High-level Cognitive Functions Research Articles

Study on correlation between perioperative cognitive function and nutritional status in elderly patients with gastric cancer

Objective: To investigate the cognitive function and nutritional status of elderly patients with gastric cancer during perioperative period, and to analyze their correlation. Methods: Aged patients undergoing gastric cancer surgery in The Affiliated Cancer Hospital of Shandong First Medical University from March to October 2021 were selected as the subjects of this study. The monitoring data of cognitive function and nutritional status were retrospectively analyzed from 1 to 3 days before surgery, 1 and 3 days after surgery, 7 days after surgery (before discharge) and 30 days after surgery to analyze the correlation between cognitive function and nutritional status in elderly patients with gastric cancer. Results: the incidence of mild cognitive impairment in elderly patients with gastric cancer was 52.43 %, the visual space of the two groups' (mild cognitive impairment) ability of execution, name, attention, language, abstract thinking, delayed memory and cognitive function scores were lower than 1 set of directional force (cognitive function in normal group), statistically significant difference (P < 0.05). The nutritional status of elderly patients with gastric cancer was lower than that of healthy elderly group at the same period (P < 0.05). The scores of visual spatial executive function, name, attention, delayed memory, orientation and total score of cognitive function in elderly gastric cancer patients were positively correlated with nutritional status (P < 0.05). Conclusions: The cognitive function and nutritional status of elderly patients with gastric cancer are both in a low state during treatment and a higher level of cognitive function can help patients maintain a more correct nutritional cognition, and the nutritional status of patients will be relatively better. There is a positive correlation between cognitive function and nutritional status in elderly patients with gastric cancer, which should be paid attention to in the treatment.

Early-life nutrition is associated with processing speed at age 5 in children born preterm with very low birth weight.

Processing speed is suboptimal among preterm-born children which is of concern as it is a foundational skill supporting higher-level cognitive functions. The study objective was to evaluate associations between early-life nutrition and processing speed in childhood. Macronutrient and human milk (mother's own, donor) intakes from 137 children born preterm with very low birth weight enrolled in a nutrition feeding trial were included. Processing speed was evaluated at age 5 using the WPPSI-IV Processing Speed Index. Associations between early-life nutrition and processing speed were explored through linear regression. Children had a mean (SD) birth gestational age of 28.1 (2.5) weeks, weight of 1036 (260) g and 52% were male. The mean (SD) assessment age was 5.7 (0.2) years. Sex-dependent relationships were identified between first postnatal month protein, lipid and energy intakes and processing speed at 5 years. For females, lower protein (per 0.1 g/kg/d: -0.88, 95% confidence interval [CI]: -1.53, -0.23; p = 0.01) and energy (per 10 kcal/kg/d: -2.38, 95% CI: -4.70, -0.05; p = 0.03) intakes were related to higher processing speed scores. Mother's milk provision was positively associated (per 10% increase: 0.80, 95% CI: 0.22, 1.37; p = 0.01) and donor milk was negatively associated (per 10% increase: -1.15, 95% CI: -2.22, -0.08; p = 0.04) with processing speed scores; no sex differences were observed. First postnatal month nutrition was related to processing speed at age 5 in children born preterm with very low birth weight. Early-life nutrition that supports processing speed may be leveraged to improve later cognitive outcomes for this vulnerable population.

The self-bias in working memory: the favorability of self-referential stimuli in resource allocation

ABSTRACT Self-representations guide and shape our thoughts and behaviour. People usually exhibit inherent biases in perception, attention, and memory to favour the information associated with themselves over that associated with others. The present study explored the phenomenon of self-bias in working memory (WM), specifically how self-referential processing impacts WM precision. Four precision-based experiments were conducted to assess the recall precision of self-referential items and items associated with other social agents. The findings revealed a robust self-prioritisation effect in WM precision, wherein self-referential items were recalled with greater precision than items associated with other social agents. Additionally, increased precision for self-referential items did not decrease the precision for simultaneously remembered items. This effect was limited by the total amount of WM resources and not influenced by a perceptual distractor. The inherent self-bias in WM can serve as a proxy to access the role self-representation in goal-oriented cognitive processing, providing a means of exploring the interaction between self-reference and high-level cognitive function.

Development of core sets for deafblindness: an international expert survey on functioning and disability of individuals living with deafblindness using the International Classification of Functioning, Disability, and Health.

