Neurocognitive Profile Research Articles

Clinical Utility of Cerebrospinal Fluid Aβ42 and Tau Measures in Diagnosing Mild Cognitive Impairment in Early Onset Dementia.

The differentiation of a preclinical or prodromal Alzheimer's disease (AD) is challenging particularly in patients with early onset Alzheimer's or related dementias (EOARD). We report our experience on diagnostic lumbar puncture to diagnose EOARD at a tertiary neurocognitive referral center in Nottingham, England from March 2018 to October 2020. To assess amyloid-β42 (Aβ42), total tau, and Thr181-phosphorylated tau (p-tau) measurements in the cerebrospinal fluid (CSF) in patients with mild cognitive impairment (MCI) and in relation to their follow-up cognitive performance. Thirty participants aged 32-68 years old (mean 59 years; 57% female) were included. Clinical diagnosis was based on clinical presentation, neurocognitive profile, neuroradiological features (MRI, FDG-PET CT) and CSF Aβ42, total tau, and p-tau measurements. Patients with MCI who progressed to AD (prodromal AD) had significantly higher CSF total (797.63 pg/ml) and p-tau (82.31 pg/ml), and lower Aβ42 levels (398.94 pg/ml) in comparison to their counterparts with stable MCI (total tau 303.67 pg/ml, p-tau 43.56 pg/ml, Aβ42 873.44 pg/ml) (p < 0.01 for CSF total and p-tau measures and p < 0.0001 for CSF Aβ42 measures). None of the CSF biomarkers correlated with any of the cognitive performance measures. Principal component analysis confirmed that the clinical diagnosis of MCI secondary to AD, namely prodromal AD (as per NIA-AA criteria) in younger adults, was associated with decreased CSF Aβ42. In early onset AD, low levels of CSF Aβ42 appear to be more sensitive than total and p-tau measures in differentiating AD MCI from other forms of dementia. Further work on larger samples of EOARD in clinical practice will address the cost effectiveness of making an earlier diagnosis.

Differential trajectory of cognitive functions in neurocognitive subgroups of newly diagnosed patients with bipolar disorder and their unaffected first-degree relatives — A longitudinal study

BackgroundCognitive impairments exist in a large proportion of remitted patients with bipolar disorder (BD). However, no study has investigated the cognitive trajectories across neurocognitive subgroups of patients or their unaffected first-degree relatives (UR). MethodsNewly diagnosed BD patients, UR and healthy controls (HC) underwent comprehensive cognitive testing at baseline and at 16-months follow-up. Hierarchical cluster analysis was conducted to identify homogeneous subgroups of patients based on their neurocognitive profile at baseline. Cognitive change across subgroups of patients and UR was assessed with linear mixed-model analyses. ResultsData from baseline and follow-up were collected from 152 patients, 53 UR and 135 HC. Patients were clustered into three discrete neurocognitive subgroups: ‘cognitively normal' (43%), ‘mild-moderately impaired’ (33%) and ‘globally impaired’ (24%). While ‘mild-moderately impaired’ patients and HC showed normative cognitive improvement over time in global cognition (p < .001), ‘globally impaired’ patients showed greater improvement than all groups (p < .001), whereas ‘cognitively normal' patients showed a lack of normative improvement (p = .17). UR of impaired patients showed a lack of normative improvement in executive functions (p = .01). ‘Globally impaired’ patients also presented with stable impairments in facial expression recognition and emotion regulation. LimitationsFollow-up data was available for 62% of participants, possibly reflecting a selection bias. ConclusionsThe greater cognitive improvement in ‘globally impaired’ patients partly speaks against neuroprogression. However, the lack of normative improvement in ‘cognitively normal' patients could indicate negative effects of illness. Further follow-up assessments are warranted to clarify whether lack of normative improvement in executive function in UR represents an illness risk-marker.

