Deficits In Cognitive Function Research Articles

Vascular Risk Factors and Brain Health in Aging: Insights from a Community-Based Cohort Study.

The aging population and high rates of Alzheimer's disease (AD) create significant medical burdens, prompting a need for early prevention. Targeting modifiable risk factors like vascular risk factors (VRFs), closely linked to AD, may provide a promising strategy for intervention. This study investigates how VRFs influence cognitive performance and brain structures in a community-based cohort. In this cross-sectional study, 4,667 participants over 50 years old, drawn from the Beijing Ageing Brain Rejuvenation Initiative project, were meticulously examined. Cognitive function and VRFs (diabetes mellitus, hypertension, hyperlipidemia, obesity, and smoking), were comprehensively assessed through one-to-one interviews. Additionally, a subset of participants (n = 719) underwent MRI, encompassing T1-weighted and diffusion-weighted scans, to elucidate gray matter volume and white matter structural network organization. The findings unveil diabetes as a potent detriment to memory, manifesting in atrophy within the right supramarginal gyrus and diminished nodal efficiency and degree centrality in the right inferior parietal lobe. Hypertension solely impaired memory without significant structural changes. Intriguingly, individuals with comorbid diabetes and hypertension exhibited the most pronounced deficits in both brain structure and cognitive performance. Remarkably, hyperlipidemia emerged as a factor associated with enhanced cognition, and preservation of brain structure. This study illuminates the intricate associations between VRFs and the varied patterns of cognitive and brain structural damage. Notably, the synergistic effect of diabetes and hypertension emerges as particularly deleterious. These findings underscore the imperative to tailor interventions for patients with distinct VRF comorbidities, especially when addressing cognitive decline and structural brain changes.

Evaluation of Cognitive Performance in Patients with Fibromyalgia Syndrome: A Case-Control Study.

Patients with fibromyalgia syndrome tend to report deficits in cognitive functions; however, there is no clear consensus on which cognitive domains are impaired. The aim of this study was to compare the differences in cognitive performance between a group of patients with fibromyalgia syndrome and a group of pain-free subjects controlling for the covariables anxiety, depression, and sleep quality. In total, 130 patients with fibromyalgia syndrome and 111 pain-free subjects with an average age of 54.96 years completed the evaluation protocol consisting of sociodemographic data, psychological data, and neurocognitive tests. All data were collected from May 2022 to May 2023. Multivariate analyses of covariance (MANCOVAs) were conducted to assess intergroup differences in all neurocognitive tests. MANCOVA analyses showed that the group of patients with fibromyalgia showed a worse cognitive performance than the group of pain-free subjects after controlling for anxiety, depression, and sleep quality. This study found that fibromyalgia patients exhibited worse cognitive performance and executive function than pain-free subjects. Thus, cognitive performance seems to not be related with anxiety, depression, or sleep quality in our sample of women with FMS.

GDF11 improves hippocampal neurogenesis and cognitive abilities in diabetic mice by reducing neural inflammation

BackgroundThe cognitive decline associated with type 2 diabetes (T2D) is often attributed to compromised hippocampal neurogenesis and exacerbated neural inflammation. This study investigates the therapeutic potential of growth differentiation factor 11 (GDF11) in reversing these neurodegenerative processes in diabetic mice. ResultWe utilized a murine model of T2D and examined the effects of GDF11 on learning, memory, neurogenesis, and neuroinflammatory markers. Our results indicate that diabetic mice exhibit significant deficits in cognitive function, mirrored by reduced hippocampal neurogenesis and increased neuroinflammation. Chronic administration of GDF11 was observed to significantly enhance cognitive abilities, as evidenced by improved performance in learning and memory tasks. Concurrently, GDF11 treatment restored neural activity and promoted the regeneration of new neurons within the hippocampus. Inflammatory profiling revealed a reduction in neuroinflammatory markers, which was further supported by reduced microglia numbers. To delineate the role of neuroinflammation, we pharmacologically depleted microglia, leading to a restoration of neurogenesis and cognitive functions in diabetic mice. ConclusionThese findings endorse the hypothesis that GDF11 exerts its beneficial effects by modulating neuroinflammatory pathways. Consequently, GDF11 represents a promising intervention to ameliorate diabetes-induced cognitive impairments and neural degeneration through its anti-inflammatory properties.

