Cognition in Pediatric Chiari Malformation Type 1 Before and After Posterior Fossa Decompression.

Social interaction deficits and anxiety-like behavioral changes in the TgF344-AD rat model of Alzheimer's disease.

Lost in Transition: Long-term Follow-up in Traumatic Brain Injury Patients.

Hyperlearning Hypothesis: Network disruption and maladaptive learning in schizophrenia.

Schizophrenia is a complex psychiatric disorder that significantly affects individuals and society. Its etiology and pathophysiology remain unclear, in part due to its heterogeneity. Although the neurobiological background is not fully understood, schizophrenia is considered a polygenic disorder influenced by multiple genes. Current hypotheses, such as the N-methyl-D-aspartate (NMDA) hypothesis, and the role of glial cells are under investigation. The disease manifests through positive, negative, and cognitive symptoms, having an impact on emotion, perception, and behavior. In particular, cognitive decline affects two domains: neurocognition (verbal memory, fluency, processing speed, working memory, visual learning, attention, reasoning, and problem-solving) and social cognition. Although pharmaceutical treatments aim to alleviate clinical symptoms, recent studies indicate that neurorehabilitation and cognitive training can improve cognitive and clinical outcomes by modifying the neurobiological framework. Cognitive therapies, like cognitive remediation therapy, RehaCom, and cognitive behavioral training, are becoming prominent. Neuroimaging studies suggest that these therapies can reorganize brain structure, thereby enhancing cognitive functions and improving daily and social life.

Distinct cortical inhibitory profiles in schizophrenia and bipolar disorder: A TMS-EEG study of GABAb function.

Few studies have longitudinally evaluated Hashimoto's encephalopathy with anti-NH2-terminal α-enolase (anti-NAE) antibodies using detailed imaging and neuropsychological assessments. We present the case of a man in his 50s who presented with acute hallucinations, catatonia, seizures, and cognitive decline. Initial MRI revealed diffuse white matter hyperintensities, and SPECT revealed widespread hypoperfusion. These symptoms improved with immunotherapy, but progressive frontal and temporal atrophy and residual hypoperfusion appeared over 33 months. His cognitive function improved, but he remained impaired, with persistent disinhibition and perseveration. This case suggests that Hashimoto's encephalopathy with anti-NAE antibodies can cause lasting structural and functional brain abnormalities and cognitive impairments, requiring long-term neuroimaging and neuropsychological follow-up.

Films are not only a medium of entertainment, but also reflect social and psychological issues in society. Film Berbalas Kejam (2023) raises the issue of Post-Traumatic Stress Disorder (PTSD) through the main character named Adam, a victim of violence and a witness to the murder of his wife and child who experienced deep trauma for two years. The study aims to determine how PTSD is represented in this film. The approach used is John Fiske's semiotics, which includes levels of reality, representation, and ideology. The results of the study show that PTSD in the film is represented through 31 scenes that display symptoms such as re-experiencing symptoms, avoidance symptoms, arousal and reactivity symptoms, and cognition and mood symptoms. Cinematic elements such as dark lighting, silent space, and close-up camera composition strengthen the representation of psychological trauma. Ideologically, this film raises criticism of the system that passively handles victims as a whole, and shows a tendency towards vigilantism as a result of untreated trauma. This research is crucial for understanding how popular media, particularly films, can shape public perceptions of mental health and violence. The findings can also open up discussions about the importance of ethical and accurate representation of psychological conditions in audiovisual media.

ABSTRACT Background: Cognitive emotion regulation (ER) strategies refer to cognitive processes used to regulate emotions. Maladaptive cognitive ER has been associated with higher posttraumatic stress disorder (PTSD) symptoms. The present study examined whether cognitive ER strategies changed during a 2-week Cognitive Processing Therapy (CPT)-based intensive treatment programme (ITP) and whether these changes were associated with improvements in PTSD and depression symptoms. Methods: Data were collected from 269 military service members and veterans. Results: Results revealed large effect sizes for self-blame (d = 0.93), moderate effect sizes for catastrophizing (d = 0.65), and small effect sizes for acceptance (d = 0.24), positive refocusing (d = 0.22), and other-blame (d = 0.26). Of these ER strategies, linear mixed effects regression models indicated that decreases in self-blame (p < .001) and catastrophizing (p < .001), and increases in positive refocusing (p = .005) were associated with reductions in PTSD severity during the programme. Similarly, decreases in self-blame (p < .001) and catastrophizing (p < .001), and increases in positive refocusing (p < .001) were associated with decreases in depression severity. Conclusions: Findings indicate that CPT-based ITPs may improve cognitive ER strategies among veterans and service members and that changes in some cognitive ER strategies are associated with reductions in PTSD and depression symptoms. Based on these results, clinicians are advised to prioritize targeting cognitive ER strategies, such as self-blame and catastrophizing. Future studies should use multiple assessment methods of cognitive ER within different treatment settings to determine the generalizability of study results.