Examining the association of life course neurocognitive ability with real-world functioning in schizophrenia-spectrum disorders

There is considerable variability in neurocognitive functioning within schizophrenia-spectrum disorders, and neurocognitive performance ranges from severe global impairment to normative performance. Few investigations of neurocognitive clusters have considered the degree to which deterioration relative to premorbid neurocognitive abilities is related to key illness characteristics. Moreover, while neurocognition and community functioning are strongly related, understanding of the sources of variability in the association between these two domains is also limited; it is unknown what proportion of participants would over-perform or under-perform the level of functioning expected based on current neurocognitive performance vs. lifelong attainment. This study examined data from 954 outpatients with schizophrenia-spectrum disorders across three previous studies. Neurocognition, community functioning, and symptoms were assessed. Neurocognitive subgroups were created based on current neurocognition, estimated premorbid IQ, and degree of deterioration from premorbid using z-score cut-offs; functional subgroups were created with cluster analysis based on the Specific Level of Functioning Scale and current neurocognition. The sample was neurocognitively heterogeneous; 65% displayed current neurocognitive impairment and 84% experienced some level of deterioration. Thirty percent of our sample was relatively higher functioning despite significant neurocognitive impairment. Individuals with better community functioning, regardless of neurocognitive performance, had lower symptom severity compared to those with worse functioning. These results highlight the variability in neurocognition and its role in functioning. Understanding individual differences in neurocognitive and functional profiles and the interaction between prior and current cognitive functioning can guide individualized treatment and selection of participants for clinical treatment studies.

The role of the default mode network in longitudinal functional brain reorganization of brain gliomas

The study of patients after glioma resection offers a unique opportunity to investigate brain reorganization. It is currently unknown how the whole-brain connectomic profile evolves longitudinally after surgical resection of a glioma and how this may be associated with tumor characteristics and cognitive outcome. In this longitudinal study, we investigate the impact of tumor lateralization and grade on functional connectivity (FC) in highly connected networks, or hubs, and cognitive performance. Twenty-eight patients (17 high-grade, 11 low-grade gliomas) underwent longitudinal pre/post-surgery resting-state fMRI scans and neuropsychological assessments (73 total measures). FC matrices were constructed considering as functional hubs the default mode (DMN) and fronto-parietal networks. No-hubs included primary sensory functional networks and any other no-hubs nodes. Both tumor hemisphere and grade affected brain reorganization post-resection. In right-hemisphere tumor patients, regardless of grade and relative to left-hemisphere gliomas, FC increased longitudinally after the intervention, both in terms of FC within hubs (phubs = 0.0004) and FC between hubs and no-hubs (phubs-no-hubs = 0.005). Regardless of tumor side, only lower-grade gliomas showed longitudinal FC increases relative to high-grade tumors within a precise hub network, the DMN. The neurocognitive profile was longitudinally associated with spatial features of the connectome, mainly within the DMN. We provide evidence that clinical glioma features, such as lateralization and grade, affect post-surgical longitudinal functional reorganization and cognitive recovery. The data suggest a possible role of the DMN in supporting cognition, providing useful information for prognostic prediction and surgical planning.

Differential Profile of High-Performance Adults with Attention Deficit Hyperactivity Disorder

Objective: To compare the neurocognitive profile of a subgroup of patients with ADHD who have a high academic-occupational functioning vs. patients with low functioning. Method: A total of 50 adults with ADHD, 10 with high academic-occupational functioning (ADHD/HF), 20 with low academic-occupational functioning (ADHD-LF), and 20 healthy controls were assessed with a standard neuropsychological battery. Independent sample tests and logistic regression were calculated to compare the performance of the three groups and to identify predictor variables. Results: Statistically significant differences were found in the forward digits subtest between the subtypes of ADHD, but not between ADHD-HF and controls, nor between controls and ADHD-LF. In matrix reasoning subtest, significantly lower performances were registered between both ADHD groups compared to the control group. In the letter number subtest, ADHD-LF obtained a significant lower performance than the control group, but the ADHD-HF group do not differ with the other two groups. Finally, regarding to the binary logistic regression analysis, it could be observed that the only variable that best predicted belonging to these groups has been forward digits, which according to the data of the model would be a protection factor. Conclusion: The profile of patients with high socio-occupational performance was characterized by a better conservation of working memory and the capacity for sustained attention, and a lower tendency to distraction.