Neurodevelopmental outcomes and occupational participation of preterm children at school age: a scoping review

Preterm children may experience major challenges that affect their occupational participation and daily functioning, especially at school age. This scoping review aims to examining and synthesizing the available literature about adverse neurodevelopmental outcomes and occupational participation restrictions of preterm children born < 37 weeks of gestation. The MEDLINE, Science Direct, CINAHL databases were searched from January 2013 to December 2023, for published cohort studies that assessed the neurodevelopmental outcomes and occupational participation of school-aged preterm children, compared to full-term born peers. Out of 6631 identified articles, 13 studies met the inclusion criteria and involved 958 preterm children, aged 6-10 years old. Studies included in the current scoping review reported adverse neurodevelopmental outcomes, such as cognitive impairment, executive function and sensory processing deficits, emotional and behavioral problems, language and visual perception difficulties, as well as occupational participation restrictions, like feeding difficulties, academic challenges and peer relationship problems. Findings suggest that neurodevelopmental deficits and occupational participation restrictions, especially in extremely preterm children, not only exist in early childhood but persist during school age. Future research should focus on exploring potential differences or patterns in neurodevelopmental outcomes and occupational participation between preterm groups with different gestational age ranges.

An exploratory, randomised, crossover study to investigate the effect of nicotine on cognitive function in healthy adult smokers who use an electronic cigarette after a period of smoking abstinence

BackgroundAs well as being associated with serious negative health outcomes, smoking has been reported to have an array of physiological and psychological effects, including effects on mood and cognitive function. Post-cessation, loss of such effects (including temporary deficits in cognitive function) have been cited as reasons for resumption of smoking. The effects of e-cigarettes and nicotine delivered by e-cigarettes on these functions have not been widely researched but may play a role in the effectiveness of e-cigarettes as a satisfactory alternative to combustible cigarettes for people who smoke, and in encouraging individuals who would otherwise continue to smoke, to transition to e-cigarettes.MethodsThe study was an exploratory, randomised, partially-blinded, single-centre, five-arm crossover trial that recruited 40 healthy male and female people who smoke. At 5 study sessions, following a 12-h period of nicotine abstinence, participants were randomly assigned to use either a combustible cigarette, an e-cigarette of three varying nicotine strengths (18 mg/mL, 12 mg/mL or 0 mg/mL respectively) or observe a no product usage session. Participants completed pre- and post-product usage assessments to examine the product usage effect on cognitive performance (using the Cambridge Neuropsychological Test Automated Battery (CANTAB)), subjective mood and smoking urges.ResultsA significant improvement in sustained attention task performance was observed following use of both the nicotine containing e-cigarettes and combustible cigarette compared to no product use. Additionally, there were no significant differences between the nicotine containing products, indicating that nicotine use enhanced sustained attention regardless of delivery format. Nicotine containing e-cigarette and combustible cigarette use also significantly improved overall mood of participants compared to no product use, with no significant differences observed between the nicotine containing products. Nicotine containing e-cigarette and combustible cigarette use significantly reduced smoking urges compared to no product use, though combustible cigarette use elicited the greatest reduction in smoking urges.ConclusionsOverall, the nicotine containing products improved sustained attention and mood while reducing smoking urges, with the studied e-cigarettes having comparable effects to combustible cigarettes across the assessed cognitive parameters and mood measures. These results demonstrate the potential role of e-cigarettes to provide an acceptable alternative for combustible cigarettes among people who would otherwise continue to smoke.Trial registration ISRCTN (identifier: ISRCTN35376793).

