Cognitive Improvement Research Articles

The Role of Neuropsychology in the Management of Spinal Cord Injury: A Comprehensive Literature Review.

Spinal cord injury (SCI) poses a complex set of physiological, psychological, and cognitive challenges that significantly affect an individual's quality of life. Analysis of longitudinal studies reveals that cognitive changes following SCI are often underestimated yet significantly impact patient's ability to adapt to their new circumstances. However, the role of neuropsychology in SCI management and rehabilitation is yet to be elucidated. This article offers an in-depth review of the role of neuropsychology in understanding and addressing the cognitive, emotional, and behavioral outcomes of SCI. Additionally, we delve into the emotional and psychological consequences of SCI, which can include increased stress, depression, anxiety, and potential changes in personality and social functioning. Neuropsychological assessment tools are highlighted as essential for diagnosing and monitoring these psychological shifts, aiding in the creation of personalized rehabilitation interventions. We also explore the role of neuroplasticity in cognitive rehabilitation post-SCI, emphasizing the potential of targeted cognitive training to alleviate cognitive deficits and improve adaptive functioning. The paper further investigates the interplay between physical and cognitive recovery, underscoring the reciprocal relationship between motor function and cognitive improvement. In conclusion, this review emphasizes the crucial role of neuropsychology in understanding the multifaceted impact of SCI. By enhancing our comprehension of the intricate connections between neural integrity, cognitive function, and psychological well-being, neuropsychology provides valuable insights for developing holistic rehabilitation strategies that address both the cognitive and emotional challenges faced by individuals with SCI. As neurorehabilitation continues to advance, integrating neuropsychological principles offers promise for improving the overall recovery and quality of life for those affected by spinal cord injury.

Cognitive Trajectory Before and After Cataract Surgery: A Population-Based Approach.

Cataract surgery is the most common surgical procedure performed for older US adults. Cataracts are associated with poor cognition and higher rates of dementia, but whether cataract surgery improves cognition for US older adults is not known. We examined the relationship between cataract surgery and long-term change in cognition in the Health and Retirement Study, a population-based study of older US adults linked with Medicare billing data. We analyzed community-dwelling participants who underwent cataract surgery between 2000 and 2018, propensity-matched on age, sex, education (four levels), diabetes status (four levels), pre-procedural latent cognition, vision impairment, and interview timing and mode to older adults who did not have cataract surgery during the study period. Cataract surgery date was ascertained using Medicare billing data. We calculated latent value of cognition using biennial self/proxy cognitive assessments, and used linear mixed effects models adjusting for demographic and health factors to model cognition from 5 years before, to 5 years after, cataract surgery (or a simulated event, for controls). The primary measure was difference-in-differences estimate of latent cognition comparing the year prior, to the year after, cataract surgery or a simulated event. We analyzed 4384 older adults who underwent cataract surgery and 4384 matched controls (mean [SD] age 76.1 [6.8] years, 62.0% women, 83.9% non-Hispanic white). Across the first postoperative year, cataract surgical participants declined 0.002 (-0.002 to 0.006) units faster than nonsurgical controls (p = 0.37), equivalent to 8 (-10 to 26) days more cognitive aging. Post hoc subgroup analyses also found no difference in cognition for groups stratified by pre-procedural latent cognition (i.e., normal vs. cognitively impaired) or vision (i.e., vision-impaired vs. intact). Under typical United States practice, cataract surgery for older patients was not significantly associated with cognitive improvement or decline in the year after, compared with the year before, surgery.

