Montreal Cognitive Scale Research Articles

КАЧЕСТВО ЖИЗНИ И КОГНИТИВНЫЕ НАРУШЕНИЯ У БОЛЬНЫХ ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТЬЮ

Abstract. Вackground. Chronic heart failure (CHF) has a high prevalence in the Russian population. It is one of the main causes of reduced quality of life in cardiology patients due to the gradual progression of the disease and the development of complications, as well as the development of cognitive impairment. Early recognition of these disorders will optimize the management of patients with CHF. Purpose of the study. To evaluate the quality of life and cognitive functions in patients with different severity of chronic heart failure. Characterization of patients and methods of the study. 105 patients with confirmed diagnosis of CHF with different functional classes according to NYHA were included in the open cross-sectional non-randomized cohort study. Cognitive screening was performed using the Montreal Cognitive Assessment (MoCA), and quality of life was assessed by the Quality of Life Questionnaire (EQ-5D). Statistical Analysis Methods. Excel data analysis package and SPSS 23.0 data analysis package were used. Results and Conclusion. A pilot study was conducted to detect mild or severe cognitive impairment using the Montreal Cognitive Scale and quality of life using the EQ-5D questionnaire in patients with different functional classes of CHF. A significant correlation was found between cognitive function and left ventricular ejection fraction. Quality of life did not depend on the severity of CHF, sex, age, concomitant pathology. The obtained data should be taken into account in personalized management of patients with CHF.

Catatonia and neurocognitive disorder in the context of schizophrenia spectrum disorders

Background. Currently, researchers are aiming to establish the relationship between neurocognitive disorder and other clinical manifestations of endogenous diseases and functional indicators of the patient’s adaptation to social life. According to some data, the development of cognitive disorders is associated with the severity of catatonic disorders in the clinical picture of various diseases, in particular the presence of catatonic symptoms determines the worst indicators of cognitive functioning in the case of schizophrenia.The aim. To study the clinical and psychopathological features of catatonic syndrome in connection with schizophrenia spectrum disorders, as well as its connection with neurocognitive disorder manifestations among patients with endogenous disorders.Methods. From September 2022 to March 2024, we conducted a prospective, multicenter study of patients (n = 69) suffering from paroxysmal schizophrenia with primary catatonic symptoms in the structure of attacks. Mental status, the severity of catatonic symptoms using Bush – Francis Catatonia Rating Scale, neurocognitive profile using a number of validated scales (Montreal Cognitive Scale, Brief Assessment of Cognition in Schizophrenia, Frontal Assessment Battery) were assessed.Results. Neurocognitive disorder was revealed in all cases studied. It has been noted that, depending on the presence/absence of affective symptoms, various domains of the neurocognitive profile are affected. Thus, in patients without severe affective symptoms, auditory and verbal memory, attention, processing speed, and motor skills are impaired. In patients with pronounced affective disorders, processing speed, motor skills, and problem-solving behavior are affected.Conclusion. Based on the results of processing the material, it was revealed that the most pronounced neurocognitive disorders were found in case of the manifestation of paroxysmal paranoid schizophrenia in male patients with a relatively early onset of the disease and hypokinetic catatonic disorders. In the future, we are planning to compare these results with the results of control group of patients with endogenous diseases and without catatonia.

Effects of rehabilitation on functional independence in daily life, exercise tolerance and quality of life in patients with relapsing-remitting multiple sclerosis