The development of International Classification of Functioning, Disability, and Health (ICF) Core Sets greatly enhances the global recognition of health conditions, thereby advancing research, education, and care provision. Aside from the work of researchers, and the viewpoint of persons with lived experience, the development of Core Sets for deafblindness needs to include the viewpoints of professionals with expertise unique to this condition. To represent the perspective of health and social service expert professionals in the development of ICF Core Sets for deafblindness. Cross-sectional cohort study. Global online survey representing all six regions of the World Health Organization. One hundred and five professionals providing and health or social service to individuals living with deafblindness with a minimum of 2 years of work experience with this population. An online survey was distributed through professional networks and social media for individuals working with persons living with deafblindness. Demographic items were summarized using descriptive statistics. Six open-ended questions explored the perceptions of body functions and structures that influence activities and participation, as well as environmental and personal factors that facilitate functioning. Data were linked to the ICF codes using established linking rules and procedures. The 2934 survey response units were linked using IFC categories. Of the 421 unique categories, 133 were used by 5% or more of respondents. Most categories within the Activities and Participation component were equally emphasized. The most frequent Environmental factors were support and relationships, services, systems, and policies, as well as and the physical environment (e.g., hearing aids or noise). Mental functions, including higher level cognitive functions, temperament and personality were frequently emphasized. Almost three quarters (73.3%) of the entire ICF classification categories were included in the expert survey results. This proportion emphasizes the importance of a multidimensional tool, such as the ICF, for assessing functioning and health for persons with deafblindness. The representation of this professional perspective in Core Set development will improve standardized assessment and documentation, intervention planning, and facilitate interprofessional communication with the goal of improving person-centered care for persons living with deafblindness.

Systematic research is needed on the potential effects of lifelong technology experience on cognition: a mini-review and recommendations.

Digital technology now occupies a fundamental space in human life. Increasingly sophisticated access to information and social interactions has enabled a sort of offloading of many aspects of cognition, and for many people, this technology use has been lifelong. While the global development of technologies advances exponentially as part of the Fourth Industrial Revolution, researchers have not yet fully characterized the human effects of this technology-centric revolution at the same pace. In this mini-review, we consider three important higher-level cognitive functions: creativity, adaptability, and decision-making, and discuss their potential relationship to lifelong digital technology experience, which here includes both passive exposure and active use of electronic devices. We then articulate the gaps in related literature and knowledge, and outline general considerations, suggestions, and challenges for future research avenues. In general, we found that prior research has investigated uses of specific technology products on lower-level cognition (e.g., how does the use of online search engines affect memory?), but there is a lack of research assessing the overall effects of technology experience on cognitive functioning, particularly complex cognition.

Facial emotion recognition in individuals with mild cognitive impairment: An exploratory study.

Understanding facial emotions is fundamental to interact in social environments and modify behavior accordingly. Neurodegenerative processes can progressively transform affective responses and affect social competence. This exploratory study examined the neurocognitive correlates of face recognition, in individuals with two mild cognitive impairment (MCI) etiologies (prodromal to dementia - MCI, or consequent to Parkinson's disease - PD-MCI). Performance on the identification and memorization of neutral and emotional facial expressions was assessed in 31 individuals with MCI, 26 with PD-MCI, and 30 healthy controls (HC). Individuals with MCI exhibited selective impairment in recognizing faces expressing fear, along with difficulties in remembering both neutral and emotional faces. Conversely, individuals with PD-MCI showed no differences compared with the HC in either emotion recognition or memory. In MCI, no significant association emerged between the memory for facial expressions and cognitive difficulties. In PD-MCI, regression analyses showed significant associations with higher-level cognitive functions in the emotional memory task, suggesting the presence of compensatory mechanisms. In a subset of participants, voxel-based morphometry revealed that the performance on emotional tasks correlated with regional changes in gray matter volume. The performance in the matching of negative expressions was predicted by volumetric changes in brain areas engaged in face and emotional processing, in particular increased volume in thalamic nuclei and atrophy in the right parietal cortex. Future studies should leverage on neuroimaging data to determine whether differences in emotional recognition are mediated by pathology-specific atrophic patterns.

Distribution of calcium-binding proteins immunoreactivity in the bottlenose dolphin entorhinal cortex.

