Improvement In Cognitive Function Research Articles

Omega-3 polyunsaturated fatty acids supplementation improves memory in first-diagnosed, drug-naïve patients with depression: Secondary analysis of data from a randomized controlled trial

IntroductionCognitive impairments are found in most patients with major depressive disorder (MDD). It is believed that low Omega-3 polyunsaturated fatty acids (n-3 PUFAs) level raise the risk of anxiety, depressive symptoms and cognition dysfunction. Since our previous research has found n-3 PUFAs supplementation improves anxiety in MDD, this study was to further explore the effectiveness on cognitive impairment among depressed patients. MethodsA total of 72 venlafaxine treated outpatients with first-diagnosed, drug-naïve depression were enrolled. Daily n-3 PUFAs supplementation (2.4 g/d of fish oil, including 1440 mg eicosapentaenoic acid and 960 mg of docosahexaenoic acid) or placebo was used for 12 weeks. Cognitive function, measure by repeatable battery for the assessment of neuropsychological status ([RBANS]) scores, was compared over time. ResultsImmediate memory, delayed memory and RBANS total scores were significant higher in both groups at week 4 and week 12 compared with baseline. Both groups exhibited improvement on attention scores at week 12. No significant differences were observed comparing n-3 PUFAs with placebo groups in the improvement of total RBANS scores and other subscales except in the change of immediate memory at both week 4 and week 12 (p < 0.05). LimitationsSample size was relatively low. Moreover, multiple ethnic populations and the income of patients should be considered. Lastly, we used raw scores instead of the standardized scores of RBANS. ConclusionN-3 PUFAs supplementation yielded a small but statistically significant improvement on immediate memory in first-diagnosed, drug-naïve depressed patients. While, antidepressant treatment resulted in significant improvement of cognitive function.

Improving cognitive function with intermittent dose escalation of curcumin extract in chemotherapy-induced cognitive impairment patients: a randomized controlled trial

Chemotherapy-induced cognitive impairment (CICI) is an impairment of memory, learning power, concentration, reasoning, executive function, attention, and visuospatial during and after chemotherapy exposures. No proven safe and effective therapeutic regimen are available to improve cognitive function in CICI patients. To evaluate the safety and effectiveness of curcumin extract to improve cognitive function in CICI patients. This study was a double-blind randomized controlled trial clinical trial in patients with cervical carcinoma who underwent a carboplatin-paclitaxel chemotherapy regimen from March to October 2021 at single center hospital. Subjects divided into two groups that received curcumin and placebo caplets by dose escalation method from 240 to 400 mg intermittently (14 days on and 7 days off) between chemotherapy cycles. Cognitive function was evaluated pre- and post-therapy using the AFI questionnaire, Stroop test, and MoCA-Ina. A total of 78 subjects were equally divided into the treatment and control groups. The percentage of drop-out, mortality, and adverse drug response were relatively comparable between each treatment arm. The group of subjects receiving curcumin extract experienced clinically and statistically significant improvements in cognitive function based on the Stroop test (∆ median 8.57 vs. 2.46; Z − 4.503 vs. − 1.762; p < 0.0001 vs. 0.078) and MoCA- Ina (∆ mean 1.53 vs. 0.72; Z − 2.99 vs. − 2.05; p < 0.003 vs. 0.04) versus placebo in between-group and between-subject analyses, respectively. Administration of curcumin extract with intermittent dose escalation regimen proved to be safe and able to improve cognitive function of CICI patients clinically and statistically significant.

PEALut in the Dietary Management of Patients with Acute Ischemic Stroke: A Prospective Randomized Controlled Clinical Trial.

