Neuropsychological Changes Research Articles

Neuroimaging correlates of cognitive disorders secondary to electroconvulsive therapy: A systematic review

ObjectivesElectroconvulsive therapy is known as an efficient therapy, which is sometimes recommended for the management of severe and resistant depression. However, ECT is associated with cognitive adverse effects. The study of the neurobiological correlates of the cognitive adverse effects of ECT has been covered in few published reviews. However, these mechanisms have been investigated in an increasing number of studies in recent years, particularly in neuroimaging. This systematic review of the literature focuses on correlates between changes in structural or functional neuroimaging and impairment of cognitive functions during the ECT treatment. MethodsWe conducted a systematic review of the literature using PRISMA methodology. Searches were performed on the Medline and Web of Science databases using the following equation: “electroconvulsive therapy AND (MRI OR fMRI OR DTI OR neuroimaging) AND depression AND cogniti*”. ResultsThis article highlights the significant heterogeneity of the results. In structural imaging, approximately 50% of the studies did not report any correlation between volumetric changes and neuropsychological changes. In studies that did highlight a correlation, the latter was mainly reported with changes in the hippocampus. From a functional perspective, we highlighted a correlation between changes in the connectivity of the hippocampal region and cognition. ConclusionThese results demonstrate a growing interest in understanding the neurobiological mechanisms underlying cognitive disorders secondary to ECT treatment. The ultimate aim behind this understanding is to adopt a more effective prevention strategy vis-à-vis these adverse effects.

Tentative Causes of Brain and Neuropsychological Alterations in Women Victims of Intimate Partner Violence.

Victims of Intimate Partner Violence Against Women (IPVAW) experience neuropsychological and cerebral changes, which have been linked to several tentative causal mechanisms, including elevated cortisol levels, psychopathological disorders, traumatic brain injury (TBI), hypoxic/ischemic brain damage, and medical conditions related to IPVAW. While these mechanisms and their effects on brain function and neuropsychological health are well-documented in other clinical populations, they manifest with unique characteristics in women affected by IPVAW. Specifically, IPVAW is chronic and repeated in nature, and mechanisms are often cumulative and may interact with other comorbid conditions. Thus, in light of existing literature on neuropsychological alterations in other populations, and recognizing the distinct features in women who experience IPVAW, we propose a new theoretical model-the Neuro-IPVAW model. This framework aims to explain the complex interplay between these mechanisms and their impact on cognitive and brain health in IPVAW victims. We anticipate that this theoretical model will be valuable for enhancing our understanding of neuropsychological and brain changes related to intimate partner violence, identifying research gaps in these mechanisms, and guiding future research directions in this area.

PGR – 2 More than Just an EEG; The Role of Neuropsychological Evaluation in Pediatric Seizure Diagnosis with Complex Comorbidities

Abstract Objective Despite the prevalence of epilepsy, diagnosis remains limited by both subjective and objective examination (Urbańska et al., 2024). This is especially true of time-limited Electroencephalogram (EEG) (Baud et al., 2021). Ability to predict who will develop epilepsy after first time seizure is also limited (Drenthen et al., 2021). Neuropsychological changes inform clinical diagnosis and provides deeper understanding of functional limitations in daily life (Tolchin et al., 2020). Method Patient is a 12-year-old left-handed boy with history of in utero drug exposure and neglect prior to adoption at 3-years-old. Evaluation was sought for developmental delays concerning for Autism Spectrum Disorder (ASD). Additional concerns included frequent falls, severe migraines, reduced attention and memory, fatigue, and tremor. He had two clinical seizures around 9 years old, though subsequent EEG was normal. Given this and prophylactic treatment with Keppra, likelihood of seizures was thought to be low. Results Cognitive and adaptive skills were in the low range. Results were concerning for atypical developmental progress and a lateralizing profile. Specifically, skills associated with the left hemisphere (verbal abilities) were developing steadily, while skills associated with the right hemisphere (spatial and pattern recognition skills) were weaker. Difficulties with processing speed and higher order executive function were also present. No unifying diagnosis was identified, but addition of Keppra and Topamax resulted in marked improvement in energy, motor functioning, and cognitive functioning. Conclusion Neuropsychological evaluation was able to identify previously undetected seizure activity resulting in significant clinical impairment. Neuropsychological evaluation is invaluable in diagnosing and monitoring epilepsy (Kishk et al., 2022).

