Neurocognitive Function Research Articles

Reduced Cerebellar Volumes Associate with P300 Amplitude Attenuation in Children with Clinical High Risk for Psychosis and Early Onset Psychosis.

Patients with psychotic illnesses, including early onset psychosis (EOP), often experience cognitive impairment. The cerebellum is critically involved in neurocognitive processes, yet possible regional alterations in the cerebellum and their associations with behavioral parameters remain largely unexplored in EOP. In this preliminary study, we aimed to investigate structural morphological properties of the cerebellum as well as the supratentorial brain, and how morphological changes in the central nervous system relate to neurocognitive performance in children with EOP and clinical high-risk for psychosis (CHR). We performed whole-brain structural magnetic resonance imaging (MRI) and voxel-based morphological analyses in children with EOP (N = 15), children with CHR (N = 11), and healthy controls (Con, N = 13). An auditory event-related potential (ERP) task to elicit a P300 response was also completed by a subset of children (N = 29) as a measure of neurocognitive functioning. Linear regression analyses were performed to explore relationships between cerebellar volume, cortical thickness, and P300 amplitudes. Volumetric reductions (Con > CHR > EOP) in bilateral Crus I, Crus II, lobule VI and VIIIa, left VIIIb, and right lobules V and IX of the cerebellum were observed (p < 0.05). This downward trend across study cohorts was also evident for rostral middle frontal cortical (RMFC) thickness, and for centroparietal P300 amplitudes. Significant positive correlations among P300 amplitudes and cerebellar volumes were observed (p < 0.05). Significant correlations between P300 amplitudes and RMFC thickness were not present. Robust morphological disruptions in cerebellar subdivisions and frontal subdivisions were quantified in children with EOP. Structural abnormalities in these regions, particularly in the cerebellum, may signify broader brain network disruptions, potentially contributing to neurocognitive dysfunction in EOP.

A Pilot Study to Evaluate Neurodevelopmental Outcomes in a Pediatric Cohort With Genodermatoses.

Our study aimed to evaluate cognitive function in individuals with genetic skin disorders involving neuroectoderm (n = 8) compared to individuals with only ectoderm or mesoderm (n = 16) involvement. We hypothesized that neuroectodermal involvement would result in poorer neurocognitive performance. A prospective, cross-sectional pilot study of 24 participants evaluated cognition, adaptive skills, behavior, and quality of life (QoL) using neurodevelopmental tests. Participants' characteristics and outcomes of interest were summarized by standard descriptive statistics using means, standard deviation, median, and 95% confidence intervals. We found no differences between mean cognitive composite standard score, adaptive composite standard score, QoL raw score, or internalizing and externalizing behavior T-scores between the neuroectodermal group (82.3, 90.3, 70.3, and 50.0, respectively; average age = 7 years) and the ectodermal/mesodermal group (87.8, 96.4, 80.4, and 54.3, respectively; average age = 5.9 years). No differences were seen in neurodevelopmental functioning between both groups. Our pilot study presents a framework for utilizing neurocognitive testing in patients with genodermatoses. A limitation of our work is the high level of heterogeneity due to varying diagnoses seen in each group requiring larger sample sizes for determination of clinical significance. Future work is needed to include homogenous diagnoses and to evaluate the most efficacious interventions to maximize neurodevelopmental outcomes in individuals with genodermatoses.

Neurocognitive and resting-state functional MRI changes in patients with diffuse gliomas after chemoradiotherapy.

Neurocognitive and resting-state functional MRI changes in patients with diffuse gliomas after chemoradiotherapy.

Longitudinal analysis of cognitive function in patients treated with postoperative radiotherapy for grade 2 and 3 IDH mutant diffuse glioma.