Acute ischemic stroke (AIS), which represents 87% of all strokes, is caused by reduced blood supply to the brain associated with a prolonged inflammatory process that exacerbates brain damage. The composite containing co-ultramicronized Palmitoylethanolamide and luteolin (PEALut) is known to promote the resolution of neuroinflammation, being a promising nutritional approach to contrast inflammatory processes occurring in AIS. This study included 60 patients affected by acute ischemic stroke and undergoing thrombolysis. PEALut 770 mg was administered to 30 patients, twice daily for 90 days, in addition to the standard therapy. Neurological deficit, independence in activities of daily living, disability and cognitive impairment were investigated. In all patients, the severity of AIS defined by the NIHSS score evolved from moderate to minor (p < 0.0001). Patients' independence in daily living activities and disability evaluated using BI and mRS showed a significant improvement over time, with a statistically significant difference in favor of PEALut-treated patients (p < 0.002 for BI, p < 0.0001 for mRS), who achieved also a marked improvement of cognitive function evaluated using MMSE and MoCA tests. PEALut proved to be a safe and effective treatment in addition to thrombolysis in the management of patients with acute ischemic stroke.

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.

Enhanced External Counterpulsation Improves Cognitive Function of Persons With Long COVID.

The aim of this study is to determine the effects of enhanced external counterpulsation (EECP) in patients with long COVID and objectively assessed cognitive impairment. A retrospective evaluation of long COVID patients referred for EECP, with cognitive sequela, and having completed an objective digital assessment before and after therapy. Patients had either cognitive impairment or no cognitive impairment at baseline. We assessed changes in composite score using multifactor analysis of variance. Multiple linear and logistic regression analyses were conducted to evaluate several independent variables. Eighty long COVID patients (38 cognitive impairment vs. 42 no cognitive impairment) were included for analyses. All baseline characteristics were well matched. There was significant improvement in composite score post EECP in those with objective cognitive impairment at baseline. There were no notable documented safety concerns. This is the first study showing that EECP led to significant improvement in cognitive functioning of long COVID patients with objectively defined cognitive impairment. Although a lack of a negative control group is a limitation of this study, EECP seems to be highly safe and effective with the potential for widespread application.

Cherries with Different Geographical Origins Regulate Neuroprotection in a Photoperiod-Dependent Manner in F344 Rats.

The photoperiod is the main environmental cue that drives seasonal adaptive responses in reproduction, behavior, and metabolism in seasonal animals. Increasing evidence suggests that (poly)phenols contained in fruits can also modulate seasonal rhythms. (Poly)phenol-rich diets are associated with an improvement in cognitive function and neuroprotection due to their anti-inflammatory and antioxidative properties. However, it is unknown whether cherries affect neuroprotection in a photoperiod-dependent manner. To test this, F344 rats were exposed to L6 (6 h light/day), L12 (12 h light/day) and L18 (18 h light/day) photoperiods and fed a standard chow diet supplemented with either a control, lyophilized cherry 1 or cherry 2 with distinctive phenolic hallmarks. Physiological parameters (body weight, eating pattern index (EPI), testosterone, T4/T3) and hypothalamic key genes (Dio2, Dio3, Raldh1 and Ghrh) were strongly regulated by the photoperiod and/or fruit consumption. Importantly, we show for the first time that neurotrophs (Bdnf, Sod1 and Gpx1) in the hippocampus are also regulated by the photoperiod. Furthermore, the consumption of cherry 2, which was richer in total flavonols, but not cherry 1, which was richer in total anthocyanins and flavanols, enhanced neuroprotection in the hippocampus. Our results show that the seasonal consumption of cherry with a specific phenolic composition plays an important role in the hippocampal activation of neuroprotection in a photoperiod-dependent manner.

Zexieyin formula alleviates atherosclerosis with cognitive impairment: A novel role in the treatment of comorbidities and its underlying mechanisms