Objective: to evaluate the efficacy of a comprehensive rehabilitation program on functional independence in daily life, exercise tolerance and quality of life (QoL) in patients with relapsing-remitting multiple sclerosis (RRMS) in remission.Material and methods. 38 patients with RRMS were analyzed (33 women and 5 men; age – 41.6±7.7 years; EDSS – 4.0 [3.5; 5.0] points, duration of MS – 8.0 [3.0; 21.0] years). The patients received comprehensive rehabilitation in a hospital for 2.5 weeks. The examination was carried out before and after the rehabilitation program. Independence in daily activities was assessed using the Functional Independence Scale, the Get Up and Go Test and the Berg Balance Scale. Exercise tolerance was determined using a cardiopulmonary exercise test (CPET) on a cycle ergometer. The following parameters were measured: oxygen consumption during exercise (VO2 peak oxygen uptake), percentage from the predicted VO2 peak (% pred VO2 peak) and maximal workload in metabolic units (MET). Walking speed was measured according to the Davis protocol in the SMART-D laboratory (Italy). QoL was determined using the SF-36 questionnaire, which assesses physical functioning (PF), general health (GH), vital activity (VT) and social functioning (SF). Cognitive functioning was assessed using the Montreal Cognitive Scale (MoCA) and depression using the Beck Depression Inventory (BDI). Results. After completion of the rehabilitation course, there was a significant increase in VO2 peak (from 18.8±3.8 to 20.4±4.3 ml/kg/min), % pred VO2 peak (from 59±13 to 63±14%), maximal workload (from 5.4±1.2 to 5.8±1.2 MET), maximal heart rate (from 140±14 to 147±13) and walking speed (from 0.84±0.29 to 0.97±0.28 m/s). At the same time, despite an improvement the patients did not reach the age- and gender adjusted reference values for exercise tolerance. QoL indicators also increased, reaching or exceeding the populational values obtained for the Russian population: PF – from 45 to 52.2; GH – from 51 to 52; VT – from 45 to 50; SF – from 62.5 to 75. The number of points on the BDI also decreased significantly (from 9 to 6), and the increase on the MoCA scale had tendency to significant difference (p=0.064). Conclusion. A comprehensive rehabilitation program in patients with RRMS in remission helps to increase exercise tolerance and improve functional independence and QoL.

Research of cognitive disorders and quality of life in patients, who are receiving methadone replacement maintenance therapy

IntroductionImportant goals of substitution therapy include: reducing the desire to use opioids - methadone enters the brain with a minimal euphoric effect, reduce the desire to use opioids, allowing to avoid the risk of overdose and control their addiction; prevention of withdrawal syndrome; improving the quality of life - can contribute to the restoration of patients, allowing them to return to a normal life, improve their social, professional and family situation; reducing the risk of transmission of infections HIV and hepatitis; reducing crime - control addiction can reduce related crime and to illicitly obtain opioids; psychosocial support helps patients develop coping strategies and increases their chances of long-term recovery.The goal of substitution therapy is not to completely get rid of addiction, but it can help stabilize the patient’s life and facilitate the recovery process.ObjectivesMany patients receiving MT also have mental disorders such as cognitive decline, depression, anxiety, PTSD, or even bipolar disorder. These conditions can greatly affect the course and results of treatment.They may also have problems with employment, housing, family conflicts, and legal issues.MethodsIn the course of the study, 134 patients aged 26 to 64 years (105 men and 29 women) with a diagnosis of opioid addiction and receiving methadone therapy were examined. Of them, 48 patients had a period of stay at MT of up to three years and 86 – more than three years. The Montreal Cognitive Scale (MoCA) was used to assess comorbid cognitive impairments. The WHOQOL-BREF questionnaire was used to assess the quality of life.ResultsThe range of indicators of cognitive functions varied from 21 to 29 points (average - 25.3). 61 patients (46%) showed a result of 26 and above, indicating the absence of cognitive impairment, 51 patients (38%) received from 24 to 21, indicating moderate cognitive impairment. 22 patients (16%) had borderline indicators.When assessing the level of quality of life, indicators of physical and psychological components varied from 12 to 31; self-perception in the range from 10 to 27 points; microsocial support from 3 to 14 points; social well-being from 11 to 36. In general, the level of satisfaction with the quality of life was in the range of 38-83%.Image:Image 2:ConclusionsOpioid addiction therapy should be consist of an assessment of physical and psychological status, comorbid disorders, quality of life, etc. We can see, MT does not significantly affect the cognitive functions. The differences in the assessment of the quality of life were noted in the components of microsocial support and social well-being, which indicates the vulnerability of patients in these areas. Duration of opioid dependence, availability of psychosocial support, presence of comorbid conditions affect the quality of life. It is important that treatment is tailored to individual needs of patients.Disclosure of InterestNone Declared

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.

Effects of parecoxib on postoperative cognitive dysfunction and serum levels of NSE and S100β in elderly patients undergoing surgery.

