Neuropsychological Criteria Research Articles

Comparison of Cognitive Impairment Diagnosis Criteria in Clinical Settings: Conventional vs. Neuropsychological.

Theories on Alzheimer disease pathogenesis propose a gap between pathological changes and the onset of clinical symptoms. The early detection of cognitive decline is crucial for the implementation of preventive strategies. Mild cognitive impairment is a transitional stage and an accurate diagnosis is vital. However, the diagnosis of mild cognitive impairment varies due to inconsistent diagnostic criteria. This study aims to explore the effectiveness of comprehensive neuropsychological criteria, including all cognitive domains, for diagnosing cognitive impairment in clinical settings. The study included 509 subjects with subjective cognitive complaints between 2017 and 2021. They were diagnosed using the conventional and neuropsychological criteria, and the results were named the complex criteria (conventional criteria-neuropsychological criteria). Concordance between the conventional and neuropsychological diagnostic criteria diagnoses was 87.82%. Some participants diagnosed with mild cognitive impairment or dementia using the conventional criteria were classified as normal according to the neuropsychological criteria. Notably, the mild cognitive impairment - normal cognition (MCI-NC) and dementia (DEM)-NC (normal cognition) groups exhibited distinct characteristics. The MCI-NC group had higher depression scores (P = .008) and better memory performance (P = .026) and executive function (P = .020) than the MCI-MCI group. The DEM-NC group had better instrumental activities of daily living (P < .001) than the DEM-DEM group. This study highlights the complexity of diagnosing cognitive impairment and the importance of comprehensive criteria. Relying solely on conventional criteria may lead to overdiagnosis. The neuropsychological criteria consider various cognitive domains and better discriminate between individuals with MCIs or other factors that contribute to cognitive difficulties.

Intrathecal administration of mesenchymal stem cells in patients with adrenomyeloneuropathy.

X-linked adrenomyeloneuropathy (AMN) is an inherited neurodegenerative disorder associated with mutations in the ABCD1 gene and the accumulation of very long-chain fatty acids (VLFCAs) in plasma and tissues. Currently, there is no effective treatment for AMN. We have aimed to evaluate the therapeutic effects of mesenchymal stem cell (MSC) transplantation in patients with AMN. This is a small cohort open-label study with patients with AMN diagnosed and treated at the University Hospital in Olsztyn, Poland. All patients met clinical, biochemical, MRI, and neuropsychological criteria for AMN. MSCs derived from Wharton jelly, 20 × 106 cells, were administered intrathecally three times every 2 months, and patients were followed up for an additional 3 months. The primary outcome measures included a blinded assessment of lower limb muscle strength with the Medical Research Council Manual Muscle Testing scale at baseline and on every month visits until the end of the study. Additional outcomes included measurements of the timed 25-feet walk (T25FW) and VLFCA serum ratio. Three male patients with AMN with an age range of 26-37 years participated in this study. All patients experienced increased muscle strength in the lower limbs at the end of the study versus baseline. The power grade increased by 25-43% at the baseline. In addition, all patients showed an improvement trend in walking speed measured with the T25FW test. Treatment with MSCs in patients with AMN appeared to be safe and well tolerated. The results of this study demonstrated that intrathecal administration of WJ-MSC improves motor symptoms in patients with AMN. The current findings lend support to the safety and feasibility of MSC therapy as a potentially viable treatment option for patients with AMN.

Comparing neuropsychological, typical, and ADNI criteria for the diagnosis of mild cognitive impairment in Vietnam-era veterans.

Neuropsychological criteria for mild cognitive impairment (MCI) more accurately predict progression to Alzheimer's disease (AD) and are more strongly associated with AD biomarkers and neuroimaging profiles than ADNI criteria. However, research to date has been conducted in relatively healthy samples with few comorbidities. Given that history of traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are risk factors for AD and common in Veterans, we compared neuropsychological, typical (Petersen/Winblad), and ADNI criteria for MCI in Vietnam-era Veterans with histories of TBI or PTSD. 267 Veterans (mean age = 69.8) from the DOD-ADNI study were evaluated for MCI using neuropsychological, typical, and ADNI criteria. Linear regressions adjusting for age and education assessed associations between MCI status and AD biomarker levels (cerebrospinal fluid [CSF] p-tau181, t-tau, and Aβ42) by diagnostic criteria. Logistic regressions adjusting for age and education assessed the effects of TBI severity and PTSD symptom severity simultaneously on MCI classification by each criteria. Agreement between criteria was poor. Neuropsychological criteria identified more Veterans with MCI than typical or ADNI criteria, and were associated with higher CSF p-tau181 and t-tau. Typical and ADNI criteria were not associated with CSF biomarkers. PTSD symptom severity predicted MCI diagnosis by neuropsychological and ADNI criteria. History of moderate/severe TBI predicted MCI by typical and ADNI criteria. MCI diagnosis using sensitive neuropsychological criteria is more strongly associated with AD biomarkers than conventional diagnostic methods. MCI diagnostics in Veterans would benefit from incorporation of comprehensive neuropsychological methods and consideration of the impact of PTSD.

