Association between executive dysfunction and mild to severe upper extremity deficits in stroke survivors: A resting state functional near-infrared spectroscopy study.

Pharmacogenomic testing may optimize antidepressant treatment in depression. Its effects on cognition and across age groups remain unclear. A total of 843 patients with depressive disorder were stratified by age (adolescent, young adult, middle-aged, elderly) and assigned to pharmacogenomic-guided or treatment-as-usual groups. Guided treatment was based on pharmacogenomic results. Primary outcomes were changes in Montreal Cognitive Assessment (MoCA), remission (HDRS<8), and response (≥50% HDRS reduction) at weeks 4, 8, and 12. MoCA improvement inversely correlated with age (week 8: r=-0.078, P=0.036; week 12: r=-0.076, P=0.041). Pharmacogenomic guidance was associated with greater cognitive gains in younger participants, with sustained improvement in adolescents (all P≤0.036), improvement in young adults at weeks 8 and 12 (both P≤0.013), and transient benefit in middle-aged patients at week8 (P=0.048). No cognitive benefit was observed in the elderly. Multi-way ANOVA for depressive symptoms (HDRS) revealed a Group×Time interaction (P<0.001), and for cognitive function (MoCA) showed both a Group×Time interaction (P=0.011) and an Age×Time interaction (P=0.024), consistent with age-dependent recovery trajectories. Pharmacogenomic guidance was associated with increased remission and response rates from week 8 through week 12 across all ages. single blinded; single-center design. Pharmacogenomic-guided treatment consistently improves depressive symptom remission but shows age-dependent cognitive effects: sustained in youth, transient in middle age, absent in elderly. Age is a key modifier of cognitive benefit, supporting prioritized use in younger patients, while elderly individuals may require integrated interventions beyond pharmacogenomics.

Dysphagia, cognitive function, amd dysphagia-related quality of life among oral cancer patients: A cross-sectional survey.

Impact of resistance training repetition ranges on cognitive function and mental health in older women: A randomized controlled clinical trial.

Association of frailty with cognitive functioning in older adults: The Chain-mediated effects of sleep and mood regulation and the moderating role of activities of daily living.

Introduction: Transcranial Direct Current Stimulation (tDCS) is a technique used to regulate neural activity by applying a lowlevel electrical current to specific brain regions. It modulates neuronal excitability and activity without directly inducing action potentials. The effects of tDCS are dependent on the type of current used, with anodal stimulation generally increasing and cathodal stimulation decreasing the excitability of brain cells. Aim: To determine the efficacy of tDCS in improving the dualtask cognitive function. Materials and Methods: This randomised clinical trial was conducted in the Maharishi Markandeswar Institute of Physiotherapy and Rehabilitation, Mullana, Ambala, Haryana, India, a tertiary health care centre, from August 2022 to April 2023. This study was conducted with 32 participants, dividing them into four groups, each receiving a different level of tDCS intensity (0.5 mA for Group A, 1.0 mA for Group B, 1.5 mA for Group C, and 2.0 mA for Group D). The stimulation was applied to the F3 region (active site) and F4 region (control site) of the frontal cortex, following the 10-20 Electroencephalography (EEG) system. Each session lasted 20 minutes and took place three times a week over a period of three weeks. Throughout the study, participants performed dual-task cognitive exercises, and their cognitive function was assessed both before and after the intervention using the Montreal Cognitive Assessment (MoCA) and Trail Making Test (TMT). Finally, data analysis was performed using Statistical Package for Social Sciences (SPSS) 26.0 software. For datasets satisfying the assumptions of parametric testing, a paired t-test was utilised for within-group comparisons, while an One-way Analysis of Variance (ANOVA) test was used to evaluate group variations. Results: It was assessed whether the demographic data and outcome measures followed a normal distribution, using the Shapiro-Wilk test. The analysis showed no statistically significant between-group dfferences in cognitive performance among healthy participants groups exposed to varying intensities of t-DCS. Although slight fluctuations were observed in the mean MoCA and TMT-A and TMT-B scores across different groups, the p-values remained above the standard level of significance (p-value&gt;0.05). This suggests that the different intensities of t-DCS did not produce a statistically significant effect on cognitive function. Conclusion: The present study found no significant differences in cognitive performance across the various tDCS intensity levels, suggesting that the tested parameters may not have a substantial impact on cognitive function in healthy individuals.

The effect of dance intervention on cognitive functions and quality of life in patients with Chronic Stroke: A single-blind, randomized controlled trial.

Comparison of the effects of aerobic exercise and computer-based cognitive stimulation in patients with schizophrenia - A randomized controlled trial.