To investigate the effects of parecoxib on postoperative cognitive dysfunction, and serum levels of neuron-specific enolase (NSE) and S100β protein (S100β) in elderly patients undergoing surgery. The retrospective cohort study method was used to collect the clinical data of 94 elderly patients who underwent elective orthopedic and general anesthesia surgery in our hospital from September 2020 to February 2022. 94 patients were divided into the control group (47 cases) and the study group (47 cases), according to different intervention methods. In the study group, 40 mg of parecoxib was injected intravenously into patients 30 min before the induction of anesthesia, and the patients in the control group were given the same dose of normal saline intravenously before the operation. The basic clinical data of the patients were collected. The levels of the indexes before operation and 6 hours after operation were compared between the two groups, including the Montreal Cognitive Scale (MoCA) score, inflammatory factor indicators [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-10 (IL-10), interleukin-1β (IL-1β), monocyte chemokine-1 (MCP-1), and inducible nitric oxide synthase (iNOS)], serum cortisol (CORT), beta-amyloid (β-AP), adiponectin (ADP), NSE, and S100β. No significant differences in the preoperative MoCA score, TNF-α, IL-6, CRP, IL-10, IL-1β, MCP-1, iNOS, CORT, β-AP, ADP, NSE, and S100β levels were observed between the two groups (p>0.05). The postoperative MoCA score in the study group was significantly higher than that in the control group (p<0.05). The postoperative levels of TNF-α, IL-6, CRP and IL-1β in the study group were significantly lower than those in the control group (p<0.05), and the postoperative levels of IL-10, MCP-1 and iNOS in the study group were significantly higher than those in the control group (p<0.05). Parecoxib can notably inhibit the levels of postoperative inflammatory cytokines, improve neurological dysfunction, and reduce the occurrence of postoperative cognitive dysfunction in patients. The contents of serum NSE and S100β have potential value in the diagnosis of postoperative cognitive dysfunction in elderly patients.

Antioxidant therapy in the complex treatment of patients with ischemic stroke in the acute and recovery period

Improvement of therapy of patients with ischemic stroke (IS) remains a relevant problem, despite the widespread use of drug and mechanical revascularization methods during recent years. One of the pathogenetic mechanisms of IS is oxidative stress as one of the components of brain tissue damage in the acute period and a factor that prevents the processes of repair and neuroplasticity in the recovery period. This is the rationale for the use of antioxidant drugs in the acute and recovery periods of stroke. Data from clinical studies on the use of antioxidants in the treatment of patients with IS are presented. We describe the use of the domestic drug dimephosphone (dimethyloxobutylphosphonyl dimethylate), a synthetic non-anticholinesterase organophosphorus compound, which has a wide range of effects: antioxidant, antacidotic, vasodilating, membrane stabilizing, anti-inflammatory, etc. Data are given on the use of dimephosphone in the acute period of IS in patients with no indications for thrombolytic therapy, there was a decrease in neurological deficit and a decrease in disability. The positive results of the use of dimephosphone in the recovery period of IS and in chronic cerebrovascular insufficiency are described. The data of our own study on the use of dimephosphone in the complex therapy of cognitive rehabilitation of patients in the recovery period of IS are presented. A statistically significant recovery of cognitive functions was registered according to the Montreal Cognitive Scale (MoCA), and an increase in the MoCA score by 2 points or more in 59.6% of patients. An improvement in executive functions, an increase in the flexibility of cognitive control of cognitive processes, and the predominance of verbal thinking over sensory-perceptual were noted.