The prevalence of mild cognitive impairment in Gulf War veterans: a follow-up study.

Gulf War Illness (GWI), also called Chronic Multisymptom Illness (CMI), is a multi-faceted condition that plagues an estimated 250,000 Gulf War (GW) veterans. Symptoms of GWI/CMI include fatigue, pain, and cognitive dysfunction. We previously reported that 12% of a convenience sample of middle aged (median age 52 years) GW veterans met criteria for mild cognitive impairment (MCI), a clinical syndrome most prevalent in older adults (e.g., ≥70 years). The current study sought to replicate and extend this finding. We used the actuarial neuropsychological criteria and the Montreal Cognitive Assessment (MoCA) to assess the cognitive status of 952 GW veterans. We also examined regional brain volumes in a subset of GW veterans (n = 368) who had three Tesla magnetic resonance images (MRIs). We replicated our previous finding of a greater than 10% rate of MCI in four additional cohorts of GW veterans. In the combined sample of 952 GW veterans (median age 51 years at time of cognitive testing), 17% met criteria for MCI. Veterans classified as MCI were more likely to have CMI, history of depression, and prolonged (≥31 days) deployment-related exposures to smoke from oil well fires and chemical nerve agents compared to veterans with unimpaired and intermediate cognitive status. We also replicated our previous finding of hippocampal atrophy in veterans with MCI, and found significant group differences in lateral ventricle volumes. Because MCI increases the risk for late-life dementia and impacts quality of life, it may be prudent to counsel GW veterans with cognitive dysfunction, CMI, history of depression, and high levels of exposures to deployment-related toxicants to adopt lifestyle habits that have been associated with lowering dementia risk. With the Food and Drug Administration's recent approval of and the VA's decision to cover the cost for anti-amyloid β (Aβ) therapies, a logical next step for this research is to determine if GW veterans with MCI have elevated Aβ in their brains.

Predictive value for cerebrospinal fluid Alzheimer’s disease profile of different measures of verbal episodic memory in patients with mild cognitive impairment

AbstractBackgroundEpisodic memory deficits represent the typical manifestation of prodromal Alzheimer’s disease (AD), namely amnestic Mild Cognitive Impairment (a‐MCI). Current neuropsychological criteria for MCI recommend the use of at least two measures for each cognitive domain. Rey Auditory Verbal Learning Test (RAVLT) and Logical Memory (LM) are two widely used verbal episodic memory measures. Our aim was to investigate the value of these measures in predicting cerebrospinal fluid (CSF) AD biomarkers positivity in a retrospective fully characterized consecutive MCI cohort.MethodOne‐hundred and six MCI patients were included. All of them underwent a comprehensive neuropsychological assessment including RAVLT (sub‐measures: RAVLT‐imm, RAVLT‐del, RAVLT‐false_recognitions) and LM. All patients underwent lumbar puncture for the analysis of CSF core AD biomarkers (Aβ42/Aβ40 ratio, phospho‐tau, total tau). By applying the A/T/(N) classification model, patients were classified as AD (A+T+, MCI‐AD, n. 62) and non‐AD (A‐T*, MCI, n. 44). Pearson’s r correlation coefficient was used to assess the relationship of RAVLT and LM sub‐scores with diagnosis. WALD logistic regression model was used to find which memory sub‐measures show the best predictive value on biomarkers positivity. To evaluate the discriminatory power of different sub‐measures for CSF AD profile, receiver‐operating characteristic (ROC) curves were generated.ResultWith respect to non‐AD MCI, MCI‐AD patients showed worse scores on all RAVLT and LM sub‐measures. RAVLT‐del could predict both positivity of each biomarker (p&lt;0.01) and CSF AD‐like profile (p&lt;0.01). The combination of RAVLT‐del with other measures (RAVLT‐imm+RAVLT‐false_recognition+LM) discriminated these groups (AUC: 0.76, 95% CI: 0.67‐0‐85) with a sensitivity of 0.74 and a specificity of 0.66.ConclusionOur study shows that the combination of all RAVLT memory sub‐measures and LM reaches the higher diagnostic accuracy in discriminating non‐AD MCI from MCI‐AD patients. Since RAVLT and LM measure different aspects of verbal episodic memory, they should be considered as complementary, rather than interchangeable, tasks. Our findings support the use of different memory measures in the neuropsychological assessment of MCI patients.