Early Alzheimer's disease (AD) treatments include donepezil, memantine and sodium oligomannate, but their comparative effects on cognitive decline and neuroinflammation are understudied. This study compares three drugs' validity in improving two aspects in early AD patients. 132 early AD patients from XX Hospital (Jan 2022-Dec 2024) were retrospectively included. After exclusion, 126 patients were divided into 3 groups (42 each): Group A (donepezil), Group B (memantine), Group C (sodium oligomannate). Cognitive function was assessed using the Mini-Mental State Examination (MMSE), the Alzheimer's Disease Assessment Scale--Cognitive Subscale (ADAS-cog), the Activity of Daily Living Scale (ADL), the Montreal Cognitive Assessment Scale (MoCA), levels of inflammatory mediators, including Tumour Necrosis Factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8 (IL-8), neuronal marker levels including β-Amyloid (1-42) (Aβ42), Total tau protein (T-tau protein) and adverse reaction incidence. After treatment, compared with Group A, Groups B/C had significantly higher MMSE, ADL, MoCA, Aβ42 (all P<0.05) and lower ADAS-cog, TNF-α, IL-6, IL-8, T-tau (all P<0.05); compared with Group B, Group C had no significant difference in MMSE, ADAS-cog, ADL, MoCA (all P>0.05), but higher Aβ42 and lower TNF-α, IL-6, IL-8, T-tau (all P<0.05); adverse reaction incidence did not differ significantly among the three groups (P>0.05). Memantine and sodium oligomannate outperform donepezil in improving cognitive function and neuroinflammation, with sodium oligomannate suggesting the best effect on neuroinflammation. This study provides a scientific basis for optimizing early AD medication.

Predicting cognitive decline: Comparative analysis of ANU-ADRI, CAIDE, CogDrisk, LIBRA, LIBRA2, UKBDRS and Lancet based dementia risk scores in the HUNT study.

A monogenic, age-related cerebral small vessel disease (cSVD), retinal vasculopathy with cerebral leukoencephalopathy and systemic manifestations (RVCL-S), causes accelerated vascular dementia, vision loss, and premature death. Given knowledge is limited regarding its pathophysiology, we examined the natural history of progression in imaging and cognitive endpoints to define the rate and variability of progression in a prospective RVCL-S cohort. We hypothesized that cerebral blood flow (CBF) and oxygen extraction fraction (OEF), as metrics of cerebral hypoxia-ischemia, would be associated with neurologic disease progression. We performed sequential brain MRI and a cognitive battery in a prospective RVCL-S cohort. Arterial spin labeling and asymmetric spin echo quantified CBF and OEF in normal-appearing white matter (WM), respectively. Three neuroimaging endpoints of cSVD included the following: log-transformed, normalized fluid-attenuated inversion recovery WM hyperintensity (WMH) volume; WM microstructure using mean diffusivity; and normalized WM volume. Five cognitive and motor endpoints included Digit Symbol Substitution Test (DSST), category fluency, free recall, Montreal Cognitive Assessment (MoCA), and gait speed. Linear mixed-effects models examined age, CBF, and OEF in association with neuroimaging and cognitive progression. Twenty-five participants, aged 23-68 years (median 47 years, 56% female), underwent 151 scans over a median (25th, 75th) of 2.2 (1.8, 4.4) years. All neuroimaging and cognitive endpoints progressed over time, except for MoCA. Of neuroimaging endpoints, WMH volume demonstrated the largest rate of change (+31.3%/year, 95% CI 20.8%-42.3%). Of cognitive endpoints, DSST, a metric of processing speed, showed the steepest decline (-13.1 T-score points/decade, 95% CI -21.2 to -5.32), followed by free recall and category fluency (-5 [-7.9 to -2.4] and -4.1 [-7.2 to -1.2] T-score points per decade, respectively). The age at first brain lesion was estimated to be 30.6 (23.8, 35.8) years, modeled from individual WMH volume trajectories. In multivariable analysis, OEF, but not CBF, was independently associated with WMH growth (β = 3.73, 95% CI 0.63-6.83, p = 0.029) and change in WM microstructure (β = 0.175, 95% CI 0.029-0.32, p = 0.029). Neither OEF nor CBF was independently associated with cognitive decline. Elevated OEF in at-risk WM was associated with progression in WMH and impairment in WM microstructure, suggesting a role for tissue hypoxia-ischemia in underlying RVCL-S pathophysiology. Cerebral OEF holds promise as a predictive biomarker to risk-stratify patients with RVCL-S and other forms of cSVD.