Association between Systemic Immune Inflammation Index and Cognitive Impairment after Acute Ischemic Stroke

Post-stroke cognitive impairment (PSCI) is one of the major complications after ischemic stroke. PSCI has been shown to be associated with low-grade systemic inflammation. As a novel inflammatory marker, the systemic immune-inflammation (SII) index could reflect clinical outcomes in severe cardiovascular diseases. We therefore performed a prospective study to investigate the correlation between the SII index and the risk of PSCI in patients with ischemic stroke. We prospectively enrolled 254 patients with ischemic stroke with symptoms onset <72 h. The SII index was detected within 24 h after admission. The Montreal Cognitive Scale (MoCA) was utilized to evaluate cognitive function, and PSCI was defined as a MoCA score of <25 points. During the 3-month follow-up, 70 participants (27.6%) had mild cognitive impairment and 60 (23.6%) had severe cognitive impairment. In binary logistic regression analysis, each one-standard deviation increase in the SII index was significantly associated with the prevalence of PSCI after adjusting for age, sex, and other confounders (odds ratio 2.341; 95% confidence interval, 1.439-3.809, p = 0.001). Similar significant findings were observed when SII was defined as a categorical variable. In addition, the multiple-adjusted spline regression model showed a linear association between the SII index and cognitive impairment (p = 0.003 for linearity). Our study indicated that an increased SII index was closely related to PSCI at 3 months in patients with ischemic stroke. Further research is required to evaluate the efficacy of inflammation management in these patients.

Serum neutrophil gelatinase-associated lipocalin as a potential biomarker for cognitive decline in spinal cord injury.

Neutrophil gelatinase-associated lipoprotein (NGAL), a protein encoded by the lipocalcin-2 (LCN2) gene, has been reported to be involved in multiple processes of innate immunity, but its relationship with spinal cord injury (SCI) remains unclear. This study set out to determine whether NGAL played a role in the development of cognitive impairment following SCI. At the Neck-Shoulder and Lumbocrural Pain Hospital, a total of 100 SCI patients and 72 controls were enrolled in the study through recruitment. Through questionnaires, baseline data on the participants' age, gender, education level, lifestyle choices (drinking and smoking) and underlying illnesses (hypertension, diabetes, coronary heart disease, and hyperlipidemia) were gathered. The individuals' cognitive performance was evaluated using the Montreal Cognitive Scale (MoCA), and their serum NGAL levels were discovered using ELISA. The investigation included 72 controls and 100 SCI patients. The baseline data did not differ substantially between the two groups, however the SCI group's serum NGAL level was higher than the control group's (p < 0.05), and this elevated level was adversely connected with the MoCA score (p < 0.05). According to the results of the ROC analysis, NGAL had a sensitivity of 58.24% and a specificity of 86.72% for predicting cognitive impairment following SCI. The changes in serum NGAL level could serve as a biomarker for cognitive impairment in SCI patients, and this holds true even after taking in account several confounding variables.

Динамика когнитивных и психоэмоциональных нарушений в раннем восстановительном периоде ишемического инсульта при проведении реабилитационных мероприятий с применением стабилотренинга

Objective: to analyze post-stroke cognitive and psycho-emotional disorders in patients in the early recovery period of ischemic stroke, to assess the dynamics of these disorders during rehabilitation measures using stabilometric training. Materials and methods. The study involved 58 patients aged 35-75 years; the average age was 60.6 years. The study was conducted on the basis of Bryansk City Hospital No. 1 in the Department of Medical Rehabilitation. Stabilometric training was carried out on a computerized stabiloanalyzer with biofeedback "Stabilan-01-2" (Taganrog). The course included 7-10 sessions of stabilotherapy. The Montreal Cognitive Scale and the Hospital Anxiety and Depression Scale were used to assess cognitive and psychoemotional status before and after rehabilitation activities. Statistical analysis of the obtained data was carried out on a personal computer using MS EXCEL and IBM Statistica 12.0 application packages. The significance of differences between the studied groups was assessed using the nonparametric Mann-Whitney test. The dynamics in each group before and after treatment was assessed using the Wilcoxon test. Results. According to the results of the study, a significant improvement in the memory indicators of patients was revealed along with a decrease in the level of anxiety and depression. Conclusion. The positive effect of the use of a stabilometric training on the intellectual-mnestic and psycho-emotional functions of patients in the early recovery period of ischemic stroke revealed during the study allows us to recommend this method not only for motor rehabilitation, also to use it as a cognitive and psycho-corrective training.