The entorhinal cortex has been shown to be involved in high-level cognitive functions in terrestrial mammals. It can be divided into two main areas: the lateral entorhinal area (LEA) and the medial entorhinal area (MEA). Understanding of its structural organization in cetaceans is particularly important given the extensive evidence for their cognitive abilities. The present study describes the cytoarchitectural and immunohistochemical properties of the entorhinal cortex of the bottlenose dolphin (Tursiops truncatus, Montagu, 1821), perhaps the most studied cetacean species and a paradigm for dolphins and other small cetaceans. Four bottlenose dolphins' entorhinal cortices were processed. To obtain a precise overview of the organization of the entorhinal cortex we used thionin staining to study its laminar and regional organization, and immunoperoxidase technique to investigate the immunohistochemical distribution of three most commonly used calcium-binding proteins (CBPs), calbindin D-28k (CB), calretinin (CR) and parvalbumin (PV). Entorhinal cortex layers thickness were measured, morphological and morphometric analysis for each layer were conducted and statistically compared. Six layers in both the LEA and MEA were identified. The main difference between the LEA and the MEA is observed in layers II and III: the neurons in layer II of the LEA were denser and larger than the neurons in layer II of MEA. In addition, a relatively cell-free zone between layers II and III in LEA, but not in MEA, was observed. The immunohistochemical distribution of the three CBPs, CB, CR and PV were distinct in each layer. The immunostaining pattern of CR, on one side, and CB/PV, on the other side, appeared to be distributed in a complementary manner. PV and CB immunostaining was particularly evident in layers II and III, whereas CR immunoreactive neurons were distributed throughout all layers, especially in layers V and VI. Immunoreactivity was expressed by neurons belonging to different morphological classes: All CBPs were expressed in non-pyramidal neurons, but CB and CR were also found in pyramidal neurons. The morphological characteristics of pyramidal and non-pyramidal neurons in the dolphin entorhinal cortex are similar to those described in the entorhinal cortex of other species, including primates and rodents. Interestingly, in primates, rodents, and dolphins, most of the CBP-containing neurons are found in the superficial layers, but the large CR-ir neurons are also abundant in the deep layers. Layers II and III of the entorhinal cortex contain neurons that give rise to the perforant pathway, which conveys most of the cortical information to the hippocampal formation. From the hippocampal formation, reciprocal projections are directed back to the deep layer of the entorhinal cortex, which distributes the information to the neocortex and subcortical area. Our data reveal that in the dolphin entorhinal cortex, the three major CBPs label morphologically heterogeneous groups of neurons that may be involved in the information flow between entorhinal input and output pathways.

Conflict detection and resolution in macaque frontal eye fields

Stimulus-induced conflicts in decision-making tasks produce both behavioral and neuronal congruency effects. However, how and when conflicts are detected and resolved at the neuronal level remains largely unclear. To address these issues, we recorded from single neurons in the frontal eye fields of two macaques performing a conflict task. Although the temporal dynamics of the neuronal congruency effects are independent of the specific task rules, they are substantially different in target- and distractor-encoding neurons. Conflicts were detected ~100 ms after the conflict-inducing cue (20–30 ms after the visual response), which is much faster than predicted based on human EEG results. This suggests that conflict detection relies on a fast mechanism in frontal eye fields. Resolving the conflict at the neuronal level, however, requires between <400 ms to ~1000 ms, and shows profound interindividual differences and depends on task rules, indicating that it is a more complex and top-down driven process. Our findings illuminate the neuronal mechanisms underlying decision-making when a conflict is present, a crucial cognitive process playing a role in basic survival and high-level cognitive functions.

Brain Frontal-Lobe Misery Perfusion in COVID-19 ICU Survivors: An MRI Pilot Study.

Post-acute COVID-19 syndrome (PCS) is highly prevalent. Critically ill patients requiring intensive care unit (ICU) admission are at a higher risk of developing PCS. The mechanisms underlying PCS are still under investigation and may involve microvascular damage in the brain. Cerebral misery perfusion, characterized by reduced cerebral blood flow (CBF) and elevated oxygen extraction fraction (OEF) in affected brain areas, has been demonstrated in cerebrovascular diseases such as carotid occlusion and stroke. This pilot study aimed to examine whether COVID-19 ICU survivors exhibited regional misery perfusion, indicating cerebral microvascular damage. In total, 7 COVID-19 ICU survivors (4 female, 20-77 years old) and 19 age- and sex-matched healthy controls (12 female, 22-77 years old) were studied. The average interval between ICU admission and the MRI scan was 118.6 ± 30.3 days. The regional OEF was measured using a recently developed technique, accelerated T2-relaxation-under-phase-contrast MRI, while the regional CBF was assessed using pseudo-continuous arterial spin labeling. COVID-19 ICU survivors exhibited elevated OEF (β = 5.21 ± 2.48%, p = 0.047) and reduced relative CBF (β = -0.083 ± 0.025, p = 0.003) in the frontal lobe compared to healthy controls. In conclusion, misery perfusion was observed in the frontal lobe of COVID-19 ICU survivors, suggesting microvascular damage in this critical brain area for high-level cognitive functions that are known to manifest deficits in PCS. Physiological biomarkers such as OEF and CBF may provide new tools to improve the understanding and treatment of PCS.