Characteristics of Alzheimer’s Disease and Mild Cognitive Impairment Influenced by the Time of Onset

Introduction: Although the prevalence of Alzheimer’s disease (AD) is higher in older people compared to younger people, dementia has also been documented in younger adults. Although early-onset dementia and late-onset dementia had been considered a single disease in pathological investigations, many studies revealed differences in cognitive and neuroimaging changes between them. We evaluated differences in cognitive and neuroimaging changes among the following groups: individuals with early-onset AD (EOAD), late-onset AD (LOAD), early-onset mild cognitive impairment (EOMCI), or late-onset MCI (LOMCI), and healthy controls (HCs). Methods: Patients underwent both a 1.5 Tesla magnetic resonance imaging scan and the Mini-Mental State Examination (MMSE). Differences in regional gray matter volumes and MMSE subscales were investigated among the five diagnostic groups. Results: Compared to the EOAD group, the LOAD group had significantly higher scores on orientation in place. Compared to the LOMCI patients, the EOMCI patients achieved significantly higher recall scores. The LOAD and LOMC groups showed significant volume reductions in bilateral medial temporal regions compared to the HCs. The EOAD and EOMCI groups did not show significant atrophy of the medial temporal region compared to the HC group. Conclusions: The hippocampal volume and memory were preserved in the patients with EOMCI or EOAD compared to those with LOMCI or LOAD. These findings may indicate that the distinct and differing patterns of neuropsychological changes between EOAD and LOAD are also common in MCI, which is intermediate between normal cognition and AD.

Benefits of Cognitive Behavior Therapy with Neuroscience-informed Psychoeducation in Young Adult Patients: A Preliminary Study

Background: Psychoeducation often is a recommended augmentation for cognitive behavior therapy (CBT) to enhance patients’ understanding of their clinical condition. But despite providing psychoeducation, there might be a lack of insightful engagement in the therapy process on the part of patients, affecting the therapy outcome. While there are neuroscience-informed psychoeducation models for addiction, there is rarely any literature on neuroscience-informed psychoeducation for CBT. It is postulated that a neuroscience-informed module of psychoeducation can bring better acceptance of CBT and improve its outcome. Methods: In this study, we used a pre- and poststudy design. Using purposive sampling, 30 consecutive young adult patients presented themselves with symptoms of depression and anxiety to receive standard CBT module. Fifteen of these received the CBT module with generic psychoeducation detailing the etiology, signs and symptoms, and treatment requirements for their condition. The other 15 received neuroscience-informed psychoeducation modules having specific inputs about the generic functioning of the human brain, the neuropsychological changes, and processes in the brain during and due to the psychotherapy (CBT) process. Acceptance and outcome of CBT were measured through changes in symptom rating as well as individual feedback, sentiment analysis of the feedback statements, and word cloud. Results: Participants of both the psychoeducation model groups – conventional psychoeducation (p < 0.001) and neuroscience-informed psychoeducation group (p < 0.001) – were found to have significant improvement in their clinical symptoms of the pre- and posttest scores. But the neuroscience-based psychoeducation group was better compliant to sessions and had better follow-up rates compared to conventional psychoeducation. Sentiment analysis of the feedback revealed a higher volume of sentiments in neuroscience-informed group. Conclusion: Neuroscience-based psychoeducation has the potential of changing perception and enhancing the credibility of CBT and can bring better acceptance and outcome for the CBT process.