Neurocognitive Profiles of Children With High Intellectual Ability: A Pilot Study

A common question among teachers of students with high intellectual ability is how to best teach this group of children. To answer this question, it is first necessary to better understand their cognitive profiles. Thus, the primary goal of this study was to examine the neurocognitive profiles of children with high intellectual ability. To do this, we used the Discrepancy Consistency Model (Naglieri, 1999), which allows researchers to detect patterns of cognitive strengths and weaknesses. One hundred forty-two children with high intellectual ability (70 females, 72 males; Mage = 127.41 months, SD = 10.76) from Grades 4, 5, and 6 were assessed on measures of general intelligence and academic achievement, as well as on measures of Planning, Attention, Simultaneous, and Successive (PASS) processes. Results showed that 54% of the sample had a PASS score that was significantly lower than that of each student’s average PASS score. Only 8% of the students had a PASS disorder (a score that was low in relation to the student’s average and below 90). Further, 4% of our sample had both a PASS disorder and an academic-skills disorder. The findings suggest that students with high intellectual ability can show variability in PASS scores that may have relevance for instructional programming and for identifying twice-exceptional children.

Improving Anxiety Screening in Patients with Turner Syndrome

Introduction: Turner syndrome (TS) results from a complete or partial loss of the X chromosome and affects 25–50 per 100,000 females. These individuals have characteristic neurocognitive and psychological profiles with an increased lifetime prevalence of mood disorders, such as depression and anxiety. Consensus guidelines recommend the use of psychometrically robust tools to screen for these conditions [Eur J Endocrinol. 2017;177(3):G1–G70 and Gynecol Endocrinol. 2004;19(6):313–9]. We propose a sustainable and informative approach to routine anxiety screening in individuals with TS and describe the prevalence of anxiety, genotype-phenotype associations, and impact of comorbidities on anxiety. Methods: We pilot the use of a self-administered version of the validated Pediatric, Parent Proxy, and Adult Patient-Reported Outcomes Measurement Information System (PROMIS®) Anxiety tool during routine visits to the Cincinnati Children’s Hospital Medical Center (CCHMC) TS clinic from October 2019 to March 2020. Results: Ninety-two eligible TS females, ages 8–62 years, received the PROMIS® Anxiety measure. Elevated anxiety scores, ≥1 standard deviation above the T-score mean, were present in 65% of patients (38% mild, 19% moderate, and 8% severe). Results were discussed during the clinic visit, and referral for further evaluation and treatment was offered. There was no apparent genotype-phenotype association among females with anxiety; however, there appeared to be elevated anxiety symptoms (T-score >60) in those with hearing deficits and also in individuals with three or more medical comorbidities. Of the 55% of patients who filled out the acceptability survey, 88% found the process helpful and ∼50% felt that screening should be performed at least every 6 months. Conclusion: Our study demonstrated a high prevalence of anxiety symptoms within a cohort of 92 females with TS. In alignment with current guidelines, these findings indicate the importance of routine neuropsychological assessments for timely recognition and subsequent management of anxiety, especially as milder presentations may otherwise go unnoticed. We have shown that screening tools, such as the PROMIS® Anxiety measure, can be easily utilized by nonmental health care providers (i.e., endocrinologists) who may see TS patients more frequently and be able to initiate impactful discussions surrounding mental health and further referral to subspecialists for expert management.

Cognitive Impairment and Neurocognitive Profiles in Major Depression-A Clinical Perspective.

Increasingly, studies have investigated cognitive functioning from the perspective of acute state- to remitted phases of Major Depressive Disorder (MDD). Some cognitive deficits observed in the symptomatic phase persist in remission as traits or scars. The etiological origin and clinical consequences of the neurocognitive profiles reported in the literature are still unclear and may vary across populations. Deficits are suspected to influence the association between MDD and neurodegenerative disorders and could thus be of particular clinical consequence. The aim of this review is to describe the clinical neuropsychological profile in MDD and how it is related to research during the past decade on cognitive deficits in MDD from a state, trait, and scar perspective. This review, with a clinical perspective, investigates research from the past decade regarding cognitive functioning in MDD in a long-term perspective. We focus on the clinical manifestation of deficits, and the potential neurodegenerative consequences of the neurocognitive profile in MDD. Searches in Medline, PsycINFO and Embase were conducted targeting articles published between 2010 and 2020. Examination of the evidence for long-lasting neurocognitive deficits in major depression within the cognitive domains of Memory, Executive Functions, Attention, and Processing Speed was conducted and was interpreted in the context of the State, Scar and Trait hypotheses. Defining the neurocognitive profiles in MDD will have consequences for personalized evaluation and treatment of residual cognitive symptoms, and etiological understanding of mood disorders, and treatments could potentially reduce or delay the development of neurodegenerative disorders.