Bloom의 신교육목표분류체계 기반 2015 및 2022 개정 초등영어 교육과정 성취기준 비교·분석

Objectives The purpose of this study is to compare the achievement standards of the 2022 revised national English curriculum with those of the 2015 curriculum based on Bloom's revised taxonomy.&#x0D; Methods The 2022 revised curriculum made efforts to ensure that the purpose of competency education is ac-tually implemented in the achievement standards, from the perspectives of knowledge, skills, and attitudes. To examine whether this purpose has been achieved, this study compares and analyzes the achievement standards of the revised English curriculum in 2015 and 2022 in terms of knowledge dimension and cognitive process di-mension based on Bloom's revised taxonomy of educational objectives.&#x0D; Results In terms of knowledge dimension, the achievement standards of both the 2015 and 2022 revised curricu-lum were the most distributed in “factual knowledge”. There were almost no achievement standards correspond-ing to “conceptual knowledge” and “procedural knowledge” in both the 2015 and 2022 revised curriculum. Meta-cognitive knowledge has increased in proportion in the 2022 revised curriculum. This is analyzed as a result of reflecting strategic knowledge and affective attitudes in the achievement standards. In terms of cognitive process dimension, both the 2015 and 2022 revised curriculum achievement standards showed a tendency to be focused on low-level cognitive functions of “remember” and “understand”, but unlike 2015, the 2022 curriculum showed a change of introducing high-level cognitive functions such as “evaluate” and “create”.&#x0D; Conclusions These changes show that the 2022 revised national English curriculum strives to present the ach-ievement standards in a balanced manner in terms of knowledge, skills, and attitudes in order to reflect the pur-pose of competency education.

Learning Spatiotemporal Brain Dynamics in Adolescents via Multimodal MEG and fMRI Data Fusion Using Joint Tensor/Matrix Decomposition.

Brain function is understood to be regulated by complex spatiotemporal dynamics, and can be characterized by a combination of observed brain response patterns in time and space. Magnetoencephalography (MEG), with its high temporal resolution, and functional magnetic resonance imaging (fMRI), with its high spatial resolution, are complementary imaging techniques with great potential to reveal information about spatiotemporal brain dynamics. Hence, the complementary nature of these imaging techniques holds much promise to study brain function in time and space, especially when the two data types are allowed to fully interact. We employed coupled tensor/matrix factorization (CMTF) to extract joint latent components in the form of unique spatiotemporal brain patterns that can be used to study brain development and function on a millisecond scale. Using the CMTF model, we extracted distinct brain patterns that revealed fine-grained spatiotemporal brain dynamics and typical sensory processing pathways informative of high-level cognitive functions in healthy adolescents. The components extracted from multimodal tensor fusion possessed better discriminative ability between high- and low-performance subjects than single-modality data-driven models. Multimodal tensor fusion successfully identified spatiotemporal brain dynamics of brain function and produced unique components with high discriminatory power. The CMTF model is a promising tool for high-order, multimodal data fusion that exploits the functional resolution of MEG and fMRI, and provides a comprehensive picture of the developing brain in time and space.