1 Associations of Locus of Control and Memory Self-Awareness in Older Adults with and without MCI

Objective:While loss of insight into one’s cognitive impairment (anosognosia) is a feature in Alzheimer’s disease dementia, less is known about memory self-awareness in cognitively unimpaired (CU) older adults or mild cognitive impairment (MCI) or factors that may impact self-awareness. Locus of control, specifically external locus of control, has been linked to worse cognitive/health outcomes, though little work has examined locus of control as it relates to self-awareness of memory functioning or across cognitive impairment status. Therefore, we examined associations between locus of control and memory self-awareness and whether MCI status impacted these associations.Participants and Methods:Participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (mean age=73.51; 76% women; 26% Black/African American) were classified as CU (n=2177) or MCI (amnestic n=313; non-amnestic n=170) using Neuropsychological Criteria. A memory composite score measured objective memory performance and the Memory Functioning Questionnaire measured subjective memory. Memory self-awareness was defined as objective memory minus subjective memory, with positive values indicating overreporting of memory difficulties relative to actual performance (hypernosognosia) and negative values indicating underreporting (hyponosognosia). Internal (i.e., personal skills/attributes dictate life events) and external (i.e., environment/others dictate life events) locus of control scores came from the Personality in Intellectual Aging Contexts Inventory. General linear models, adjusting for age, education, sex/gender, depressive symptoms, general health, and vocabulary examined the effects of internal and external locus of control on memory self-awareness and whether MCI status moderated these associations.Results:Amnestic and non-amnestic MCI participants reported lower internal and higher external locus of control than CU participants. There was a main effect of MCI status on memory self-awareness such that amnestic MCI participants showed the greatest degree of hyponosognosia/underreporting, followed by non-amnestic MCI, and CU participants slightly overreported their memory difficulties. While, on average, participants were fairly accurate at reporting their degree of memory difficulty, internal locus of control was negatively associated with self-awareness such that higher internal locus of control was associated with greater underreporting (ß=-.127, 95% CI [-.164, -.089], p&lt;.001). MCI status did not moderate this association. External locus of control was positively associated with self-awareness such that higher external locus of control was associated with greater hypernosonosia/overreporting (ß=.259, 95% CI [.218, .300], p&lt;.001). Relative to CU, amnestic, but not non-amnestic, MCI showed a stronger association between external locus of control and memory self-awareness. Specifically, higher external locus of control was associated with less underreporting of cognitive difficulties in amnestic MCI (ß=.107, 95% CI [.006, .208], p=.038).Conclusions:In CU participants, higher external locus of control was associated with greater hypernosognosia/overreporting. In amnestic MCI, the lower external locus of control associations with greater underreporting of objective cognitive difficulties suggests that perhaps reduced insight in some people with MCI may result in not realizing the need for external supports, and therefore not asking for help from others. Alternatively, in amnestic participants with greater external locus of control, perhaps the environmental cues/feedback translate to greater accuracy in their memory self-perceptions. Longitudinal analyses are needed to determine how memory self-awareness is related to future cognitive declines.

74 A Phase I Trial of Accelerated, HighDose Repetitive Transcranial Magnetic Stimulation to Improve Cognition in Amnestic MCI

Objective:Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation therapy most widely used in depression, has shown evidence of secondary benefits for cognition in both neurologic and neuropsychiatric conditions. The recent development of more efficient stimulation protocols, such as accelerated high-dose intermittent theta burst (iTBS)-rTMS, has substantially reduced treatment burden by shortening the treatment course by &gt;50%. This study aimed to establish the safety, feasibility, acceptability, and preliminary efficacy of iTBS-rTMS as a tool for bolstering cognition in individuals with amnestic mild cognitive impairment (aMCI).Participants and Methods:Twenty-four patients with aMCI were enrolled in an open-label phase I trial of iTBS-rTMS; 2 withdrew prior to initiating treatment due to personal circumstances. All participants had received a diagnosis of MCI due to possible AD from a healthcare provider (i.e., neurologist or neuropsychologist) and met actuarial neuropsychological criteria for aMCI. This sample of older adults (range: 61.5-85.2 years, M = 74.1, SD = 5.71) was predominantly White/non-Hispanic (n = 23; Black/non-Hispanic: n = 1), roughly half female (n = 13), with a college education (range: 12-20 years, M = 15.9, SD = 2.5). Participants received 24 sessions of iTBS-rTMS to the left dorsolateral prefrontal cortex over 3 days (8 sessions each, lasting roughly 2 hours per day). Participants rated their perceptions and experience of common side effects during and after each treatment session as well as retrospectively at post-treatment and 4-week follow-up. They completed structural and functional brain MRI, neuropsychiatric evaluations, and neuropsychological assessments before and after treatment and were administered a subset of these measures at 4-week follow-up. MoCA scores were used to monitor for adverse neurocognitive effects, and the fluid cognition composite score from the NIH Toolbox Cognition Battery was used to test preliminary efficacy.Results:We achieved a high retention rate (95%), with 21 of the 22 participants completing all study procedures. There were no clinically significant adverse neuroradiological, neuropsychiatric, or neurocognitive effects of treatment. Participant reports indicated high tolerability and acceptability, with a modal rating of 0 (on a scale from 0=not at all to 10=extremely) for six common side effects (i.e., headache, pain, scalp irritation, facial twitching, fatigue, fear/anxiety), assessed both during and after each treatment session. They reported very low desire to quit despite some participants rating the treatment as moderately tiring. We observed significant, large effect-size (d = 0.98) improvements in fluid cognition from pre- to post-treatment.Conclusions:Our findings support the safety, feasibility, and acceptability of iTBS-rTMS treatment in patients with aMCI. Further, although not explicitly dosed for efficacy, we provide preliminary evidence of improved fluid cognition as a function of treatment, highlighting the potential of this treatment for improving trans-domain cognitive impairment. These promising results can directly inform future trials aimed at optimizing treatment parameters, broadening the indication to other MCI subtypes, and testing the augmentation of established cognitive rehabilitation interventions when combined with rTMS.