Results of using the neuroprotective drug Cellex in non-traumatic intracranial hemorrhage

Introduction.In the Russian Federation, neuroprotective agents are widely used in the treatment of patients with ischemic stroke. There are accumulated data on the efficacy and safety of the neuroprotective agent Cellex® in ischemic stroke. The use of this drug in hemorrhagic stroke has been studied to a lesser extent.Aim. To study the efficacy and safety of Cellex® in non-traumatic intracerebral hemorrhage.Materials and methods. The study included 60 patients with hypertensive intracerebral hemorrhage aged 30 to 80 years. Thirty patients (the main group) received Cellex 0.1 mg (1 ml) once a day for 10 days in addition to basic therapy; the remaining 30 patients (control group) received only basic therapy. Over the course of 30 days, the patients were evaluated for various parameters on the Glasgow Coma Scale, stroke severity on the NIHSS scale, patient disability on the Modified Rankin Scale, Barthel Index and Rivermead Mobility Index, speech disorders on the Speech Questionnaire, cognitive function on the Montreal Cognitive Scale (MoCA), and other parameters.Results and discussion. The survival rate was higher in the treatment group than in the control group (p = 0.0237). Speech function improved from 17.0 (14.0–22.0) to 25.0 (21.0–27.0) scores (p = 0.0073) in the Cellex group, no significant improvement in speech function was noted in the control group. There was a trend toward a more significant reduction in stroke severity according to the NIHSS scale and inpatient disability according to the Rankin, Barthel, and Rivermead scales in the Cellex group compared with the control group. Cognitive function on MoCA score improved in Cellex® group from 14.0 (12.0; 22.5) to 20.0 (14.5; 25.0). No adverse events were observed in the group of patients taking Cellex.Conclusion. The efficacy and safety of Cellex® in patients with hypertensive intracerebral hemorrhage has been proven.

Evaluation of the Effects of Folic Acid Combined with Atorvastatin on the Poststroke Cognitive Impairment by Low-Rank Matrix Denoising Algorithm-Based MRI Imaging.

This research aimed to study the optimization effects of the low-rank matrix denoising (LRMD) algorithm based on the Gaussian mixture model (GMM) on MRI images of stroke patients, aiming to evaluate the effects of atorvastatin combined with folic acid on poststroke cognitive impairment (PSCI) in patients with ischemic stroke. First, the GMM-based low-rank matrix denoising (LRMD) algorithm was constructed and applied to process MRI images of 64 patients with ischemic stroke. Then, the MRI images before and after processing were compared for the denoising degree and quality. An image with 5% noise was not as clear as an MRI image with 1% noise, and the effects of atorvastatin combined with folic acid on PSCI in patients with ischemic stroke were discussed. It was found that the denoising degree of MRI images processed by the GMM-based LRMD algorithm was significantly improved, the image quality was significantly enhanced (P < 0.05), and the diagnosis accuracy and efficiency of stroke patients were heightened. Atorvastatin combined with folic acid reduce the homocysteine (HCY) and total cholesterol (TC) levels, as well as Montreal Cognitive Scale (MOCA) scores of PSCI patients (P < 0.05). In conclusion, the MRI images processed by the LRMD algorithm have good quality. Folic acid combined with atorvastatin can effectively reduce HCY and TC levels, thereby alleviating PSCI of stroke patients.

Personality traits as risk factors for the development of cognitive impairment and affective symptoms in patients with COVID-19

To identify possible associations between premorbid personality traits and cognitive impairment and affective symptoms in patients who have recovered from COVID-19. The study included 30 people with the so-called post-COVID syndrome. The diagnosis of COVID-19 was previously confirmed by laboratory tests in each patient. The control group included 15 healthy individuals. The Hospital Anxiety and Depression Scale was used to assess depression and anxiety. Cognitive function was assessed using the Verbal Fluency Test (VF), the Montreal Cognitive Scale (MOCA), and the Wisconsin Card Sorting Test (WCST). The Munich Personality Test (MRT) and the Toronto Alexithymia Scale (TAS-26) were used to assess premorbid personality characteristics. Multiple stepwise regression analysis was used as the main statistical method to identify the relationship between premorbid personality constructs and cognitive test results and affective and anxiety symptoms. The presence of frustration tolerance in the personality structure reduced the number of incorrect answers (beta coefficient -0.811) in WCST and decreased the delay in responses with positive reinforcement (-0.630), and also reduced the level of depression (-0.465). Extraversion decreased the MOCA test score (-0.675) and increased the percentage of perseverative incorrect answers on the WCST test (0.573). The constructs of adherence to social norms and propensity to isolate lowered the final MOCA score (beta coefficients are -0.725 and -0.527, respectively). The esoteric tendencies construct decreased the latency of positive and negative reinforcement responses in WCST (-0.441 and -0.528, respectively). The severity of alexithymia was positively correlated with depression (beta 0.577), while neuroticism was positively correlated with anxiety (0.737). Low levels of frustration tolerance and esoteric tendencies have negative effects on cognition in COVID-19 survivors, while high levels of these constructs are protective against cognitive decline and depression.