Protection of Alzheimer’s disease progression by a human-origin probiotics cocktail

Microbiome abnormalities (dysbiosis) significantly contribute to the progression of Alzheimer’s disease (AD). However, the therapeutic efficacy of microbiome modulators in protecting against these ailments remains poorly studied. Herein, we tested a cocktail of unique probiotics, including 5 Lactobacillus and 5 Enterococcus strains isolated from infant gut with proven microbiome modulating capabilities. We aimed to determine the probiotics cocktail’s efficacy in ameliorating AD pathology in a humanized AD mouse model of APP/PS1 strains. Remarkably, feeding mice with 1 × 1011 CFU per day in drinking water for 16 weeks significantly reduced cognitive decline (measured by the Morris Water Maze test) and AD pathology markers, such as Aβ aggregation, microglia activation, neuroinflammation, and preserved blood-brain barrier (BBB) tight junctions. The beneficial effects were linked to a reduced inflammatory microbiome, leading to decreased gut permeability and inflammation in both systemic circulation and the brain. Although both male and female mice showed overall improvements in cognition and biological markers, females did not exhibit improvements in specific markers related to inflammation and barrier permeability, suggesting that the underlying mechanisms may differ depending on sex. In conclusion, our results suggest that this unique probiotics cocktail could serve as a prophylactic agent to reduce the progression of cognitive decline and AD pathology. This is achieved by beneficially modulating the microbiome, improving intestinal tight junction proteins, reducing permeability in both gut and BBB, and decreasing inflammation in the gut, blood circulation, and brain, ultimately mitigating AD pathology and cognitive decline.

Probing the Neurodynamic Mechanisms of Cognitive Flexibility in Depressed Individuals with Autism Spectrum Disorder.

Introduction: Autism spectrum disorder (ASD) is characterized by deficits in social behavior and executive function (EF), particularly in cognitive flexibility. Whether transcranial magnetic stimulation (TMS) can improve cognitive outcomes in patients with ASD remains an open question. We examined the acute effects of prefrontal TMS on cortical excitability and fluid cognition in individuals with ASD who underwent TMS for refractory major depression. Methods: We analyzed data from an open-label pilot study involving nine participants with ASD and treatment-resistant depression who received 30 sessions of accelerated theta burst stimulation of the dorsolateral prefrontal cortex, either unilaterally or bilaterally. Electroencephalography data were collected at baseline and 1, 4, and 12-weeks posttreatment and analyzed using a mixed-effects linear model to assess changes in regional cortical excitability using three models of spectral parametrization. Fluid cognition was measured using the National Institutes of Health Toolbox Cognitive Battery. Results: Prefrontal TMS led to a decrease in prefrontal cortical excitability and an increase in right temporoparietal excitability, as measured using spectral exponent analysis. This was associated with a significant improvement in the NIH Toolbox Fluid Cognition Composite score and the Dimensional Change Card Sort subtest from baseline to 12 weeks posttreatment (t = 3.79, p = 0.005, n = 9). Improvement in depressive symptomatology was significant (HDRS-17, F (3, 21) = 28.49, p < 0.001) and there was a significant correlation between cognitive improvement at week 4 and improvement in depression at week 12 (r = 0.71, p = 0.05). Conclusion: These findings link reduced prefrontal excitability in patients with ASD and improvements in cognitive flexibility. The degree to which these mechanisms can be generalized to ASD populations without Major Depressive Disorder remains a compelling question for future research.

Vitamin D Supplementation Is Associated with Inflammation Amelioration and Cognitive Improvement in Decompensated Patients with Cirrhosis.