Bipolar I disorder is frequently accompanied by persistent cognitive dysfunction, but the extent to which routine pharmacological treatment influences subjective and objective cognition remains unclear. We sought to examine short-term changes in cognitive functioning among euthymic bipolar I disorder patients receiving routine pharmacotherapy. In this prospective observational study, adults with bipolar I disorder in euthymia (Young Mania Rating Scale ≤10; Hamilton Depression Rating Scale ≤7) underwent cognitive assessment using the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and the Montreal Cognitive Assessment (MoCA) at baseline and again after 3 to 4 months. Medication regimens, dose stability, adherence, and clinical variables were recorded. Paired tests evaluated within-subject cognitive change; categorical shifts were examined using the McNemar test. Limitations related to study design were explicitly evaluated. Fifty-one participants were enrolled (median age 39years), and 50 completed follow-up. COBRA scores improved from 7.48±7.13 to 4.04±5.94 (mean change -3.44; P<0.001), and MoCA scores increased from 23.90±4.89 to 25.84±4.40 (mean change +1.94; P<0.001). The proportion with normal cognition increased from 42% to 78% on MoCA, while COBRA-defined impairment decreased from 20% to 6%. Improvements were observed across medication classes, and no regimen demonstrated consistent superiority. Routine pharmacological treatment was associated with short-term cognitive improvement, but the findings are preliminary and not causal.

BackgroundPredicting cognitive function across dementia stages remains challenging. Plasma biomarkers and electroencephalogram (EEG) features may provide complementary information, but their combined predictive value requires further study.ObjectiveTo evaluate the feasibility of integrating plasma biomarkers and EEG features to predict cognitive function in dementia and examine their correlations.MethodsFrom September 2023 to October 2024, 75 patients from two medical centers with mild cognitive impairment, mild dementia, or moderate dementia were enrolled. Resting-state 19-channel EEG data yielded 2737 time-frequency and connectivity features. Plasma biomarkers included tau, p-Tau181, Aβ1-42, neurofilament light chain (NfL), brain-derived neurotrophic factor, apolipoprotein E genotype, and glial fibrillary acidic protein. Cognitive function was assessed using Cognitive Abilities Screening Instrument (CASI), Mini-Mental State Examination, Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating Sum of Boxes. Machine learning models were developed using plasma-only, EEG-only, and hybrid approaches.ResultsNfL was negatively correlated with CASI (t = -2.059, p < 0.05). Several EEG features showed moderate correlations with cognitive measures and plasma biomarkers, with delta-band relative power between left frontal and temporal regions (F7-FT7) showing the strongest correlation with MoCA. The hybrid model achieved the best performance, with R2 > 0.74 across all cognitive measures, outperforming plasma-only and EEG-only models.ConclusionsIntegrating EEG features with plasma biomarkers improves prediction of cognitive function from mild cognitive impairment to moderate dementia, pending external validation.

Postoperative cognitive dysfunction (POCD) is a common disorder following surgery. The mechanisms underlying are still under exploration. We hypothesize that hormonal changes in patients undergone pituitary surgery contribute to the pathogenesis of POCD. In a 12-month follow-up study, a total of 103 patients with pituitary adenoma and received pituitary surgery were included. Patients were categorized into three groups based on their postoperative hormonal supplement: stable; sufficient; and insufficient, to eliminate the effects of surgery and hormone dosage. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were employed as evaluation tools to assess the degree of cognitive impairment. The MoCA score in stable group showed no significant decrease, while in sufficient and insufficient groups, the score began to decrease from the 6th month compared to 0 month of each group. Compared to the stable group at the same time point, the MoCA scores in both groups decreased at 6th month and 12th month. A similar trend was observed on MMSE score. Cognitive impairment (MCI and dementia) in both sufficient group and insufficient group increased significantly by the 3rd month after surgery, but the rate of increase was much slower subsequently in sufficient group than in insufficient group. Our study confirms that POCD is highly prevalent in patients after pituitary tumor surgery. Postoperative hormone deficiency plays a crucial role in the progression of POCD, especially ACTH and the glucocorticoids it affects. It is worth mentioning that, a novel aspect of our study is the identification of hormonal rhythms disturbance as a potential contributor to POCD, which provide valuable insights into the mechanisms of POCD in pituitary surgery. We call for more personalized and chronobiological hormone replacement therapy approaches.