Postoperative radiotherapy and chemotherapy improve survival in IDH mutated diffuse glioma. We investigated whether neurocognitive function declines over time, and whether mean dose to the brain outside of CTV (mean brain dose) is related to neurocognitive function. Patients that underwent resection and postoperative radiotherapy for grade 2 or 3 IDH mutated diffuse glioma were tested using the Hopkins Verbal Learning Test, Letter Fluency and Trail Making Test before surgery and afterwards up until disease progression. Mixed effects models were fitted for each of three cognitive test scores, using time from surgery, mean brain dose, CTV volume, and tumor grade as fixed effects. Between 1-10-2013 and 31-12-2022, 49 patients underwent longitudinal neurocognitive testing. Average mean dose to brain minus CTV was 17.8 Gy (95 % CI 16.1 - 19.4). At the time of analysis, median follow-up in patients free from disease progression was 5.8 years (range 1.1 - 20.8). Attrition rate during the first five years of follow up was 14.1 %. There was no decline of test performance over time (p ≥ 0.526). However, there was a negative effect of increasing mean brain dose on TMT score A (-0.11, p = 0.008) and TMT score B (-0.13, p = 0.004). In this study, no effect of time after resection on test scores was found. Multivariable modelling indicates an negative relationship between mean brain dose and specific neurocognitive test scores, accounting for effects of tumor grade and CTV volume.

Multi-target activity of ethanolic extract of Crinum woodrowii Baker for the treatment of Alzheimer's disease.

Multi-target activity of ethanolic extract of Crinum woodrowii Baker for the treatment of Alzheimer's disease.

Neurocognitive Gains Among Ugandan Children with Sickle Cell Anemia on Hydroxyurea: 18-month trial interim results.

Children with sickle cell anemia (SCA) frequently develop progressive neurocognitive impairment. We aimed to determine effects of hydroxyurea therapy on neurocognitive function in Ugandan children with SCA by comparing levels at enrollment to a planned 18-month interim assessment. Ugandan children (N=264) ages 3-9 years were enrolled from a SCA clinic and treated in a 30-month single-arm open-label trial with escalation to maximum tolerated dose (MTD). Primary outcome was the effects of hydroxyurea on cognition, attention and executive function, along with transcranial doppler ultrasound (TCD) blood flow velocity. Sibling controls (N=110) without SCA underwent neurocognitive testing in parallel to establish age-normalized z-scores for comparison. Participant enrollment mean age was 5.6±1.2 years, with comparable socio-economic status (SES) and caregiver education versus controls. At enrollment, SCA participants had lower mean cognitive z-scores than controls; 8.7% had cognitive impairment versus 1.6% controls. Month 18 mean dose 25.4mg/kg, with participants significantly improved z-scores versus baseline in all three domains: cognition: -0.54±1.10 vs. -0.07±1.16, p<0.001; attention: -0.07±1.01 vs. 0.27±0.84, p<0.001; and executive function: -0.06±0.62 vs. 0.08 ±0.72, p=0.010. No measure differed from controls. Proportion with SCA and cognitive impairment declined to 4.0%, with decreased mean TCD velocity. Higher neurocognitive treatment z-scores were primarily associated with higher baseline, also with better SES, hydroxyurea-induced TCD and hematological effects. Despite improvement, unadjusted cognitive scores remained negatively associated with age. Hydroxyurea therapy improved SCA neurocognitive function in sub-Saharan children, potentially aided by practice effects. Early treatment is needed for optimal effect. Our ongoing trial will assess impact from longer-term therapy. This trial was registered at www.clinicaltrials.gov as NCT04750707.

Factor structure of social cognition in schizophrenia: Investigation of four core domains.

Factor structure of social cognition in schizophrenia: Investigation of four core domains.

Association of microstructural lesions of the corpus callosum with cognitive impairment in patients with high grade glioma