Characterizing the neurocognitive profiles of children with moyamoya disease using the Das Naglieri cognitive assessment system

Although cognitive impairment is well-documented in children with moyamoya disease (MMD), selective decline in specific neurocognitive domains remains controversial. The purpose of this study was to characterize the neurocognitive profile of children with MMD using the Das Naglieri Cognitive Assessment System (CAS) and the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). We analyzed the neurocognitive data of 30 children (median age, 7 years) with MMD who were assessed with the CAS and the WISC-IV before surgery. We focused on the comparison of standard scores and intraindividual differences across domains. The CAS scores significantly varied across four measures (standard scores, p < 0.001; intraindividual differences, p < 0.001). Post-hoc analyses revealed that the standard scores and intraindividual differences for successive processing were significantly lower than those for planning and attention. The WISC-IV scores did not significantly vary among the four measures, although the working memory index was the lowest among the four measures. The within-individual weakness in successive processing, a form of working memory function, may be a distinct characteristic of children with MMD. The CAS may be more sensitive than the WISC-IV for detecting this selective neurocognitive weakness in children with MMD.

Hope in Neurodiverse Adolescents: Disparities and Correlates

ObjectivesHope is reliably associated with positive outcomes in youth; however, prior literature has yet to explore hope in neurodiverse individuals. As adolescents with neurodevelopmental differences (ND) display distinct neurocognitive profiles and are at risk for poor psychosocial outcomes, it is essential to understand how this marginalized group may vary in their own subjective ratings of hope, and how hope may relate to positive adjustment in this population. Further investigation of relational determinants, such as family characteristics and peer relationships, is also warranted to increase understanding of how various dimensions of social support relate to hope for different populations.MethodsThe current study assessed group differences in hope for ND adolescents on the autism spectrum and/or with intellectual disabilities, as compared to neurotypical (NT) adolescents. Additionally, correlates and predictors of hope were clarified across neurodiverse groups. Participants included 185 adolescents (NT: n = 96; ND: n = 89) and their mothers as part of a larger longitudinal study.ResultsResults indicated that adolescents with ND reported significantly lower hope than NT peers, t(183) = 3.31, p = .001, with autistic adolescents at highest risk. Regardless of neurodevelopmental status, greater hope was associated with fewer internalizing symptoms (F(1,178) = 12.35, p = .001) and higher quality of life (F(1,179) = 57.05, p < .001). Furthermore, maternal scaffolding and adolescent social skills were predictive of higher hope across groups.ConclusionsFindings underscore the importance of hope in adolescence for all youth and highlight avenues for intervention.

EP136: An exploration of the impact of Hormonal Replacement Therapy (HRT) upon vocabulary skills in males with 49,XXXXY