Background/Objectives: Decompensated cirrhosis is characterized by systemic inflammation and innate and adaptive immune dysfunction. Hepatic encephalopathy (HE) is a prevalent and debilitating condition characterized by cognitive disturbances in which ammonia and inflammation play a synergistic pathogenic role. Extraskeletal functions of vitamin D include immunomodulation, and its deficiency has been implicated in immune dysfunction and different forms of cognitive impairment. The aim was to assess changes in cognitive function and inflammation in decompensated patients with cirrhosis receiving vitamin D supplementation. Methods: Patients with cirrhosis discharged from decompensation in two tertiary hospitals in Spain (from September 2017 to January 2020) were assessed before, at 6 and 12 months after vitamin D supplementation. A comprehensive neuropsychological battery and neuroinflammatory markers were examined. In a subgroup of patients, peripheral immune blood cells were analyzed. Results: Thirty-nine patients were recruited. Of those, 27 completed the 6 months evaluation and were analyzed [age 62.4 ± 11.3 years; 22 men; Model for End-Stage Liver Disease (MELD) 11.7 ± 4.0; prior overt HE 33%; median 25-hydroxyvitamin D (25OHD) plasma level 12.7 µgr/L] and 22 achieved 12 months assessment. At baseline, learning and memory (R = 0.382; p = 0.049) and working memory (R = 0.503; p = 0.047) subtests correlated with plasma 25OHD levels. In addition, processing speed (R = -0.42; p = 0.04), attention (R = -0.48; p = 0.04), Tinnetti balance (R = -0.656; p < 0.001) and Tinnetti score (R = -0.659; p < 0.001) were linked to neuroinflammation marker IL-1β. Patients with lower 25OHD had a greater proportion of TH1cells at baseline and a larger amelioration of IL-1β and IL-6 following supplementation. An improvement in working memory was found after 25OHD replacement (46.7 ± 13 to 50 ± 11; p = 0.047). Conclusions: This study supports that vitamin D supplementation modulates low-grade inflammation in decompensated cirrhosis providing cognitive benefits, particularly in working memory.

Large-scale network mechanisms underlying postoperative cognitive improvement after spine surgery.

The outcome of major surgery is determined not only by the success of the procedure itself but also by its neurocognitive effects. We previously reported improved cognition following spine surgery (Müller et al. 2023 Spine), but the mechanisms underlying these changes remain unknown. We analyzed resting-state (rs) functional magnetic resonance images of 79 patients (mean/SD age: 71/7years) acquired at baseline in this previously published trial. For 26 patients, data was additionally available at 3-months follow-up visits. To delineate large-scale connectivity, we calculated functional connectivity (FC) within and between three core neural networks, the central executive network (CEN), the salience network (SAL), and the default mode network (DMN). FC between CEN and SAL predicted cognitive improvement (beta=0.36, 95%-CI 0.28 to 0.45, P=0.033). Average FC between all nodes of the CEN showed changes towards an increase after surgery (beta=0.057, 95%-CI-0.01 to 0.123, P=0.086). Further seed-based FC analyses revealed that this increase was most pronounced in the functional coupling between left dorsolateral prefrontal and right posterior parietal cortex (beta=0.10, T(24)=2.73, Punc=0.012, PFDR=0.035). The increase of CEN-FC correlated with individual enhancements of executive scores (beta=0.34, 95%-CI 0.32 to 0.36, P=0.034). Integration of activity between the CEN and SAL networks predicted postoperative cognitive improvements, suggesting that less segregated large-scale functional networks may facilitate beneficial cognitive changes following surgery. Postoperative increases in functional coupling may serve as a biomarker for individual improvements in executive functions. These results indicate that surgery should not be routinely deferred in elderly patients due to concerns about postoperative neurocognitive complications. Moreover, our findings highlight potential targets for non-invasive brain stimulation interventions aimed at preventing neurocognitive complications.

The effectiveness of dance interventions on the cognitive functioning of people with dementia or cognitive impairment: A systematic review