Cognitive impairments are common among patients suffering from brain tumors. Up to date, however, it is rarely assessed in clinical routine. This study aimed to evaluate pre- and postoperative neurocognitive performance in a wide range of patients suffering from gliomas representing clinical routine by using a test battery of easy-to-use and established neurocognitive tests. Patients undergoing microsurgical glioma resection between 04/2019 and 03/2021 were prospectively included. A structured test set for neurocognitive function was performed preoperatively in 33 patients and during follow-up in 14 patients. Data were converted into z-scores and combined with the corresponding cognitive domains. Thirty-three patients aged 49.2 ± 14.4 (22-81) years were included. The individual tests showed impairments preoperatively most frequently in the trail-making test B (TMT-B) in 63.6% of patients, followed by the Montreal Cognitive Assessment (MoCA) with 39.4%. Preoperatively, a clinically significant impairment was found in the domain of executive function and attention, with a mean domain score of -2.49. At follow-up, the group domain scores were impaired on the same cognitive domains as preoperatively, with executive function and attention significantly impaired (z = -2.58). Neurocognitive deficits are present in the majority of patients with glioma before surgery while still performing well in conventional scores regarding functional status. We did not observe any significant surgery-related deterioration in cognitive performance; however, this finding is compromised by a considerable number of patients lost to follow-up.

BackgroundMultiple sclerosis (MS) is a chronic disease with an unpredictable clinical course, presenting both recurrent relapses and progressive worsening over time. People living with MS (pwMS) are impacted physically, psychologically, and socially. Illness perception refers to a person's cognitive and emotional representations of their disease, which can impact their psychophysical well-being and treatment adherence.ObjectiveTo assess the illness perception of pwMS and determine how it is impacted by cognitive dysfunction and fatigue.MethodsIn this cross-sectional pilot survey study, the Brief Illness Perception Questionnaire (B-IPQ), Montreal Cognitive Assessment (MoCA-BR), Modified Fatigue Impact Scale (MFIS-BR), and Multiple Sclerosis Quality of Life Questionnaire (MSQOL-54) were used. Demographic and clinical data, as well as the Expanded Disability Status Scale (EDSS), were collected.ResultsA total of 30 RRMS patients (66.7% of female subjects, with a mean age of 36.8 ± 1.8 years) were enrolled. The mean score on the B-IPQ scale was of 30.2 ± 8.9 points, with 40% presenting a threat perception of the disease. No significant correlation was observed between cognitive performance and illness perception (r = −0.058;p = 0.761). However, significant correlations were found between illness perception and all fatigue domains (total: r = 0.578;p = 0.001; physical: r = 0.594;p = 0.001; psychosocial: r = 0.672;p < 0.001), except the cognitive domain (r = 0.360;p = 0.051). The EDSS and MSQOL-54 scores also demonstrate significant correlations with illness perception (EDSS = 2.30;p = 0.034; MSQOL-54 physical: r = −0.776;p < 0.001; MSQOL-54 mental: r = −0.704;p < 0.001).ConclusionIllness perception in MS is influenced by patients' fatigue, quality of life, and disability levels, but it does not appear to be affected by cognition.

Cerebral small vessel disease (CSVD) represents a leading aetiology of vascular cognitive impairment, yet effective treatments for CSVD-related cognitive impairment (CSVD-CI) are limited. Although edaravone has shown potential in alleviating CSVD's pathophysiological changes, its efficacy in CSVD-CI remains underexplored, partly due to the lack of a suitable long-term dosage form. This trial aims to assess the efficacy and safety of edaravone sublingual tablets (EST) for cognitive impairment in patients with CSVD. This multicentre, randomised, double-blind, placebo-controlled trial will enrol patients with CSVD-CI, randomly assigning them to receive either EST or placebo for 24 weeks of treatment with concurrent follow-up, followed by an additional 24-week post-treatment follow-up period. Cognitive function, safety, MRI-based CSVD burden, cerebral arterial endothelial function and immune-mediated inflammation will be assessed. The primary outcome is the between-group difference in Montreal Cognitive Assessment score changes from baseline to week 48, along with adverse event incidence. Secondary outcomes include changes in cognitive domain scores, CSVD burden, deep regional cerebral perfusion and levels of glial fibrillar acidic protein (GFAP), neurofilament light chain and inflammatory factors in peripheral blood from baseline to weeks 24 and 48. This trial will evaluate the efficacy and safety of EST in patients with CSVD-CI, potentially offering a new treatment strategy for this condition.

