Deterioration Of Cognitive Function Research Articles

The impact of obesity on dementia

IntroductionDementia is a syndrome characterized by a gradual deterioration of cognitive functions, including memory, thinking, orientation, attention span, perception, judgment, and language abilities. Obesity influences its development. Materials and methodsThe following review of studies is based on recent scientific articles available in PubMed and Google Scholar databases.The most searched phrases included: "dementia", "obesity", "midlife",and "the relationship between obesity and the risk of dementia". ResultsLiterature review indicates the existence of a relationship between midlife obesity and later dementia. It has also been pointed out that the forecasts for the onset of obesity and dementia are alarmingly rising world wide.It is estimated that by the year 2050, we can expect a threefold increase in dementia cases.ConclusionThe results of the cited studies indicate that further research into the occurrence of obesity and its later association with dementia is necessary. Midlife obesity likely plays a significant role in the etiopathogenesis of dementia.

Structural neuroimaging changes associated with subjective cognitive decline from a clinical sample

BackgroundAlzheimer’s disease (AD) is characterized by progressive deterioration of cognitive functions. Some individuals with subjective cognitive decline (SCD) are in the early phase of the disease and subsequently progress through the AD continuum. Although neuroimaging biomarkers could be used for the accurate and early diagnosis of preclinical AD, the findings in SCD samples have been heterogeneous. This study established the morphological differences in brain magnetic resonance imaging (MRI) findings between individuals with SCD and those without cognitive impairment based on a clinical sample of patients defined according to SCD-Initiative recommendations. Moreover, we investigated baseline structural changes in the brains of participants who remained stable or progressed to mild cognitive impairment or dementia. MethodsThis study included 309 participants with SCD and 43 healthy controls (HCs) with high-quality brain MRI at baseline. Among the 99 subjects in the SCD group who were followed clinically, 32 progressed (SCDp) and 67 remained stable (SCDnp). A voxel-wise statistical comparison of gray and white matter (WM) volume was performed between the HC and SCD groups and between the HC, SCDp, and SCDnp groups. XTRACT ATLAS was used to define the anatomical location of WM tract damage. Region-of-interest (ROI) analyses were performed to determine brain volumetric differences. White matter lesion (WML) burden was established in each group. ResultsVoxel-based morphometry (VBM) analysis revealed that the SCD group exhibited gray matter atrophy in the middle frontal gyri, superior orbital gyri, superior frontal gyri, right rectal gyrus, whole occipital lobule, and both thalami and precunei. Meanwhile, ROI analysis revealed decreased volume in the left rectal gyrus, bilateral medial orbital gyri, middle frontal gyri, superior frontal gyri, calcarine fissure, and left thalamus. The SCDp group exhibited greater hippocampal atrophy (p < 0.001) than the SCDnp and HC groups on ROI analyses. On VBM analysis, however, the SCDp group exhibited increased hippocampal atrophy only when compared to the SCDnp group (p < 0.001). The SCD group demonstrated lower WM volume in the uncinate fasciculus, cingulum, inferior fronto-occipital fasciculus, anterior thalamic radiation, and callosum forceps than the HC group. However, no significant differences in WML number (p = 0.345) or volume (p = 0.156) were observed between the SCD and HC groups. ConclusionsThe SCD group showed brain atrophy mainly in the frontal and occipital lobes. However, only the SCDp group demonstrated atrophy in the medial temporal lobe at baseline. Structural damage in the brain regions was anatomically connected, which may contribute to early memory decline.

Association of Basal Forebrain Volume with Amyloid, Tau, and Cognition in Alzheimer's Disease.

