Montreal Cognitive Assessment Scale Scores Research Articles

Comparison of brain gray matter volume changes in peritoneal dialysis and hemodialysis patients with chronic kidney disease: a VBM study.

This study aims to compare gray matter volume changes in patients with chronic kidney disease (CKD) undergoing peritoneal dialysis (PD) and hemodialysis (HD) using voxel-based morphometry (VBM). A total of 27 PD patients, 25 HD patients, and 42 healthy controls were included. VBM analysis was performed, and cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment Scale (MoCA). The correlation between cognitive function and changes in brain gray matter volume was analyzed. Both peritoneal dialysis and hemodialysis patients had partial gray matter volume reduction compared to the controls, but the affected brain regions were not uniform. The hemodialysis patients had greater volume reduction in certain brain regions than the PD patients. The MMSE and MoCA scores were positively correlated with gray matter volume changes. Different dialysis modalities cause damage to specific areas of the brain, which can be detected using VBM. VBM, combined with cognitive function assessment, can help detect structural brain changes and cognitive impairment in patients with different dialysis modalities. The comprehensive application of VBM in the field of neurological function deserves further exploration.

Microstructural brain abnormalities and associated neurocognitive dysfunction in obstructive sleep apnea: a pilot study with diffusion kurtosis imaging.

To assess the possible brain abnormalities in adult patients with moderate and severe obstructive sleep apnea (OSA) using the mean kurtosis (MK) from diffusion kurtosis imaging (DKI) and analyze the correlation between MK and cognitive function. A total of 30 patients with moderate and severe OSA and 30 healthy controls (HCs) evaluated by the Montreal Cognitive Assessment (MoCA) scale were enrolled. All subjects underwent DKI and 3D T1-weighted imaging (T1WI) on a 3.0T MR scanner. The MK values of gray and white matter brain regions were compared. Partial correlation analysis was used to analyze the correlation between respiratory sleep parameters/cognitive score and MK values in different brain regions. Compared with the HCs, the MK of 20 brain regions (13 after false discovery rate (FDR) correction) and cognitive scores in the OSA group were significantly lower. In the OSA group, the apnea-hypopnea index (AHI) was negatively correlated with the MK in the white matter of the right occipital lobe; the LSpO2 was positively correlated with the MK in the bilateral parietal, precentral, and right postcentral cortex; the total score of MoCA scale was positively correlated with MK in the left hippocampus; the language function was positively correlated with MK in the white matter of left parietal lobe, and the delayed recall was positively correlated with the MK in right insula cortex and bilateral cingulate. After FDR correction, only the correlations of LSpO2 with right precentral gyrus cortex, and bilateral parietal cortex were significant. MK values of DKI imaging may provide valuable information in assessing the neurological impacts of obstructive sleep apnea.

GDNF and miRNA-29a as biomarkers in the first episode of psychosis: uncovering associations with psychosocial factors.

Schizophrenia involves complex interactions between biological and environmental factors, including childhood trauma, cognitive impairments, and premorbid adjustment. Predicting its severity and progression remains challenging. Biomarkers like glial cell line-derived neurotrophic factor (GDNF) and miRNA-29a may bridge biological and environmental aspects. The goal was to explore the connections between miRNAs and neural proteins and cognitive functioning, childhood trauma, and premorbid adjustment in the first episode of psychosis (FEP). This study included 19 FEP patients who underwent clinical evaluation with: the Childhood Trauma Questionnaire (CTQ), the Premorbid Adjustment Scale (PAS), the Positive and Negative Syndrome Scale (PANSS), and the Montreal Cognitive Assessment Scale (MoCA). Multiplex assays for plasma proteins were conducted with Luminex xMAP technology. Additionally, miRNA levels were quantitatively determined through RNA extraction, cDNA synthesis, and RT-qPCR on a 7500 Fast Real-Time PCR System. Among miRNAs, only miR-29a-3p exhibited a significant correlation with PAS-C scores (r = -0.513, p = 0.025) and cognitive improvement (r = -0.505, p = 0.033). Among the analyzed proteins, only GDNF showed correlations with MoCA scores at the baseline and after 3 months (r = 0.533, p = 0.0189 and r = 0.598, p = 0.007), cognitive improvement (r = 0.511, p = 0.025), and CTQ subtests. MIF concentrations correlated with the PAS-C subscale (r = -0.5670, p = 0.011). GDNF and miR-29a-3p are promising as biomarkers for understanding and addressing cognitive deficits in psychosis. This study links miRNA and MIF to premorbid adjustment and reveals GDNF's unique role in connection with childhood trauma.