The Effect of Iron-Fortified Lentils on Blood and Cognitive Status among Adolescent Girls in Bangladesh

Background: Iron deficiency is highly prevalent in South Asia, especially among women and children in Bangladesh. Declines in cognitive performance are among the many functional consequences of iron deficiency. Objective: We tested the hypothesis that, over the course of a 4-month iron fortification trial, cognitive performance would improve, and that improvement would be related to improvements in iron status. Methods: Participants included 359 adolescent girls attending Bangladesh Rural Advancement Committee (BRAC) clubs as a subsample of a larger double-blind, cluster-randomized community trial in which participants were assigned to one of three conditions: a condition in which no lentils were supplied (NL, n = 118, but which had the usual intake of lentils), a control (non-fortified) lentil condition (CL, n = 124), and an iron-fortified lentil condition (FL, n = 117). In the FL and CL conditions, approximately 200 g of cooked lentils were served five days per week for a total of 85 feeding days. In addition to biomarkers of iron status, five cognitive tasks were measured at baseline (BL) and endline (EL): simple reaction time task (SRT), go/no-go task (GNG), attentional network task (ANT), the Sternberg memory search Task (SMS), and a cued recognition task (CRT). Results: Cognitive performance at EL was significantly better for those in the FL relative to the CL and NL conditions, with this being true for at least one variable in each task, except for the GNG. In addition, there were consistent improvements in cognitive performance for those participants whose iron status improved. Although there were overall declines in iron status from BL to EL, the declines were smallest for those in the FL condition, and iron status was significantly better for those in FL condition at EL, relative to those in the CL and NL conditions. Conclusions: the provision of iron-fortified lentils provided a protective effect on iron status in the context of declines in iron status and supported higher levels of cognitive performance for adolescent girls at-risk of developing iron deficiency.

The Look AHEAD Aging Study: design, cohort characteristics, and cognitive function

AbstractBackgroundData on cognitive trajectories and characteristics associated with cognitive resilience among older individuals with type 2 diabetes and overweight or obesity are scant. To date, the NIA‐funded Action for Health in Diabetes (Look AHEAD) Aging Study has enrolled 1245 individuals, ages 64 to 95 years, who have been richly characterized over 18 years of prior follow‐up with factors associated with cognitive aging.MethodVolunteers from the Look AHEAD clinical trial of a multidomain lifestyle intervention and its subsequent clinic‐based post‐trial observational phase were invited to join a 4‐year telephone‐based observational study that includes annual cognitive assessments to assess memory, attention/processing speed, executive function, and global cognitive function. A composite measure of cognitive function based on the average standardized cognitive function tests was used to capture global cognitive function. Mild cognitive impairment and probable dementia will be centrally adjudicated. Additional measures include depressive symptoms, physical function and abilities, medical events, medication use, and health related quality of life. Recruitment will be completed in early 2023.ResultThe enrolled cohort to date (N = 1590) includes 62% women, 32% individuals from traditionally under‐represented racial/ethnic minorities, 49% without college education, and 52% who had been randomly assigned to the lifestyle intervention. The mean (SD) age is 76.3 (5.6) and years of diabetes is 25.5 (5.5). When last measured, the mean BMI was 33.8 (6.3) kg/m2 and 4 m walk speed was 0.86 (0.22) m/sec. Of 1060 who were tested, 20.6% have one apoE‐e4 allele and 1.1% have two apoE‐e4 alleles. Modified Telephone Interview for Cognitive Status (TICSm) scores ranged from 12 to 48, with mean 34.7 (4.7), with no difference between intervention groups (p = 0.66). While TICSm scores tended to be lower for older participants, many still demonstrated relatively high levels of cognitive functioning, even into the 8th decade of life (attached figure).ConclusionThe Look AHEAD Aging study holds great promise to identify factors across two decades of follow‐up that are associated with cognitive resilience in a large cohort with type 2 diabetes and overweight or obesity. Our presentation will provide data on the full cohort and cognitive battery.

중 고령자 자원봉사와 인지기능의 종단관계 및 교육과 연령의 조절

This study investigates the longitudinal associations between volunteering among older adults and the cognitive functioning for the purpose of preventing the cognitive decline, examining how volunteerism of older persons affects the cognitive functioning. For the purpose, the study analyzes about 8,688 older subjects who are observed six times with intervals of two years, using statistical analysis model of linear multilevel mixed regression. The results show that volunteering is associated with higher level of cognitive function over time, and the education moderates the association, with volunteering benefiting the most differentially least-educated elderly among four higher-educated groups. Also age weakens the effect size of volunteering, but volunteering effects work in all ages. Volunteering is lifestyle behaviors that enhance cognitive functioning of older persons. The results suggests that cognition-strengthened volunteer programs are beneficial to older persons at the population level.