Degeneration of cholinergic basal forebrain (BF) neurons characterizes Alzheimer's disease (AD). However, what role the BF plays in the dynamics of AD pathophysiology has not been investigated precisely. To investigate the baseline and longitudinal roles of BF along with core neuropathologies in AD. In this retrospective cohort study, we enrolled 113 subjects (38 amyloid [Aβ]-negative cognitively unimpaired, 6 Aβ-positive cognitively unimpaired, 39 with prodromal AD, and 30 with AD dementia) who performed brain MRI for BF volume and cortical thickness, 18F-florbetaben PET for Aβ, 18F-flortaucipir PET for tau, and detailed cognitive testing longitudinally. We investigated the baseline and longitudinal association of BF volume with Aβ and tau standardized uptake value ratio and cognition. Cross-sectionally, lower BF volume was not independently associated with higher cortical Aβ, but it was associated with tau burden. Tau burden in the orbitofrontal, insular, lateral temporal, inferior temporo-occipital, and anterior cingulate cortices were associated with progressive BF atrophy. Lower BF volume was associated with faster Aβ accumulation, mainly in the prefrontal, anterior temporal, cingulate, and medial occipital cortices. BF volume was associated with progressive decline in language and memory functions regardless of baseline Aβ and tau burden. Tau deposition affected progressive BF atrophy, which in turn accelerated amyloid deposition, leading to a vicious cycle. Also, lower baseline BF volume independently predicted deterioration in cognitive function.

Potencial terapêutico de fitoconstituintes de Pilocarpus microphyllus Stapf ex Wardlew. e da própolis na doença de Alzheimer: uma Revisão Integrativa

Introduction: Alzheimer's disease (AD) is an irreversible neurodegenerative disorder characterized by the deterioration of cognitive functions, for which the available pharmacotherapy is not capable of effecting a cure. Objectives: To investigate the neuroprotective properties of phytoconstituents from Jaborandi (Pilocarpus microphyllus) and propolis as potential agents in the therapy of AD. Methodology: This is an integrative literature review study, in which the PICO strategy was followed in formulating the guiding question. Five databases were used: PubMed, Web of Science, Scopus, Embase, and Lilacs. The analysis was conducted with the descriptors "epiisopiloturine", "episopilosin", "pilocarpine", "macaubine", "propolis", "alzheimer" extracted from the DeCS (Health Sciences Descriptors) and Medical Subject Headings (MeSH). Keywords were isolated and combined using boolean operators AND and OR. Results: The search resulted in 602 studies identified in the databases, 337 were duplicates, leaving 265 for title and abstract reading, of which 250 were excluded. In the end, 10 studies were read in full and 08 studies were included in the scope of the review. The research evidenced neuroprotective activity for propolis, through antioxidative, anti-inflammatory, and anticholinesterase action, configuring it with therapeutic potential in AD. For pilocarpine, a substance with various clinical applications, few studies demonstrated a correlation with AD, in cognitive and behavioral improvement. Conclusion: Therefore, benefits for the use of propolis in cognitive dysfunctions are concluded, while for pilocarpine, this relationship was not established. It is necessary to develop research that elucidates the possible functional roles for these substances.

P028 Progressive multifocal leukoencephalopathy in a patient with systemic lupus erythematosus