Cognition and health-related quality of life in long-term survivors of high-grade glioma: an interactive perspective from patient and caregiver

BackgroundThe health-related quality of life (HRQoL) and cognition are important indicators for the quality of survival in patients with high-grade glioma (HGG). However, data on long-term survivors and their caregivers are scarce. We aim to investigate the interaction between cognition and HRQoL in long-term survivors, their caregivers’ evaluations, and the effect on caregiver strain and burden.Methods21 long-term HGG (8 WHO grade III and 13 WHO grade IV) survivors (survival ≥ 5 years) and 15 caregivers were included. Cognition (verbal memory, attention, executive functioning, and language), HRQoL, anxiety and depression, caregiver strain, and caregiver burden were assessed with standardized measures. Questionnaires were completed by patients and/or their caregivers.ResultsMean survival was 12 years (grade III) and 8 years (grade IV). Cognition was significantly impaired with a large individual variety. Patients’ general HRQoL was not impaired but all functioning scales were deviant. Patient-proxy agreement was found in most HRQoL subscales. Three patients (14%) showed indications of anxiety or depression. One-third of the caregivers reported a high caregiver strain or a high burden. Test scores for attention, executive functioning, language, and/or verbal memory were correlated with perceived global health status, cognitive functioning, and/or communication deficits. Caregiver burden was not related to cognitive deficits.ConclusionsIn long-term HGG survivors maintained HRQoL seems possible even when cognition is impaired in a large variety at the individual level. A tailored approach is therefore recommended to investigate the cognitive impairments and HRQoL in patients and the need for patient and caregiver support.

Euonymus alatus Leaf Extract Attenuates Effects of Aging on Oxidative Stress, Neuroinflammation, and Cognitive Impairment.

Our study aimed to explore the impact and mechanism of Euonymus alatus leaf extract on age-dependent oxidative stress, neuroinflammation, and progressive memory impairments in aged mice. Twenty-four-month-old mice received EA-L3 (300 mg/kg/day) or the reference drug, donepezil (DPZ, 5 mg/kg/day), for 6 weeks, and learning and memory functions were detected using the Passive Avoidance Test (PAT). As expected, cognitive function deficits were detected in aged mice compared with young mice, and these deficits were significantly mitigated by dietary treatments with EA-L3. In parallel, it upregulated the brain-derived neurotrophic factor (BDNF) and subsequently activated the extracellular-signal-regulated kinase (ERK)/cAMP response element-binding (CREB) signaling in the mouse hippocampus and scopolamine-induced B35 and SH-SY5Y neuroblastoma cells. EA-L3 showed strong anti-inflammatory effects with decreased NF-κBp65, cyclooxygenase 2 (COX-2), and tumor necrosis factor alpha (TNF-α), increased interleukin (IL)-10, and doublecortin (DCX) protein expression in the hippocampus of aged mice. Similar results were also confirmed in LPS-induced BV-2 microglia and neuroblastoma cells upon treatment with EA-L3 extract. In addition, EA-L3 notably dose-dependently decreased ROS in BV2 cells after exposure to LPS. Taken together, EA-L3 might be used as a dietary supplement to alleviate oxidative stress, the deterioration of hippocampal-based memory tasks, and neuroinflammation in elderly people.

Efficacy of rTMS in treating functional impairment in post-stroke patients: a systematic review and meta-analysis.