Ethnopharmacological relevancyZexieyin formula (ZXYF) has been identified to have therapeutic actions of atherosclerosis (AS). It's unknown that whether ZXYF has therapeutic potential of atherosclerosis (AS) with cognitive impairment (CI) and its underlying mechanisms. Aim of the studyTo elucidate therapeutic effect of ZXYF for AS with CI as well as its underlying mechanisms in AS with CI mice model. Methods and materialsTo establish AS with CI model, we fed ApoE−/− mice with high-fat diet (HFD) for 8 weeks. Oil red O staining (ORO) and Hematoxylin-eosin staining (HE) were used to detect aortic plaque area. Morris water maze (MWM) and Y-maze were used to measure cognitive function and cognitive improvement after administration of ZXYF and atorvastatin (ATO). Network pharmacology was used to screen for potential mechanisms for improving cognitive function. Western blot was used to detect expressions of MAPK, Aβ and synaptic proteins in hippocampus. ResultsHFD caused and accelerated the AS in ApoE−/− mice, while it was easier able to produce CI than normal mice. Administration of ZXYF or ATO for 8 weeks significantly reduced aortic plaque area in ORO and HE tests, and improved cognitive abilities in MWM and Y-maze tests. Network pharmacology results showed that MAPK or synaptic proteins were highly associated with CI. HFD contributed to abnormal expressions of MAPK (pERK, pP38, pJNK), NF-kB, synaptic proteins (PSD95, synapsin1) and β-amyloid (Aβ) in hippocampus, which were all reversed by ZXYF. However, ERK and PSD95 expressions were not reversed by ATO in hippocampus. ConclusionsZXYF mitigated AS, further alleviating CI by modulating MAPK signaling, relating to synaptic proteins enhancing and Aβ protein decreasing in the hippocampus. This study firstly lit up the new clinical application of ZXYF, which might promote the use of ZXYF in AS and CI patients.

Evaluation of the impact of a comprehensive psychiatric rehabilitation program on the improvement of cognitive functions in patients of the Mental Health Support Centre in Tarnowskie Gory using the Wisconsin Card Sorting Test

Aim: The purpose of our study was check to how a 3-month program of physical, cognitive and social rehabilitation affected the cognitive functions of patients of the Mental Health Support Centre in Tarnowskie Gory by using the Wisconsin Card Sorting test Materials and Methods: The Wisconsin Card Sorting Test (WCST) was conducted twice among patients of the Mental Health Support Center in Tarnowskie Gory, who were undergoing a 3 month rehabilitation program that included physical, cognitive, and social rehabilitation. The test was conducted at the beginning and after the participation in the rehabilitation program. Results: The rehabilitation program led to a significant decrease in patients’ perseverative responses compared to the initial study. Other indicators were also assessed in the Wisconsin Card Sorting Test (WCST). There were no statistically significant differences between the results of the first and second studies. Conclusions: After completing the rehabilitation program, patients showed a significant decrease in perseverative responses, indicating improved speed in responding to changing task conditions. Cognitive flexibility, including the ability to respond to changing environmental conditions, is a key skill that enables adequate and adaptive actions.

A mixed antioxidant supplement improves cognitive function, and coordination in aged mice.

Accumulation of oxidative damage increases the risk of several disorders. To prevent these diseases, people consume supplements. However, there is little evidence of the impact of supplement intake on cognitive function. Recently, frailty and sarcopenia have become serious issues, and these phenomena include a risk of mild cognitive impairment. In this study, aged mice were fed the combination supplement and cognitive and motor functions were measured. Following 1 month of treatment with the supplement, significant improvements in cognitive function and neuromuscular coordination were observed. Following 2 weeks of treadmill training, treatment with the supplement dramatically increased running distance compared to that in untreated normal aged mice. Serum indices such as triglyceride and total cholesterol were significantly decreased in the supplement-treated aged mice compared to untreated aged mice. These results indicate that the combination supplement may play a role in maintaining cognitive function, coordination ability and improving lipid metabolism.

Examination of the proportion and characteristics of cognitive function changes during hospitalization in patients with cardiovascular diseases.