PurposeGlioblastoma is one of the most common malignant brain tumors. To ensure a treatment that does not only lengthen survival, but also improves preservation of neurocognitive functions, reliable methods to measure changes in neurocognitive abilities at an early stage are necessary. The most direct way to objectify neurocognitive properties is neuropsychological testing. Neurocognitive decline is often based on lesions of the connectome. We take the corpus callosum (CC) as a reliable structure to identify decline of white matter (WM) integrity. We hypothesized a relation between compromised structural integrity in specific regions of the CC and neurocognitive deficits in glioma patients.MethodsWe included 28 patients with high-grade glioma who underwent a neuropsychological test battery and MRI with Diffusion tensor imaging (DTI) preoperatively. MRI data was processed using the software fsl, Oxford. Neuropsychological parameters were correlated with the fractional anisotropy (FA) in three parts of the CC.ResultsPreoperatively, most of the neuropsychological parameters correlated significantly with FA of at least one of the CC volumes. Higher FA-values were associated with better focus, memory, speed and speech fluency. Different tests examined the same neuropsychological parameter and then correlated with the same region of the CC.ConclusionsWe consider the FA of the CC for an adequate parameter to examine the influence of distant lesions on neurocognitive abilities.

Interrelatedness of Neurocognitive Domain Functioning Between Unprompted and Prompted Identification Testing With Psychophysical Olfactory Evaluation in a Post‐COVID‐19 Cohort

ABSTRACTObjectiveAssessment of olfactory function with psychophysical testing requires cognitive demand to correctly pair test odors with remembered scents. Individuals suffering from long‐Corona Virus Disease 2019 (long‐COVID‐19) may develop a decline in neurocognitive performance, which may be concurrent with persistent olfactory dysfunction (OD). Given the rigorous cognitive demand of the unprompted identification (UI) olfactory assessment, the goal of this study is to understand whether it could serve as a proxy for specific neurocognitive domains during clinical assessment of olfaction.MethodsParticipants from our long‐COVID cohorts with persistent OD underwent a panel of neurocognitive screening followed by olfactory assessment of threshold followed by unprompted (UI) and prompted identification (PI) tests using Sniffin' Sticks. Hierarchical linear mixed‐effect models were used to understand the relative impact of each neurocognitive variable after controlling for demographics and olfactory threshold scores.ResultsNeurocognitive variables demonstrated common correlation trends. Models containing Montreal Cognitive Assessment (MoCA) and digit‐span backward scores had statistically significant fits for both UI (MoCA: χ2 = 10.20, p = 0.001/digit‐span backward: χ2 = 4.27, p = 0.04) and PI (MoCA: χ2 = 4.51, p = 0.03/digit‐span backward: χ2 = 5.04, p = 0.02) linear mixed‐effect models, but UI was further explained by logical memory (χ2 = 7.84, p = 0.005), verbal fluency (χ2 = 8.79, p = 0.003), and digit‐span forward (χ2 = 12.30, p = 0.0004). These relationships were statistically significant after controlling for demographic and olfactory threshold covariates.ConclusionsUI and PI have interrelated neurocognitive dependence on global cognition (MoCA) and executive function (digit‐span backward) among long‐COVID participants. As UI draws upon neurocognitive domains of episodic (logical memory), semantic (verbal fluency), and working memory (digit‐span forward), the inclusion of a UI task may provide supplementary screening for cognitive impairments in those undergoing clinical olfactory assessment, particularly among those with lingering effects of COVID‐19.

High-precision radiotherapy achieves excellent long-term control and preserves function in pediatric craniopharyngioma - Subset analysis of a randomized trial.

The evolving treatment paradigm in children and adolescents with craniopharyngioma (CP) aims at minimizing late functional sequelae. Advanced radiotherapeutic techniques offer theoretical advantages of preserving neurological functions, however, clinical evidence of such is limited. The current study constitutes a secondary analysis of CP patients in a Randomized Control Trial testing Conventional RT (ConvRT) versus Stereotactic Conformal Radiotherapy (SCRT)(NCT00517959). Eighty-two patients of CP (SCRT: 39, ConvRT: 43, Dose: 54Gy in 30 fractions) were analysed, assessing the clinical impact of dosimetric sparing on neurocognitive function, endocrine function, overall survival (OS) and local control (LC). Patients were longitudinally assessed from baseline through five years post-treatment using the WISC/WAIS scales. The median age was 13 years (IQR= 9-17 years). The 10-year OS and LC rates were 86.4% and 92.7%, respectively, with no significant difference between the arms.SCRT patients showed significant improvement in mean full-scale IQ (difference in slope=3.3 points per year, p= 0.01) and performance quotient (difference in slope=3.6, p= 0.04) compared to those treated with ConvRT. Freedom from cognitive decline (a 5-point drop) at 5 years was higher with SCRT (66.6% vs. 38.2%; HR=0.41, p=0.03). Younger age (<15 years) was a significant negative predictor of neurocognitive outcomes (p=0.002). SCRT patients also experienced lower cumulative incidence of new neuroendocrine dysfunction (25.7% vs. 48.8%, p=0.029). SCRT offers excellent tumour control and similar survival with superior long-term preservation of neurocognitive and endocrine functions in CP patients compared to conventional RT. High precision RT should constitute the standard of care in CP.