Background &amp; Aim: Dementia significantly impair cognitive abilities, well-being, and the functioning of daily life, but there is no cure yet. In the search for non-pharmacological interventions, dance has emerged as a potential complementary therapy to support people with dementia or cognitive impairment. The aim of this study is to investigate the effectiveness of various dance interventions on the cognitive performance of people with dementia or cognitive impairment. Methods &amp; Materials: In accordance with the PRISMA 2020 guidelines, a systematic search was conducted in six databases (APA-PsycINFO, Web of Science, Medline, CINAHL, Embase, and Cochrane)from 2002 to 2023. The quality of the studies was rigorously assessed using the JBI tool. A narrative synthesis approach was used to summarize the findings. Effects of the interventions were presented either as Standardized Mean Difference (SMD), Weighted Mean Difference (WMD), or Mean Difference (MD). An effect size of &lt; 0.1 is considered trivial, 0.1-0.3 is small while &gt; 0.5 is interpreted as a large effect. Results: The systematic results showed significant improvements in global cognition (SMD= 0.54 to 6.10), memory (SMD= 0.24 to 0.56), attention (SMD= 0.38), and language and fluency (SMD=0.61) in different dance genres such as ballroom, Latin and aerobics. However, different effects were observed in executive and visuospatial functions. Conclusion: This systematic review shows the effectiveness of dance interventions in improving several cognitive functions in people with dementia, including memory, attention, language, and fluency. This study supports the use of dance as an effective non-pharmacological approach in dementia care and merits its consideration in treatment strategies and further research studies.

Co-methylation networks associated with cognition and structural brain development during adolescence.

Typical adolescent neurodevelopment is marked by decreases in grey matter (GM) volume, increases in myelination, measured by fractional anisotropy (FA), and improvement in cognitive performance. To understand how epigenetic changes, methylation (DNAm) in particular, may be involved during this phase of development, we studied cognitive assessments, DNAm from saliva, and neuroimaging data from a longitudinal cohort of normally developing adolescents, aged nine to fourteen. We extracted networks of methylation with patterns of correlated change using a weighted gene correlation network analysis (WCGNA). Modules from these analyses, consisting of co-methylation networks, were then used in multivariate analyses with GM, FA, and cognitive measures to assess the nature of their relationships with cognitive improvement and brain development in adolescence. This longitudinal exploration of co-methylated networks revealed an increase in correlated epigenetic changes as subjects progressed into adolescence. Co-methylation networks enriched for pathways involved in neuronal systems, potassium channels, neurexins and neuroligins were both conserved across time as well as associated with maturation patterns in GM, FA, and cognition. Our research shows that correlated changes in the DNAm of genes in neuronal processes involved in adolescent brain development that were both conserved across time and related to typical cognitive and brain maturation, revealing possible epigenetic mechanisms driving this stage of development.

Impact of different treatments for chronic pain on cognitive function: A systematic review.

Experimental evidence supports the hypothesis of reciprocal influence between neural systems involved in cognition and central pain processing circuits. Furthermore, studies have demonstrated bidirectional communication between central pain processing areas and the immune system, leading to changes in behaviour, sensory perception, mood, and cognition. However, the academic community has not yet reached a consensus on whether effective analgesic interventions can mitigate or reverse cognitive deterioration. This systematic review evaluated the effectiveness of various therapeutic interventions in improving cognitive functions (primary outcome) and altering the profile of immunological markers (secondary outcome) in chronic pain patients. The review was limited to randomised controlled trials addressing chronic pain of any aetiology, with searches conducted in PubMed, EMBASE, and Scopus databases. The qualitative synthesis of twelve studies conducted between 2003 and 2021, involving 1432 participants in experimental (n = 950) and control (n = 482) groups, revealed some interesting patterns. Only half of the studies (6/12) reported cognitive improvement, with attention being the most analysed cognitive domain, followed by memory and executive function. Fibromyalgia was the most studied aetiology of chronic pain. The strategies of intervention/treatment and durations varied widely; however, milnacipran versus placebo emerged as the most frequently employed intervention. Only one study reported immunological markers, limiting the evaluation of this outcome. Based on this analysis, it is not possible to affirm that interventions targeting chronic pain improve cognition. This review suggests new research directions and calls for more robust methodological approaches.