Clinical markers of cognitive impairment in patients with chronic heart failure of ischemic origin during out-patient regular follow-up: a cross-sectional study

Background: Cognitive impairment (CI) is present in 25–50% of chronic heart failure (CHF) patients. Doctors who monitor patients with cardiovascular disorders do not have clearly set criteria for their referral to a neurologist in case of suspected CI. Therefore, CHF patients do not receive treatment for CI on time.
 Aim: To identify significant clinical markers of CI in patients with CHF of ischemic origin.
 Materials and methods: This cross-sectional cohort study included 134 patients with CHF of ischemic origin (mean age 63.36 ± 10.63 years; men, 76.12%), who were regularly monitored in a municipal polyclinic. All patients were tested for CI with the Montreal Cognitive Assessment Scale (MoCA); basic hemodynamic parameters, lipid profile, brain natriuretic peptide (NT-proBNP) were assessed, and triglyceride-glucose index (TyG) and body mass index (BMI) were calculated. Cardio-ankle vascular index (CAVI) was measured, echocardiography and a 6-minute walk test (SMWТ) were performed and past history of CHF, arterial hypertension (AH) and diabetes mellitus (DM) was collected.
 Results: CI (MoCA score ≤ 25) was detected in 85 (63.43%) outpatients with CHF of ischemic origin; the group without CI (MoCA score 26) included 49 (36.67%) patients. There were significant correlations between MoCA and CAVI scores (partial correlation coefficient, r = -0.802, p 0.001; adjusted squared multiple correlation coefficient (adj. R2) = 0.881, p 0.001), MoCA and TyG (r = -0.357, p = 0.029; adj. R2 = 0.363, p 0.001), MoCA and SMWТ (r = -0.211, p = 0.037; adj. R2 = 0.696, p 0.001). The multivariate test for significance of planned comparisons between CAVI and MoCA scores (Wilks' lambda) was 0.005 (F = 4.74; p 0.001).
 Conclusion: CAVI, TyG and SMWТ values are the clinical markers of CI in patients with CHF of ischemic origin. There is a direct association between increased CAVI and the presence of CI, regardless of age, lipid metabolism parameters, structural and functional heart parameters, CHF duration, AH and DM. Identification of these markers could be an indication for an in-depth assessment of CHF patients by a neurologist.

Safety and efficacy of acupuncture for mild cognitive impairment: a study protocol for clinical study.

Mild cognitive impairment (MCI) is an intermediary condition between typical cognitive decline that occurs owing to aging and dementia. It is necessary to implement an intervention to slow the progression from MCI to Alzheimer's disease. This manuscript reports the protocol for a clinical trial on the effect of acupuncture in patients with MCI. The trial will be a randomized, prospective, parallel-arm, active-controlled trial. Sixty-four patients with MCI will be randomized to the Rehacom or acupuncture group (n = 32 each). The participants in the acupuncture group will receive electroacupuncture at GV24 (Shenting) and GV20 (Baihui) and acupuncture at EX-HN1 (Sishencong) once (30 min) a day, twice per week for 12 weeks. The patients in the Rehacom group will receive computerized cognitive rehabilitation using RehaCom software once (30 min) daily, twice weekly for 12 weeks. The primary outcome measure is the change in the Montreal Cognitive Assessment Scale score. The secondary outcome measures are the Geriatric Depression Scale, Alzheimer's Disease Assessment Scale-Korean version-cognitive subscale-3 scores, and European Quality of Life Five Dimensions Five Level Scale. The safety outcomes will include the incidence of adverse events, blood pressure, blood chemistry parameters, and pulse rate. The efficacy outcome will be assessed at baseline and at six weeks, 13 weeks, and 24 weeks after baseline. The findings of this protocol will provide information regarding the effects of acupuncture on MCI. https://cris.nih.go.kr/cris/search/detailSearch.do?search_lang=E&focus=reset_12&search_page=M&pageSize=10&page=undefined&seq=25579&status=5&seq_group=25579, KCT0008861.

The Impact of Sleep Quality on Cognitive Function in Patients with Chronic Subjective Tinnitus.