Abstract Background/Aims Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease that develops following the reactivation of the John Cunningham virus (JCV) that in rare circumstances can occur in autoimmune disorders such as systemic lupus erythematosus (SLE). We present a 75-year-old female with SLE who had been treated with immunosuppressive therapy (mycophenylate and steroids) for one year. Methods A 75 year-old female presented with sub-acute deterioration of physical and cognitive function over the course of a few months including memory loss, ataxia, dysgraphia, word finding difficulty, confusion, low mood and reduced oral intake. Neurological examination revealed receptive and expressive aphasia, gaze fixation, unilateral weakness, brisk reflexes with positive plantar reflex and rigidity. A diagnosis of PML was made due to the detection of JC virus in the cerebrospinal fluid (234 copies/ml) and brain MRI findings consistent with the disease. Haematology results showed a profound lymphopenia (0.1x109 ). Mycophenolate was held and she was commenced on increasing doses of Mirtazapine up to 45mg. Clinical review at four months found marked improvement in her cognitive and physical abilities. Repeat CSF analysis found JC virus to be undetectable. Results PML has a 20-fold greater incidence in SLE when compared with the general population. Lymphopenia is a common finding in patients with SLE and has been found to correlate with both the risk and severity of opportunistic infections. The cause of this can be multifactorial and immunosuppressive drugs are often implicated however SLE in isolation can cause severe CD4+ lymphopenia leading to an increased risk of PML reactivation. This case demonstrates the importance of monitoring lymphocyte counts in SLE. Current guidance suggests adjusting regimes of immunosuppressive therapy if lymphocyte counts fall below 1x109 however further guidance on its management may be warranted. The heterogenous manifestation of SLE can make differentiating between the neurological syndromes associated with rheumatic disease and PML challenging. Given the management of PML is vastly different to that of SLE in regards to introduction or withdrawal of immunosuppressive therapies, there should be a high index of clinical suspicion in the early stages of investigation. In vitro studies have explored the possibility of mirtazapine (a 5-HT2A antagonist) providing a low-risk treatment option for those with SLE and this warrants further research into its efficacy in treating or preventing PML in this cohort. Our patient had improved symptomology after cessation of mycophenolate and the commencement of Mirtazapine. Conclusion PML is a rare complication of SLE but should be considered in patients admitted with neuropsychiatric presentations, the use of Mirtazapine may provide a low-risk treatment strategy. Disclosure D. Babla: None. Y. Suleman: None. A. Whittington: None. S. Hamdulay: None.

Light on Alzheimer's disease: from basic insights to preclinical studies.

Alzheimer's disease (AD), referring to a gradual deterioration in cognitive function, including memory loss and impaired thinking skills, has emerged as a substantial worldwide challenge with profound social and economic implications. As the prevalence of AD continues to rise and the population ages, there is an imperative demand for innovative imaging techniques to help improve our understanding of these complex conditions. Photoacoustic (PA) imaging forms a hybrid imaging modality by integrating the high-contrast of optical imaging and deep-penetration of ultrasound imaging. PA imaging enables the visualization and characterization of tissue structures and multifunctional information at high resolution and, has demonstrated promising preliminary results in the study and diagnosis of AD. This review endeavors to offer a thorough overview of the current applications and potential of PA imaging on AD diagnosis and treatment. Firstly, the structural, functional, molecular parameter changes associated with AD-related brain imaging captured by PA imaging will be summarized, shaping the diagnostic standpoint of this review. Then, the therapeutic methods aimed at AD is discussed further. Lastly, the potential solutions and clinical applications to expand the extent of PA imaging into deeper AD scenarios is proposed. While certain aspects might not be fully covered, this mini-review provides valuable insights into AD diagnosis and treatment through the utilization of innovative tissue photothermal effects. We hope that it will spark further exploration in this field, fostering improved and earlier theranostics for AD.

Prediction Of Mild Cognitive Impairment to Alzheimer’s Disease Conversion Via Machine Learning

Alzheimer’s Disease (AD) is a progressive neurodegenerative condition characterized by deterioration of cognitive functions. Although there does not exist a cure for AD, early diagnosis and intervention during stages of Mild Cognitive Impairment (MCI) can be incredibly beneficial in slowing its development. However, predicting the conversion from MCI to AD remains a challenging task. This paper aims to provide an overview of the current research on predicting MCI to AD conversion, with a focus on machine learning methodologies to aid feature extraction and classification. Through a literature review, we aim to offer insights into the latest state-of-the-art techniques to predict MCI to AD conversion as well as prevailing trends in this field including deep learning, transfer learning, contrastive learning, and graph neural networks. We conclude from our study that utilizing AD/HC classes for feature extraction is a promising approach for generating discriminative features for stable MCI and progressive MCI classification. In addition, employing multi-modality models is instrumental in attaining a robust validation framework for the early diagnosis of AD.