Longitudinal neuropsychological performance of post-stroke adults with and without rehabilitation

This study compared the neuropsychological performance of two post-stroke groups, one undergoing rehabilitation and the other not receiving any intervention, on the acute and chronic stroke phases, and explored sociodemographic and neurological variables associated with changes in performance over time. Sixty-three adults underwent neuropsychological assessment with the Cognitive Screening Instrument (TRIACOG) less than thirty days after having a stroke and were reassessed three to six months after stroke. Thirty-eight participants did not undertake rehabilitation and twenty-five did physiotherapy and/or speech therapy between the two time points. The frequency of cognitive deficits (between groups) and the range of cognitive assessment scores over time (between and within groups) were analyzed. There was a significant decrease in the frequency of neuropsychological deficits and improvement on neuropsychological assessment scores over time only in the group undergoing rehabilitation. Severity of the neurological condition, years of education and being in rehabilitation explained the longitudinal changes in several cognitive domains measured by TRIACOG. Engaging in rehabilitation within three to six months post-stroke is crucial for enhancing the recovery of neuropsychological deficits. Cognitive screening instruments like TRIACOG can be used by health professionals to identify stroke-related neuropsychological changes and plan interventions.

Therapeutic doses of ketamine acutely attenuate the aversive effect of losses during decision-making.

The discovery of rapid-acting antidepressant, ketamine has opened a pathway to a new generation of treatments for depression, and inspired neuroscientific investigation based on a new perspective that non-adaptive changes in the intrinsic excitatory and inhibitory circuitry might underlie the pathophysiology of depression. Nevertheless, it still remains largely unknown how the hypothesized molecular and synaptic levels of changes in the circuitry might mediate behavioral and neuropsychological changes underlying depression, and how ketamine might restore adaptive behavior. Here, we used computational models to analyze behavioral changes induced by therapeutic doses of ketamine, while rhesus macaques were iteratively making decisions based on gains and losses of tokens. When administered intramuscularly or intranasally, ketamine reduced the aversiveness of undesirable outcomes such as losses of tokens without significantly affecting the evaluation of gains, behavioral perseveration, motivation, and other cognitive aspects of learning such as temporal credit assignment and time scales of choice and outcome memory. Ketamine's potentially antidepressant effect was separable from other side effects such as fixation errors, which unlike outcome evaluation, was readily countered with strong motivation to avoid errors. We discuss how the acute effect of ketamine to reduce the initial impact of negative events could potentially mediate longer-term antidepressant effects through mitigating the cumulative effect of those events produced by slowly decaying memory, and how the disruption-resistant affective memory might pose challenges in treating depression. Our study also invites future investigations on ketamine's antidepressant action over diverse mood states and with affective events exerting their impacts at diverse time scales.

Therapeutic doses of ketamine acutely attenuate the aversive effect of losses during decision-making

The discovery of rapid-acting antidepressant, ketamine has opened a pathway to a new generation of treatments for depression, and inspired neuroscientific investigation based on a new perspective that non-adaptive changes in the intrinsic excitatory and inhibitory circuitry might underlie the pathophysiology of depression. Nevertheless, it still remains largely unknown how the hypothesized molecular and synaptic levels of changes in the circuitry might mediate behavioral and neuropsychological changes underlying depression, and how ketamine might restore adaptive behavior. Here, we used computational models to analyze behavioral changes induced by therapeutic doses of ketamine, while rhesus macaques were iteratively making decisions based on gains and losses of tokens. When administered intramuscularly or intranasally, ketamine reduced the aversiveness of undesirable outcomes such as losses of tokens without significantly affecting the evaluation of gains, behavioral perseveration, motivation, and other cognitive aspects of learning such as temporal credit assignment and time scales of choice and outcome memory. Ketamine’s potentially antidepressant effect was separable from other side effects such as fixation errors, which unlike outcome evaluation, was readily countered with strong motivation to avoid errors. We discuss how the acute effect of ketamine to reduce the initial impact of negative events could potentially mediate longer-term antidepressant effects through mitigating the cumulative effect of those events produced by slowly decaying memory, and how the disruption-resistant affective memory might pose challenges in treating depression. Our study also invites future investigations on ketamine’s antidepressant action over diverse mood states and with affective events exerting their impacts at diverse time scales.