The aim of this study was to explore the impact of sleep quality on cognitive function in patients with chronic subjective tinnitus. The Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment Scale (MoCA) were used to assess sleep quality and cognitive function in patients with chronic subjective tinnitus, sleep disorder patients (SD), and normal controls (NC). The tinnitus evaluation questionnaire (TEQ) and tinnitus loudness were used to assess the severity in patients with chronic subjective tinnitus. Tinnitus patients were divided into two groups based on PSQI results: "tinnitus with sleep disorder (TwSD)" and "tinnitus without sleep disorder (TnSD)." The MoCA scores in TwSD and TnSD groups were compared with those in SD and NC groups, and the correlation between PSQI, TEQ, tinnitus loudness, and MoCA scores in subjective tinnitus patients were analyzed. Whether TwSD group or TnSD group, the MoCA score was significantly lower than those in the NC group and SD group. Meanwhile, there was no significant difference between TwSD and TnSD groups in MoCA score, and PSQI, TEQ, and tinnitus loudness were not significantly correlated with MoCA. Subjective tinnitus may be an independent risk factor for cognitive impairment. The underlying neural mechanisms between subjective tinnitus, sleep disorders, and cognitive impairment need to be further explored and clarified.

Abstract 62: Effect of Ginkgo Diterpene Lactone Meglumine on Cognitive Function in Patients With Acute Ischemic Stroke

Objective: To investigate the effect of ginkgo diterpene lactone meglumine injection on cognitive function in patients with acute ischemic stroke. Methods: This was a randomized, double-blind, placebo parallel-controlled, multicenter clinical trial. Patients with acute ischemic stroke within 48 hours of onset were enrolled. Patients were divided ginkgo diterpene group and placebo control group receive a 14-day treatment, the ginkgo diterpene group was treated with ginkgo diterpene lactone glucamine, and the placebo control group was treated with mimic ginkgo diterpene lactone glucamine injection. The evaluation index was the change of Montreal Cognitive Assessment scale (MoCA) score of at Day 14 and Day 90. Results: A total of 3452 patients from 100 centers were randomized, of which 3163 patients with complete data on MoCA at baseline, day 14, and day 90 were included in analysis set, with 1588 patients received ginkgo diterpene lactone glucamine injection and 1575 patients received mimic ginkgo diterpene lactone glucamine injection. The MoCA scores of the two groups increased after treatment, the average change of MoCA scores at Day 14 and Day 90 in ginkgo diterpene group was 3.93[95% confidence interval (CI), 3.77-4.09] and 5.51 (5.34-5.69), respectively, which was significantly higher than that in the in the placebo control group ( P < 0.05). MoCA subentry analysis showed that the scores of visual space and execution and language in the ginkgo diterpene group were significantly higher than those in the placebo control group at Day 14, and the scores in visual space and execution, attention, language and abstract in the ginkgo diterpene group were significantly higher than those in the placebo control group at Day 90. Conclusions: Ginkgo biloba diterpene lactone meglumine can effectively improve the cognitive function of patients with acute ischemic stroke.

Retinal Nerve Fiber Layer Thickness in Patients with Schizophrenia and Its Relation with Cognitive Impairment.

Schizophrenia is a chronic severe mental illness with heterogeneous clinical presentation, course, and outcome. Cognitive impairment is one of its core features. Retinal nerve fiber layer (RNFL) imaging using OCT (optical coherence tomography) could provide easy access for in vivo imaging of the retina, rendering it as a "window to the brain." Studies done on schizophrenia have shown RNFL thinning. This study attempts to look into the association between cognitive impairment, disease duration, and RNFL abnormality in patients with schizophrenia using OCT. Patients diagnosed with schizophrenia meeting DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria and who were confirmed to be in remission for at least six months clinically and scoring less than three on PANSS-8 (positive and negative symptom scale-8) remission scale were included. They were administered the Montreal Cognitive Assessment Scale (MoCA) for cognitive assessment. RNFL measures were taken using spectral domain-OCT. Variables were compared using Pearson's correlation test, one-way ANOVA test, and independent t-test as appropriate. A total of 36 patients were studied. MoCA scores and RNFL thickness showed a positive correlation. Patients with schizophrenia had reduced average RNFL thickness and reduced RNFL thickness in superior, inferior, and temporal quadrants. Average RNFL thickness, Superior and inferior quadrant RNFL thickness showed a positive correlation with MoCA scores. No correlation was obtained between macular volume, macular thickness, duration of illness, and MoCA scores. Patients with schizophrenia have reduced average RNFL thickness. Patients with low MoCA scores have RNFL thinning.

Electroencephalographic power spectrum changes in cerebral small vessel disease combined with cognitive dysfunction and its relationship with neutrophil/lymphocyte ratio and its clinical value - a pilot study.