ABSTRACT Aim: Moral injury (MI), originally studied in military contexts, refers to emotional distress resulting from actions that conflict with one's core values. MI outcomes may help explain how potentially morally injurious events (PMIEs) contribute to mental health issues, yet empirical evidence remains limited. This longitudinal study examined whether MI outcomes mediate the relationship between PMIE exposure during combat and posttraumatic stress symptom (PTSS) clusters following discharge. Method: We followed 374 male combat veterans over a five-year period. Pre-enlistment psychological characteristics were conducted 12 months prior to enlistment (T1). PMIE exposure was measured during the final month of military service (T2) using the Moral Injury Events Scale (MIES), capturing experiences throughout active duty. MI outcomes were assessed six months post-discharge (T3) using the Expressions of Moral Injury Scale–Military Version–Short Form (EMIS-M-SF). Finally, PTSS clusters were evaluated one year after discharge (T4) using the PTSD Checklist for DSM-5 (PCL-5). Results: A total of 48.7% of participants reported exposure to PMIEs, while 8% met criteria for probable PTSD. Path analysis demonstrated a direct effect of PMIE-betrayal (T2) on arousal and reactivity as well as negative alterations in cognition and mood symptom clusters (T4). Results also showed indirect associations between exposure to all PMIE dimensions (T2) and PTSS clusters (T4) via MI outcomes (T3). Conclusions: Findings underscore the role of MI outcomes in the development of specific PTSS clusters following PMIE exposure. Integrating MI-informed interventions may enhance treatment for veterans transitioning to civilian life.

Mounting evidence suggests that circadian rhythm disruption may be linked to the onset and progression of Alzheimer's disease. However, whether this disruption occurs before the appearance of cognitive symptoms and whether it drives disease development remain unclear. Understanding the temporal relationship between circadian rhythm dysregulation and early Alzheimer's disease pathological changes may open up new avenues for disease prevention and intervention. To determine if circadian rhythm disruption precedes cognitive decline, we conducted high-resolution transcriptome analyses of the hippocampus in a 5-month-old mouse model of Alzheimer's disease and age-matched wild-type control mice at multiple time points over a 24-hour period. While the mouse model of Alzheimer's disease did not exhibit obvious cognitive symptoms at this stage, the expression of circadian-related genes in the hippocampus exhibited extensive abnormalities. In the control group, 2109 genes exhibited rhythmic expression characteristics. In the mouse model of Alzheimer's disease, a marked proportion of these genes lost their rhythmicity, some genes newly developed rhythmicity, and some maintained rhythmicity but with altered expression patterns. Genes related to neuronal function, including those involved in protein homeostasis regulation, neuroinflammation, and ion homeostasis, showed significant changes in circadian rhythm amplitude and phase, and some completely lost their rhythmicity. These findings point to the following critical early events in Alzheimer's disease: hippocampal circadian gene disruption occurs before cognitive symptoms emerge, genes related to neuronal function are uniquely susceptible to this early dysregulation, and circadian dysfunction may even precede the pathological changes of Alzheimer's disease and influence disease onset. This work advances Alzheimer's disease research by clarifying that circadian disruption is an early pre-symptomatic event, reinforcing the potential of circadian rhythm regulation as a strategy for early intervention of Alzheimer's disease, and identifying neuronal pathways that may serve as intervention targets.

