredients.

As the world becomes a super-aged society, cognitive decline is public health problems that are increasing rapidly. A healthy diet has great potential for maintaining cognitive health. A diet that could delay the onset of neurodegenerative diseases has been developed: the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, a hybrid form of the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet. In this review, the effects of the MIND diet on improving cognitive function, including memory, are summarized. In most studies, the higher the adherence to the MIND diet, the higher the cognitive function evaluation score, and the lower the incidence of dementia. This is because of the anti-inflammatory and antioxidant effects of the major nutritional components of the MIND diet: folate, carotenoids, polyphenols, and polyunsaturated fatty acids. Adherence to the MIND diet, containing various bioactive food ingredients, is related to cognitive improvement in the elderly population.

Cenobamate as add-on therapy for drug resistant epilepsies: effectiveness, drug to drug interactions and neuropsychological impact. What have we learned from real word evidence?

Background: Cenobamate (CNB) is an anti-seizure medication (ASM) approved in 2021 in Europe for adjunctive treatment of focal-onset seizures in adults who were not adequately controlled with at least two previous ASMs. Methods: seizure outcome, treatment-emergent adverse events, neuropsychological profile, and blood levels of CNB and concomitant ASM were analyzed in a real world setting in two different Italian epilepsy centers in the context of CNB early access program. All patients performed a general cognitive evaluation, while 32 patients underwent the administration of a battery of neuropsychological tests at baseline and 6months after CNB treatment. We performed CNB quantification in plasma in 31 patients at different doses in the range of 100-400mg/day (65 measures). Results: we enrolled 54 patients with a median age of 27.9years. The mean follow-up was 10.7months. Most (91%) completed the efficacy analysis. At last follow-up visit, a 69.5% median seizure reduction was registered. Thirty-two patients (59.2%) had a ≥50% reduction of seizures that was ≥75% in 20 (42.0%) cases, whilst 10 (20.2%) patients were seizure-free. The most common adverse events were somnolence (53.1%), dizziness (28.1%) and diplopia (12.5%). The correlation between CNB dose and plasma concentration, revealed a significant linear correlation (r = 0.86, p < 0.0001), and there was a significant difference in mean plasma concentration/dose administered ratio (C/D ratio) between patients taking or not at least one inducer (0.10 ± 0.04 [(μg/mL)/(mg/day)]; n = 47 vs. 0.13 ± 0.05 [(μg/mL)/(mg/day)]; n = 18, p = 0.04). CNB dose was inversely correlated (r = -0.31, p = 0.02) to the C/D ratio of Carbamazepine blood levels. and positively correlated (r = 0.74, p < 0.0001) with an increased plasma concentration of the active Clobazam metabolite N-desmethylclobazam. General Anxiety Disorder-7 showed a significant improvement of score from baseline evaluation of 6.82 to follow-up 6months evaluation of 4.53 (p = 0.03). Conclusion: In this real-world study, we registered a clinically meaningful reduction in seizure frequency after CNB administration in most patients along with a good tolerability profile. CNB treatment is correlate to a reduction in symptom severity of anxiety score. Plasma levels measurements confirm that CNB acts both as "victim" and as "perpetrator" of drug-drug interactions.