The study aimed to explore the changes in the electrical power spectrum of the brain and its correlation with neutrophil/lymphocyte ratio (NLR) in patients with cognitively impaired cerebral small vessel disease (CSVD) and to explore its clinical application. A total of 61 patients with CSVD who attended the People's Hospital of Shaanxi Province from September 2021 to September 2022 were divided into the group with cognitive impairment (cerebral small vascular with cognitive impairment, CSVCI group, n = 29) and the group without cognitive impairment (CSVD group, n = 32) based on the Montreal Cognitive Assessment Scale (MoCA) score, while 20 healthy subjects were recruited as the control group (healthy control, HC group). EEG was performed in the three groups, and the difference in whole brain quantitative EEG power spectral density (PSD) was calculated and compared between the three groups. The PSD values in the δ and θ bands of the CSVCI group were higher than those of the CSVD group, while the PSD values in the α band were lower than those of the CSVD and HC groups. In addition, PSD values in the δ-band in the CSVD group were lower than those in the HC group (all p < 0.05). Multifactorial logistic regression showed that reduced α-band global average PSD and low years of education were independent risk factors for cognitive impairment in patients with CSVD (p < 0.05). In patients with cerebral small-vessel disease, α-band PSD was positively and δ-band PSD negatively correlated with MoCA score, and paraventricular, deep white matter, and total Fazekas scores were negatively correlated with MoCA score. Furthermore, θ-band PSD is positively correlated with NLR (all p < 0.05). EEG activity was slowed down in patients with CSVD with cognitive impairment. The α-band global mean PSD values independently affected the occurrence of cognitive impairment in CSVD patients beyond the Fazekas score. NLR may be one of the mechanisms leading to the slowing down of the EEG, which can be used as an objective indicator for the early prediction of cognitive impairment but still needs to be clarified by further studies.

Obstructive Sleep Apnea Plasma-Derived Exosomes Mediate Cognitive Impairment Through Hippocampal Neuronal Cell Pyroptosis

ObjectiveObstructive sleep apnea (OSA) is associated with impaired cognitive function. Exosomes are secreted by most cells and play a role in OSA-associated cognitive impairment (CI). The aim of this study was to investigate whether OSA plasma-derived exosomes cause CI through hippocampal neuronal cell pyroptosis, and to identify exosomal miRNAs in OSA plasma-derived. Materials and MethodsPlasma-derived exosomes were isolated from patients with severe OSA and healthy comparisons. Daytime sleepiness and cognitive function were assessed using the Epworth Sleepiness Scale (ESS) and the Beijing version of the Montreal Cognitive Assessment Scale (MoCA). Exosomes were coincubated with mouse hippocampal neurons (HT22) cells to evaluate the effect of exosomes on pyroptosis and inflammation of HT22 cells. Meanwhile, exosomes were injected into C57BL/6 male mice via caudal vein, and then morris water maze was used to evaluate the spatial learning and memory ability of the mice, so as to observe the effects of exosomes on the cognitive function of the mice. Western blot and qRT-PCR were used to detect the expressions of Gasdermin D (GSDMD) and Caspase-1 to evaluate the pyroptosis level. The expression of IL-1β, IL-6, IL-18 and TNF-α was detected by qRT-PCR to assess the level of inflammation. Correlations of GSDMD and Caspase-1 expression with clinical parameters were evaluated using Spearman's rank correlation analysis. In addition, plasma exosome miRNAs profile was identified, followed by Gene Ontology (GO) term and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways. ResultsCompared to healthy comparisons, body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and ESS scores were increased in patients with severe OSA, while lowest oxygen saturation during sleep (LSaO2), mean oxygen saturation during sleep (MSaO2) and MoCA scores were decreased. Compared to the PBS group (NC) and the healthy comparison plasma-derived exosomes (NC-EXOS), the levels of GSDMD and Caspase-1 and IL-1β, IL-6, IL-18 and TNF-α were increased significantly in the severe OSA plasma-derived exosomes (OSA-EXOS) coincubated with HT22 cells. Compared to the NC and NC-EXOS groups, the learning and memory ability of mice injected with OSA-EXOS was decreased, and the expression of GSDMD and Caspase-1 in hippocampus were significantly increased, along with the levels of IL-1β, IL-6, IL-18 and TNF-α. Spearman correlation analysis found that clinical AHI in HCs and severe OSA patients was positively correlated with GSDMD and Caspase-1 in HT22 cells from NC-EXOS and OSA-EXOS groups, while negatively correlated with clinical MoCA. At the same time, clinical MoCA in HCs and severe OSA patients was negatively correlated with GSDMD and Caspase-1 in HT22 cells from NC-EXOS and OSA-EXOS groups. A unique exosomal miRNAs profile was identified in OSA-EXOS group compared to the NC-EXOS group, in which 28 miRNAs were regulated and several KEGG and GO pathways were identified. ConclusionsThe results of this study show a hypothesis that plasma-derived exosomes from severe OSA patients promote pyroptosis and increased expression of inflammatory factors in vivo and in vitro, and lead to impaired cognitive function in mice, suggesting that OSA-EXOS can mediate CI through pyroptosis of hippocampal neurons. In addition, exosome cargo from OSA-EXOS showed a unique miRNAs profile compared to NC-EXOS, suggesting that plasma exosome associated miRNAs may reflect the differential profile of OSA related diseases, such as CI.