49,XXXXY is a rare variant of 47,XXY, Klinefelter syndrome, that occurs in approximately 1 in 100,000 live male births. It is the most uncommon and complex X and Y chromosomal variation consisting of neurodevelopmental, physical, and medical complications. These boys are at an increased risk for musculoskeletal abnormalities and health difficulties. Intellectual disability, motor deficits, and severe speech dysfunction are common to this population. Specifically, receptive language skills are typically more advanced than expressive language skills, with some individuals being nonverbal. Childhood Apraxia of Speech (CAS) is thought to be the origin of speech and expressive language dysfunction in these boys suggesting that the core challenge is rooted in motor planning deficiency. Challenges in expressive language typically affect all aspects of daily life for males with 49,XXXXY, as it is difficult for them to convey their thoughts and feelings. This often leads to difficulties expressing themselves, social communication challenges, and peer isolation. Males with 49,XXXXY have androgen deficiency that benefits from hormonal replacement therapy (HRT). HRT has been found to have positive effects on neurodevelopmental capabilities in males with 49, XXXXY. Specifically, treated individuals have been found to have improved neurodevelopmental function than the untreated and may therefore have a potential beneficial impact on social skills. Two types of HRT are common during infancy and the childhood years: early hormonal treatment (EHT) and hormonal booster therapy (HBT). EHT is often administered during the “mini-puberty” period, ideally given at 4, 5, and 6 months old, but can be given up until 2 years of age. HBT may be recommended during the school-aged population, often beginning around 5 years old and given up until 11years old. The current study explores the effect of HRT upon expressive and receptive vocabulary skills in males with 49,XXXXY. One hundred and one participants with a diagnosis of 49,XXXXY were evaluated for this study (CA: 88.9 months). Participants completed the Expressive One-Word Picture Vocabulary Test 4th Edition (EOWPVT-4) and the Receptive One-Word Picture Vocabulary Test 4th Edition (ROWPVT-4). Subjects were segregated into four different groups according to their HRT status: no-T, EHT, HBT, and EHT&HBT. EHT consisted of 3 intramuscular injections of 25 mg of testosterone enanthate, once monthly, for three months given between 4 and 24 months of age. HBT consisted of 3 intramuscular injections of 50 mg of testosterone enanthate, once monthly for three months administered between the ages of 5 and 11. Two-tailed t-tests were completed to assess the differences within HRT groups between performance on the EOWPVT-4 and ROWPVT-4. The no-T group (CA: 90.3 months, N = 20) showed a significant difference between EOWPVT-4 and ROWPVT-4 scores (p = .00888) with receptive capabilities being higher than their expressive skills. The EHT group (CA: 79.3 months, N = 44) approached significance with greater skills on the ROWPVT-4 in comparison to the EOWPVT-4 (p = .0556). Finally, the HBT (CA: 104.5 months, N = 8) and EHT&HBT groups (CA: 98.1 months, N = 29) showed no differences between their receptive and expressive capabilities (p = .532; p = .700). The current study expands on the neurocognitive profile of boys with 49,XXXXY and the impact of HRT on their expressive and receptive vocabulary skills. Individuals with 49,XXXXY typically present with severely depressed expressive capabilities in comparison to their receptive skills. The no-T group had this typical presentation with higher receptive language abilities in comparison to expressive capabilities while the EHT, HBT, and EHT&HBT groups showed no differences between receptive and expressive vocabulary skills. Participants who received EHT, HBT, or a combination performed higher on the EOWPVT-4 and presented with commensurate and higher receptive and expressive vocabulary skills than those who had not been treated. These results suggest a positive treatment effect of both EHT and HBT on expressive vocabulary capabilities in boys with 49,XXXXY.

Neurocognitive Profiles of Caucasian Moyamoya Disease Patients in Greece: A Case Series.

The impact of Moyamoya Disease (MMD) on cognition inadult Caucasian patients has not yet been thoroughly investigated. The current study is the first to present detailed neuropsychological data on a series of Greek patients with MMD. A group of eight patients was assessed with an extensive neuropsychological battery, including measures of episodic memory, working memory, executive functions, language, and social cognition. The results indicated that MMD may be characterized by a trichotomous neurocognitive profile, characterized by prominent impairment in working memory, executive functions, and social cognition. Overall, we stress the need for a thorough cognitive evaluation of MMD patients and further highlight the potential importance of social cognition in this particular disease. Possible associations between the three impaired cognitive domains in our group are also discussed.

Neurocognitive outcomes of children with non-syndromic single-suture craniosynostosis.