Structural integrity of the anterior mid‐cingulate cortex contributes to resilience to delirium in SuperAging

AbstractBackgroundIdentifying factors that confer resilience to developing delirium is critical given the negative impact of delirium on clinical care and risk for mortality. Here, we investigated a cohort of cognitively normal older adults undergoing elective surgery and examined the role of pre‐operative memory function and cortical thickness in the incidence and severity of post‐operative delirium (POD). We hypothesized that 1) those older adults with episodic memory function comparable to that of young adults (“SuperAgers" or SA) would show reduced incidence of POD compared with typically‐aging older adults (TOA) and 2) cortical thickness in the anterior mid‐cingulate cortex (aMCC), the integrity of which has been consistently associated with SuperAging, would predict reduced incidence and severity of POD.Method19 SA and 74 TOA (mean age 75.8 +/‐ 4.1; 57F/36M) completed neuropsychological testing and underwent structural brain MRI pre‐operatively as part of the Successful AGing after Elective Surgery (SAGES) Study. SA were identified based on neuropsychological criteria defined in previous studies. Delirium incidence and severity were assessed using the Confusion Assessment Method (CAM) daily throughout hospitalization. A general linear model analysis was performed to identify regions of the cerebral cortex whose thickness was associated with CAM scores.ResultsNo differences were found in age or education between SA and TOA. Remarkably, no SA developed POD; POD occurred only in the TOA group (D‐TOA = 15). Severity of POD was negatively associated with cortical thickness of bilateral aMCC. A one‐way ANOVA comparing mean aMCC thickness across subgroups revealed a significant effect (F(2,89) = 3.09, p ≤ .05), with thickness greatest in SA compared with D‐TOA (t(31) = 2.47, p ≤ .019, Cohen’s d = 0.89), but comparable compared to thickness seen in non‐delirious (ND) TOA (t(76) = 0.72, p ≤ .72, d = 0.10). Greater aMCC thickness was also observed for ND‐TOAs compared with D‐TOAs (t(71) = 2.26, p ≤ .03 d = 0.72).ConclusionThese findings suggest that superior memory function and greater structural integrity of the aMCC may be important indices of resilience to delirium in older adults that can serve as a target of preventive or therapeutic interventions.

Research trends and hotspots of post-stroke cognitive impairment: a bibliometric analysis.

Background: Post-stroke cognitive impairment (PSCI) is a major complication of stroke that affects more than one-third of stroke survivors, threatening their quality of life and increasing the risk of disability and death. Although various studies have described the etiology, epidemiology, and risk factors of PSCI, there are a limited number of comprehensive and accurate reports on research trends and hotspots in this field. Therefore, this review aimed to evaluate research trends, hotspots, and frontiers in PSCI using bibliometric analysis. Methods: We screened the literature spanning 20 years in the Web of Science Core Collection: Science Citation Index Expanded (SCI-Expanded) database from 1 January 2003 to 31 December 2022. We included all eligible literature reports based on our comprehensive search strategy, inclusion criteria, and exclusion criteria. The analysis of annual publications, countries/regions, institutions, journals, co-cited references, and keywords was conducted using CiteSpace and VOSviewer, and the hotspots and major findings of PSCI were summarized. Results: A total of 1,024 publications were included in this review. We found that the number of publications on PSCI increased annually. These publications were published in 75 countries or regions by over 400 institutions. Although Chinese institutions had the highest number of publications, their international influence was limited. The United States showed a strong influence in the field. The journal "Stroke" published the most publications (57) with a high impact factor and was considered the most co-cited journal. The most frequently cited references focused on the prevalence, incidence, neuropsychological assessment scales, criteria, and guidelines of PSCI. The strongest citation burst keywords for PSCI were "neurotrophic factor" and "synaptic plasticity", which were regarded as research focuses and research hotspots, respectively. Conclusion: This review provided a comprehensive summary of the literature of PSCI, identified the authoritative and frequently cited literature and journals, clarified the trends in PSCI research, and highlighted the hotspots in this field. Currently, studies on the mechanisms and treatment of PSCI are limited, and we hope that this review has effectively highlighted the research trajectory of PSCI and will lay the foundation for more innovative research in the future.

Association between Age Gain, Parkinsonism and Pesticides: A Public Health Problem?

As life expectancy increases worldwide, so does the time available for prolonged exposure to toxic materials in the environment that have the potential to exert gradual pressure, facilitating the onset of aging in the body.&#x0D; Neural/behavioral alterations are linked to age gain, making the understanding of the aging process more complex considering the high complexity of the neural system and, although neuropsychological, pathological and neuroimaging criteria have been established to differentiate between normal and pathological aging, diagnosing the mild cognitive problems of each elderly individual remains a challenge.&#x0D; Parkinson's disease is recognized as one of the most common neurological disorders in the elderly, whose intrinsic cause is still unknown, but its main molecular basis is the decrease in dopamine produced in the substantia nigra. Studies have suggested that exposure to organophosphate, the glyphosate class, in different organisms, are capable of promoting bodily malformations, neurotoxicity, hepatotoxicity, genotoxicity, metabolic disorders, among others. The effects of pesticides on the environment, associated with their exacerbated permanence in the environment, indicate that more and more people may suffer their deleterious action, which may be the cause of some neurodegenerative disorders. The main objective of this study was to use specific data from the literature on Parkinsonism, correlating it with aging and contamination by pesticides.&#x0D; In fact, the health risks inherent in the use of pesticides are greater the greater the intensity of exposure to them and, considering the widespread use of pesticides today, the number of poisoning of the human population and animals will increase. Therefore, in terms of literary data, contamination with pesticides may be associated with a public health problem and, therefore, a possible increase in dementia processes, thus Parkinsonism.