Recommendation of: Comparison of Two Exergame-based Motor-Cognitive Trainings: Protocol for a Pilot Study on Cognitive, Motor and Psychiatric Symptoms in Patients with Huntington&amp;amp;#x27;s Disease (CARE-MH). Round#2

BackgroundThe association between open-angle glaucoma (OAG) and early-onset Alzheimer's disease (EOAD) remains unclear.ObjectiveTo investigate the association between OAG and EOAD.MethodsWe conducted a case-control study using a Japanese nationwide administrative claims database. Individuals aged 40-64 with a diagnosis of Alzheimer's disease (AD) and a prescription for AD medications were defined as EOAD cases (n = 2344). The index date was the first AD medication prescription. Controls (n = 9376) were matched to cases in a 4:1 ratio by age and sex using risk set sampling. OAG exposure was defined as a diagnosis ≥12 months before the index date. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsOAG was present in 15.8% of EOAD cases and 12.5% of controls. A significant association was observed between OAG and EOAD (OR, 1.22; 95% CI, 1.06-1.40; p = 0.006). EOAD was associated with diabetes (OR, 1.56; 95% CI, 1.37-1.77; p < 0.001), hypertension (OR, 1.15; 95% CI, 1.02-1.29; p = 0.021), depression (OR, 7.81; 95% CI, 6.76-9.02; p < 0.001), and excessive alcohol use (OR, 2.35; 95% CI, 1.72-3.21; p < 0.001). In sex-stratified analyses, the association between OAG and EOAD was significant in males (OR, 1.32; 95% CI, 1.09-1.60; p = 0.005) but not in females (OR, 1.11; 95% CI, 0.90-1.37; p = 0.321).ConclusionsIndividuals with OAG may be associated with an increased risk of EOAD, and careful monitoring of cognitive symptoms may help facilitate early detection and intervention.

A preliminary investigation of a Geriatric Depression Scale, Dementia version (GDS-D).

BackgroundCorticobasal syndrome (CBS) is a neurodegenerative disease usually associated with accumulation of tau in the cortex and basal ganglia, leading to cognitive, movement, and behavioral symptoms that progressively impair function. Few clinical trials have ever been conducted in CBS, and perceptions and preferences about clinical trials in this population are largely unknown.MethodAn online survey was conducted (February 2015 ‐ November 2020) among research participants recruited through a multisite observational study (ARTFL). Responses from patients with CBS were tabulated and reported below.ResultN=66 respondents had CBS as a primary or secondary phenotype (determined by study clinician), with 62% of surveys patient‐reported, and 38% completed by a caregiver/family member. Within CBS, 91% requested to be contacted about clinical trials. 2/6 decliners commented that disease severity precluded participation. 97% were willing to come in annually, 88% quarterly (3 months), 66% monthly, 43% weekly, and 17% would come in more than weekly; two patients could not travel due to disease severity. Comments included “we would live here for trials” and “whatever is needed.” Full day evaluations were acceptable to 91%, whereas 9% preferred a half‐day or less, although 65% would complete multi‐day evaluations spread over a week. Numerous remote and in person modes of assessment (e.g., surveys, examinations, cognitive testing, blood/saliva sampling, MRI, PET), were broadly acceptable by respondents (80‐93%), whereas remote activity monitoring (70%), lumbar puncture (68%), and remote video conferencing memory testing (67%) were less preferred, though still broadly acceptable. For distance willing to travel, 95% would travel 30 minutes, 91% one hour, 65% three hours, 54% five hours, and 37% would travel more than five hours or take a flight if needed. Travel reimbursement was very/extremely important for 40%, and unimportant for 26% (34% neutral). Feedback about clinical progression (81%), study results (74%), and an open‐label extension (68%) were factors identified as the highest importance to patients.ConclusionPatients with CBS are eager to participate in clinical trials, even trials that are complex, far away, and have visits over multiple days. Travel reimbursement, providing feedback to patients, and access to experimental treatments were key considerations.