Cognitive and emotional disorders in patients with migraine and signs of leukoencephalopathy

To identify cognitive and emotional disorders and their correlation with neuroimaging parameters in patients with chronic migraine. We examined 50 patients (8 men and 42 women, mean age 41.9±11.9 years) with migraine, including 31 with chronic migraine, and signs of leukoencephalopathy according to magnetic resonance imaging (MRI). A control group comprised 40 healthy individuals (13 men and 27 women) aged 20 to 64 years (mean 42.6±12.0 years). A number of tests for neuropsychological examination and assessment of the emotional state, including a 12-word test, literal and categorical associations, Benton Test, the Montreal cognitive scale (MOCA), the Hospital Depression Scale, the Beck Depression Scale, the Center for Epidemiological Research scale, the Hospital Anxiety Scale and the Spielberger-Khanin scale, were administered at baseline and after 3 and 6 month of preventive therapy. Patients with migraine had lower scores (p=0.004) on MOCA, memorization of 12 words (p=0.0003), test for literal (p=0.001) and categorical associations (p=0.0002) compared with the control group. No significant correlations were found between the volume of white matter lesions according to MRI and the severity of cognitive impairment. An inverse correlation of average strength was noted (correlation coefficient R=-0.41) between the number of days with headache per month and the MOCA score (p<0.05). In patients with migraine, signs of depression were found on the Hospital Depression Scale (p=0.04), Beck Depression Scale (p=0.003), the Center for Epidemiological Research scale (p=0.0001), and increased anxiety on the Hospital Anxiety Scale (p=0.0001) and the Spielberger-Khanin scale (p=0.0001). A significant relationship was found between the degree of depression and the MOCA score (p=0.007). The frequency of headaches decreased from 19.4±2.9 to 12.6±4.4 days per month (p<0.05). There were a significant decrease of emotional disorders and improvement of cognitive functions compared with baseline scores during the 6 month therapy. Preventive treatment of migraine and concomitant emotional disorders seems to be the most effective way to improve cognitive functions.

Serum Galectin-3 as a Potential Predictive Biomarker Is Associated with Poststroke Cognitive Impairment.

Objective Galectin-3, an inflammatory mediator derived from microglia, participates in the pathophysiological process of various neurological diseases. However, the relationship between galectin-3 and poststroke cognitive impairment (PSCI) remains ambiguous. This research purposed to prove whether serum galectin-3 can predict PSCI. Methods In the end, an aggregate of 416 patients with the first acute ischemic stroke (AIS) were continuously and prospectively enrolled in the study. Upon admission, the baseline data of AIS patients were collected, and their serum galectin-3 levels were measured. Three months after the stroke, the Montreal Cognitive Scale (MoCA) was utilized to measure the cognitive function of AIS patients, and PSCI was defined as a MoCA score less than 26 points. Results Premised on the MoCA scores, patients were categorized into PSCI cohort and non-PSCI cohort. The two AIS patient cohorts did not exhibit any statistical difference in their baseline characteristics (p > 0.05). However, the serum galectin-3 level of AIS patients in the PSCI cohort was considerably elevated (p < 0.001). Pearson correlation analysis illustrated that serum galectin-3 level was negatively linked to MoCA score (r = −0.396, p < 0.05). The findings from the receiver-operating curve (ROC) illustrated that the sensitivity of serum galectin-3 as a possible biomarker for diagnosing PSCI was 66%, and the specificity was 94%. The cut-off value of serum galectin-3 to diagnose PSCI is 6.3 ng/mL (OR = 5.49, p < 0.001). Upon controlling for different variables, serum galectin-3 level remained to be an independent predictor of PSCI (p < 0.001). Conclusions Elevated serum galectin-3 levels are linked to a higher risk of PSCI. Serum galectin-3 could be a prospective biomarker for predicting PSCI.