Clinical outcomes and anti-inflammatory mechanisms predict maximum heart rate improvement after physical activity training in individuals with psychiatric disorders and comorbid obesity

Introduction This study aimed to evaluate the predictive validity and discriminatory ability of clinical outcomes, inflammatory activity, oxidative and vascular damage, and metabolic mechanisms for detecting significant improve maximum heart rate after physical activity training in individuals with psychiatric disorders and obesity comorbid using a longitudinal design and transdiagnostic perspective. Methods Patients with major depressive disorder, bipolar disorder and, schizophrenia and with comorbid obesity (n = 29) were assigned to a 12-week structured physical exercise program. Peripheral blood biomarkers of inflammation, oxidative stress, vascular mechanisms, and metabolic activity, as well as neurocognitive and functional performance were assessed twice, before and after intervention. Maximum heart rate was considered a marker of effectiveness of physical activity. Mixed one-way analysis of variance and linear regression analyses were performed. Results Individuals with psychiatric disorders and comorbid obesity exhibited an improvement in cognition, mood symptoms and body mass index, increase anti-inflammatory activity together with enhancement of the oxidative and cardiovascular mechanisms after physical activity training (p&lt;0.05 to 0.0001; d = 0.47 to 1.63). A better clinical outcomes along with regulation of inflammatory, oxidative, and cardiovascular mechanisms were critical for predicting significant maximum heart rate variation over time (χ2 = 32.2 to 39.0, p &lt; 0.0001). Conclusions The regulation of the anti-inflammatory mechanisms may be essential for maintained of healthy physical activity across psychiatric disorders and obesity. Likewise, inflammatory activity, oxidative stress, vascular and cardio-metabolic mechanisms may be a useful to identify individuals at greater risk of multi-comorbidity.

Effective engagement in computerized cognitive training for older adults.

Computerized cognitive training (CCT) is a frontline therapy to prevent or slow age-related cognitive decline. A prerequisite for CCT research to provide clinically relevant improvements in cognition is to understand effective engagement, i.e., the pattern of energy investment that ensures CCT effectiveness. Even though previous studies have assessed whether particular variables (e.g., gamification) predict engagement and/or CCT effectiveness, the field lacks a systematic approach to understanding effective engagement. Here, by comprehensively reviewing and evaluating engagement and adjacent literature, we propose a standardized measurement and operational framework to promote effective engagement with CCT targeting cognitive decline in older adults. We suggest that promoting effective engagement with CCT has two key steps: 1) comprehensively measuring engagement with CCT and 2) identifying which aspects of engagement are essential to achieve the pre-specified outcome of clinically relevant improvements in cognition. The proposed measurement and operational framework of effective engagement will allow future research to maximize older adults' engagement with CCT to slow/prevent age-related cognitive decline.

Effects of acute PM2.5 purification on cognitive function and underlying mechanisms: Evidence from integrating alternative splicing into multi-omics.

The relationship between fine particulate matter (PM2.5) and cognition has been extensively investigated. However, the causal impact of acute PM2.5 purification on cognition improvement and the underlying biological mechanisms remain relatively opaque. Our double-blinded randomized controlled trial assessed the impact of acute PM2.5 purification on executive function, underpinned by multi-omics approaches including alternative splicing (AS) analysis. A total of 93 participants experienced a two-hour exposure to either reduced and normal PM2.5 levels. We measured the cognition of healthy young adults, collected peripheral blood before and after intervention, and performed multi-omics analysis including transcriptomics, metabolomics, and proteomics. Results indicated that reducing PM2.5 by 1 μg/m3 was associated with a 0.10 % (95 % CI: [0.18 %, 0.01 %]; p = 0.031) improvement in executive function. Notably, we identified 96 AS events without concurrent transcriptional amount alterations. Multi-layered omics analyses revealed disrupted pathways in hypoxia, mitochondrial function and energy metabolism, and immune responses, validated by ELISA and biochemical assay. These findings demonstrated short-term improvements of cognition following PM2.5 purification and provide mechanistic understandings of PM2.5-induced cognition alterations. This study underscores the significance of incorporating AS in the molecular framework of multi-omics research by exploring variable exon splicing, which could enrich multi-omics analysis methodologies and expose to broader audience.

Effect of proanthocyanidins on cognitive improvement in thyroxin-induced aging mice.