Cognitive function decline is influenced by cardiovascular diseases and associated risk factors. However, changes in the cognitive function of patients with cardiovascular diseases during hospitalization and the factors influencing these changes remain unclear. This study elucidated the proportion and characteristics of changes in cognitive function during hospitalization in patients with cardiovascular diseases. We conducted cognitive function assessments at admission and discharge for patients with cardiovascular diseases. Using the Mini-Mental State Examination (MMSE) and the Japanese version of the Montreal Cognitive Assessment (MoCA-J), we categorized the patients into cognitive impairment, mild cognitive impairment (MCI), and non-cognitive impairment. Changes in MMSE or MoCA-J scores of ≥2 points at discharge were classified as improvement or decline, and all others as maintenance. The cognitive impairment, MCI, and non-cognitive impairment categories comprised 215 (41.3%), 224 (40.2%), and 103 (18.5%) patients, respectively. The results of the cognitive function assessment at the time of discharge classified 90 patients (35.9%) into the maintenance group, 117 (46.6%) into the improvement group, and 44 (17.5%) into the decline group based on changes during hospitalization. There was a statistically significant difference among the three groups only in cognitive function at admission (P = 0.026). In multivariate analysis, those with MCI or cognitive impairment at admission and younger patients were associated with improved cognitive function during hospitalization. No factors were extracted that showed statistically significant associations with cognitive decline. Approximately half of the patients with cardiovascular disease experienced improvements in cognitive function during hospitalization, while approximately 20% showed a decline in cognitive function during the same period. These findings demonstrate the importance of assessing cognitive changes in hospitalized patients with cardiovascular disease. Future studies are needed to identify factors associated with changes in cognitive function.

Effect of altered gene expression in lipid metabolism on cognitive improvement in patients with Alzheimer's dementia following fecal microbiota transplantation: a preliminary study.

The brain-gut axis has emerged as a potential target in neurodegenerative diseases, including dementia, as individuals with dementia exhibit distinct gut microbiota compositions. Fecal microbiota transplantation (FMT), the transfer of fecal solution from a healthy donor to a patient, has shown promise in restoring homeostasis and cognitive enhancement. This study aimed to explore the effects of FMT on specific cognitive performance measures in Alzheimer's dementia (AD) patients and investigate the relationship between cognition and the gut microbiota by evaluating changes in gene expression following FMT. Five AD patients underwent FMT, and their cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB)] was assessed before and after FMT. The patients' fecal samples were analyzed with 16S rRNA to compare the composition of their gut microbiota. We also assessed modifications in the serum mRNA expression of patients' genes related to lipid metabolism using serum RNA sequencing and quantitative real-time polymerase chain reaction. Significant improvements in cognitive function, as measured by the MMSE (pre- and post-FMT was 13.00 and 18.00) and MoCA were seen. The MoCA scores at 3 months post-FMT (21.0) were the highest (12.0). The CDR-SOB scores at pre- and post-FMT were 10.00 and 5.50, respectively. Analysis of the gut microbiome composition revealed changes via 16S rRNA sequencing with an increase in Bacteroidaceae and a decrease in Enterococcaceae. Gene expression analysis identified alterations in lipid metabolism-related genes after FMT. These findings suggest a link between alterations in the gut microbiome, gene expression related to lipid metabolism, and cognitive function. The study highlights the importance of gut microbiota in cognitive function and provides insights into potential biomarkers for cognitive decline progression. FMT could complement existing therapies and show potential as a therapeutic intervention to mitigate cognitive decline in AD.

Immediate and long-term electrophysiological biomarkers of antidepressant-like behavioral effects after subanesthetic ketamine and medial prefrontal cortex deep brain stimulation treatment.

Both ketamine (KET) and medial prefrontal cortex (mPFC) deep brain stimulation (DBS) are emerging therapies for treatment-resistant depression, yet our understanding of their electrophysiological mechanisms and biomarkers is incomplete. This study investigates aperiodic and periodic spectral parameters, and the signal complexity measure sample entropy, within mPFC local field potentials (LFP) in a chronic corticosterone (CORT) depression model after ketamine and/or mPFC DBS. Male rats were intraperitoneally administered CORT or vehicle for 21 days. Over the last 7 days, animals receiving CORT were treated with mPFC DBS, KET, both, or neither; then tested across an array of behavioral tasks for 9 days. We found that the depression-like behavioral and weight effects of CORT correlated with a decrease in aperiodic-adjusted theta power (5-10 Hz) and an increase in sample entropy during the administration phase, and an increase in theta peak frequency and a decrease in the aperiodic exponent once the depression-like phenotype had been induced. The remission-like behavioral effects of ketamine alone correlated with a post-treatment increase in the offset and exponent, and decrease in sample entropy, both immediately and up to eight days post-treatment. The remission-like behavioral effects of mPFC DBS alone correlated with an immediate decrease in sample entropy, an immediate and sustained increase in low gamma (20-50 Hz) peak width and aperiodic offset, and sustained improvements in cognitive function. Failure to fully induce remission-like behavior in the combinatorial treatment group correlated with a failure to suppress an increase in sample entropy immediately after treatment. Our findings therefore support the potential of periodic theta parameters as biomarkers of depression-severity; and periodic low gamma parameters and cognitive measures as biomarkers of mPFC DBS treatment efficacy. They also support sample entropy and the aperiodic spectral parameters as potential cross-modal biomarkers of depression severity and the therapeutic efficacy of mPFC DBS and/or ketamine. Study of these biomarkers is important as objective measures of disease severity and predictive measures of therapeutic efficacy can be used to personalize care and promote the translatability of research across studies, modalities, and species.