While the focus of craniosynostosis surgery is to improve head shape, neurocognitive sequelae are common and are incompletely understood. Neurodevelopmental problems that children with craniosynostosis face include cognitive and language impairments, motor delays or deficits, learning disabilities, executive dysfunction, and behavioral problems. Studies have shown that children with multiple suture craniosynostosis have more impairment than children with single-suture craniosynostosis. Children with isolated single-suture subtypes of craniosynostosis such as sagittal, metopic, and unicoronal craniosynostosis can have distinct neurocognitive profiles. In this review, we discuss the unique neurodevelopmental profiles of children with single-suture subtypes of craniosynostosis.

Neurocognitive profile of adolescents with early-onset schizophrenia and their unaffected siblings

Background We investigated the neurocognitive profiles of Early-Onset Schizophrenia (EOS; onset before age 18) and paired unaffected siblings and the little-studied effect of age-of-onset and duration of illness on cognitive performance. Methods 31 EOS probands, and 31 of their siblings, had four cognitive domains assessed: (a) Memory: California Verbal Learning Test, and the Wechsler Memory Scale-Revised; (b) Working memory: Digit Span; (c) Attention: Degraded-Stimulus Continuous Performance Test, Span of Apprehension (SPAN), and Trail Making Test (TMT) part A; (d) Executive function: Wisconsin card sorting task, and TMT part B. Diagnosis was confirmed using the structured clinical interview for DSM-IV. Results While EOS showed a generalised neurocognitive deficit (0.25–0.50 effect size) compared with siblings, across all cognitive domains, significantly greater patient deficits were observed with, working memory, attention, and executive function and minimal differences for digit span forward, block design and false alarms on the SPAN-12 confirmed by repeated measures MANOVA. Patients with earlier onset (12–15) showed greater deficits on false alarm and digits backward scores. Siblings showed individual cognitive task profiles similar to patients, confirming familial effects. EOS showed much more variable scores than siblings with more individual tasks showing 2 SD deficits than siblings. Long duration patients had greater z-score variability across tasks. Conclusions Duration of illness was a more important characteristic in patients with onset 16 and over than in younger onset patients with comparable durations. Both the similarity of sibling pair profiles and greater patient variability across task provide further support for neurobiological heterogeneity in schizophrenia.

Neurocognitive Profiles in Patients With Persisting Cognitive Symptoms Associated With COVID-19.

ObjectiveA subset of individuals with coronavirus disease 2019 (COVID-19) appears to develop persisting cognitive and medical symptoms. Research in the acute stages of illness, generally utilizing cognitive screening measures or case reports, suggests presence of deficits in attention and executive function. This observational study investigated cognitive functioning among individuals with persistent cognitive complaints about 5.5 months after COVID-19 infection.MethodsPatients with polymerase chain reaction confirmed COVID-19 and persistent cognitive complaints underwent comprehensive in-person neuropsychological evaluations. Patients with prior neurological disorders were excluded. When diagnosed, 40% required hospitalization, 15% were in an intensive care unit, 10% needed mechanical ventilation, and 10% experienced delirium.ResultsThis sample was predominately women (90%), White non-Hispanic (70%), with average education of 15 years. Mild cognitive deficits were seen on tests involving attention and processing speed or executive function. Seventy percent of patients were diagnosed with a mood disorder prior to COVID-19 infection. At the time of testing, 35%–40% endorsed moderate to severe mood symptoms and 85% noted significant fatigue as measured by the Fatigue Severity Scale.ConclusionsThe pattern of cognitive deficits, although mild, is consistent with prior research at the acute stage of the illness. These findings suggest that psychological factors and other persisting symptoms (e.g., sleep, fatigue) may play a significant role in subjective cognitive complaints in patients with persisting complaints post COVID-19 who did not require intensive treatment. These patients would likely benefit from resources to manage persisting or new mood symptoms and compensatory strategies for the cognitive inefficiencies they experience.