Determinants of successful cognitive aging over 15 years: a population‐based study

AbstractBackgroundAlthough aging is related to loss in cognitive function, some individuals maintain high levels of cognitive performance also in late life. However, studies mapping longitudinal cognitive trajectories are scarce and little is known about the factors that may promote successful cognitive aging (SCA). We sought to identify predictors of SCA, based on latent profiles derived from interindividual differences in rate of change across several cognitive domains.MethodWe followed 1,966 individuals from the Swedish National Study on Aging and Care in Kungsholmen (SNAC‐K) over 15 years (mean baseline age = 71.6 years; 62.9% female). Participants were free from dementia at baseline and had undergone at least two cognitive assessments during follow‐up. Cognition was assessed with a comprehensive battery, including tests of semantic memory, episodic recall and recognition, letter and verbal fluency, and executive function. We estimated level and change within each of the cognitive domains with linear mixed effect models, based on which we classified participants into successful, normal, or decline groups. These groups were used to derive profiles of overall cognitive change trajectories, through latent class analysis. We then investigated demographic, health, lifestyle, and genetic predictors of profile membership.ResultWe obtained three latent cognitive profiles. 31.6% of the sample was classified as successful, 50.6% as normal, and 17.8% as decliner. In multi‐adjusted multinomial logistic regression analysis, membership in the successful profile was predicted by female sex, higher education, and a faster walking speed (ps &lt; 0.003). Current smoking, feelings of loneliness, and carrying the Apolipoprotein ԑ4‐allele were associated with a lower likelihood of being classified as successful (ps &lt; 0.037). Higher age, diagnosis of diabetes or depression, and being an ԑ4‐carrier increased the likelihood of being classified into the decline profile (ps &lt; 0.026).ConclusionWe identified several demographic, lifestyle, health, and genetic factors of SCA. Of note, these factors were different from those that predicted accelerated cognitive decline. Although some cognitive loss may be an inevitable part of aging, our results suggest certain modifiable factors (i.e. smoking and quality of social interactions) to be related to maintained cognitive function in older age.

Cross-movie prediction of individualized functional topography.

Participant-specific, functionally defined brain areas are usually mapped with functional localizers and estimated by making contrasts between responses to single categories of input. Naturalistic stimuli engage multiple brain systems in parallel, provide more ecologically plausible estimates of real-world statistics, and are friendly to special populations. The current study shows that cortical functional topographies in individual participants can be estimated with high fidelity from naturalistic stimuli. Importantly, we demonstrate that robust, individualized estimates can be obtained even when participants watched different movies, were scanned with different parameters/scanners, and were sampled from different institutes across the world. Our results create a foundation for future studies that allow researchers to estimate a broad range of functional topographies based on naturalistic movies and a normative database, making it possible to integrate high-level cognitive functions across datasets from laboratories worldwide.

Effects of visual-electrotactile stimulation feedback on brain functional connectivity during motor imagery practice

The use of neurofeedback is an important aspect of effective motor rehabilitation as it offers real-time sensory information to promote neuroplasticity. However, there is still limited knowledge about how the brain’s functional networks reorganize in response to such feedback. To address this gap, this study investigates the reorganization of the brain network during motor imagery tasks when subject to visual stimulation or visual-electrotactile stimulation feedback. This study can provide healthcare professionals with a deeper understanding of the changes in the brain network and help develop successful treatment approaches for brain–computer interface-based motor rehabilitation applications. We examine individual edges, nodes, and the entire network, and use the minimum spanning tree algorithm to construct a brain network representation using a functional connectivity matrix. Furthermore, graph analysis is used to detect significant features in the brain network that might arise in response to the feedback. Additionally, we investigate the power distribution of brain activation patterns using power spectral analysis and evaluate the motor imagery performance based on the classification accuracy. The results showed that the visual and visual-electrotactile stimulation feedback induced subject-specific changes in brain activation patterns and network reorganization in the alpha band. Thus, the visual-electrotactile stimulation feedback significantly improved the integration of information flow between brain regions associated with motor-related commands and higher-level cognitive functions, while reducing cognitive workload in the sensory areas of the brain and promoting positive emotions. Despite these promising results, neither neurofeedback modality resulted in a significant improvement in classification accuracy, compared with the absence of feedback. These findings indicate that multimodal neurofeedback can modulate imagery-mediated rehabilitation by enhancing motor-cognitive communication and reducing cognitive effort. In future interventions, incorporating this technique to ease cognitive demands for participants could be crucial for maintaining their motivation to engage in rehabilitation.