Background:Substance use disorder (SUD) comprises a spectrum of cognitive, behavioral, and physiological symptoms, indicating that individuals continue to use substances despite significant substance-related problems. Recent evidence suggests multiple types of exercise as adjunctive or main intervention options for SUD. The study aimed to evaluate the effectiveness of supervised exercise in improving quality of life, mental health outcomes, and substance use in individuals with SUD.Methods:Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials. gov were systematically searched for relevant randomized controlled trials. We assessed depression, anxiety, urine drug screen (UDS) and quality of life (QoL) of participants in the included studies. The revised Cochrane risk-of-bias tool assessed the quality of the studies. Regarding meta-analysis, effect sizes reported using standardized mean difference (SMD) and risk ratio (RR), the random-effects model, and the inverse variance (IV) technique. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were used to evaluate the certainty of the evidence.Results:Eight studies were included in the qualitative review, whereas 4 were included in the quantitative synthesis. Exercise interventions demonstrated superior effects compared with standard treatment in improving outcomes for individuals with SUD in terms of QoL in the subdomains of physiology (SMD = 0.94, 95% confidence interval [CI]: 0.67–1.22, P < .00001, I2 = 0%), psychology (SMD = 0.89, 95% CI: 0.62–1.16, P < .00001, I2 = 0%), and social (SMD = 0.73, 95% CI: 0.31–1.14, P < .0006, I2 = 58%). However, exercise showed a similar effect to the control in the number of patients with positive urine drug screen (risk ratio = 0.79, 95% CI: 0.56–1.12, P = .18, I2 = 0%).Conclusion:Adjunctive exercise effectively improved the QoL of patients with SUD. However, it showed no effect on decreasing use. More evidence is needed to establish this as an adjunct to the initial lines of SUD interventions.

To evaluate whether consumer-grade wearable devices (CGWDs) can detect physiological differences between adolescent athletes recovering from sport-related concussion (SRC) versus musculoskeletal (MSK) injury, and to examine whether wearable-derived physiological markers are associated with symptom burden during the acute post-injury phase. Outpatient sports medicine clinic at a pediatric academic medical center. High school student-athletes aged 14-18years were eligible if they presented within 10days of SRC or acute, nonsurgical MSK injury and had internet access and willingness to comply with study procedures. Thirty-eight participants were enrolled; four were excluded due to protocol deviations. The final analytic sample included 34 participants (SRC: n =17; MSK: n =17). Prospective observational cohort study conducted from September 2021 to April 2022. All participants were issued a Fitbit Sense to passively monitor sleep, activity, and heart rate for up to 6weeks post-injury. No randomization or blinding occurred, as this was an observational study. The primary outcome was group differences in CGWD-derived physiological metrics (sleep patterns and architecture, physical activity, heart rate) across 3 post-enrollment time intervals (Days 1-14, 15-28, 29-42). Secondary outcomes included correlations between physiological data and symptom burden based on the Post-Concussion Symptom Inventory, Second Edition (PCSI-2). Compared to MSK peers, participants with SRC showed significantly more light sleep, more nocturnal wake time, and lower daily step counts during the first 4weeks post-injury (P <.0038). No significant differences were observed in REM sleep, deep sleep, or heart rate. In SRC participants, greater nocturnal wake time and lower resting heart rate were modestly associated with higher cognitive symptom ratings; emotional symptoms were modestly associated with step counts. No adverse events occurred. CGWDs may capture recovery-specific physiological disruptions in adolescent SRC, particularly in sleep and physical activity. These findings support the potential for wearable technology to inform individualized, objective approaches to concussion monitoring in clinical practice.

BackgroundLong COVID‐associated cognitive impairments significantly diminish patients' quality of life. However, there is a lack of research exploring patient perspectives on treatment preferences and expectations, especially across age groups.MethodIn this qualitative study, we employed a constructivist grounded theory approach. Semi‐structured online interviews were conducted with 23 Chinese participants, comprising 10 young adults (aged 18‐39 years) and 13 older adults (aged ≥60 years).ResultA central theoretical framework of ‘Individualized and Dynamic Adaptation to Cognitive Challenges’ was developed, illustrating how factors including age, severity of cognitive symptoms, economic affordability, accessibility of medical resources, prior management experiences regarding cognitive symptoms, baseline health status, personal lifestyle, interests, and attitudes, doctor‐patient interactions, and health literacy shaped participants’ preferences and expectations. ‘Preference for non‐pharmacological interventions’ emerged as the core theme for young adults, consisting of subthemes including self‐directed strategies (formed by concepts such as psychological adaptation and practical tools like to‐do lists and alarms) and emotional and psychological support. In contrast, ‘balanced use of pharmacological interventions’ was identified as the core theme for older adults, consisting of non‐pharmacological interventions (formed by concepts such as family support and structured and predictable routines), pharmacological interventions, and holistic expectations (formed by the concept that address not only cognitive but also physical and emotional well‐being). Across both age groups, improving sleep quality and psychological well‐being was consistently highlighted as essential for effective management. Disrupted sleep was viewed not only as a symptom but also as a factor that could exacerbate cognitive symptoms. For older adults, the need for psychological support often stemmed from poorer baseline health and feelings of neglect and isolation due to limited family presence in daily life. By comparison, young adults expressed a need for emotional care primarily driven by the stigma surrounding long COVID, particularly the perceived lack of trust and understanding from older generations and broader society.ConclusionOur study is the first to qualitatively explore and compare age‐specific treatment preferences, experiences, and expectations regarding long COVID‐associated cognitive impairments. By highlighting the heterogeneity of age‐specific preferences and expectations, it provides a comprehensive theoretical framework to inform the development of dynamic, patient‐centred interventions.