Biochemical and morphometric methods for assessing cognitive impairment in patients with type 2 diabetes

Aim. To study the features of biochemical and morphometric parameters in patients with type 2 diabetes (T2D) and cognitive impairment (CI).Material and methods. The experimental group included 72 patients with CI and T2D, the control group − 20 patients with T2D and without CI. We used the Montreal Cognitive Scale (MoCA) to assess the presence of CI. We also evaluated the levels of 1,5-anhydroglucitol (1,5-AG), continuous glucose monitoring (CGM), and data of brain magnetic resonance imaging (MRI).Results. We revealed that patients with T2D and CI have high HbA1c levels, but there was no significant difference of 1,5-AG levels between the groups. In patients with CI, we also established a decrease in gray and white matter surface area, as well as subcortical structures (the hippocampus, nucleus accumbens and putamen on both sides; the amygdala and globus pallidus on the right). The severity of CI correlated with polyneuropathy severity. In patients with proliferative retinopathy, there was a decrease in the volume of the caudate nucleus, globus pallidus, putamen and nucleus accumbens. Conclusion. The study revealed that patients with T2D with CI have worse levels of carbohydrate metabolism parameters, as well as a decrease in the cortical and subcortical brain structures.

Therapeutic Role of Transcranial Direct Current Stimulation in Alzheimer Disease Patients: Double-Blind, Placebo-Controlled Clinical Trial

Objective. To explore the neuropsychological effects and levels of tau protein (TAU), amyloid β 1-42 (Aβ 1-42), and lipid peroxidase after 10 sessions of anodal transcranial direct current stimulation (tDCS) in patients with mild to moderate Alzheimer disease (AD). Patients and methods. A total of 46 consecutive patients with probable AD participated in this study. They were classified randomly into 2 equal groups: active versus sham. Each patient received 10 sessions of anodal tDCS over the left and right temporoparietal region for 20 minutes for each side with the cathode on the left arm. Patients were assessed using the Modified Mini Mental State Examination (MMMSE), clock drawing test, Montreal Cognitive Scale (MoCA), and the Cornell Scale for depression. Serum TAU, Aβ 1-42, and lipid peroxidase were measured before and after the 10th session. Results. There was a significant improvement in the total score of each cognitive rating scale (MMMSE, clock drawing test, and MoCA) in the real group, whereas no such change was observed in the sham group. The Cornell depression score improved significantly in both groups. There was a significant increase in serum Aβ 1-42 (P = .02) in the real but not in the sham group, with a significant Treatment condition × Time interaction (P = .009). There was no significant effect on tau or lipid peroxidase in either group but a significant positive correlation between changes of Aβ1-42 and MMMSE (P = .005) and MoCA (P = .02). Conclusion. The observed cognitive improvements were complemented by parallel changes in serum levels of Aβ 1-42.

Influence factors of carotid endarterectomy improving vascular cognitive impairment