MANAGEMENT OF CHRONIC POSTSURGICAL PAIN AND HYPERALGESIA IN CHILDREN AND ITS INFLUENCE ON COGNITIVE FUNCTIONING

Introduction. Persistent postsurgical pain (PPSP) or chronic postsurgical pain (CPSP) is recognized as a relevantpostoperative complication. Inadequate pain management in the early postoperative period may contribute to the development of hyperalgesia and the use of local anesthetics in regional anesthesia can help in its treatment and prevention.The aim of the study was to study the eff ectiveness of regional analgesia techniques in preventing PPSP and hyperalgesiain children after anterior abdominal wall surgery and to assess quality of life (QoL) using the Cognitive Functioning Scale.Material and Methods. The study included 87 children at the age of 7-18 years who underwent anterior abdominal wallsurgery with diff erent anesthetic techniques. Group I included 27 children who underwent anterior abdominal wall surgery under general anesthesia using the transversalis fascia plane block (TFPB), combined with the quadratus lumborum block 4 (QLB-4). Group II comprised 33 children who underwent anterior abdominal wall surgery under general anesthesia using fentanyl. Group III consisted of 27 children who underwent anterior abdominal wall surgery under general anesthesia using the TFPB. General anesthesia included either inhalation anesthesia or propofol infusion. The control group included 30 healthy children whose cognitive functioning was assessed. All clinical and laboratory studies were conducted in accordance with the World Medical Association Declaration of Helsinki “Ethical Principles for Medical Research Involving Human Subjects”. According to the Law, prior to a subject’s participation in the study, a written informed consent form was signed by each subject (parents/adult guardians). The manuscript was approved by the Ethics Committee of the Communal Non- Profi t Enterprise “Ivano- Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council”, as evidenced by an Excerpt from the Minute of the Committee Meeting No. 2 dated February 24, 2022.The results obtained were statistically processed using statistical measures of variation, correlation analysis, Student’s t-test.Diff erences were considered statistically signifi cant at p&lt;0.05. The proportions were statistically compared by a z-test.The study is a fragment of the research project of the Department of Children Diseases of Postgraduate Medical EducationFaculty, Ivano- Frankivsk National Medical University “Health Status and Adaption of Children from the Precarpathian Regionwith Somatic Diseases, Their Prevention” (state registration number 0121U111129; 2021-2026).Results. A signifi cantly higher mechanical pain threshold was observed in children of Group I and Group III both three(226.422.2, 220.318.6, and 182.414.2 g/mm2, respectively, рІ-ІІ&lt;0.05, рІІ-ІІІ&lt;0.05) and six months (288.214.4, 276.414.8,and 174.216.4 g/mm2, respectively, рІ-ІІ&lt;0.05, рІІ-ІІІ&lt;0.05) after surgery.The surface area of hyperalgesia in children of Group I and Group III was signifi cantly smaller as compared to childrenof Group II three (68.69.4, 79.411.4, and 116.814.0 mm2, respectively, рІ-ІІ&lt;0.05, рІІ-ІІІ&lt;0.05) and six months (70.213.0,77.213.2, and 117.212.6 mm2, respectively, рІ-ІІ&lt;0.05, рІІ-ІІІ&lt;0.050) after surgery.The frequency of CPSP was higher in children of Group II (21%) as compared to children in Group I (4%) and Group III(11%). Additionally, assessing chronic pain with the DN4 questionnaire showed its signifi cantly lower level in children of Group Iand Group III as compared to Group II six months after surgery (5.46±0.42, 8.69±0.78, and 13.69±0.38 points, respectively,рІ-ІІ&lt;0.05, рІІ-ІІІ&lt;0.05, рІ-ІІІ&lt;0.05). No statistically signifi cant diff erence in QoL assessment on the Cognitive Functioning Scale was observed on the 7th day following surgery; the QoL scores in all the groups were signifi cantly lower compared to the control group. Three months after surgery, QoL was signifi cantly lower in children of Group II (69.38±6.93 points) as compared to children of Group I (92.08±4.46 points, pІ-ІІ&lt;0.001) and Group III (83.54±4.16 points, pІІ-ІІІ&lt;0.01). Six months following surgery, the lowest QoL was diagnosed in children of Group II (72.08±6.64) as compared to those in Group І (94.17±4.36 points, p&lt;0.001) and Group ІІІ (91.67±4.27, p&lt;0.001).Conclusions.1. The use of general analgesia in combination with regional anesthesia techniques (TFPB or TFPB+QLB) was associatedwith a higher mechanical pain threshold and a smaller area of hyperalgesia around the postoperative wound three and six months after anterior abdominal wall surgery, compared to conventional anesthesia.2. In addition, combined use of regional (TFPB or QLB+TFPB) with general anesthesia demonstrated a lower frequencyof CPSP, a lower level of chronic pain, and a higher level of cognitive functioning in children throughout these time intervals.3. The results obtained provide a foundation for introducing these analgesia techniques (TFPB or TFPB+QLB) in pediatricpatients undergoing anterior abdominal wall surgery, with the aim of mitigating the eff ects of pain syndrome and improving their Qo L.