A study on the treatment of Parkinson's disease and cognitive impairment with multiple system atrophy by intranasal injection of insulin

Parkinson's disease (PD) and multiple system atrophy (MSA) are both common neurodegenerative diseases. To investigate the effects of intranasal insulin injection on motor function and cognitive impairment in patients with Parkinson's disease (PD) and multiple system atrophy (MSA).Thirteen PD patients and one MSA patient participated in the experiment . Using a random number table method, the participants were assigned to an experimental group (n=8) and a control group (n=6). The experimental group received insulin injection, while the control group received physiological saline injection. Both groups received nasal injection for 4 consecutive weeks. Compare the general information, language fluency (FAS), Montreal Cognitive Assessment Scale (MoCA), Beck Depression Inventory (BDI), and Parkinson's Unified Rating Scale (UPDRS) results between the two groups. Compared to the control group, the experimental group had a significantly higher FAS score, but there was no significant difference in the FAS score before and after treatment in the experimental group, and the prognosis score improved compared to before. In the experimental group, a MSA patient showed improvement in FAS scores during the four week treatment period, with no significant progression of the disease. There was no significant improvement in UPDRS score, BDI score, and MoCA score before and after treatment, the difference was not significant statistically. The use of insulin therapy for cognitive and motor disorders related to PD is safe and feasible. Intranasal insulin may improve functional motor function and cognitive performance in Parkinson's disease.

A Study of Neurological Soft Signs and Cognition in Schizophrenia.

Neurological soft signs (NSS) are delicate neurological abnormalities that comprise deficits in motor coordination, problems with the sequencing of complex motor acts, and sensory integration difficulties. These are nonspecific with no specific localization in the brain. NSS are found in many patients with Schizophrenia. Cognitive dysfunctions are also present in more than two-thirds of patients with Schizophrenia. This study aims at assessing the NSS and its association with cognitive impairment in patients with Schizophrenia. A total of 100 Schizophrenia patients were included in the study. The Heidelberg scale was used for assessing the NSS. The Montreal Cognitive Assessment Scale(MoCA) for cognitive impairment, the Positive and Negative Syndrome Scale(PANSS) for Schizophrenia, and the Brief Psychiatric Rating Scale (BPRS) were used to assess the severity. Statistical analysis was performed by Pearson's Chi-square test, Kruskal-Wallis test, Wilcoxon rank testsand Spearman rank correlation along with mean and standard deviation. NSS were present in 68% (N=68) of the patients with motor coordination being maximally affected. Cognitive impairment was found in 73% (N=73) of patients with a MoCA score <26. Patients with predominant negative symptoms had higher NSS scores and lower MoCA scores. A "statistically significant" correlation was observed between cognitive impairment and NSS. Most patients with NSS and impaired cognition were in the "markedly ill" category of BPRS. A significant association was observed between cognitive deficits, negative symptoms, and NSS in Schizophrenia.NSS and cognitive dysfunctions are integral parts of Schizophrenia symptomdomains and need to be assessed as the negative symptoms and severity of illness are associated with NSS, especially problems with motor coordination and cognitive dysfunctions.

Differentially Expressed miR-511-3p in Stroke Patients Predicts the Presence of Post-Stroke Cognitive Impairment.