Most stroke patients suffer from an imbalance in blood supply, which causes severe brain damage leading to functional deficits in motor, sensory, swallowing, cognitive, emotional, and speech functions. Repetitive transcranial magnetic stimulation (rTMS) is thought to restore functions impaired during the stroke process and improve the quality of life of stroke patients. However, the efficacy of rTMS in treating post-stroke function impairment varies significantly. Therefore, we conducted a meta-analysis of the number of patients with effective rTMS in treating post-stroke dysfunction. The PubMed, Embase, and Cochrane Library databases were searched. Screening and full-text review were performed by three investigators. Single-group rate meta-analysis was performed on the extracted data using a random variable model. Then subgroup analyses were performed at the levels of stroke acuity (acute, chronic, or subacute); post-stroke symptoms (including upper and lower limb motor function, dysphagia, depression, aphasia); rTMS stimulation site (affected side, unaffected side); and whether or not it was a combination therapy. We obtained 8955 search records, and finally 33 studies (2682 patients) were included in the meta-analysis. The overall analysis found that effective strength (ES) of rTMS was 0.53. In addition, we found that the ES of rTMS from acute/subacute/chronic post-stroke was 0.69, 0.45, and 0.52. We also found that the ES of rTMS using high-frequency stimulation was 0.56, while the ES of rTMS using low-frequency stimulation was 0.53. From post-stroke symptoms, we found that the ES of rTMS in sensory aspects, upper limb functional aspects, swallowing function, and aphasia was 0.50, 0.52, 0.51, and 0.54. And from the site of rTMS stimulation, we found that the ES of rTMS applied to the affected side was 0.51, while the ES applied to the unaffected side was 0.54. What's more, we found that the ES of rTMS applied alone was 0.53, while the ES of rTMS applied in conjunction with other therapeutic modalities was 0.53. By comparing the results of the data, we recommend rTMS as a treatment option for rehabilitation of functional impairment in patients after stroke. We also recommend that rehabilitation physicians or clinicians use combination therapy as one of the options for patients.

TAAR1 in dentate gyrus is involved in chronic stress-induced impairments in hippocampal plasticity and cognitive function

Multiple lines of evidence suggest that the trace amine-associated receptor 1 (TAAR1) holds promise as a potential target for stress-related disorders, such as treating major depressive disorder (MDD). The role of TAAR1 in the regulation of adult neurogenesis is recently supported by transcriptomic data. However, it remains unknown whether TAAR1 in dentate gyrus (DG) mediate chronic stress-induced negative effects on hippocampal plasticity and related behavior in mice. The present study consisted of a series of experiments using RNAscope, genetic approaches, behavioral tests, immunohistochemical staining, Golgi-Cox technique to unravel the effects of TAAR1 on alterations of dentate neuronal plasticity and cognitive function in the chronic social defeat stress model. The mice subjected to chronic defeat stress exhibited a noteworthy decrease in the mRNA level of TAAR1 in DG. Additionally, they exhibited compromised social memory and spatial object recognition memory, as well as impaired proliferation and maturation of adult-born dentate granule cells. Moreover, the selective knockout TAAR1 in DG mostly mimicked the cognitive function deficits and neurogenesis impairment induced by chronic stress. Importantly, the administration of the selective TAAR1 partial agonist RO5263397 during stress exposure attenuated the adverse effects of chronic stress on cognitive function, adult neurogenesis, dendritic arborization, and the synapse number of dentate neurons in DG. In summary, our findings suggest that TAAR1 plays a crucial role in mediating the detrimental effects of chronic stress on hippocampal plasticity and cognition. TAAR1 agonists exhibit therapeutic potential for individuals suffering from cognitive impairments associated with MDD.

Motor creativity assessment: A test-retest reliability and validity protocol study in fibromyalgia and healthy women

IntroductionPrevious studies have found brain abnormalities and deficits in cognitive functions in people with fibromyalgia. It is known that choreography or creative tasks significantly generate cognitive improvements. Various methods have been described in the literature to evaluate creative activities using electroencephalography (EEG), such as the imagination of dance improvisations. However, there is the notion that creative solutions can emerge during the action and that creative motor action may reflect new, statistically rare, and adaptive coordination and/or the control solutions performed. AimThis study seeks to establish an operational approach to test how constraints are combined to induce variability of movement and how to evaluate it, but without forgetting the ideation or preparation of the activity as a relevant section in the study of motor creativity. To this end, this study aims to validate and test the reliability and applicability of an innovative test of motor creativity: The Motor Creativity Assessment (MCA), with the aim of achieving an objective score of motor creativity that can be used to test patients and monitor the interventions. Material and methodsto correctly satisfy the requirements of the standard protocol for clinical trials, this study has followed the SPIRIT 2013 Statement Items. A total of 13 women with fibromyalgia and 13 healthy women were included in the study. The individual's cognitive impairment, sleep quality, pain, quality of life, level of physical activity, fear of falling, and the impact of fibromyalgia will be studied. This study develops a specific test of motor creativity without the use of objects, with the aim of achieving an objective score of motor creativity. An observation score sheet allows motor creativity to be analyzed and scored by viewing a video of the creative movement test. The Enobio® instrument (Neuroelectrics, Cambridge, MA, USA) and Neuroelectrics® instrument driver software (NIC1) were used to record EEG and heart rate variability signals.