Novel CAD gene mutations in a boy with developmental and epileptic encephalopathy 50 with dramatic response to uridine therapy: a case report and a review of the literature

BackgroundDevelopmental and epileptic encephalopathy-50 (DEE-50) is a rare clinical condition believed to be caused by a mutation in the CAD gene and is associated with a bleak prognosis. CAD-related diseases have a wide range of clinical manifestations and other symptoms that may be easily overlooked. Like other rare diseases, the clinical manifestations and the treatment of DEE-50 necessitate further investigation.Case presentationA 1-year-old male patient presented with developmental delay, seizures, and anaemia at 3 months of age. He further developed refractory status epilepticus (SE), rapid deterioration of cognitive and motor function, and even became comatose at 5 months of age. Whole-exome sequencing of trios (WES-trios) revealed a compound heterozygous variant in the CAD gene, with one locus inherited from his father (c.1252C>T: p.Q418* nonsense mutation) and one from his mother (c.6628G>A: p.G2210S, missense mutation). This compound heterozygous CAD variant was unreported in the Human Gene Mutation Database. After uridine treatment, his cognitive faculties dramatically improved and he remained seizure-free.Forty two cases with CAD gene mutation reported in the literatures were reviewed. Among them, 90% had onset before 3 years of age, with average of 1.6±1.8 years old. The average age of diagnosis was 7.7 ± 10 years. The mortality rate was approximately 9.5%, with all reported deaths occurring in patients without uridine treatment. The clinical entity could be improved dramatically when the patient treated with uridine.ConclusionsWe present a boy with DEE 50 caused by novel CAD gene mutations and reviewed the clinical features of 42 patients reported previously. DEE 50 has early onset, refractory seizures, even status epilepticus leading to death, with favorable response to treatment with oral uridine. Early uridine treatment is recommended if CAD defect is suspected or genetically diagnosed. This study enhances the knowledge of DEE 50 and expands the spectrum of CAD gene mutations.

Neuroprotective effects of repetitive transcranial magnetic stimulation on Alzheimer's disease: Undetermined therapeutic protocols and mechanisms

AbstractAlzheimer's disease (AD) is a prevalent neurodegenerative disorder characterized by gradual deterioration of cognitive functions, for which an effective treatment is currently unavailable. Repetitive transcranial magnetic stimulation (rTMS), a well‐established noninvasive brain stimulation method, is utilized in clinical settings to address various neuropsychiatric conditions, such as depression, neuropathic pain, and poststroke dysfunction. Increasing evidence suggests that rTMS may enhance cognitive abilities in individuals with AD. However, its optimal therapeutic protocols and precise mechanisms are currently unknown, impeding its clinical implementation. In the present review, we aimed to summarize and discuss the efficacy‐related parameters in rTMS treatment, encompassing stimulus frequency, stimulus pattern, stimulus intensity, and the configuration of the stimulus coil. Furthermore, we reviewed promising rTMS therapeutic protocols involving various combinations of these factors, that were examined in clinical studies. Based on our analysis, we propose that a multisite high‐frequency rTMS (HF‐rTMS) regimen has value in AD therapy, and that promising single‐site protocols, such as HF‐rTMS, applied over the left dorsolateral prefrontal cortex, precuneus, or cerebellum are required to be validated in larger clinical studies. Lastly, we provide a comprehensive review of the potential mechanisms underlying the neuroprotective effects of rTMS on cognition in AD in terms of brain network modulation as well as cellular and molecular reactions. In conclusion, the interaction of diverse mechanisms may be responsible for the total therapeutic effect of rTMS on AD. This review provides theoretical and practical evidence for the future clinical application and scientific research of rTMS in AD.

Cognitive performance in aged rats is associated with differences in distinctive neuronal populations in the ventral tegmental area and altered synaptic plasticity in the hippocampus.