Stroke is common cerebrovascular disease in the elderly, which is characterized by neurological defects caused by cerebral vessels. Multiple studies have shown that miRNAs play important roles in stroke. In addition, a large number of evidence suggest that stroke increases the risk and severity of cognitive impairments. miR-511-3p expression levels were detected by real-time PCR. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of miR-511-3p in distinguishing stroke patients from healthy controls and to assess risk of post-stroke cognitive impairment (PSCI) in stroke patients. Pearson correlation coefficient was used to determine the relationship between miR-511-3p expression level and Montreal Cognitive Assessment Scale (MoCA) scores. Serum miR-511-3p expression levels were decreased in stroke patients, and the decrease was more significant in PSCI patients. ROC curve results showed that miR-511-3p had high diagnostic accuracy in distinguishing healthy controls from stroke patients. Moreover, the expression level of miR-511-3p can be used as an independent predictor for the occurrence of PSCI and is positively correlated with MoCA scores of PSCI patients. miR-511-3p may be involved in the occurrence and development of stroke. In addition, miR-511-3p may be a novel biomarker for predicting PSCI occurred in stroke patients. These results may help improve the quality of prognosis of stroke.

Clinical application of multidisciplinary team- and evidence-based practice project in gynecological patients with perioperative hypothermia

BACKGROUND Perioperative hypothermia (PH) negatively affects the physical and mental health of patients to varying degrees. Currently, there is no effective multidisciplinary team (MDT) intervention for gynecological patients with PH. AIM To apply the best evidence on the prevention and management of PH in gynecological patients, improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT- and evidence-based practice (EBP) projects on the psychological status and cognitive function of gynecological patients with PH. METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts, the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting. Based on the evidence, the practice plan was developed, and the MDT intervention was carried out in the preoperative ward, the preoperative preparation room, the intraoperative operating room, the postanesthesia care unit, and the 24-hour postoperative gynecological ward through the EBP program. The incidence of hypothermia, the nurses’ awareness, the implementation rate of examination indicators, and the thermal comfort level, psychological status and cognitive function of patients were compared before and after the implementation of the program. RESULTS The incidence of PH in gynecological patients decreased from 43.33% to 13.33% after the implementation of the scheme. The implementation rate of examination indicators 6-10, 12, 14, 16-18, 21, and 22 reached 100%, and that of other indicators was above 90%, except for examination indicators 5 and 13, which was 66.67%; the indices were significantly improved compared with the baseline (before evidence application) (P &lt; 0.05). The score of nurses' awareness of PH prevention and management in gynecological patients increased from 60.96 ± 9.70 to 88.08 ± 8.96, and the difference was statistically significant (P &lt; 0.001). The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97 ± 2.04, which was significantly increased compared with the score of 21.27 ± 1.57 observed by researchers at baseline (P &lt; 0.001). The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03 ± 3.16 and 13.93 ± 2.64 to 4.30 ± 1.15 and 3.53 ± 0.78, respectively, with statistically significant differences (P &lt; 0.001). The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17 ± 1.68 to 26.93 ± 1.11, also with statistical significance (P &lt; 0.001). CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations, improve nurses' awareness and behavioral compliance with gynecological hypothermia management, and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’ negative emotions and enhancing their cognitive function.

Usefulness of Serum Translocator Protein as a Potential Predictive Biochemical Marker of Three-Month Cognitive Impairment After Acute Intracerebral Hemorrhage: A Prospective Observational Cohort Study.

Translocator protein (TSPO) is a biomarker of neuroinflammation and brain injury. This study aimed to ascertain the potential of serum TSPO as a predictor of cognitive impairment after acute intracerebral hemorrhage (ICH). In this prospective observational cohort study, 276 patients with supratentorial ICH were randomly assigned to two groups (184 patients in the study group and 92 in the validation group) in a 2:1 ratio. Serum TSPO levels were gauged at admission, and cognitive status was assessed using the Montreal Cognitive Assessment Scale (MoCA) post-stroke 3 months. A MoCA score of < 26 was considered indicative of cognitive impairment. Serum TSPO levels were inversely correlated with MoCA scores (ρ=-0.592; P<0.001). Multivariate linear regression analysis showed that serum TSPO levels were independently associated with MoCA scores (β, -0.934; 95% confidence interval (CI), -1.412--0.455; VIF, 1.473; P<0.001). Serum TSPO levels were substantially higher in patients with cognitive impairment than in the remaining patients (median, 2.7 versus 1.6 ng/mL; P<0.001). Serum TSPO levels were linearly correlated with the risk of cognitive impairment under a restricted cubic spline (P=0.325) and independently predicted cognitive impairment (odds ratio, 1.589; 95% CI, 1.139-2.216; P=0.016). Subgroup analysis showed that the relationship between serum TSPO levels and cognitive impairment was not markedly influenced by other parameters, such as age, sex, drinking, smoking, hypertension, diabetes mellitus, body mass index, and dyslipidemia (all P for interaction > 0.05). The model, which contained serum TSPO, National Institutes of Health Stroke Scale scores and hematoma volume, performed well under the receiver operating characteristic curve, calibration curve and decision curve, and using the Hosmer-Lemeshow test. This model was validated in the validation group. Serum TSPO level upon admission after ICH was independently associated with cognitive impairment, substantializing serum TSPO as a reliable predictor of post-ICH cognitive impairment.