Clinically approved immunomodulators ameliorate behavioral changes in a mouse model of hereditary spastic paraplegia type 11.

We have previously demonstrated that neuroinflammation by the adaptive immune system acts as a robust and targetable disease amplifier in a mouse model of Spastic Paraplegia, type 11 (SPG11), a complicated form of Hereditary Spastic Paraplegia (HSP). While we identified an impact of neuroinflammation on distinct neuropathological changes and gait performance, neuropsychological features, typical and clinically highly relevant symptoms of complicated HSPs, were not addressed. Here we show that the corresponding SPG11 mouse model shows distinct behavioral abnormalities, particularly related to social behavior thus partially reflecting the neuropsychological changes in patients. We provide evidence that some behavioral abnormalities can be mitigated by genetic inactivation of the adaptive immune system. Translating this into a clinically applicable approach, we show that treatment with the established immunomodulators fingolimod or teriflunomide significantly attenuates distinct behavioral abnormalities, with the most striking effect on social behavior. This study links neuroinflammation to behavioral abnormalities in a mouse model of SPG11 and may thus pave the way for using immunomodulators as a treatment approach for SPG11 and possibly other complicated forms of HSP with neuropsychological involvement.

Cohort profile: the China surgery and anesthesia cohort (CSAC)

The China Surgery and Anaesthesia Cohort (CSAC) study was launched in July 2020 and is an ongoing prospective cohort study recruiting patients aged 40–65 years who underwent elective surgeries with general anaesthesia across four medical centres in China. The general objective of the CSAC study is to improve our understanding of the complex interaction between environmental and genetic components as well as to determine their effects on a wide range of interested surgery/anaesthesia-related outcomes. To achieve this goal, we collected enriched phenotypic data, e.g., sociodemographic characteristics, lifestyle factors, perioperative neuropsychological changes, anaesthesia- and surgery-related complications, and medical conditions, at recruitment, as well as through both active (at 1, 3, 7 days and 1, 3, 6, 12 months after surgery) and passive (for more than 1 year after surgery) follow-up assessments. We also obtained omics data from blood samples. In addition, COVID-19-related information was collected from all participants since January 2023, immediately after COVID-19 restrictions were eased in China. As of July 18, 2023, 12,766 participants (mean age = 52.40 years, 57.93% were female) completed baseline data collection (response rate = 94.68%), among which approximately 70% donated blood and hair samples. The follow-up rates within 12 months after surgery were > 92%. Our initial analyses have demonstrated the incidence of and risk factors for chronic postsurgical pain (CPSP) and postoperative cognitive dysfunction (POCD) among middle-aged Chinese individuals, which may prompt further mechanistic exploration and facilitate the development of effective interventions for preventing those conditions. Additional studies, such as genome-wide association analyses for identifying the genetic determinants of CPSP and POCD, are ongoing, and their findings will be released in the future.

Neuropsychological Changes Across Life Stages and Their Impact on Spirituality

This study examines neuropsychological changes across life stages and their impact on spirituality. Focusing on infancy to old age, it explores how the brain’s evolution influences spiritual perception and experiences. Key findings include the foundational role of early brain development in shaping basic spiritual awareness and the significant transformation during adolescence and early adulthood, marked by deep questioning and exploration of spiritual identity. The research highlights that peak spiritual experiences and brain complexity may coincide around age 18, suggesting a crucial period for spiritual exploration. In contrast, older adulthood, despite potential cognitive decline, often leads to a deepening of spiritual life, characterized by reflection and wisdom. The study underscores the interconnectedness of neuropsychological development and spirituality, emphasizing the importance of considering spiritual well-being alongside physical and mental health. It concludes that spirituality is a vital, evolving aspect of the human experience, closely linked to neuropsychological changes throughout life.