Deterioration of cognitive functions is commonly associated with aging, although there is wide variation in the onset and manifestation. Albeit heterogeneity in age-related cognitive decline has been studied at the cellular and molecular level, there is poor evidence for electrophysiological correlates. The aim of the current study was to address the electrophysiological basis of heterogeneity of cognitive functions in cognitively Inferior and Superior old (19-20 months) rats in the ventral tegmental area (VTA) and the hippocampus, having Young (12 weeks) rats as a control. The midbrain VTA operates as a hub amidst affective and cognitive facets, processing sensory inputs related to motivated behaviours and hippocampal memory. Increasing evidence shows direct dopaminergic and non-dopaminergic input from the VTA to the hippocampus. Aged Superior and Inferior male rats were selected from a cohort of 88 animals based on their performance in a spatial learning and memory task. Using in vivo single-cell recording in the VTA, we examined the electrical activity of different neuronal populations (putative dopaminergic, glutamatergic and GABAergic neurons). In the same animals, basal synaptic transmission and synaptic plasticity were examined in hippocampal slices. Electrophysiological recordings from the VTA and hippocampus showed alterations associated with aging per se, together with differences specifically linked to the cognitive status of aged animals. In particular, the bursting activity of dopamine neurons was lower, while the firing frequency of glutamatergic neurons was higher in VTA of Inferior old rats. The response to high-frequency stimulation in hippocampal slices also discriminated between Superior and Inferior aged animals. This study provides new insight into electrophysiological information underlying compromised cerebral ageing. Further understanding of brain senescence, possibly related to neurocognitive decline, will help develop new strategies towards the preservation of a high quality of life.

Psichikos sutrikimų simptomai, sergant Alzheimerio liga

Alzheimer’s disease is one of the most common neurodegenerative diseases among older people that manifests as deterioration of cognitive functions, impaired daily activities, and progressive degeneration of cerebral cortex neurons. Even up to 90% of Alzheimer’s patients develop neuropsychiatric symptoms at different stages of the disease. In some cases, neuropsychiatric symptoms appear earlier than cognitive symptoms. Neuropsychiatric symptoms worsen everyday activities, quality of life, and ability to socialise of people with Alzheimer's disease, making the diagnosis and treatment of these symptoms increasingly important. Evaluation of both cognitive and neuropsychiatric symptoms together with differentiation from primary psychiatric disorders is crucial for the correct diagnosis of Alzheimer’s disease. Furthermore, neuropsychiatric symptoms can be considered as risk factors for the development of Alzheimer’s disease. Treatment is recommended with combined pharmacological and non-pharmacological measures. Despite the large number of studies, the pathogenesis of the neuropsychiatric symptoms has not been studied in depth, therefore the treatments provided are not always effective. It is recommended that neuropsychiatric symptoms should be treated through a combined approach using pharmacological and non-pharmacological measures.

Alternating hemiplegia of childhood misdiagnosed as hysteria: a case report

BackgroundAlternating hemiplegia of childhood (AHC) is a rare pediatric syndrome characterized by recurring episodes of hemiplegia or quadriplegia, and frequently accompanied by dystonic posturing, choreoathetosis movements, anomalous ocular motions, and a gradual deterioration in cognitive function. The principal etiology of this disorder is traced back to mutations in the ATP1A3 gene.Case presentationHere, we report a 16-year-old girl with recurrent hemiplegia since her infancy. This patient has experienced paroxysmal limb weakness and aphasia for over 15 years, and has kept seeking medical attention but without receiving effective treatment. A misdiagnosis of hysteria persisted for over 4 years until the patient’s admission to our hospital. Whole-exome sequencing identified a known pathogenic heterozygous c.2270T>C (p.Leu757Pro) mutation in her ATP1A3 gene. Notably, her clinical manifestations, including pathological emotional responses and autonomic dysfunction, differed from the established profile associated with the same ATP1A3 mutation, which typically present with intellectual disability, a rostrocaudal symptom gradient, choreoathetosis, and dysarthria. The patient was finally diagnosed with AHC and treated with flunarizine thus significantly ameliorated hemiplegic episodes.ConclusionsThis case enhances our understanding of the intricate clinical manifestations of AHC, which require careful differentiation from various diseases such as epilepsy, hysteria, and paroxysmal dyskinesias. In the diagnosis of patients presenting with suspected symptoms, adhering to a systematic approach for localizing and diagnosing neurological disorders is crucial to prevent misdiagnosis and inappropriate treatments. Additionally, when AHC is suspected in a patient, genetic testing should be considered as part of the diagnostic approach.