Preliminary MRS study of critical values of relevant brain metabolites in elderly Chinese patients with post-stroke cognitive impairment

ObjectiveProton magnetic resonance spectroscopy (1H-MRS) was applied in this study to detect metabolite changes in the brain of post-stroke cognitive impairment (PSCI) and normal volunteers. The levels of N-acetylaspartate (NAA) and creatinine (Cr) and in the frontal lobe, hippocampus and cingulate gyrus were measured to distinguish patients with post-stroke cognitive impairment (PSCI) and normal control group (NC). The relationship between them and cognitive function was explored and a critical value of the metabolite ratio was predicted. This study may serve as a reference for the diagnosis of cognitive dysfunction after stroke. MethodsA total of 46 patients with PSCI (PSCI group, all patients are unilateral cerebral infarction or intracerebral haemorrhage) were screened by the Mini-Mental Status Examination (MMSE), and 35 healthy volunteers were selected as normal control group (NC group). The general information of gender, age, and education level was matched between the two groups. Two groups of subjects were examined using MRS and evaluated for cognitive function using the MMSE test and the Montreal Cognitive Assessment Scale (MoCA). The correlation between MRS and neurobehavioral scale (MMSE test and MoCA scale) was analysed, and the possible demarcation points of the brain metabolism of PSCI were evaluated. ResultThe MMSE and MoCA scores of patients with PSCI were lower significantly when compared with those of the NC group (P < 0.05). The NAA/Cr values of the bilateral hippocampus, bilateral frontal lobe and bilateral anterior and posterior cingulate gyrus in the PSCI group were lower than those in the NC group (P < 0.05). The NAA/Cr cut-off value for the right frontal lobe was 1.533, and the NAA/Cr sensitivity, specificity and Youden index for the right frontal lobe were 0.943, 0.935, and 0.878. ConclusionNAA/Cr values in the MRS bilateral frontal, bilateral hippocampus and bilateral anterior and posterior cingulate gyrus were reduced in the cognitively impaired post-stroke patients compared to the normal control group. MRS was also found to be correlated with the score of neurobehavioral scale (MMSE test and MoCA scale) and the combination of the two could evaluate cognitive dysfunction more comprehensively and objectively. NAA/Cr value of the right frontal lobe < 1.533 indicated that PSCI may occur. In accordance with this cut-off point, PSCI could be detected as early as possible and timely intervention could be carried out.

Cognitive impairment among an Egyptian sample of patients with schizophrenia and bipolar disorders: a comparative study

BackgroundThe cognitive profile among patients with schizophrenia (SZ) and bipolar disorder (BD) has varied widely across different studies. The aim of the current study was to compare different cognitive domains using psychometric and neurophysiological tests in patients with SZ to those with BD. A case–control study was conducted on 30 BD, 30 SZ and 30 age and sex matched control group. Each subject was submitted to the following: Wechsler Adult Intelligence Scale-3rd edition (WAIS-III), Montreal cognitive assessment scale (MoCA), Brief Visuospatial Memory Test-Revised (BVMT-R), Memory Assessment Scales (MAS), and the P300 event related potential (ERP).ResultsSZ and BD patients had significantly lower total and subscales of WAIS-III scores than the control group. SZ patients had significantly higher deterioration index (DI) than controls, while absence of such significant between BD and controls. SZ patients reported significantly lower MoCA scores and subitems, especially in visuospatial, naming, attention, delayed recall, and orientation subtests than controls. Only visuospatial and delayed recall scores were significantly decreased in BD than controls. SZ patients performed poorer on BVMT-R subscales than the control group. Both SZ and BD groups had lower mean values of all subscales except verbal assessment in the four memory tests. P300 latencies and amplitude had no significant difference among the three groups, although the BD group had a shorter P300 latency.ConclusionPatients with SZ and BD had significantly lower scores on various cognitive function domains in comparison to controls with more affection in SZ. The frequency of mood episodes, disease duration, and education level must be considered.

The Relationship of Cognitive Dysfunction with Inflammatory Markers and Carotid Intima Media Thickness in Schizophrenia.