Longitudinal assessment of quality of life, neurocognition, and psychopathology in patients with low-grade glioma on first-line temozolomide: A feasibility study.

The treatment timing and choice after neurosurgical resection in patients with newly diagnosed diffuse low-grade glioma (DLGG) remain controversial. Indeed, the effect of such treatments must be balanced with the possible side effects. This study evaluated the feasibility of longitudinal exhaustive quality of life (QoL) and neuropsychological assessments in patients with DLGG receiving first-line temozolomide. QoL, neurocognition, and psychological disorders were assessed prospectively until disease progression, using testing, clinician-reported, and self-reported questionnaires. The primary endpoint was the participation and adherence to this complete assessment at Baseline (before temozolomide initiation), months 6 and 12 of treatment, and month 6 post-treatment. The QoL and neuropsychological changes over time also were described. Twenty-six of the twenty-nine eligible patients were enrolled (participation rate: 89.7%, 95% CI: 72.6-97.8). The adherence rate was 95.7% (95% CI: 78.1-99.9; n = 23 because 3 patients progressed in the first 12 months of treatment). Up to month 6 post-treatment, QoL and fatigue remained stable (EORTC QLQC30 and BN20, MFI-20); some specific symptoms were transitory. Both subjective (FACT-Cog) and objective (Z-scores of neurocognitive tests) neurocognitive outcomes remained stable or tended to improve. The percentage of patients with severe depression (BDI-II), anxiety (STAI-Y), or anger (STAXI-II) was stable over time. This prospective study demonstrated the feasibility of an exhaustive and longitudinal evaluation of QoL, neurocognition, and psychological disorders, with high acceptability by patients with DLGG undergoing chemotherapy. First-line temozolomide seems to have limited short-term effects on QoL and neurocognition. These findings must be confirmed in the long term and in a larger cohort.

Comparative characteristics of neuropsychological and neurometabolic changes in patients with Alzheimer's disease and vascular cognitive impairment

To investigate the pattern and connections of neuropsychological and metabolic indices in patients with cognitive disorders of Alzheimer's and vascular (subcortical-cortical) types of different severity. A total of 177 patients were examined, including 85 patients with Alzheimer's disease (AD) and 92 patients with vascular cognitive impairment (VCI). All patients underwent complex neuropsychological examination; 18F-FDG PET was performed in 17 patients with AD and 15 patients with VCI. The greatest changes in patients with AD were noted in the mnestic sphere, and the indicators significantly differed from the results of the study of patients with VCI already at the pre-dementia stage. Neurodynamic and dysregulatory disorders prevailed in patients with VCI. Patients with AD showed bilateral symmetrical reduction of metabolic activity in the cortex of parietal and temporal lobes, often in combination with marked hypometabolism in the hippocampal region. In patients with VCI, there were areas of decreased brain tissue metabolism of different localization and size, mainly in the projection of the basal ganglia and in the prefrontal and parietal cortex, as well as in the cingulate gyrus, which indirectly confirms the mechanism of disconnection of subcortical and cortical structures. In AD, impaired metabolic activity in the hippocampal region correlated with impaired temporal and spatial orientation (ρ=-0.54, p<0.05), memory impairment (ρ=-0.71, p<0.005). Hypometabolism of the parietal lobe cortex was associated with total MMSE score (ρ=-0.8, p<0.001), 10-word test (ρ=-0.89, p<0.001 and ρ=-0.82, p<0.001), visual-spatial impairment (ρ=-0.64, p<0.01), categorical association test (ρ=-0.73, p<0.005). In patients with VCI, dysregulatory disorders correlated with hypometabolism in the thalamic projection (ρ=-0.56, p<0.05), prefrontal cortex (ρ=-0.64, p<0.05) and in the cingulate gyrus (anterior regions) (ρ=-0.53, p<0.05). The results indicate the presence of differences in cognitive impairment and cerebral metabolism in patients with AD and VCI.