Relationship of the balloon analog risk task to neurocognitive impairment differs by HIV serostatus and history of major depressive disorder

HIV and major depressive disorder (MDD) commonly co-occur and are both linked to greater risk-taking behavior, possibly due to neurocognitive impairment (NCI). The present study examined the concordance of the Balloon Analog Risk Task (BART), a gold standard measure of risk-taking propensity, with NCI and real-world sexual risk behaviors in PWH with comorbid MDD. Participants included 259 adults, stratified by HIV serostatus (HIV + /HIV −) and lifetime MDD (MDD + /MDD −), who completed neuropsychological testing, the BART, and sexual risk behavior questionnaires. Logistic regression, stratified by HIV serostatus, examined joint effects of MDD and BART (linear and quadratic) on NCI. Follow-up linear regressions examined sexual risk behavior and neurocognitive domain T-scores as correlates of the BART. NCI prevalence was lowest in HIV − /MDD − , but BART scores did not differ by HIV/MDD status. In the HIV + group, BART performance predicted NCI such that high and low BART scores related to greater odds of NCI, but only in dual-risk HIV + /MDD + individuals. HIV + /MDD + individuals with both low and high BART scores exhibited poorer learning and recall, whereas processing speed and executive function were only poor in low BART risk-taking HIV + /MDD + . Higher BART scores linearly related to higher sexual risk behaviors only in MDD + individuals, independent of HIV serostatus. Low and high risk-taking on the BART may reflect discrete neurocognitive profiles in HIV + /MDD + individuals, with differential implications for real-world sexual risk behavior. HIV and comorbid MDD may disturb corticostriatal circuits responsible for integrating affective and neurocognitive components of decision-making, thereby contributing to risk-averse and risk-taking phenotypes.

FEATURES OF NEUROCOGNITIVE IMPAIRMENTS IN PATIENTS WITH MILD COGNITIVE DISORDER OF DIFFERENT ETIOLOGY

Introduction. Mild cognitive disorder (MCD) is a heterogeneous syndrome that involves problems with memory, speech, and thinking that are inconspicuous and do not affect the patient's independence and daily life. The article considers similarities and differences in the neurocognitive profiles of patients with mild cognitive disorders of various etiologies. Materials and methods. We examined 60 people: 30 subjects aged 50 to 83 years with a mild cognitive disorder of various etiologies and 30 relatively healthy individuals as the control group. All patients underwent a magnetic resonance imaging (MRI) examination of the brain. We used the psychometric method and the following scales: the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MoCA), the Frontal Assessment Battery (FAB), the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-cog), the Clinical Dementia Rating (CDR); the results were analyzed using the method of statistical processing. Results. According to the results of neurocognitive testing, no significant differences were found in the total scores (p = 0.6209), in particular, using the MMSE scale in patients with non-anamnestic (nMCD) and anamnestic (aMCD) мild cognitive disorder and мild cognitive disorder (aMCD). However, patients with nMCD showed significantly lower results with subtests: "attention and calculation" (p = 0.0443). According to the MoCA scale, patients with nMCD had a higher score vs. patients with aMCD (p = 0.0457), namely in the "delayed recall" subtests (p = 0.0102). Patients with nMCD had significantly lower results with the "attention and calculation" subtest (p = 0.0468). No significant differences were found between the groups of patients with MCD according to the results of testing with the FAB scale (p = 0.4778). According to some subtests of the ADAS-cog scale, patients with aMCD showed worse results with the "word recall" test (p = 0.0069) and "word recognition" (p = 0.0350). In patients with nMCD, lower scores were observed for the subtests "concentration and distractibility" (p = 0.0468), "number cancellation task" (p = 0.0217), and "passing the labyrinth" (p = 0.0015). Patients with aMCD showed significantly lower cognitive abilities than patients with nMCD. Consequently, patients with aMCD may be significantly at high risk of progression to Alzheimer's disease. Conclusions. After comparing the data of neurocognitive profiles, we established that in patients with anamnestic мild cognitive disorder, the clinical picture presented with a pronounced memory disorder, especially delayed recall, while the patients with non-anamnestic мild cognitive disorder were characterized by regulatory cognitive impairment (attention and calculation, reduced speed of thinking, impaired planning of activities). The MoCA and ADAS-cog scores had better diagnostic accuracy and specificity for the detection and differential diagnosis of mild cognitive disorders than the MMSE scale.