Schizophrenia is a devastating and chronic mental disorder that affects 1% of the population worldwide. It is also associated with cognitive dysfunction and cardiovascular risk factors. The aim of this study is to investigate the relationship between cognitive impairment and some inflammatory markers and carotid intima-media thickness (CIMT) in schizophrenia. The participants of this study were 51 schizophrenia and 57 healthy controls (HC). The Positive and Negative Syndrome Scale (PANSS) was used for severity of illness, and the Montreal Cognitive Assessment Scale (MoCA) was used for cognitive functioning. The MoCA scores, some biochemical and inflammatory markers, and CIMT were compared between schizophrenia and HC groups. Of the patients with schizophrenia, 11 were women (21.6%), and 40 were men (78.4%). MoCA scores were lower, and levels of NLR, MLR, PLR, SII, CRP, ESR, and CIMT were higher in schizophrenia compared to the HC group (respectively; p < 0.001, p < 0.001, p = 0.035, p = 0.008, p = 0.002, p < 0.001, p < 0.001, p < 0.001). In the schizophrenia group, there was no correlation between MoCA and inflammatory markers. MoCA and CIMT had a significant negative and moderate correlation (p < 0.001). This is the first study to show the relationship between cognitive impairment and CIMT in schizophrenia. In this study, NLR, MLR, PLR, SII, CRP, and ESR markers were higher in schizophrenia compared to HC, indicating inflammation. Our finding of elevated CIMT in schizophrenia suggests that there may be an atherosclerotic process along with the inflammatory process. The finding of a positive correlation between cognitive impairment and CIMT may be promising for new therapies targeting the atherosclerotic process in the treatment of cognitive impairment.

Aerobic exercise combined with memory strategy training improve the cognitive function.

Type 2 diabetes mellitus (T2DM) is closely associated with the occurrence of cognitive impairment, imposing a heavy burden on the patient's family and society. Aerobic exercise and targeted memory strategies have been widely reported to improve cognitive function. A total of 122 T2DM patients with Montreal Cognitive Assessment Scale (MoCA) test scores of less than 26 received the aerobic exercise combined with memory strategy training. After 6 months of intervention, a final group of 113 patients entered the final evaluation and analysis. Diabetes-specific quality of life scale (DSQL) and activities of daily living (ADL) assessments were performed to evaluate the life quality of the patients. The scores of MoCA and ADL were significantly upregulated, and the scores of DSQL were significantly reduced after the 6-month intervention of T2DM patients. The levels of fasting plasma glucose (FPG), hemoglobin A1c, total cholesterol (TC), and triglyceride (TG) levels of T2DM patients with cognitive impairment significantly decreased post intervention. A significant decrease in low density lipoprotein cholesterol (LDL-C) and an increase in high density lipoprotein cholesterol (HDL-C) were observed. The FPG, HbA1, TC, TG, and LDL-C levels were significantly lower, and the HDL-C levels were significantly higher in patients with normal cognitive function than in patients with abnormal cognitive function. Aerobic exercise combined with memory strategy training effectively improved the memory and cognitive function in patients with T2DM.

Effects of surgical treatment modalities on postoperative cognitive function and delirium in elderly patients with extremely unstable hip fractures.

As the perioperative risk of elderly patients with extremely unstable hip fractures (EUHFs) is relatively high and therapeutic effect is not satisfactory, new thera-peutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients. To determine the influence of two surgical treatment modalities on postoperative cognitive function (CF) and delirium in elderly patients with EUHFs. A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included. Of them, 30 patients received conventional treatment (control group; general consultation + fracture type-guided internal fixation), and the other 30 received novel treatment (research group; perioperative multidisciplinary treatment diagnosis and treatment + individualized surgical plan + risk prediction). Information on hip function [Harris hip score (HHS)], perioperative risk of orthopedic surgery [Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM)], CF [Montreal cognitive assessment scale (MoCA)], postoperative delirium [mini-cognitive (Mini-Cog)], adverse events (AEs; internal fixation failure, infection, nonunion, malunion, and postoperative delirium), and clinical indicators [operation time (OT), postoperative hospital length of stay (HLOS), ambulation time, and intraoperative blood loss (IBL)] were collected from both groups for comparative analyses. The HHS scores were similar between both groups. The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group, and MoCA and Mini-Cog scores were statistically higher. In addition, the overall postoperative complication rate was significantly lower in the research than in the control group, including reduced OT, postoperative HLOS, ambulation time, and IBL. The new treatment modality has more clinical advantages over the conventional treatment, such as less IBL, faster functional recovery, more effectively optimized perioperative quality control, improved postoperative CF, mitigated postoperative delirium, and reduced operation-related AEs.