Clinical and neuropsychological features and changes to regional cerebral blood flow in ‍patients with Parkinson's disease dementia

This study aimed to clarify associations of clinical and neuropsychological features and change in regional cerebral blood flow (rCBF) on 123I-IMP-SPECT in patients with Parkinson's disease (PD) who developed dementia. Sixty-one PD patients (mean age, 65.9 ± 8.6 years; mean disease duration, 11.0 ± 11.0 years) were recruited and followed-up for two years. Clinical and neuropsychological characteristics, and rCBF from SPECT were compared between PD patients who developed dementia (PDD+) and those who remained undemented (PDD-). Thirty-eight PD patients (62.3%) were diagnosed with PD-MCI at baseline. During follow-up, 22 PD patients (36%) developed dementia (PDD+). Univariate logistic regression models showed that Hoehn and Yahr scale 4 (odds ratio [OR] 5.85; 95% confidence interval [CI] 1.35-30.75]), visual hallucination (OR 5.95; 95%CI 1.67-25.4]), and PD-MCI (OR 6.47; 95%CI 1.57-39.63]) represented a significant risk factor for PDD+. Among neuropsychological parameters, WAIS (Wechsler Adult Intelligence Scale)-III block design (OR 6.55; 95%CI 1.66-29.84), letter number sequencing (OR 7.01; 95%CI 1.65-36.64), digit-symbol coding (OR 3.90; 95%CI 1.13-14.2), Wechsler Memory Scale, revised (WMS-R) visual paired associates II (delayed recall) (OR 4.68; 95%CI 1.36-17.36), Logical memory I (immediate recall) (OR 8.30; 95%CI 1.37-90.89), Logical memory II (delayed recall) (OR 6.61; 95%CI 1.35-44.33), Visual reproduction I (immediate recall) (OR 7.67; 95%CI 2.11-31.40), and Visual reproduction II (delayed recall) (OR 5.64; 95%CI 1.62-21.47) were significant risk factors. Decreased rCBF assessed using the general linear model (two-sample t-test) by SPM8 was observed in the left precuneus (0, -66, 16), right cuneus (6, -76, 30), and left angular gyrus (-46, -74, 32) in PDD+ compared with PDD- patients. Collectively, we have here shown that clinical and neuropsychological characteristics as well as changes to rCBF in PD patients who converted to PDD+. These features should be carefully monitored to detect the development of dementia in PD patients.

LONGITUDINAL CHANGES IN WELL-BEING ASSOCIATED WITH AGING ATTITUDE, COGNITIVE STATUS, AND WIDOWHOOD TRANSITION

Abstract This symposium brings together four studies that employ national data collected from older Americans to examine longitudinal changes in older adults’ cognitive, social, and psychological health. The first study focuses on the role of self-perception of aging in memory decline and social mechanisms linking aging perception and memory. It found that negative perceptions of aging predicted memory decline 8 years later and that loneliness and social isolation were pathways. The second study is concerned with neuropsychological changes before the onset of dementia. Using latent growth modeling, it found that the trajectory of depression increased over time in a quadratic fashion before the onset of incident dementia. Further, there were racial/ethnic group differences in levels of depression. Using fixed-effect linear regression, the third study reports that changes in cognitive status were associated with changes in social isolation in older adults. Specifically, it found that transitioning from cognitive intact to cognitive impairment status was associated with increased social isolation. The fourth and final paper examines changes in psychological well-being related to the transition to widowhood. It found that during the year right after the spouse died, older adults experienced increased depressive symptoms and reduced positive well-being. But adaptation is evident—the surviving spouse returned to pre-loss levels of psychological well-being around two years after the death. Together, the four studies show that attitude, cognitive status, and life course transition shape the dynamics of cognitive, social, and psychological health in later life.