As the population ages, functional dietary supplements are increasingly used to reduce age-related diseases, especially in the field of cognitive impairment. In this study, a thyroxine (Th)-induced aging model was established, and the effect of proanthocyanidins (Pc) on cognitive impairment of aging mice was evaluated based on cognitive ability, neuroinflammation and immune level. The results showed that Pc significantly reduced AchE activity compared to the Model group, improving learning deficits and spatial memory in aged mice (P < 0.01). Further study showed that Pc could maintain the organism's redox balance, markedly increasing T-AOC, GSH, and SOD levels (P < 0.01) while reducing MPO and MDA levels (P < 0.01). Pc also improved systemic inflammation, raising the levels of the anti-inflammatory cytokine PF4 and significantly lowering pro-inflammatory factors in the blood (P < 0.01). In the DG region of the hippocampus, Pc effectively repaired nerve damage, inhibited the over-activation of microglia and astrocytes, down-regulated GFAP and IBA-1 proteins (P < 0.01), and then reduced neuroinflammation. Additionally, Pc supplementation also significantly increased the levels of WBC, Lymph, Mid, and Gran in aged mice (P < 0.01), aiding in the recovery of leukocyte counts. At the same time, the CD3+ level and CD4+/CD8+ ratio were significantly increased (P < 0.01) to maintain the dynamic balance of lymphocyte subsets in aging mice and enhance the immune capacity of aging mice. The study revealed that Pc, as a dietary supplement, can effectively alleviate cognitive impairment in the elderly population. This provides a new dietary nutrition supplement strategy for the health of the aging population.

A 3-Month Dual-Task Exercise Randomized Pilot Trial Improves Dynamic Stability and Coordination in Community-Dwelling Older Adults.

Dual-task (DT) exercises combine both physical and cognitive activities and have the potential to efficiently enhance both physical and cognitive function. This study aimed to determine if, compared with exercise-only (EO) and control (C) groups, adults in a DT training program improved measures of cognitive and/or physical functioning. Thirty-five participants (Mage = 65.7 ± 8.5years; 74.3% female, 25.7% male) were randomly sorted into EO (n = 15), DT (n = 10), and C (n = 10). EO and DT participated in 3months of twice weekly, 50-min exercise. DT played cognitive games on a SMARTfit Cognitive-Motor Exercise System during exercise sessions. C did not participate in any supervised sessions. Cognition was assessed with a Cognivue Thrive program. Dynamic stability, coordination, and lower body strength were assessed. Linear mixed-effects models investigated effects for different groups. For outcomes showing significant (p < .05) differences, pairwise t tests were conducted between all treatment and time comparisons. Dynamic stability and coordination improved in DT and EO (p = .002 and .04, respectively), but not in C in the first 6weeks (p = .58). Cognition and memory did not change over time among the three groups. Healthy, independent-living older adults in either DT or EO improved dynamic stability and coordination over time and DT improved balance and functional mobility more than either EO or C. No improvements in several standard cognition or memory measurements were observed. Significance/Implications: A DT exercise program improved balance and coordination, but not cognition or memory, in healthy, independent-living older adults.

Does metacognitive training for psychosis (MCT) improve neurocognitive performance? A systematic review and meta-analysis.

Metacognitive training for psychosis (MCT) offers benefits for addressing hallmark deficits/symptoms in schizophrenia spectrum disorders including reductions in cognitive biases and positive/negative symptoms as well as improvements in social cognition and functioning. However, differing results exist regarding the relationship between MCT and neurocognition. A comprehensive understanding of the nature of this relationship would significantly contribute to the existing literature and our understanding of the potential added value of MCT as a cognitive intervention for psychosis. Across eleven electronic databases, 1312 sources were identified, and 14 studies examining MCT and neurocognition in psychosis were included in this review. Measures of estimated effect sizes were calculated with Hedge's g, moderator analyses used Cochrane's Q statistic and significance tests to measure group differences according to control conditions. Twelve studies, 11 randomized controlled trials (RCTs) and 1 non-RCT, were included in the main meta-analyses, consisting of 673 participants (nMCT=345, ncontrol=328). When comparing MCT against control interventions, non-significant differences in estimated effect sizes were observed across all neurocognitive domains when evaluating pre-post changes (g≤0.1, p>.05). Two additional studies corroborated these results in a narrative review. These findings suggest that when compared against control conditions, MCT does not pose a statistically meaningful benefit to neurocognitive performance. General practice/learning effects are likely the main contributor that explains improvement in neurocognitive performance, and not a difference of intervention allocation when considering MCT against the included control comparators. These findings help establish the specificity of the effects of MCT.