Dementia rates have accelerated in recent decades, yet our ability to screen for and predict who is at risk remains limited. The Montreal Cognitive Assessment (MoCA) and the Alzheimer's Disease Assessment Scale-Cog-13 item (ADAS-Cog-13) are common screeners that provide insight into early dementia progression. However, how these tools relate to biomarkers and psychological predictors before formal diagnosis is unclear. This study examines associations between biological and psychological factors with MoCA and ADAS-Cog-13 scores to guide clinicians in selecting the most informative screener for specific dementia risk profiles. Zero-order correlations and Classification and Regression Trees were conducted using data from the ADNI-DOD database, comprising high-risk veterans without baseline dementia. MoCA scores were primarily associated with biomarker predictors and depression, whereas ADAS-Cog-13 scores were primarily associated with post-traumatic stress disorder diagnoses. Cognitive screeners tailored to brief psychological and medical histories may improve early detection of cognitive decline and Alzheimer's disease.

Neurofibrillary tangles (NFTs) progressively damage gray matter in Alzheimer disease (AD). Resulting cortical microstructural alterations might not be detectable using macrostructural metrics but may be studied using isotropic water diffusion, as it reflects extracellular free water content. The aim of this study was to examine the effect of NFTs on cortical microstructure by investigating whether cortical free water increases as a function of tau load. We also investigated whether phosphorylated tau in blood plasma also indicated cortical microstructural abnormalities. For this cross-sectional study, we sampled participants with T1 MRI, multishell diffusion-weighted MRI, amyloid PET ([18F]AZD4694), tau PET, and plasma phosphorylated tau 217+ (p-tau217) from the Translational biomarkers in Aging and Dementia cohort at McGill University; participants were recruited between 2017 and 2024. We used the Neurite Orientation Dispersion and Density Imaging algorithm to calculate isotropic free water images ("free water"). FreeSurfer was used to calculate cortical thickness in the entorhinal, fusiform, inferior temporal, and middle temporal gyri regions of interest ("meta-ROI"); Automatic Segmentation of Hippocampal Subfields was used to calculate hippocampal volumes. We grouped participants by amyloid PET positivity (A), plasma p-tau217 positivity (T1), and tau PET positivity (T2). We performed voxel-wise correlation analyses between free water and these proteinopathy markers, as well as ROI-based analyses in the meta-ROI. A total of 303 participants (mean age 67 years, 58.7% female) were included in this study (168 cognitively normal individuals, 43 with mild cognitive impairment, 23 with AD dementia, 68 not diagnosed). Tau PET was positively correlated with free water in gray matter predominantly in the temporal lobe (partial R2 = 0.39, p < 0.001), and the correlation of p-tau217 with the meta-ROI free water was entirely mediated by tau PET (p < 0.001). In addition, medial temporal and hippocampal free water was negatively correlated with Montreal Cognitive Assessment scores in the A-T1+ and A+T2+ groups. The strongest ROI-based multilinear models for predicting temporal gray matter and hippocampal tau PET burden used both cortical thickness and free water as predictors (temporal gray matter partial R2 = 0.62; hippocampal partial R2 = 0.64). In AD-relevant regions, increased free water correlates with tau load independently of macrostructural metrics or amyloid load. Free water may serve as an imaging marker for microstructural changes in gray matter resulting from NFT accumulation, complementary to macrostructural metrics.

Patients with hypermobile Ehlers-Danlos syndrome (hEDS) frequently present with circulatory dysfunction, including postural orthostatic tachycardia syndrome (POTS), and cognitive impairments, leading to substantial disability and limitations in daily functioning. Few studies have examined attention, and concentration and associated conditions in hEDS. In this case-control study, we used a comprehensive cognitive test battery to assess whether cognitive performance is impaired in individuals with hEDS and depends on different body positions. Twenty-nine patients and 29healthy controls (HC) were enrolled. Baseline cognitive assessments included the Performance Scale of an intelligence test (LPS), Montreal Cognitive Assessment (cognitive deficit screening), and Test of Attentional Performance (TAP). The main cognitive tests for assessing the effects of body position were conducted in randomized conditions (supine, standing, and standing legs-crossed) and included the Stroop test, Corsi block-tapping test, Trail Making Test PartB, and Wechsler Memory Scale-revised. Compared to HC, patients with hEDS had higher intellectual performance (p < .050), but besides relevant comorbid conditions, also significantly impaired attention in the TAP (p < .010) and an impairment of executive function assessed by the Stroop test (p < .010) in the legs-crossed compared to the supine position. Attention in the hEDS group was impaired compared to HC, and executive performance was dependent on body position. Individuals performed worse when standing legs-crossed. Hence, impaired proprioception as present in hEDS may, along with comorbid conditions such as pain, be a contributing factor affecting executive function.