Fasting, a Potential Intervention in Alzheimer's Disease.

Alzheimer's disease (AD) is a neurodegenerative disorder characterized by the onset of symptoms, typically occurring later in life, and significant deficits in cognitive functions including learning, memory, speech, and behavior. Ongoing research endeavors seek to explore methods for preventing and treating AD, as well as delving into the molecular mechanisms underlying existing and novel therapeutic approaches encompassing exercise, diet, and drug regimens for individuals with AD or those at risk of developing AD. Among these interventions, dietary interventions have garnered increasing attention due to their potential in addressing the disease. Eating is among the most fundamental of human daily activities, and controlled dietary practices, such as fasting, have gained prominence as essential clinical methods for disease prevention and treatment. Research findings indicate that fasting holds promise in effectively alleviating and improving the cognitive decline associated with age or as consequence of disease. The clinical efficacy of fasting in addressing AD and related disorders might be grounded in its influence on various molecular mechanisms, including neuroinflammation, glial cell activation, insulin resistance, autophagy regulation, nerve regeneration, the gut microbiome, and accumulations of amyloid-β and tau proteins. The present study reviews possible molecular mechanisms underpinning the therapeutic effects of fasting in patients with AD, as well as in models of the disorder, to establish a theoretical basis for using fasting as a viable approach to treat AD.

Piezo2 Contributes to Traumatic Brain Injury by Activating the RhoA/ROCK1 Pathways.

Traumatic brain injury (TBI) can lead to short-term and long-term physical and cognitive impairments, which have significant impacts on patients, families, and society. Currently, treatment outcomes for this disease are often unsatisfactory, due at least in part to the fact that the molecular mechanisms underlying the development of TBI are largely unknown. Here, we observed significant upregulation of Piezo2, a key mechanosensitive ion channel protein, in the injured brain tissue of a mouse model of TBI induced by controlled cortical impact. Pharmacological inhibition and genetic knockdown of Piezo2 after TBI attenuated neuronal death, brain edema, brain tissue necrosis, and deficits in neural function and cognitive function. Mechanistically, the increase in Piezo2 expression contributed to TBI-induced neuronal death and subsequent production of TNF-α and IL-1β, likely through activation of the RhoA/ROCK1 pathways in the central nervous system. Our findings suggest that Piezo2 is a key player in and a potential therapeutic target for TBI.

The Role of Cognition in Balance Control

Balance is the ability to move and/or preserve a particular position while not falling under external force. Human balance is a complex process of integration and coordination of the sensory, motor, and biomechanical components, which is influenced by intrinsic and exogenous factors. One inherent factor that is hypothesized to have an impact on balance is cognition. However, studies about cognition's role in balance control are still limited, and study literature is needed to gain a better understanding. Cognition is involved in various thinking processes. Attention, memory, visuospatial, and executive functions are among the cognitive areas integrated with information processing in the processing of information, followed by a reaction that aims to preserve body balance and prevent falls. Cognition limitation has been linked to decreased function associated with gait alterations, mobility limitation, and increased risk of falling. Cognitive function impairments such as executive function (EF) limitations are thought to increase the risk of losing. Injury to the cerebral cortex, basal ganglia, and cerebellum can also affect the cognitive function in balance. The role of cognition in maintaining physical balance is critical. Deficits in cognitive function caused by diseases or injuries will impact bodily balance control.