Risk factors, clinical presentation and 1-year outcome of ischemic stroke caused by small artery disease

BackgroundThe prevalence of ischemic stroke (IS) caused by small-artery disease (SAD) is increasing recently. The present study aimed to report the risk factors, clinical presentations and outcome in patients presented with IS due to SAD with follow up for one year. The present study included 100 patients with IS due to SAD diagnosed on the basis of clinical and radiological findings. All patients were submitted to careful history taking, thorough clinical examination and standard laboratory work-up. Assessment of neurological functions was achieved using the National Institute of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS). Cognitive functions were evaluated using Trail making test, Stroop color word test, Arithmetic test, Vocabulary test, Wechsler adult intelligence scale IV digit span forward assessment and backward assessment. Magnetic resonance imaging (MRI) was done using a standard 1.5 Tesla unit. According to radiological findings, patients were classified into three groups: GI (n = 40) with IS due to SAD, GII (n = 30) with IS due to SAD plus internal watershed infarcts and GIII (n = 30) with IS due to SAD plus large artery infarctions (n = 30).ResultsComparison between the three groups regarding the reported risk factors identified significantly lower frequency of hyperlipidemia in GI patients as compared to GII and GIII patients (35.0% versus 60.0% and 66.7% respectively, p = 0.018). Clinically, it was shown that GI patients had significantly higher frequency of dizziness, dysphasia and tinnitus in comparison to the other two groups. It was also shown that those patients had significantly lower mean cortical thickness at the end of follow up (3.12 ± 0.9 versus 2.22 ± 0.8, p = 0.031). Finally, MRI brain volumetric study showed significantly decreased total cerebral cortical volume (TCCV) (589,456 ± 1689 versus 559,152 ± 1459) and total cerebral white matter volume (TCWMV) (521,546 ± 1785 versus 501,306 ± 1259) at the end of follow up.ConclusionsIschemic stroke caused by small artery disease is related to poor outcome with deterioration of cognitive functions.

Molecular basis of dementia

Dementia is a set of symptoms characterized by deterioration of memory and cognitive functions. Dementia diseases include Alzheimer's disease, dementia with Lewy bodies, frontotemporal dementia, vascular dementia, and mixed dementia. This disease represents an escalating social issue, particularly in a society with an increasing elderly population. In 2019, 271,998 people succumbed to dementia, making Alzheimer's disease the sixth most prevalent cause of death. The pathophysiology of Alzheimer's disease is complex and not fully understood. It is a multifaceted disease, with its pathogenesis influenced by a combination of genetic, environmental, and lifestyle factors. One of the genes involved in the pathogenesis of the disease is the apolipoprotein E (APOE) gene, which is one of the most common risk factors for Alzheimer's disease. The significance of other genes, including presenilin genes (PSEN1 and PSEN2), the TREM2 gene, the MAPT gene, and the APP gene, linked to various forms of dementia, is also emphasized. Another issue is the growing number of identified genetic variants within genes implicated in the onset of dementia. Dementia diseases are also characterized by chemical alterations in the brain, including the accumulation of abnormal excitotoxic proteins, varying degrees of inflammation, and metabolic disorders. This review summarizes current research in the field of dementia and highlights the significance of molecular factors in its pathogenesis. Gaining insight into the pathogenic mechanisms of dementia may allow for faster diagnosis of the disease and facilitate the creation of more efficient patient care plans.

Breaking barriers: a statistical and machine learning-based hybrid system for predicting dementia.