Assessing Infant Gross Motor Performance With an At-Home Wearable.

Early development of gross motor skills is foundational for the upcoming neurocognitive performance. Here, we studied whether at-home wearable measurements performed by the parents could be used to quantify and track infants' developing motor abilities. Unsupervised at-home measurements of the infants' spontaneous activity were made repeatedly by the parents using a multisensor wearable suit (altogether 620 measurements from 134 infants at age 4-22months). Machine learning-based algorithms were developed to detect the reaching of gross motor milestones (GMM), to measure times spent in key postures, and to track the overall motor development longitudinally. Parental questionnaires regarding GMMs were used for developing the algorithms, and the results were benchmarked with the interrater agreement levels established by World Health Organization (WHO). A total of 97 infants were used for the algorithm development and cross-validation, whereas an external validation was done using 37 infants from an independent recruitment in the same hospital. The algorithms detected the reaching of GMMs very accurately (cross-validation: accuracy, 90.9%-95.5%; external validation, 92.4%-96.8%), which compares well with the human experts in the WHO reference study. The wearable-derived postural times showed strong correlation to parental assessments (ρ = .48-.81). Individual trajectories of motor maturation showed strong correlation to infants' age (ρ = .93). These findings suggest that infants' gross motor skills can be quantified reliably and automatically from unsupervised at-home wearable recordings. Such methodology could be used in health care practice and in all developmental studies for gaining real-world quantitation and tracking of infants' motor abilities.

Effects of an app-based physical training for long- and post-COVID treatment (A PILOT) study: protocol for a multicentre randomised controlled trial

Long- and post-COVID syndrome (PCS) affect at least 65 million individuals globally, with an estimated incidence of 10% among over 651 million documented cases of SARS-CoV-2 infection. PCS impacts nearly...

Efficacy of perioperative dexmedetomidine on postoperative pain and neurocognitive functions in orthopaedic surgery: a systematic review and meta-analysis with trial sequential analysis of randomized controlled trials.

With an estimated 2.1 million hip and knee replacements performed annually in developed countries, orthopaedic surgeries can result in complications such as postoperative pain and cognitive dysfunctions. Dexmedetomidine shows potential for reducing pain and opioid use and improving cognitive outcomes, but its efficacy in orthopaedic settings needs further evaluation. A comprehensive literature search was performed across electronic databases (e.g. PubMed) up to 1 June 2024, to identify relevant randomised controlled trials (RCTs) investigating the use of dexmedetomidine for orthopaedic surgeries. The primary outcomes included visual analogue scale (VAS), opioid consumption, incidence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). The meta-analysis was conducted via RevMan 5.3 and Stata 16.0, with statistical significance set at p < 0.05. Sensitivity analyses, along with trial sequential analysis (TSA), were used to evaluate the robustness of the findings. The meta-analysis included 59 RCTs with 7,713 participants and demonstrated that dexmedetomidine significantly reduced postoperative VAS score [mean difference (MD)-0.50, P=0.0003] and opioid consumption (MD -11.91, P<0.0001) and decreased the incidence of POCD [risk ratio (RR) 0.59, P=0.006] and POD (RR 0.49, P<0.0001). Dexmedetomidine also prolonged motor (MD: 1.70, P<0.0001), sensory block durations (MD: 1.80, P<0.0001), and delayed the time to first rescue analgesics (MD: 1.51, P<0.0001). TSA and sensitivity analysis confirmed the robustness and reliability of the results, whereas meta-regression revealed no significant effect of variables on primary outcomes. Our study demonstrates that intravenous dexmedetomidine significantly improved postoperative pain and neurocognitive functions in orthopaedic surgery patients.