Neurocognitive functioning in young patients with chronic endogenous depression

To identify the specific features of cognitive functioning in patients with youth chronic endogenous depressions (YCED). Fifty-one male patients with YCED (duration 36.5±12.5 month) and 18 patients with youth depression without chronic course as a comparison group were examined. A neuropsychological battery of the following techniques was used to assess cognitive functioning: the Rey - Osterrieth complex figure test, the Design Fluency Test, the Verbal Fluency Test, the 20-question Test, the Color-Word Interference Test, arithmetic problem solving, compilation of stories based on Bidstrup's cartoons, SDMT, the Digit span. Based on the heterogeneity of psychopathological features of YCED, two types were identified: unitary depressions (type 1) and supplementary depressions (type 2). Among type 2 depressions, two subtypes were distinguished: with neurosis-like disorders (subtype 2.1) and with psychopathic-like disorders (subtype 2.2). The following significant differences between different types of YHED and comparison groups were revealed: on the scale «Copying», «Simultaneity « and points when reproducing the Rey-Osterritz figure (p=0.049, p=0.024 and p=0.043); performing the second series in the Digit Span (p=0.022); in the switching test (p=0.004) and the number of errors (p=0.046) in the Color-Word Interference Test; «expansion of the utterance program» when solving arithmetic problems (p=0.012). The total number of patterns in the «Visual Fluency» test and the execution time of the «Encryption» method were significantly lower in the YHED group (p=0.049 and p=0.046). Patients with YCED show signs of neurocognitive dysfunction. The patients of supplementary and unitary types of YCED demonstrate the differences in the neurocognitive profile. The revealed peculiarities show the perspective of YCED research and typification of chronic depression in adolescence due to the differences in the neurocognitive profile.

Cognitive functioning and cannabis use in first-episode psychosis

Aim Cannabis use is common in people with psychotic disorders. However, the effect of cannabis on cognition in psychosis remains unclear. Our study investigates relationships between the history of cannabis use and cognitive performance in patients with first-episode psychosis (FEP) during a one-year follow-up. Methods The present study included FEP (N = 91) and control (N = 61) groups. Cannabis use was evaluated with a self-report questionnaire, clinical assessment, and medical records during a lifetime and 12 months prior to the treatment onset (recent). Symptoms of psychosis and anxiety were evaluated on the brief psychiatric rating scale. Negative symptoms were assessed using the scale for the assessment of negative symptoms. Cognitive tests were used to evaluate neurocognition (summarized in the g factor) and social cognition. Crude regression analyses for the g factor included variables of cannabis use as independent variables. Full regression models were controlled for gender, education, and clinical symptoms. Results In the FEP group, men used cannabis more frequently than women. In the crude regression model for FEP patients, never having used cannabis was associated with a better neurocognitive profile at 12 months. In the full model, more severe anxiety symptoms were associated with better neurocognition at two months, and less severe negative symptoms were associated with better neurocognition at 12 months. Cannabis use was not associated with social cognition. No associations between cognitive performance and cannabis use emerged in the controls. Conclusion Negative and affective symptom severity in FEP was associated with cognitive performance to a greater degree than a lifetime history of cannabis use.

The neurocognitive profiles of justice involved people with foetal alcohol spectrum disorder: A systematic review.

Foetal alcohol spectrum disorder (FASD) is highly prevalent in criminal justice settings. Despite increased awareness of the neurocognitive deficits among justice-involved individuals with FASD, no systematic evaluation of the literature in the field has been conducted to date. We aimed to conduct a systematic review of the literature on the neurocognitive profiles of justice-involved individuals with FASD, by searching five key electronic databases, dissertations database, and Google scholar, up to January 2021. The findings indicate that when contrasted with comparison groups, justice-involved individuals with FASD display significant impairment in a greater number of neurocognitive domains including intellectual capacity, executive function, language, academic achievements, motor skills, and adaptive living skills. The relatively small number of the studies included in the review, along with the confounding effects of comorbidities among study participants, precludes drawing firm conclusions about the true extent and implications of neurocognitive deficits in this population. To advance the field further, there is an urgent need to conduct robust studies involving larger samples of justice-involved individuals with FASD and suitable comparison groups. Advancing knowledge in the field can have important implications for understanding of the antecedents of offending behaviour in this population, and informing strategies for early identification and intervention.