Mild Cognitive Impairment, Reversion Rates, and Associated Factors: Comparison of Two Diagnostic Approaches.

As mild cognitive impairment (MCI) is typically used to identify prodromal stages of dementia, it is essential to identify MCI criteria with high diagnostic stability and prediction of dementia. Moreover, further investigation into pinpointing key factors for reversion is required to foresee future prognosis of MCI patients accurately. To explore disparities in diagnostic stability by examining reversion rates produced by two operationalizations of the MCI definition: the widely applied Petersen criteria and a version of the Neuropsychological (NP) criteria and to identify cognitive, lifestyle, and health related factors for reversion. MCI was retrospectively classified in a sample from the Swedish community-based study Good Aging in Skåne with the Petersen criteria (n = 744, median follow-up = 7.0 years) and the NP criteria (n = 375, median follow-up, 6.7 years), respectively. Poisson regression models estimated the effect of various factors on the likelihood of incident reversion. Reversion rates were 323/744 (43.4%, 95% confidence intervals (CI): 39.8; 47.0) and 181/375 (48.3% 95% CI: 43.2; 53.5) for the Petersen criteria and NP criteria, respectively. Participants with impairment in a single cognitive domain, regular alcohol consumption, living with someone, older age, and lower body mass index had a higher likelihood of reverting to normal. Reversion rates were similar for Petersen and NP criteria indicating that one definition is not superior to the other regarding diagnostic stability. Additionally, the results highlight important aspects such as multiple domain MCI, cohabitation, and the role of alcohol on predicting the trajectory of those diagnosed with MCI.

Subjective vs informant-reported cognitive complaints have differential clinical significance in covert cerebral small vessel disease

ObjectiveSubjective cognitive complaints are common in patients with cerebral small vessel disease (cSVD), yet their relationship with informant evaluations, objective cognitive functions and severity of brain changes are poorly understood. We studied the associations of subjective and informant reports with findings from comprehensive neuropsychological assessment and brain MRI. MethodIn the Helsinki SVD Study, 152 older adults with varying degrees of white matter hyperintensities (WMH) but without stroke or dementia were classified as having normal cognition or mild cognitive impairment (MCI) based on neuropsychological criteria. The measures also included continuous domain scores for memory and executive functions. Cognitive complaints were evaluated with the subjective and informant versions of the Prospective and Retrospective Memory Questionnaire (PRMQ) and Dysexecutive Questionnaire (DEX); functional abilities with the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL); and depressive symptoms with the Geriatric Depression Scale (GDS-15). ResultsSubjective cognitive complaints correlated significantly with informant reports (r=0.40–0.50, p<0.001). After controlling for demographics, subjective and informant DEX and PRMQ were not related to MCI, memory or executive functions. Instead, subjective DEX and PRMQ significantly associated with GDS-15 and informant DEX and PRMQ with WMH volume and A-IADL. ConclusionsNeither subjective nor informant-reported cognitive complaints associated with objective cognitive performance. Informant-evaluations were related to functional impairment and more severe WMH, whereas subjective complaints only associated with mild depressive symptoms. These findings suggest that awareness of cognitive impairment may be limited in early-stage cSVD and highlight the value of informant assessments in the identification of patients with functional impairment.

Neuropsychological criteria for diagnosing cognitive impairment in patients with occupational diseases caused by physical factors

The aim. To identify neuropsychological signs of a decrease in higher mental functions associated with professional exposure to physical factors.Materials and methods. The study involved 40 patients with vibration disease caused by local vibration (Group 1), 50 patients with vibration disease caused by combined exposure to local and general vibration (Group 2), 71 civil aviation pilots with an established diagnosis of occupational sensorineural hearing loss (Group 3), and 38 healthy men (Group 4, control group). Methods of neuropsychological testing were used.Results. In Groups 1–3 the state of functioning of the cognitive sphere is represented by a mildly pronounced nature of impairments. The results of MMSE and FAB tests in patients of Groups 1–2, when compared with Group 4, determine a decrease in the functional activity of the frontal lobes and subcortical structures (25 (24–27), 25 (22–26), 15 (14–16) and 15 (13–16) points respectively). The most informative feature associated with the fact of occupational exposure to local vibration is the indicator of long-term memory (F = 9.41; р = 0.003); with combined impact of local and general vibration – short-term memory (F = 11.0; р = 0.001); with aircraft noise – objective gnosis (F = 8.48; р = 0.001). The obtained features make it possible to track with a high degree of accuracy the development of a decrease in cognitive functions in this contingent (86.1 %, 84.8 % and 72.1 % respectively).Conclusion. Common signs of changes in the cognitive sphere and lesions of the brain structures in patients with vibration disease are a decrease in praxis, impressive speech, for occupational sensorineural hearing loss – the lack of analytical-synthetic and conceptual thinking, object and finger gnosis, characterizing the inferiority of the functioning of the frontal and parietal regions of the left hemisphere.