Sex differences in psychosocial functioning and neurocognition in bipolar disorder: a systematic review and meta-analysis.

Impairment in both psychosocial functioning and neurocognition (NC) performance is present in bipolar disorder (BD) yet the role of sex differences in these deficits remains unclear. The present systematic review and meta-analysis examined whether males and females with BD demonstrate differences in psychosocial functioning and NC performance. The Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, and Web of Science databases were systematically searched from inception until November 20, 2023. Twenty studies published between 2005 and 2023 with a total sample size of 2286 patients with BD were included. A random effects meta-analysis revealed a statistically significant result with a small effect (SMD = 0.313) for sex differences in verbal learning and memory as well as visual learning and memory (SMD = 0.263). Females outperformed males in both domains. No significant sex differences were observed for any other NC outcome or psychosocial functioning. High heterogeneity and differences in assessment scales used should be considered when interpreting these findings, given their potential impact on results. Future research should adopt a more homogenous, standardized approach using longitudinal designs to gain a clearer insight into sex differences in this population. This approach so may increase the use of preventative therapeutic options to address the difficult clinical challenge of reaching cognitive and functional recovery.

Impact of early nutrition on brain development and neurocognitive outcomes in very preterm infants.

Malnutrition of preterm infants may negatively affect brain growth and later neurocognitive function. We aimed to investigate the association between very preterm infants' macronutrient intakes, and brain MRI at term and neurodevelopment at 2 years. Single-center, retrospective cohort including extremely (22-27w) and very (28-31w) preterm infants born 2011-2014. The intakes of fluid, protein, carbohydrate, fat, and total calories during days 0-28 together with body weights were assessed in relation to brain MRI (morphology, volumetry, diffusion-weighted imaging) at term, and cognition (BSID-III) at 2 years, using adjusted multivariable regression analyses. Seventy-two infants were included. A lower (p < 0.001) caloric intake in extremely preterm (n = 26) than in very preterm (n = 46) infants did not translate to any differences in brain volumes. While bivariate correlations (p < 0.01) were found between the enteral intakes of all macronutrients, and white matter volume and apparent diffusion coefficients, none of the correlations remained significant after adjusting for covariates in the multivariable analysis. Similarly, no associations between nutrient intakes and cognitive development remained after covariate adjustment. In a cohort of preterm infants receiving macronutrient intakes meeting current recommendations, individual variations in nutrition did not influence brain growth or neurodevelopment. Early postnatal macronutrient intake was not associated with brain volumes at term or neurocognitive outcomes at 2 years in very preterm infants All infants received nutritional intakes meeting current recommendations Adequate macronutrient intake based on a standardized protocol may eliminate the need for further minor adjustments in the pursuit of supporting brain growth and neurodevelopment in preterm infants.

Greater Cognitive-Motor Interference Among Patients After Anterior Cruciate Ligament Reconstruction Compared With Controls.