Microstructural Changes in the Cerebral White Matter After 12 Months of CPAP Treatment for Moderate to Severe Obstructive Sleep Apnoea: A TBSS Study.

Continuous positive airway pressure (CPAP) therapy improves clinical symptoms in patients with obstructive sleep apnea (OSA); however, the mechanism of this clinical improvement and how it may be associated with the restoration of white matter (WM) structures in the brain is unclear. Therefore, this study investigated the relationship between the structural recovery of brain WM and improvements in cognitive function and emotion after long-term (12 months) CPAP treatment in patients with OSA. We collected data from 17 patients with OSA before and 12 months after CPAP treatment, including sleep monitoring, clinical assessment, and diffusion tensor imaging (DTI) magnetic resonance imaging. We observed a partial reversible recovery of brain WM (mean and radial diffusion coefficients) after treatment. This recovery involved the commissural fibers (cingulum, body of corpus callosum), projection fibers (retrolenticular part of the internal capsule, posterior thalamic radiation, posterior limb of the internal capsule, superior corona radiata, posterior corona radiata), association fibers (external capsule, superior longitudinal fasciculus, inferior longitudinal fasciculus), and other regions. In addition, the improvements in WM fibers in one part of the brain significantly were correlated with the Hamilton Anxiety Scale and Hamilton Depression Scale scores. Our results suggest that reversible recovery of reduced brain WM integrity due to OSA may require longer CPAP treatment. Moreover, changes in the integrity of the commissural fibers were associated with emotion regulation. These restored WM areas may explain the cognitive and mood improvements observed after OSA treatment.

Meta-analysis of randomized controlled trials of the effectiveness of Prospekta in the treatment of vascular cognitive impairment of varying severity

To conduct a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of Prospekta in the treatment of SCI of varying severity. The meta-analysis included the results of RCTs of the efficacy of Prospekta in the treatment of VCI, the severity of which was assessed using the Montreal Cognitive Scale (MoCA). The pooled effect estimate included all publications of double-blind, placebo-controlled RCTs that provided sufficient MoCA efficacy data to support further statistical analysis. The main result of the meta-analysis was obtained for the final values of the efficacy indicator in the groups of patients receiving the drug Prospekta, in comparison with the placebo group. A meta-analysis of the effectiveness of Prospekta in the treatment of SCI of varying severity was carried out based on data from 3 RCTs and 2 CTs involving 12.701 patients aged 18 years and older. When using the mixed models method, the effect size for the endpoint «change in total MoCA score from baseline to follow-up visit» was 3.4 points for Prospekta (2.7 points for placebo, p<0.0001); for the end point «∆ between changes in the total score on the MoCA scale while taking Prospekta and placebo» - 0.6736 points (p<0.0001). A statistically significant improvement in cognitive function according to the MoCA scale was demonstrated in patients with VCI using the drug Prospekta.