Abstract TP17: SPAK Kinase Inhibitor ZT-1a Prevents Reactive Astrogliosis, Blood-Brain Barrier Breakdown, and Demyelination in a Mouse Model of VCID

Background: Blood-brain barrier (BBB) breakdown, reactive astrogliosis, and myelin losses are the key features of vascular contributions to cognitive impairment and dementia (VCID). However, the molecular and cellular mechanisms underlying VCID are not well understood. Stimulation of Na-K-Cl cotransport 1 (NKCC1) and its downstream kinase SPAK (the STE20/SPS1-related proline/alanine-rich kinase) causes intracellular Na + overload, astrocytic hypertrophy, and swelling. In this study, we investigated the effect of SPAK inhibitor ZT-1a on bilateral carotid artery stenosis (BCAS)-mediated reactive astrogliosis, BBB breakdown, demyelination, and cerebral blood flow (CBF) in mice. Methods: BCAS was induced in male mice using two metal microcoils twined around both carotid arteries. Sham or BCAS mice receiving vehicle or a selective SPAK inhibitor ZT-1a were monitored for changes in CBF by laser speckle imaging and cognitive functions by the novel object recognition test. Expression of NKCC1 and BBB proteins, reactive astrogliosis, and demyelination were examined by immunofluorescence staining. Results: BCAS mice exhibited sustained CBF reduction and cognitive function deficits along with significant demyelination in corpus callosum and external capsule 8 weeks after BCAS procedure. Compared to sham mice, the BCAS mice showed increased NKCC1 expression in GFAP + astrocytes, reduced expression of ZO-1 and Claudin-5 in GLUT1 + endothelial cells, decreased APC + mature oligodendrocyte and NG2 + oligodendrocyte progenitor cells. Interestingly, delayed administration of ZT-1a (4-8 weeks post-BCAS) prevented BCAS-induced reactive astrogliosis, BBB breakdown, demyelination, and significantly improved CBF and cognitive functions. Conclusion: Our study demonstrates that BCAS-induced stimulation of NKCC1 involves in reactive astrogliosis, BBB breakdown, OL death, and cognitive impairment. Inhibition of the SPAK-NKCC1 cascade by pharmacological inhibitor has therapeutic potential for VCID therapy. This research was supported by NIH R01 166199 Grant (M.I.H.B.).

Cognitive Abilities in Schizoid Personality Disorder with and without Borderline Intellectual Functioning: The Burden in Psychopathology

Background: Borderline intellectual functioning (BIF) and schizoid personality disorder (Schizoid PD) are clinical conditions under-researched and poorly understood. The principal aim of this retrospective study was to investigate cognitive abilities in people with BIF and Schizoid PD. Clinical, demographic, and neuropsychological data of forty-seven Schizoid PD participants, with an average age of 35, were analyzed. The sample split into two groups: Schizoid PD with BIF (BIF+: n = 24; intelligence quotient – IQ range: 71-84) and Schizoid PD without BIF (BIF-: n = 23; IQ range: 89-121). A descriptive analysis of the clinical and demographic characteristics of the two groups was performed.
 Methods: Neuropsychological measures (Wechsler Adult Intelligence Scale-Revised – WAIS-R IQ, factor index, subtest scores) and cognitive performance deficits in the two groups were compared using parametric and non-parametric tests, as necessary. Correlation coefficients were calculated for relationships between variables. Regression analyses were conducted to identify predictors associated with negative outcomes, such as substance use behavior.
 Results: The results revealed that the cognitive profile of BIF+ deviated significantly from that observed in BIF-. Peculiar BIF+ dysfunctions were found in the domains of verbal and perceptual reasoning, attention, memory, processing speed, planning, and problem-solving. The verbal IQ had the highest discriminative value for the presence of BIF in patients with Schizoid PD.
 Conclusions: The BIF condition and the verbal comprehension index were the predictors most associated with substance use behavior. Early identification of BIF should be relevant to planning targeted intervention strategies to improve daily life skills and outcomes.