Microlearning beyond boundaries: A systematic review and a novel framework for improving learning outcomes.

Microlearning has become increasingly popular not only in education sector but also in corporate sector in recent years. However, its definition and didactics conceptualization, integration into instruction design, and effects on learning outcomes remain largely underexplored in terms of synthesized findings. Consequently, challenges persist in clarifying microlearning definition, and didactics, and designing effective microlearning instruction to yield improved learning outcomes. To address these gaps, we analyzed 40 relevant studies following PRISMA guidelines. Based on the findings, we maintain that microlearning is an instructional approach that delivers targeted, action-oriented, bite-sized content to achieve specific objectives within a short period, typically within a few seconds or minutes. The most important findings from the reviewed studies indicate that microlearning has positive impact on learning outcomes. The key learning outcomes identified, categorized according to Bloom's Taxonomy, include cognitive (knowledge acquisition, retention, improvement, recall, transfer, and application as well as critical thinking, problem-solving, professional, feedback and self-regulation skills, core competencies such as digital and pedagogical competence, and performance like test performance), behavioural (presentation skills development, task or work performance, higher completion rates, behavioural patterns, engagement, and collaboration), and affective (positive perceptions and attitudes, increased motivation, satisfaction, and improved self-efficacy). Based on Andragogy in Practice Model, Bloom's Taxonomy, and Sweller's CLT, we proposed a novel microlearning instructional design framework consisting of three integral components-differences consisting of individual, situational, and subject differences; guiding principles including specific-objective, bite-sized content, appropriate timeframe, interactive and engaging content, personalization, and selecting appropriate delivery medium and mode; and learning outcomes (cognitive, behavioural and affective). The proposed framework aims to integrate microlearning into instruction to improve learning outcomes. Educators, instruction designers, and policymakers can use the framework to design microlearning instruction to improve learning outcomes.

Do Cognitive Bias and Heuristics Influence Improvement in Knee Pain in Patients with Knee Osteoarthritis Treated with Open Label Placebo? The CHIPS Study - An Exploratory Study Using Questionnaire and Group Concept Mapping.

Do Cognitive Bias and Heuristics Influence Improvement in Knee Pain in Patients with Knee Osteoarthritis Treated with Open Label Placebo? The CHIPS Study - An Exploratory Study Using Questionnaire and Group Concept Mapping.

Exploring the Efficacy and Safety of Vagus Nerve Stimulation for the Treatment of Epilepsy in Patients With Sturge-Weber Syndrome: A Pilot Study.