Trimetazidine attenuates neuroinflammation via TLR4/NF-KB pathway inhibition in lipopolysaccharides-induced dementia in rats

Neurodegenerative dementia impairs mental ability and short-term memory. This study investigated the effectiveness of trimetazidine (TMZ) in mitigating lipopolysaccharides-induced dementia in rats. Fifty male rats were randomly assigned into five groups; normal control, dementia, whereas other groups represented as dementia groups administered with 20, 40 mg/kg of TMZ, and 10 mg/kg of memantine, successively. Behavioral testing demonstrated a cognitive decline in dementia rats. Moreover, treatment with TMZ or memantine revealed a substantial decline in serum tau and phosphorylated tau with concurrent amelioration of serum Amyloid beta 1-42, neurogranin, 3-methoxy4-hydroxyphenyl glycol, APL1b25, APL1b27, and APL1b28 levels. Furthermore, such treatments yielded a significant down-expression of hippocampal toll-like receptor 4, NF-kB, cyclooxygenase-2, tumor necrosis factor-α, inducible nitric oxide synthase, caspase-3, and over-expression of Bcl-2 gene along with remarkable improvement in the hippocampal histoarchitecture as well as in the ionized calcium-binding adapter molecule 1 immunostaining compared the derangement in the dementia group. This study sheds light on TMZs neuroprotective effect on dementia pathophysiology by counteracting neuroinflammation. In conclusion, this study underscores the potential of TMZ in attenuating lipopolysaccharide-induced dementia in rats, offering significant cognitive and molecular benefits. The observed improvements in cognitive performance, serum markers, and hippocampal gene expression patterns collectively highlight TMZs neuroprotective capacity, suggesting its viability as a promising therapeutic intervention for addressing neurodegenerative dementia.

High-Frequency Repetitive Transcranial Magnetic Stimulation and Its Effects on Symptoms, Cognition and Subjective Experiences in Chronic Schizophrenia: A Sham-Controlled Study.

Our object is to examine the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on the symptoms, cognitive functions and subjective experiences in patients with chronic schizophrenia and to enhance the overall understanding of the TMS method. Thirty three patients who had chronic schizophrenia were included in the study. Seventeen patients received rTMS and 16 received sham. The Positive and Negative Syndrome Scale, Repeatable Battery for the Assessment of Neuropsychological Status Scale, Insight and Treatment Attitudes Questionnaire and a self-experience checklist developed by the researchers to evaluate post-TMS experiences were applied to all patients. There were no statistical differences between the groups with regard to symptoms, cognitive functions and insight. However rTMS group reported overall better treatment experience and more positive subjective experiences. rTMS treatment did not cause any improvement in symptoms, cognitive functions and insight but provided a better self-experience, which might improve treatment compliance.

Cognitive-motor exergame training on a labile surface in stroke inpatients: study protocol for a randomized controlled trial.

Cognitive-motor training in form of exergames has been found to be feasible and effective for the improvement of motor and cognitive functioning in older adults and several patient populations. Exergame training under unstable conditions might increase the proprioceptive resources needed and thus might be a superior training approach compared to exergame training on stable ground for stroke patients, who often have proprioceptive deficits. Aim of this study is to assess the feasibility and effects of exergame-based cognitive-motor training on a labile platform on physical and cognitive functioning in stroke inpatients. This is two-armed pilot randomized controlled trial taking place in an inpatient neurologic rehabilitation clinic. A total of 30 persons that are undergoing inpatient rehabilitation due to a stroke will be randomly assigned to either the intervention group (IG) or the control group (CG). Participants of the IG will receive exergame-based motor-cognitive training on a labile surface, whereas participants of the CG will train on a stable surface. Primary outcome is feasibility comprising measures of adherence, attrition, safety and usability. Secondary outcomes will be measures of cognitive (psychomotor speed, inhibition, selective attention, cognitive flexibility, brain activity) and motor (functional mobility, gait speed, balance, proprioception) functioning. Data collection started in February 2024 and is expected to be completed by August 2024. This is the first study looking into exergame training on labile surface in stroke patients. It will give valuable insights into the feasibility and potential added value of this type of training and thus inform further implementation efforts in the context of inpatient rehabilitation. ClinicalTrials.gov, NCT06296069.