Improved biomarker associations using neuropsychological criteria versus ADNI criteria for diagnosis of MCI in Vietnam‐era veterans with head injury histories

AbstractBackgroundCompared to conventional Petersen/Winblad criteria for mild cognitive impairment (MCI), our prior work has shown that neuropsychological or “actuarial” criteria more accurately predicts progression to dementia, and is more strongly associated with Alzheimer’s disease (AD) biomarkers and imaging profiles. However, research to date has been conducted in relatively healthy samples with few comorbidities. Given that history of traumatic brain injury (TBI) and post‐traumatic stress disorder (PTSD) is common in older veteran populations, and both conditions are well‐documented risk factors for AD, we compared Jak/Bondi neuropsychological and ADNI MCI criteria to examine cross‐sectional cognitive and biomarker profiles in a well‐characterized sample of Vietnam‐era veterans with history of TBI and PTSD.Method186 veterans (mean age = 70.11) from the DoD‐ADNI study with history of TBI were evaluated for MCI using (1) ADNI criteria: subjective memory concern, objective memory impairment using WMS‐R Logical Memory, and Clinical Dementia Rating Global = 0.5; and (2) neuropsychological criteria: &gt;1 standard deviation (SD) below age‐appropriate norms on two tests within any cognitive domain, or &gt;1 SD below age‐appropriate norms on one test across all domains. Accounting for age and education, linear regression evaluated relationships between MCI diagnosis and AD biomarkers (Aβ42, total tau [t‐tau], and phosphorylated tau [p‐tau]). Logistic regression evaluated whether PTSD symptoms (CAPS total score) predicted MCI.ResultRoughly 17% of the sample met neuropsychological criteria for MCI, while 13% met ADNI criteria. Agreement between criteria was poor (κ = .17). APOE4 carrier status did not predict diagnosis by either criteria. MCI diagnosis using neuropsychological criteria was associated with higher t‐tau (p = .049) and p‐tau (p = .04), but not Aβ42 (p = .15), while ADNI diagnosis was not associated with any biomarkers (p&gt;.05). PTSD symptoms predicted MCI diagnosis using ADNI (p = .005) but not neuropsychological criteria (p = .19).ConclusionFindings showed that MCI diagnosis using sensitive neuropsychological methods is more strongly associated with AD biomarkers than conventional diagnostic methods. Additionally, ADNI criteria may be capturing false‐positive diagnoses secondary to PTSD. MCI diagnostics benefit from the incorporation of comprehensive neuropsychological methods, particularly in complex populations with medical and psychiatric comorbidities.

Tau levels are higher in objective subtle cognitive decline, but not subjective memory complaint

AbstractBackgroundThe 2018 NIA‐AA Alzheimer’s disease (AD) Research Framework states that subtle cognitive decline in cognitively unimpaired individuals can be measured by subjective report or evidence of objective decline on neuropsychological measures. Both subjective memory complaint (SMC) and objective subtle cognitive decline (Obj‐SCD) have been shown to be associated with future cognitive decline and AD biomarkers. We examined whether there are tau PET differences in a) SMC‐ vs. SMC+ participants, b) Obj‐SCD‐ vs. Obj‐SCD+ participants, and c) participants with overlapping/discrepant SMC and Obj‐SCD classifications.MethodParticipants without MCI or dementia from the Alzheimer’s Disease Neuroimaging Initiative (ADNI; n = 236) were classified at baseline as positive or negative for SMC (SMC‐ n = 77; SMC+ n = 159) based on the first 12 items of the Cognitive Change Index and/or classified as positive or negative for Obj‐SCD (Obj‐SCD‐ n = 173; Obj‐SCD+ n = 63) based on previously defined neuropsychological criteria. Analyses of covariance, adjusting for age, sex, APOE ε4 status, and pulse pressure, examined group differences in tau PET (AV‐1451) using a composite SUVR for regions consistent with Braak stage III/IV. Chi‐squared tests examined tau positivity rates across groups.ResultObj‐SCD+ participants had higher tau levels (p = .035, ηp 2 = .019) and higher rates of tau positivity (15.8% Obj‐SCD‐ vs. 30.2% Obj‐SCD+) than Obj‐SCD‐ participants. Neither tau levels (p = .381, ηp2 = .003) nor tau positivity rates (18.2% SMC‐ and 20.1% SMC+) differed for SMC groups. There was little agreement between SMC and Obj‐SCD (42%; κ = 0.01, p = .811). Participants with only Obj‐SCD had the highest tau PET levels and differed from participants with only SMC (p = .022). Tau levels in SMC+/Obj‐SCD+ participants did not differ from those with only Obj‐SCD (p = .216). Tau positivity rates across SMC‐/Obj‐SCD‐, SMC+/Obj‐SCD‐, SMC‐/Obj‐SCD+, and SMC+/Obj‐SCD+ groups were 10.5%, 18.1%, 40.0%, and 25.6%, respectively.ConclusionParticipants with Obj‐SCD had greater tau burden than those without Obj‐SCD, but SMC was not associated with higher tau levels. The combination of SMC and Obj‐SCD did not have higher tau levels than Obj‐SCD alone. Findings add to the evidence that the Obj‐SCD classification is associated with AD biomarkers and faster cognitive decline in ADNI participants, but further work is needed to validate this approach in more representative/diverse cohorts.