Chaotic sporting environments require the performance of concurrent cognitive and motor tasks. A reduced capacity for either or both of the tasks when performed concurrently is known as cognitive-motor interference (CMi) and is believed to increase the injury risk. A greater susceptibility to CMi after a rupture of the anterior cruciate ligament (ACL) has been suggested to be caused by central nervous system adaptations, thus possibly contributing to high secondary ACL injury rates. To investigate whether patients after ACL reconstruction (ACLR) demonstrate greater CMi than noninjured controls when adding secondary cognitive tasks to the drop vertical jump (DVJ) and explore the potential influence of sex on CMi. Controlled laboratory study. A total of 40 (50% male) sports-active patients who had undergone ACLR (mean, 24.9 ± 16.1 months after surgery) and 40 (50% male) sports-active noninjured controls performed DVJs with and without secondary cognitive tasks targeting short-term memory, attention, fast decision-making, and inhibitory control. Outcomes included a letter position recall task and 3 motor variables: (1) correct action (landing or landing with a subsequent vertical jump), (2) relative jump height (relative between DVJs), and (3) relative peak vertical ground-reaction force (relative between DVJs). Participants also completed isolated cognitive tests (CANTAB) included as covariates in multivariate analysis. Multivariate analysis of variance revealed that the ACLR group had greater CMi than the control group (P < .001), as manifested by more incorrect answers for the cognitive letter recall task (mean difference [MD], -13.3% [95% CI, -20.8% to -5.9%]; P < .001), more incorrect motor actions (MD, -7.5% [95% CI, -12.4% to -2.6%]; P = .003), and a reduced relative jump height (MD, -4.5% [95% CI, -7.9% to -1.2%]; P = .010). No difference in relative peak vertical ground-reaction force was found (MD, 2.8% [95% CI, -7.7% to 13.3%]; P = .59). Isolated cognitive outcomes did not affect these results, and there were no significant differences between male and female participants. Patients after ACLR showed greater CMi than noninjured controls, which was unrelated to isolated cognitive outcomes, thus indicating aberrant neurocognitive function. Clinicians should consider cognitive and dual-task training and screening during ACL rehabilitation to better prepare patients for chaotic and uncontrolled sporting environments in which dual tasking is prevalent. Such interventions may help to reduce the risk of secondary ACL injuries.

Cognitive and social functions of craniopharyngioma and germ cell tumor differ in patients with and without apathy.

Apathy, the quantitative reduction of self-generated voluntary and purposeful behaviors, can affect social functions in patients with acquired brain injury. However, how apathy impairs social life in patients with craniopharyngioma and germ cell tumor (diencephalon tumor) remains unclear. Therefore, this study investigated patients with diencephalon tumors to assess the impact of apathy on their neurocognitive, social cognitive, and social functions. Patients with diencephalon tumors treated at Kyoto University Hospital were enrolled in this observational study. Apathy was assessed using the Apathy Scale, while neurocognitive functions were evaluated using the Wechsler Adult Intelligence Scale-IV (WAIS-IV), Wechsler Memory Scale-Revised (WMS-R), and Behavioural Assessment of the Dysexecutive Syndrome. Social cognitive functions were evaluated by means of an emotion perception task and a theory of mind (ToM) task. Finally, social functions were evaluated using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0, where a high score indicates greater functioning difficulties experienced. Apathy was observed in 11 (45.8%) of 24 patients (15 males), with a mean (standard deviation) age of 35.83 (14.79) years. Patients with apathy scored significantly lower on the Verbal Comprehension Index (WAIS-IV), Working Memory Index (WAIS-IV), Attention (WMS-R), and ToM task than those without apathy (P = 0.03, 0.04, 0.01, and 0.046, respectively). Further, they scored significantly higher on the WHODAS 2.0 than patients without apathy. Apathy manifests as a neuropsychological complication and affects social functions in patients with diencephalon tumors. Effective interventions for apathy may ameliorate the social dysfunctions of patients with diencephalon tumors.

Illuminating the hidden cost: A systematic review of cognitive late effects regarding cancer-related fatigue in treated paediatric brain tumors.

Illuminating the hidden cost: A systematic review of cognitive late effects regarding cancer-related fatigue in treated paediatric brain tumors.

Alterations in degree centrality and functional connectivity associated with cognitive Impairment in myotonic dystrophy type 1:A Preliminary functional MRI study.

Alterations in degree centrality and functional connectivity associated with cognitive Impairment in myotonic dystrophy type 1:A Preliminary functional MRI study.

Specific immune-inflammatory profiles and neurocognitive deficits predict illness trajectories in people with type 2 diabetes mellitus or psychiatric disorders.

Specific immune-inflammatory profiles and neurocognitive deficits predict illness trajectories in people with type 2 diabetes mellitus or psychiatric disorders.