Introduction: Dementia is a condition (a collection of related signs and symptoms) that causes a continuing deterioration in cognitive function, and millions of people are impacted by dementia every year as the world population continues to rise. Conventional approaches for determining dementia rely primarily on clinical examinations, analyzing medical records, and administering cognitive and neuropsychological testing. However, these methods are time-consuming and costly in terms of treatment. Therefore, this study aims to present a noninvasive method for the early prediction of dementia so that preventive steps should be taken to avoid dementia. Methods: We developed a hybrid diagnostic system based on statistical and machine learning (ML) methods that used patient electronic health records to predict dementia. The dataset used for this study was obtained from the Swedish National Study on Aging and Care (SNAC), with a sample size of 43040 and 75 features. The newly constructed diagnostic extracts a subset of useful features from the dataset through a statistical method (F-score). For the classification, we developed an ensemble voting classifier based on five different ML models: decision tree (DT), naive Bayes (NB), logistic regression (LR), support vector machines (SVM), and random forest (RF). To address the problem of ML model overfitting, we used a cross-validation approach to evaluate the performance of the proposed diagnostic system. Various assessment measures, such as accuracy, sensitivity, specificity, receiver operating characteristic (ROC) curve, and Matthew's correlation coefficient (MCC), were used to thoroughly validate the devised diagnostic system's efficiency. Results: According to the experimental results, the proposed diagnostic method achieved the best accuracy of 98.25%, as well as sensitivity of 97.44%, specificity of 95.744%, and MCC of 0.7535. Discussion: The effectiveness of the proposed diagnostic approach is compared to various cutting-edge feature selection techniques and baseline ML models. From experimental results, it is evident that the proposed diagnostic system outperformed the prior feature selection strategies and baseline ML models regarding accuracy.

Potential Therapeutic Role of Cannabinoid System in Alzheimer’s Disease: A Review

Abstract: The purpose of the study was to investigate the role of the endocannabinoid system and the therapeutic potential benefits of cannabinoids in Alzheimer’s disease. The most frequent form of dementia in older individuals is Alzheimer's disease (AD), a progressive neurological ailment that gradually deprives people of their memory, cognitive abilities, and, ultimately, their ability to perform daily tasks. Alzheimer's disease is distinguished by a progressive deterioration in cognitive function, which includes a decline in memory, learning capacity, and thinking power. The human body's endocannabinoid system functions as a channel for cell communication. It is a neurotransmission system that is present in various regions of the body and tissues as well as assists in the control of a number of metabolic processes. Endocannabinoids, enzymes, and cannabinoid receptors all play a role in managing a variety of biological functions. In this review, we aimed to summarize the endocannabinoid system, the effect of beta-amyloid, tau-protein accumulation and neuroinflammation, potential therapeutic benefits of cannabinoids, current pre-clinical and clinical evidence for the potential therapeutic benefits, limitations, and challenges, and potential future research in the field. Emerging scientific data suggests that the ECS (Endocannabinoid system) is linked to neurodegenerative illnesses and that altering its tone may be a useful therapeutic strategy for the treatment of AD (Alzheimer’s disease).

Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients.

The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (β = 0.434), experiencing insomnia (β = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (β = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.

Brain functional and structural changes in diabetic children. How can intellectual development be optimized in type 1 diabetes?

The neuropsychological functioning of people with type 1 diabetes (T1D) is of key importance to the effectiveness of the therapy, which, in its complexity, requires a great deal of knowledge, attention, and commitment. Intellectual limitations make it difficult to achieve the optimal metabolic balance, and a lack of this alignment can contribute to the further deterioration of cognitive functions. The aim of this study was to provide a narrative review of the current state of knowledge regarding the influence of diabetes on brain structure and functions during childhood and also to present possible actions to optimize intellectual development in children with T1D. Scopus, PubMed, and Web of Science databases were searched for relevant literature using selected keywords. The results were summarized using a narrative synthesis. Disturbances in glucose metabolism during childhood may have a lasting negative effect on the development of the brain and related cognitive functions. To optimize intellectual development in children with diabetes, it is essential to prevent disorders of the central nervous system by maintaining peri-normal glycemic levels. Based on the performed literature review, it seems necessary to take additional actions, including repeated neuropsychological evaluation with early detection of any cognitive dysfunctions, followed by the development of individual management strategies and the training of appropriate skills, together with complex, multidirectional environmental support.