Tau levels are higher in objective subtle cognitive decline but not subjective memory complaint

BackgroundThe 2018 NIA-AA Alzheimer’s Disease (AD) Research Framework states that subtle cognitive decline in cognitively unimpaired individuals can be measured by subjective reports or evidence of objective decline on neuropsychological measures. Both subjective memory complaint (SMC) and objective subtle cognitive decline (Obj-SCD) have been shown to be associated with future cognitive decline and AD biomarkers. We examined whether there are differences in tau PET levels between (a) SMC− vs. SMC+ participants, (b) Obj-SCD− vs. Obj-SCD+ participants, and (c) participants with overlapping vs. discrepant SMC and Obj-SCD classifications.MethodsCognitively unimpaired participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI; n = 236) were classified at baseline as positive or negative for SMC (SMC− n = 77; SMC+ n = 159) based on the first 12 items of the Cognitive Change Index and/or classified as positive or negative for Obj-SCD (Obj-SCD− n = 173; Obj-SCD+ n = 63) based on previously defined neuropsychological criteria. Analyses of covariance, adjusting for age, sex, APOE ε4 carrier status, and pulse pressure, examined the group differences in tau PET (AV-1451) using a composite standardized uptake variable ratio (SUVR) for regions consistent with Braak stage III/IV. The chi-squared tests examined the tau positivity rates across the groups.ResultsObj-SCD+ participants had higher tau continuous SUVR levels (p = .035, ηp2 = .019) and higher rates of tau positivity (15.8% Obj-SCD− vs. 30.2% Obj-SCD+) than Obj-SCD− participants. Neither tau levels (p = .381, ηp2 = .003) nor rates of tau positivity (18.2% SMC− and 20.1% SMC+) differed between the SMC groups. There was very little agreement between SMC and Obj-SCD classifications (42%; κ = 0.008, p = .862). Participants who were Obj-SCD+ without SMC had the highest tau PET levels and differed from participants who were SMC+ without Obj-SCD (p = .022). Tau levels in participants with both SMC and Obj-SCD did not differ from those with only Obj-SCD (p = .216). Tau positivity rates across the SMC-/Obj-SCD−, SMC+/Obj-SCD−, SMC−/Obj-SCD+, and SMC+/Obj-SCD+ groups were 10.5%, 18.1%, 40.0%, and 25.6%, respectively.ConclusionParticipants with Obj-SCD had a greater tau PET burden than those without Obj-SCD, but SMC was not associated with higher tau levels. The combination of SMC and Obj-SCD did not have higher tau levels than Obj-SCD alone. Findings add to the evidence that the Obj-SCD classification is associated with AD biomarkers and faster cognitive decline in ADNI participants, but further work is needed to validate this approach in more representative/diverse cohorts.

Structural integrity of the anterior mid-cingulate cortex contributes to resilience to delirium in SuperAging.

Despite its devastating clinical and societal impact, approaches to treat delirium in older adults remain elusive, making it important to identify factors that may confer resilience to this syndrome. Here, we investigated a cohort of 93 cognitively normal older patients undergoing elective surgery recruited as part of the Successful Aging after Elective Surgery study. Each participant was classified either as a SuperAger (n = 19) or typically aging older adult (n = 74) based on neuropsychological criteria, where the former was defined as those older adults whose memory function rivals that of young adults. We compared these subgroups to examine the role of preoperative memory function in the incidence and severity of postoperative delirium. We additionally investigated the association between indices of postoperative delirium symptoms and cortical thickness in functional networks implicated in SuperAging based on structural magnetic resonance imaging data that were collected preoperatively. We found that SuperAging confers the real-world benefit of resilience to delirium, as shown by lower (i.e. zero) incidence of postoperative delirium and decreased severity scores compared with typical older adults. Furthermore, greater baseline cortical thickness of the anterior mid-cingulate cortex—a key node of the brain’s salience network that is also consistently implicated in SuperAging—predicted lower postoperative delirium severity scores in all patients. Taken together, these findings suggest that baseline memory function in older adults may be a useful predictor of postoperative delirium risk and severity and that superior memory function may contribute to resilience to delirium. In particular, the integrity of the anterior mid-cingulate cortex may be a potential biomarker of resilience to delirium, pointing to this region as a potential target for preventive or therapeutic interventions designed to mitigate the risk or consequences of developing this prevalent clinical syndrome.