Compressed primary-to-transmodal gradient is accompanied with subcortical alterations and linked to neurotransmitters and cellular signatures in major depressive disorder.

Major depressive disorder (MDD) has been shown to involve widespread changes in low-level sensorimotor and higher-level cognitive functions. Recent research found that a primary-to-transmodal gradient could capture a cortical hierarchical organization ranging from perception and action to cognition in healthy subjects, but a prominent gradient dysfunction in MDD patients. However, whether and how this cortical gradient is linked to subcortical impairments and whether it is reflected in the microscale neurotransmitter systems and cell type-specific transcriptional signatures remain largely unknown. Data were acquired from 323 MDD patients and 328 sex- and age-matched healthy controls derived from the REST-meta-MDD project, and the human brain neurotransmitter systems density maps and gene expression data were drawn from two publicly available datasets. We investigated alterations of the primary-to-transmodal gradient in MDD patients and their correlations with clinical symptoms of depression and anxiety, as well as their paralleled subcortical impairments. The correlations between MDD-related gradient alterations and densities of the neurotransmitter systems and gene expression information were assessed, respectively. The results demonstrated that MDD patients had a compressed primary-to-transmodal gradient accompanied by paralleled alterations in subcortical regions including the caudate, amygdala, and thalamus. The case-control gradient differences were spatially correlated with the densities of the neurotransmitter systems including the serotonin and dopamine receptors, and meanwhile with gene expression enriched in astrocytes, excitatory and inhibitory neuronal cells. These findingsmapped the paralleled subcortical impairments in cortical hierarchical organization and also helped us understand the possible molecular and cellular substrates of the co-occurrence of high-level cognitive impairments with low-level sensorimotor abnormalities in MDD.

The Conflict between Top-down and Bottom-up Impairments in Consciousness Disorder in Schizophrenia

Introduction: Schizophrenia, a complex psychiatric disorder, is often associated with consciousness disorders, typically characterized by an elevated threshold of conscious perception. Over the years, a multitude of research has been dedicated to uncovering the primary cause of these disorders, leading to the development of several theories. Methods: In this article, two central answers to this problem have been reviewed. For this, the articles that were more related to the topic were selected. Based on the relevance to the subject of research, the main ideas of targeted articles are reordered to be comprehensible for the readers. Finally, the judgment and conclusion of the authors about the discussed problem are presented in this study. Discussion: The first theory, which we will explore in this article, suggests that the root cause of these disorders lies in defects within bottom-up processes. These processes, fundamental to our understanding of the world, involve the progression of sensory information from low-level perception to high-level awareness. In individuals with schizophrenia, these processes are believed to be compromised, leading to a distorted perception of reality. The second theory, in contrast, attributes the cause to impairments in top-down processes. These processes, which refer to the influence of high-level cognitive functions on lower-level sensory perception, are also considered dysfunctional in schizophrenic patients. This dysfunction is thought to disrupt the integration of sensory information, thereby affecting the individual's consciousness. However, a third perspective has emerged, suggesting the coexistence of impairments in both bottom-up and top-down processing. This perspective argues that to fully comprehend the nature of consciousness disorders in schizophrenia, it is crucial to determine the type and severity of both bottom-up and top-down impairments. Conclusion: In this review, we delve into these theories, examining the evidence supporting each and discussing their implications for our understanding of schizophrenia. Considering both bottom-up and top-down impairments, the third perspective offers a more holistic explanation for these disorders. We further argue that this perspective underscores the need for a more nuanced approach to studying schizophrenia. It suggests that future research should not only focus on these processes in isolation but also explore their interaction and the potential synergistic effects of their impairment. By doing so, we can hope to gain a more comprehensive understanding of consciousness disorders in schizophrenia, which could ultimately lead to more effective treatment strategies.