Comparing the Combination of Banana Consumption and Deep Breathing Exercises with Banana Consumption Alone and Deep Breathing Exercises Alone for Anxiety, and Depression among Postmenopausal Women: A Research Protocol

Introduction: Sleep disturbances are associated with increased healthcare costs and negative health outcomes. Oestrogen levels decrease after menopause, which may also be accompanied by deterioration in cognitive function along with the symptoms of depression and depressive disorders. Need for the study: The need of the study is evident in postmenopausal women, where physiological changes lead to a decline in vital hormones such as oestrogen and melatonin, contributing to anxiety, depression, and obstructive sleep apnoea. Consuming fruits rich in tryptophan which is a precursor of melatonin and serotonin can reduce sleep disorders and enhance sleep quality. Fruits containing tryptophan and melatonin can improve the sleep quality of healthy adults when consumed for seven days. Bananas are the prime example of nutritious food which enhances the mood-boosting benefits of serotonin. Deep breathing exercises are effective in reducing menopausal symptoms and help to manage stress related to life and menopause. Aim: To evaluate and compare the efficacy of a combination of banana consumption and deep breathing exercises with banana consumption alone and deep breathing exercises alone for managing sleep deprivation, anxiety, and depression among post-menopausal women. Materials and Methods: A random 3-arm parallel intervention study will be carried out at Acharya Vinoba Bhave Rural Hospital, Sawangi Meghe Wardha, and Near Mai Hospital, Gandhi Nagar Arvi Naka Wardha, Maharashtra, India. The study will be conducted from May 2023 to May 2026. A random sampling technique will be used to select the sample. A total of 135 post-menopausal women, meeting the inclusion criteria will be chosen for the study. The Pittsburgh Sleep Quality Index (PSQI) will be used to evaluate sleep deprivation, the self-rating anxiety and depression scale will be used to assess depression and anxiety, and serum magnesium tests along with demographic variables will be recorded. Statistical analysis will be performed using Analysis of Variance (ANOVA), among the outcome variables between the three groups. A p-value less than 0.05 will be considered as statistically significant.

Shared Decision-Making in the Treatment of Multiple Sclerosis: Results of a Cross-Sectional, Real-World Survey in Europe and the United States.

Multiple sclerosis (MS) is a neurodegenerative disease characterized by progressive deterioration of cognitive and physical functioning, reducing activities of daily living and quality of life (QoL). Several treatments are available that modify the course of the disease and reduce the frequency of relapses. Although effective, all treatment options are accompanied by adverse events, and this study aimed to assess the extent to which patients were involved in the choice of treatment. Data were drawn from the Adelphi Multiple Sclerosis Disease Specific Program (DSP)™, a cross-sectional survey of healthcare practitioners (HCP) and their patients with MS in real-world clinical settings in Europe and the United States (US) between December 2020 and July 2021. HCPs reported patient demographics, clinical characteristics, current and previous treatment, and treatment outcomes. Patients voluntarily completed questionnaires reporting the physical and psychological impact of their MS and its treatment. Regression analysis with inverse probability of treatment weighting was used to compare treatment outcomes in patients actively involved in their current treatment choice with those who were not. Of a total of 692 patients, median age 40 years and 64% female, mostly diagnosed with relapsing-remitting MS, those who were involved in shared decision-making tended to choose oral therapies such as dimethyl fumarate more often than HCPs. MS had greater impact on physical and psychological functioning in patients whose HCP made treatment decisions solely. Patients involved in decision-making reported greater satisfaction with their treatment and a better QoL. Because no single optimal therapy exists for patients with MS, treatments should be individualized with consideration of patients' preferences. Our study shows that shared decision-making is under-utilized in the management of MS and supports the benefits of patient involvement. Patients who have an active role in treatment decision-making show improved wellbeing and QoL, and overall treatment satisfaction.