Atrial Fibrillation Follow-up Investigation to Recover Memory and Learning Trial (AFFIRMING): Rationale and Design of a Multi-center, Double-blind, Randomized Controlled Trial

Background: People with atrial fibrillation (AF) have elevated risk of developing cognitive impairment. At present, there is a dearth of randomized controlled trials investigating cognitive impairment management in patients with AF. The Atrial Fibrillation Follow-up Investigation to Recover Memory and learning (AFFIRMING) study is aimed at evaluating the potential for computerized cognitive training to improve cognitive function in patients with AF. Methods: The study is a multi-center, double-blind, randomized controlled study using a 1:1 parallel design. A total of 200 patients with AF and mild cognitive decline without dementia are planned to be recruited. The intervention group will use the adaptive training software with changes in difficulty, whereas the positive control group will use basic training software with minimal or no variation in difficulty level. At the end of 12 weeks, the participants will be unblinded, and the positive control group will stop training. The intervention group will be rerandomized 1:1 to stop training or continue training. All participants will be followed up until 24 weeks. The primary endpoint is the proportion of the improvement of the global cognitive function at week 12 compared with baseline, using the Basic Cognitive Ability Test (BCAT).

Evaluating physical therapy interventions for pediatric developmental disorders: Enhancing motor skill

Objective: To evaluate the efficacy of specific physical therapy interventions, including Metaverse Physical Therapy, Nintendo Wii-integrated therapy, Whole-Body Vibration training, Segmental trunk and head control training, Ride-on car training, swimming programs, structured bimanual skill training, and running interventions in enhancing motor skills in children with pediatric developmental disorders. Methodology: A systematic review of randomized controlled trials (RCTs) and longitudinal studies published from 2013 to 2023 was conducted. Studies that compared the effects of innovative physical therapy interventions such as metaverse physical therapy, virtual reality-enhanced treatments, and Nintendo Wii-integrated therapy, and traditional physical therapies on children with developmental disorders were included. Primary outcomes assessed included improvements in motor skills, cognitive functions, and social interactions. Results: The review identified significant improvements in motor function across various interventions. Innovations like metaverse physical therapy and virtual reality-enhanced treatments showed additional benefits in engagement and motivation. While all interventions generally improved motor skills, those incorporating advanced technologies and integrative approaches also positively impacted cognitive and social development, although to varying degrees. Conclusion: Physical therapy, particularly when integrating new technologies and holistic approaches, is crucial for improving overall development in children with developmental disorders. The review highlights the need for personalized, multifaceted therapy plans that address not only physical but also cognitive and social needs to optimize outcomes.

Effects of Banhabaekchulcheonma-Tang on Brain Injury and Cognitive Function Impairment Caused by Bilateral Common Carotid Artery Stenosis in a Mouse Model.

Vascular dementia (VD) is the second most prevalent dementia type, with no drugs approved for its treatment. Here, the effects of Banhabaekchulcheonma-Tang (BBCT) on ischemic brain injury and cognitive function impairment were investigated in a bilateral carotid artery stenosis (BCAS) mouse model. Mice were divided into sham-operated, BCAS control, L-BBCT (40 ml/kg), and H-BBCT (80 ml/kg) groups. BBCT's effects were characterized using the Y-maze test, novel object recognition test (NORT), immunofluorescence staining, RNA sequencing, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Gene Ontology (GO) analyses. The NORT revealed cognitive function improvement in the H-BBCT group, while the Y-maze test revealed no significant difference among the four groups. The CD68+ microglia and GFAP+ astrocyte numbers were reduced in the H-BBCT group. Furthermore, H-BBCT treatment restored the dysregulation of gene expression caused by BCAS. The major BBCT targets were predicted to be cell division cycle protein 20 (CDC20), Epidermal growth factor (EGF), and tumor necrosis factor receptor-associated factor 1 (TRAF1). BBCT regulates the neuroactive ligand-receptor interaction and neuropeptide signaling pathways, as predicted by KEGG and GO analyses, respectively. BBCT significantly improved cognitive impairment in a BCAS mouse model by inhibiting microglial and astrocyte activation and regulating the expression of CDC20, EGF, TRAF1, and key proteins in the neuroactive ligand-receptor interaction and neuropeptide signaling pathways.