Preliminary Assessment of Cognitive Changes in Pediatric Cancer Survivors After a Neurocognitive Intervention

Background: Pediatric patients with acute lymphoblastic leukemia (ALL) receive large doses of neurotoxic chemotherapy as part of their treatment. Though lifesaving, it can induce life-long issues. Cognitive deficits are one of the most common reported concerns in survivorship clinic among pediatric cancer survivors. One unique approach to improving deficits in cognitive functioning is The Mediated Learning Experience (MLE) developed by Reuven Feuerstein. MLE is based on neuronal plasticity. Findings from MLE studies have shown improvements in cognitive task performance, increases in daily functioning, and increased learning in patients with neurological impairment. However, MLE has never been administered to children or adolescent cancer survivors with cognitive deficits.
 Methods: Survivors were recruited from the Survivor Clinic in IU North Hospital. Survivors were 10-16 years of age, English speaking, and reporting executive functioning issues in school. The intervention utilized was the MLE enrichment tool: Organization of Dots. Participants met with MLE certified mediators 30 – 40 minutes biweekly for 8 weeks. At 5 weeks, separate interviews were conducted with parents and participants to assess perceived changes in cognitive functions. These interviews asked participants to rate perceived changes on a Likert-type scale, which allowed for comparison of perceived changes reported by participants and parents.
 Results: Four participants and their parents completed the 5-week interview. Preliminary results show participants and their parents perceive positive changes in the participants’ cognitive skills, new learning, motivation, transfer, metacognition, and active learning.
 Conclusion/Potential Impact: Many pediatric cancer survivors experience cognitive deficits following their cancer treatment. There are limited options for these individuals for assistance in improving function, most of which are costly or difficult to access. The current study demonstrated that utilization of the MLE approach by Feuerstein can be a feasible option for filling the resource gap in neurocognitive rehabilitation.

Outcome and Sequelae of Autoimmune Encephalitis.

Autoimmune etiologies are a common cause for encephalitis. The clinical syndromes consistent with autoimmune encephalitis are both distinct and increasingly recognized, but less is known about persisting sequelae or outcomes. We searched PubMed for reports on outcomes after autoimmune encephalitis. Studies assessing validated, quantitative outcomes were included. We performed a narrative review of the published literature of outcomes after autoimmune encephalitis. We found 146 studies that produced outcomes data. The mortality rates were 6%-19% and the relapse risks were 10%-62%. Most patients achieved a good outcome based on a score on the modified Rankin Scale (mRS) of ≤2. Forty-nine studies evaluated outcomes beyond mRS; these studies investigated cognitive outcome, psychiatric sequelae, neurological deficits, global function, and quality-of-life/patient-reported outcomes using various tools at varying time points after the index hospital discharge. These more-detailed assessments revealed that most patients had persistent impairments, with frequent deficits in cognitive function, especially memory and attention. Depression and anxiety were also common. Many of these sequelae continued to improve over months or even years after the acute illness. While we found that lasting impairments were common among survivors of autoimmune encephalitis, additional research is needed to better understand the nature and impact of these sequelae. Standardized evaluation protocols are needed to improve the ability to compare outcomes across studies, guide rehabilitation strategies, and inform outcomes of interest in treatment trials as the field advances.

Psychophysiological Responses in Soldiers during Close Combat: Implications for Occupational Health and Fitness in Tactical Populations.

This study explores the psychophysiological responses and subjective exertion experiences of soldiers in simulated hand-to-hand combat, aligning these findings with established physiological benchmarks. Active military personnel were monitored for heart rate, blood lactate levels, subjective exertion, cortical arousal, and muscle strength during combat scenarios. The results showed significant increases in heart rate and blood lactate, indicating intense cardiovascular demands and a reliance on anaerobic energy systems. Contrary to these physiological changes, soldiers reported lower levels of exertion, suggesting a possible underestimation of physical effort or individual differences in perception and mental resilience to stress. Notably, a decrease in cortical arousal post-combat was observed, potentially signaling cognitive function deficits in decision-making and information processing in high-stress environments. This decline was more pronounced than typically seen in other high-stress situations, highlighting the unique cognitive demands of hand-to-hand combat. Additionally, an increase in muscle strength was noted, underscoring the physiological adaptations arising from intensive combat training. These findings provide valuable insights into the psychophysiological effects of hand-to-hand combat, emphasizing the complex interplay between physical exertion, cognitive function, and stress response in military contexts. The study underscores the need for comprehensive training strategies that address both physical and psychological aspects to enhance combat readiness and decision-making under stress.