The Reduced Gray Matter Volume and Functional Connectivity of the Cerebellum in Type 2 Diabetes Mellitus with High Insulin Resistance

Introduction: Insulin resistance is widely thought to be a critical feature in type 2 diabetes mellitus (T2DM), and there is significant evidence indicating a higher abundance of insulin receptors in the human cerebellum than cerebrum. However, the specific structural or functional changes in the cerebellum related to T2DM remain unclear, and the association between cerebellar alterations, insulin resistance, cognition, and emotion is yet to be determined. Methods: We investigated neuropsychological performance, and structural and functional changes in specific cerebellar subregions in 43 T2DM patients with high insulin resistance (T2DM-highIR), 72 T2DM patients with low insulin resistance (T2DM-lowIR), and 50 controls. Furthermore, the correlation and stepwise multiple linear regression analysis were performed. Results: Compared to the controls, T2DM exhibited lower cognitive scores and higher depressive/anxious scores. Furthermore, T2DM-highIR patients showed reduced gray matter volume (GMV) in the right cerebellar lobules VIIb, Crus I/II, and T2DM showed reduced GMV in left lobules I–IV compared to controls. Additionally, functional connectivity decrease was observed between the right lobules I–V and orbital part of the superior frontal gyrus in T2DM-highIR compared to both T2DM-lowIR and controls. Notably, there were negative correlations between the GMV of the lobules VIIb, Crus I/II, and updated homeostatic model assessment of insulin resistance, and positive correlation with executive/visuospatial performance in T2DM patients. Conclusions: These results suggest that the cerebellar lobules VIIb, Crus I/II, represent vulnerable brain regions in the context of insulin resistance. Overall, this study offers new insights into the neuropathophysiological mechanisms of brain impairment in patients with T2DM.

Neuropsychological, plasma marker, and functional connectivity changes in Alzheimer's disease patients infected with COVID-19.

Patients with COVID-19 may experience various neurological conditions, including cognitive impairment, encephalitis, and stroke. This is particularly significant in individuals who already have Alzheimer's disease (AD), as the cognitive impairments can be more pronounced in these cases. However, the extent and underlying mechanisms of cognitive impairments in COVID-19-infected AD patients have yet to be fully investigated through clinical and neurophysiological approaches. This study included a total of 77 AD patients. Cognitive functions were assessed using neuropsychiatric scales for all participants, and plasma biomarkers of amyloid protein and tau protein were measured in a subset of 25 participants. To investigate the changes in functional brain connectivity induced by COVID-19 infection, a cross-sectional neuroimaging design was conducted involving a subset of 37 AD patients, including a control group of 18 AD participants without COVID-19 infection and a COVID-19 group consisting of 19 AD participants. For the 77 AD patients between the stages of pre and post COVID-19 infection, there were significant differences in cognitive function and psychobehavioral symptoms on the Montreal Scale (MoCA), the neuropsychiatric inventory (NPI), the clinician's global impression of change (CIBIC-Plus), and the activity of daily living scale (ADL). The COVID-19 infection significantly decreased the plasma biomarker level of Aβ42 and increased the plasma p-tau181 level in AD patients. The COVID-19-infected AD patients show decreased local coherence (LCOR) in the anterior middle temporal gyrus and decreased global correlation (GCOR) in the precuneus and the medial prefrontal cortex. The findings suggest clinical, cognitive, and neural alterations following COVID-19 infection in AD patients and emphasize the need for close monitoring of symptoms in AD patients who have had COVID-19 and further exploration of the underlying mechanisms.