BackgroundAlzheimer’s disease (AD) begins with a preclinical period of accumulating pathologic biomarkers prior to onset of objective cognitive impairment (CI). Although clinical trials are increasingly targeting this earlier stage, recruitment of preclinical AD (preAD) individuals is challenging due to a lack of appropriate tools to triage presymptomatic patients. PreAD persons with subjective cognitive decline (SCD) may represent a more identifiable pool of participants given that they report SCD but do not yet have overt CI. Here we estimate amyloid‐positive (Aβ+) individuals with SCD in nine European countries among those 50+ years with considerations for help‐seeking and trial eligibility.MethodWe first estimated individuals 50+ years with SCD by applying age‐stratified estimates of SCD prevalence to 2025 United Nations population data for each of the countries examined (Belgium, France, Germany, Italy, Netherlands, Poland, Spain, Switzerland, United Kingdom). Next, we applied age‐stratified estimates of Aβ+ probability from the Amyloid Biomarker Study among those with SCD. We then applied estimates from a European study of help‐seeking for SCD symptoms to determine the number of preAD likely to speak to a healthcare professional (HCP) regarding their cognitive symptoms. Finally, we estimated those potentially eligible for inclusion in a preAD trial by applying estimates of relevant screen‐failure criteria from a trial in a preAD population.ResultAcross nine European countries, approximately 8.4 million people 50+ years with SCD are potentially preAD (Table 1). Estimates ranged from ∼177k in Switzerland to ∼1.9 million in Germany. Of those with preAD, approximately 1.5 million likely have spoken with an HCP regarding their symptoms. When considering potential eligibility for a clinical trial of preAD, an estimated 460k of those who have spoken to an HCP would likely qualify for trial inclusion, ranging from approximately 10k in Switzerland to 102k in Germany.ConclusionOf the ∼8 million individuals in nine European countries with preAD and SCD symptoms, only 5.5% would likely be identifiable and eligible for a trial of preAD individuals. Future work should incorporate tau pathology and APOE ε4 status into estimates. Accelerating development of biomarkers and other diagnostic tools is important to identifying additional preAD trial participants.

Plasma phosphorylated-tau (p-tau) biomarkers show high performance as first-in-line tests in the evaluation of patients with cognitive symptoms and have also found utility in clinical trials for anti-amyloid drug therapies for Alzheimer’s disease (AD). Plasma p-tau212 is a novel blood biomarker that can discriminate cognitively unimpaired (CU) and subjective cognitive decline patients from mild cognitive impairment (MCI)-AD and AD dementia patients in clinical cohorts. Using Simoa technology, we evaluated plasma p-tau212 for its ability to detect emerging amyloid-beta (Aβ) pathology in CU individuals with brain amyloidosis from CSF Aβ42/40 ratio (n = 317) or Aβ PET scans (n = 277). We benchmarked plasma p-tau212 against p-tau181, p-tau217, and p-tau231 by comparing their accuracies and fold changes for detecting brain amyloidosis. Our results showed that all the plasma p-tau biomarkers are increased in the CU CSF Aβ + participants, with the highest median fold change observed for plasma p-tau212. Discrimination performance of the biomarkers to differentiate amyloid PET-positive from amyloid PET-negative participants differed between plasma p-tau biomarkers, being higher for plasma p-tau217 and p-tau212 compared to plasma p-tau181 and p-tau231. Furthermore, plasma p-tau212 was elevated in participants with low Aβ burden (CSF Aβ-positive, amyloid PET-negative), supporting its potential as a cost-effective, easily implemented biomarker for trial recruitment in early stages. Its further increase in Aβ PET-positive participants suggests additional utility for monitoring anti-amyloid therapies.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00415-025-13572-5.