Emerging role of miR‐223‐3p in regulating sex dimorphic neuroinflammation and cognitive function in mice following controlled cortical impact

AbstractBackgroundNeuroinflammation is a key feature of many neurodegenerative diseases, however its regulation is not well understood. MicroRNAs (miRNAs) are small, non‐coding RNAs that involve in the regulation of many biological and pathological pathways including inflammation. MiR‐223‐3p is macrophage/microglia enriched miRNA that involves in inflammation and immunity. However, the role of miR‐223‐3p in neurodegeneration is unknown.MethodMiR‐223‐3p knockout (KO) and genetic background matched wildtype (WT), female and male young (12‐14‐week) or aged (18‐20‐month) mice were used in the studies. CD11b+ cells were isolated from brain tissues of KO and WT, female and male naïve mice and RT‐qPCR was used to quantify inflammatory markers. Immunofluorescent studies using anti‐IBA1 was used to determine the number of activated microglia in brain sections of aged KO and WT female mice following a CCI. To evaluate the impact of miR‐223‐3p on cognitive and behavior, young (12‐14‐week) or old (18‐20‐month) mice were subjected to CCI followed by a radio arm water maze (RAWM) test (young mice) or Y‐maze test (aged mice) 2 weeks after controlled cortical impact (CCI).ResultOur preliminary studies reveal that deficiency of miR‐223‐3p resulted in a female‐biased elevation of inflammatory transcripts including such as NLRP3, TRAF6, TNFα, NFκB, and ITGAM in brain CD11b+ cells. In addition, immunofluorescent analysis demonstrated that a greater number of IBA1 staining microglia in KO than that of WT mice brains. Furthermore, deficiency of miR‐223‐3p seemed to associate with a deficit in cognitive function in aged female mice following CCI. We also examined the level of CCAAT‐enhancer‐binding protein beta (CEBPβ), an important transcription factor regulating inflammation and a validated target of miR‐223‐3p. Our preliminary data showed that CEBPβ protein was increased in the brain of miR‐223‐3p KO mice brain tissue relative to that of WT.ConclusionOur preliminary data suggest that miR‐223‐3p may regulate a sexually dimorphic neuroinflammation and cognitive function, likely via regulating inflammation transcription factor CEBPβ.

Supraphysiological testosterone levels from anabolic steroid use and reduced sensitivity to negative facial expressions in men

RationaleAnabolic-androgenic steroids (AAS) are used to improve physical performance and appearance, but have been associated with deficits in social cognitive functioning. Approximately 30% of people who use AAS develop a dependence, increasing the risk for undesired effects.ObjectivesTo assess the relationship between AAS use (current/previous), AAS dependence, and the ability to recognize emotional facial expressions, and investigate the potential mediating role of hormone levels.MethodsIn total 156 male weightlifters, including those with current (n = 45) or previous (n = 34) AAS use and never-using controls (n = 77), completed a facial Emotion Recognition Task (ERT). Participants were presented with faces expressing one out of six emotions (sadness, happiness, fear, anger, disgust, and surprise) and were instructed to indicate which of the six emotions each face displayed. ERT accuracy and response time were recorded and evaluated for association with AAS use status, AAS dependence, and serum reproductive hormone levels. Mediation models were used to evaluate the mediating role of androgens in the relationship between AAS use and ERT performance.ResultsCompared to never-using controls, men currently using AAS exhibited lower recognition accuracy for facial emotional expressions, particularly anger (Cohen’s d = −0.57, pFDR = 0.03) and disgust (d = −0.51, pFDR = 0.05). Those with AAS dependence (n = 47) demonstrated worse recognition of fear relative to men without dependence (d = 0.58, p = 0.03). Recognition of disgust was negatively correlated with serum free testosterone index (FTI); however, FTI did not significantly mediate the association between AAS use and recognition of disgust.ConclusionsOur findings demonstrate impaired facial emotion recognition among men currently using AAS compared to controls. While further studies are needed to investigate potential mechanisms, our analysis did not support a simple mediation effect of serum FTI.