Objective: To investigate the influence factors of carotid endarterectomy(CEA) improving cognitive function in patients with carotid stenosis. Methods: The clinical data of carotid stenosis patients with cognitive impairment who underwent CEA in Nanjing Drum Tower Hospital and the First People's Hospital of Lianyungang from December 2011 to July 2017 were retrospectively analyzed. One week before operation, carotid CT angiography and cranial magnetic resonance imaging were performed, and the cognitive function of patients was evaluated with Montreal Cognitive Scale (MoCA). The magnetic resonance imaging and MoCA were reexamined 4 weeks after the procedure. The patients were divided into improved group (COI+) and un-improved group (COI-) according to whether the cognitive function score was improved or not after operation. The general data, carotid artery occlusiontime, surgical site, preoperative carotid calcification score (CS) and the Fazekas score, pre-operative and post-operative cerebral perfusion parameters, like mean transit time(MTT), time to peak(TTP) and arrivetime (T0), and any new infarcts after operation between the two groups were compared. Results: A total of 70 patients were selected, including 50 patients in group COI+ and 20 patients in group COI-. There were no significant differences in age, gender, hypertension, diabetes mellitus, smoking and drinking habits, as well as in carotid artery occlusiontime and preoperative Fazekas score between the two groups (all P>0.05). The preoperative carotid artery calcification scores of the two groups were 469.75±50.86 and 393.51±77.41, respectively. The changes of pre-and post-operation perfusion parameters between the two groups were statistically significant, with ΔMTT were 7.79±9.51 and 3.03±6.40, ΔTTP were 5.83±8.98 and 1.17±4.77, T0 were 5.89±8.08 and 3.05±5.95, respectively(t=4.844, 2.053, 2.192 and 1.423, respectively, all P<0.05). Proportion of cases with new infarcts after operation(0.38 vs 0.65) or undergoing left CEA (0.66 vs 0.40)between the two groups was statistically different (χ(2)=4.197 and 9.677, respectively, both P<0.05). Conclusion: Higher preoperative CS score, undergoing left CEA, significantly improved cerebral perfusion and without new infarct postoperatively, are independent factors contributing to improving cognitive function through CEA operation.

Interhemispheric functional connectivity for Alzheimer's disease and amnestic mild cognitive impairment based on the triple network model.

The purpose of this study was to explore the differences in interhemispheric functional connectivity in patients with Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI) based on a triple network model consisting of the default mode network (DMN), salience network (SN), and executive control network (ECN). The technique of voxel-mirrored homotopic connectivity (VMHC) analysis was applied to explore the aberrant connectivity of all patients. The results showed that: (1) the statistically significant connections of interhemispheric brain regions included DMN-related brain regions (i.e. precuneus, calcarine, fusiform, cuneus, lingual gyrus, temporal inferior gyrus, and hippocampus), SN-related brain regions (i.e. frontoinsular cortex), and ECN-related brain regions (i.e. frontal middle gyrus and frontal inferior); (2) the precuneus and frontal middle gyrus in the AD group exhibited lower VMHC values than those in the aMCI and healthy control (HC) groups, but no significant difference was observed between the aMCI and HC groups; and (3) significant correlations were found between peak VMHC results from the precuneus and Mini Mental State Examination (MMSE) and Montreal Cognitive Scale (MOCA) scores and their factor scores in the AD, aMCI, and AD plus aMCI groups, and between the results from the frontal middle gyrus and MOCA factor scores in the aMCI group. These findings indicated that impaired interhemispheric functional connectivity was observed in AD and could be a sensitive neuroimaging biomarker for AD. More specifically, the DMN was inhibited, while the SN and ECN were excited. VMHC results were correlated with MMSE and MOCA scores, highlighting that VMHC could be a sensitive neuroimaging biomarker for AD and the progression from aMCI to AD.

Effects of virtual rehabilitation on cognition and quality of life of patients with Parkinson’s disease

Abstract Introduction: Parkinson’s disease causes progressive decline of motor and cognitive functions leading to a decrease in the independence and quality of life of people affected. Training through virtual reality is proving effective, as it promotes cognitive and motor stimuli, which can be beneficial for these individuals, improving their quality of life. Objective: To analyze the effects of virtual reality on the cognition and quality of life of patients with Parkinson’s disease. Methods: A total of 11 individuals with a mean age of 65 (9.6) years classified in stages 1 to 3 of the Hoehn and Yahr Scale participated in this study. The subjects participated in fourteen sessions lasting one hour, twice a week for seven weeks in which they practiced four games of Kinect Adventures!. They were evaluated before, immediately after the intervention and 30 days after the intervention. Cognition was assessed using the Montreal Cognitive Scale (MoCA) and quality of life was assessed using the Parkinson’s Disease Questionnaire (PDQ-39). Results: Only PDQ-39 activities from the domain of daily living demonstrated a statistically significant improvement. The MoCA scores, in general, remained the same. Conclusion: Although virtual reality training promoted improvement in PDQ-39 activities in the daily life domain, it was not effective in the other domains assessed for quality of life and cognition.