Neuropsychological change in Mild Cognitive Impairment using estimated standardized regression‐based formulas

AbstractBackgroundNeuropsychological change in Mild Cognitive Impairment (MCI) can be tracked with repeated assessments to determine if an individual remains stable or progresses to dementia. However, few studies have quantified these cognitive changes over time, especially using standardized regression‐based (SRB) change formulae.MethodParticipants included 283 MCI patients from a cognitive disorders clinic who were assessed twice with a comprehensive neuropsychological battery across approximately one‐ and one‐half years. SRB z‐scores were calculated for each of 17 test scores this battery for each participant. Change on these 17 z‐scores were examined for the entire sample, as well as between two subgroups: those who remained MCI on follow‐up (i.e., MCI‐Stable) and those who progressed to dementia (i.e., MCI‐Decline).ResultFor the entire MCI sample, significant declines were observed on all 17 z‐scores (p&lt;0.001), with the largest declines occurring on memory tests. When the two subgroups were compared, significant differences were observed between these two groups across nearly all cognitive domains, with the largest differences being on tests of attention and processing speed. For these group differences, those in the MCI‐Decline group showed the most decline compared to the MCI‐Stable participants. However, notable cognitive decline was also observed in the MCI‐Stable group.ConclusionThis study highlights the degree of cognitive decline that occurs in MCI across time, even among those who remain “stable” on follow‐up. It also highlights the value of the SRB method in more accurately capturing and quantifying cognitive decline, which may help identify individuals most vulnerable to MCI progression.

Shared and unique effects of ApoEε4 and pathogenic gene mutation on cognition and imaging in preclinical familial Alzheimer’s disease

AbstractBackgroundNeuropsychology and imaging changes have been reported in the preclinical stage of familial Alzheimer’s disease (FAD). This study investigated the effects of APOEε4 and known pathogenic gene mutation on different cognitive domains and circuit imaging markers in preclinical FAD.Method139 asymptomatic subjects in FAD families, including 26 APOEε4 carriers, 17 APP and 20 PS1 mutation carriers, and 76 control subjects, went through a series of neuropsychological tests and MRI scanning. Test scores and imaging measures including volumes, diffusion indices and functional connectivity (FC) of frontostriatal and hippocampus to posterior cingulate cortex pathways were compared between groups, and analyzed for correlation.ResultCompared with controls, APOEε4 group showed increased hippocampal volume and decreased FC of fronto‐caudate pathway (figure 1). APP group showed increased recall scores in auditory verbal learning test, decreased fiber number, increased radial diffusivity and FC of frontostriatal pathway (figure 1 &amp; 2). All three genetic groups showed decreased fractional anisotropy of hippocampus to posterior cingulate cortex pathway (figure 1). These neuropsychological and imaging measures were able to discriminate genetic groups from controls, with areas under the curve from 0.733 to 0.837 (figure 3). Circuit imaging measures are differentially associated with scores in various cognitive scales in control and genetic groups.ConclusionThere are neuropsychological and imaging changes in the preclinical stage of FAD, some of which are shared by APOEε4 and known pathogenic gene mutation, while some are unique to different genetic groups. These findings are helpful for the early identification of Alzheimer’s disease, and for developing generalized and individualized prevention and intervention strategies.

Neuropsychological Changes in Pregnant Women with Preeclampsia/Eclampsia (PE-E): Health Behavior Implications

Objectives: Preeclampsia/eclampsia (PE-E) is a significant cause of maternal morbidities and mortalities in many countries. To expand this topic, the prime aim of this study was to examine the linkage of neuropsychological changes with PE-E in pregnant women. In addition, this study also analyzed the impact of numerous health behavior on development of PE-E in pregnant women. Methods: Employing the quantitative methodology, the data was collected from 350 pregnant women from hospitals in Turkey. Results: The findings of study indicate that health behavior associated with negative psychological predictors indicate significant association with risk of PE-E in pregnant women. Accordingly, sadness, anxiety, depression, disgust and distress were found as negative and significant predictor of PE-E. In addition, the health behavior associated with positive psychological predictors like love, joy, happiness and acceptance were found positive predictor as they improved the healthcare behavior and reduced risk of PE-E in pregnant women. Conclusions: Consequently, the study indicated that pregnant women with neuropsychological distress have twice threat of development of PE-E as compared to normal pregnant women. This study has significant implications for health sector and recommends encouraging positive health behavior to avert effect of PE-E on pregnancy and birth outcomes.