Sturge-Weber syndrome (SWS) is a rare congenital neurocutaneous disorder, often complicated by epilepsy. Approximately 50% of patients with SWS with epilepsy develop drug-resistant seizures, leaving limited treatment options. Vagus nerve stimulation (VNS) is a known therapy for refractory epilepsy, modulating neural activity to reduce seizures. This study examines the therapeutic outcomes, efficacy, and safety of VNS in five patients with SWS suffering from epilepsy. A retrospective analysis of VNS treatment data from January 2021 to January 2022 in patients with SWS was conducted. Preoperative assessments included neuroimaging and video-electroencephalography monitoring. Cognitive function and quality of life were assessed using age-appropriate scales. VNS settings and seizure outcomes were recorded at different follow-up intervals. Seizure outcomes were classified using the modified Engel and McHugh classification. Cognitive function and quality of life were reassessed at two-year follow-up. Five patients, primarily pediatric, with seizure onset between age 0.5 and eightyears, were included. After VNS therapy, all patients experienced a reduction in seizure frequency, with one patient becoming seizure free and three achieving a ≥50% reduction in seizures. Two children with cognitive impairments at baseline demonstrated cognitive improvements following treatment. All patients reported significant enhancements in quality of life. VNS was well tolerated, with no major adverse events reported. VNS offers promising therapeutic benefits for epilepsy in patients with SWS, reducing seizure frequency, improving cognitive function in children, and enhancing quality of life with a favorable safety profile. Further research with larger sample sizes and control groups is warranted to validate efficacy and explore personalized treatment options.

Dihuang Yinzi improves scopolamine-induced learning and memory impairment by regulating plasma exosome-derived BDNF.

Dihuang Drink (DHD), formulated by Liu Hejian during the Yuan Dynasty, is listed as one of the first ancient classical prescriptions by the National Medical Products Administration of China. It is commonly used for the prevention and treatment of Alzheimer's disease (AD). This study further investigates the therapeutic effects and potential mechanisms of DHD in AD. This study aimed to evaluate the cognitive improvement effects of DHD on scopolamine (SCOP)-induced memory impairment in mice and to explore its anti-AD mechanisms mediated by exosomes. A cognitive impairment model was established in C57BL/6J mice via intraperitoneal injection of SCOP (1mg/kg) for 21 consecutive days, followed by DHD intervention to assess its effects on learning, memory, hippocampal synaptic density, and the cholinergic system. SD rats were gavaged with DHD (22.00g/kg) for 7 days, and plasma exosomes were extracted. These exosomes were injected into SCOP-treated mice (2mg/kg, every other day for 14 days, 7 injections) to verify the role of exosomes in improving cognitive function. Behavioral performance and brain ChAT and BDNF levels were measured. DHD improved learning and memory in SCOP model mice, attenuated neuronal loss and decreases in dendritic spines induced by scopolamine, and modulated the expression of BDNF, SYN-1, PSD95, and M1 mAChR. DHD-derived plasma exosomes further enhanced learning and memory function and significantly increased brain ChAT activity and BDNF levels. DHD may alleviate cognitive impairment in SCOP model mice, potentially through exosome-mediated neuroprotection.

Single-session gamma sensory stimulation entrains real-time electroencephalography but does not enhance perception, attention, short-term memory, or long-term memory

Background Studies have shown that gamma (40 Hz) audiovisual stimulation can enhance gamma oscillations and improve cognitive functioning in patients with Alzheimer's disease. However, despite promising long-term results, the efficacy of short-duration or single-session 40 Hz entrainment in humans has been questioned by behavioral studies that fail to find observable cognitive aftereffects, for two possible reasons: 1) lack of validated gamma entrainment, as most studies lacked concurrent electroencephalography (EEG) data to verify that gamma neural entrainment did take place, and 2) lack of diverse cognitive tests, as most studies did not test a wide range of cognitive factors. Objective This study aimed to increase sensitivity for detecting single-session gamma entrainment. We employed 1) mid- and post-stimulation EEG monitoring to ensure entrainment worked, and 2) a comprehensive cognitive battery that probes perception, attention, working memory, and long-term memory. Methods Participants received 30 min of synchronized 40 Hz light and sound stimulation, followed by a visual perceptual task, attentional network task, change detection working memory task, and long-term picture memory task, with concurrent EEG. Results We observed robust 40 Hz EEG entrainment during stimulation but no significant 40 Hz oscillation after stimulation, and no significant cognitive improvements. Conclusions Despite robust 40 Hz online entrainment, gamma sensory entrainment requires consistent long-term exposure to induce cognitive and neurological changes. Future research should determine the optimal duration and frequency of 40 Hz stimulation to maximize its therapeutic potential.