Objective subtle cognitive decline is associated with a more rapid increase in plasma phosphorylated‐tau181 levels over time

AbstractBackgroundEarly identification of Alzheimer’s disease (AD) is imperative for early intervention and planning. Objectively‐defined subtle cognitive decline (Obj‐SCD) criteria, based on sensitive neuropsychological scores, is associated with AD biofluid and neuroimaging markers as well as progression to mild cognitive impairment (MCI) and dementia. However, the relationship between Obj‐SCD and newer plasma markers, such as plasma phosphorylated‐tau181 (p‐tau181), is unknown. Therefore, we examined baseline and longitudinal plasma p‐tau181 across CN, Obj‐SCD, and MCI groups.Method953 Alzheimer’s Disease Neuroimaging Initiative participants without dementia had plasma p‐tau181 data, which were log‐transformed prior to analyses. Participants were classified as CN (n=403), Obj‐SCD (n=200), or MCI (n=350) based on actuarial neuropsychological criteria. Baseline analyses compared p‐tau181 across groups. Linear mixed effects models, adjusting for age, sex, APOE e4 allele frequency, and pulse pressure, examined 4‐year p‐tau181 rate of change in Obj‐SCD and MCI participants relative to CN. Follow‐up analyses examined whether the group p‐tau181 x time trajectories differed by Aβ‐PET positivity status.ResultCN and Obj‐SCD groups had lower baseline plasma p‐tau181 than the MCI group and did not differ from one another (Figure 1). However, longitudinally, the Obj‐SCD group had the steepest increase in plasma p‐tau181 over four years and was the only group to differ from CN participants (Figure 2; b=.016, 95% CI: .003‐.018, p=.016). When groups were split by Aβ status, only the Aβ‐negative Obj‐SCD group showed a slightly faster increase in p‐tau181 relative to the Aβ‐negative CN group (b=.019, 95% CI: .001‐.037, p=.044).ConclusionBaseline plasma p‐tau181 did not differ between CN and Obj‐SCD; however, consistent with prior findings, Obj‐SCD was associated with future pathologic changes, including those measured by plasma p‐tau181, prior to frank impairment associated with MCI. Importantly, these results do not appear to be driven by Aβ+ Obj‐SCD participants. Despite the long‐held assumption that cognitive changes invariably follow biomarker changes, these findings suggest that early neuropsychological difficulties may emerge before or in tandem with measurable changes in plasma markers. Future work will examine the prognostic impact of combining Obj‐SCD and plasma markers, which both have the potential to be accessible early markers of future AD‐related declines.

Plasma Aβ40, Aβ42 and Aβ‐clearance proteins as blood biomarkers for Alzheimer's disease, subjective cognitive decline, and MCI

AbstractBackgroundFor early intervention and prevention of dementia, diagnostic biomarkers for MCI and preclinical Alzheimer's disease (AD) are important. amyloid β (Aβ) and tau are known as biomarkers for AD, and the CSF Aβ40 / Aβ42 ratio is clinically useful for diagnosis of AD. We have reported that three proteins in serum related to Aβ clearance: ApoA1, complement protein C3 and transthyretin (TTR) are useful as blood biomarkers for MCI (Triple marker). Plasma Aβ has been shown to correlate with amyloid PET, however, its clinical utility in MCI and AD diagnosis is unclear. Therefore, we investigated usefulness plasma Aβ in addition to the triple marker as blood test for MCI and AD. Here we analyzed plasma levels of Aβ40, Aβ42 and Triple marker in MCI and AD as diagnostic markers.MethodA total of 909 cases consisting of 354 non‐demented control (NDC), and 76 subjective cognitive decline (SCD), 312 MCI, and 167 AD diagnosed according to ADNI neuropsychological criteria were selected in the multicenter clinical study. The positron emission tomography (PET) using with [18F] Florbetapir was performed 24 APOE4‐carring SCD and MCI subjects. Plasma Aβ40, Aβ42 were measured by ELISA (EUROIMMUN, Lübeck). Plasma levels of ApoA1, TTR, complement C3 was measured as described previously (Liu et al., Alzheimer Dement (Amst) 2019).ResultPlasma ApoA1 and complement C3 levels were decreased in progression of the disease. Plasma Aβ40 / 42 ratio showed ROC AUC = 0.82 and 0.67 in AD vs. NDC and MCI vs. NDC, respectively. Combination of plasma levels of Aβ40 / 42 ratio and Triple marker (ApoA1, TTR, C3) showed AUC = 0.85 (80% sensitivity and 85% specificity) in AD vs. NDC and AUC = 0.76 (76% sensitivity and 70% specificity) in MCI vs. NDC. Aβ40 / 42 ratio and TTR were significantly decreased in amyloid‐positive subjects (SUVR≥1.10) compared to amyloid‐negative subjects (SUVR&lt;1.10).ConclusionCombination of plasma Aβ40 / Aβ42 ratio and Triple marker is a useful blood test for not only AD but also the early stages of cognitive decline.

NEUROPSYCHOLOGICAL DETERMINANTS OF DYSLEXIA IN SCHOOLCHILDREN

The article describes the results of the research exploring the link between the neurodynamic component of schoolchildren’s psychic activity at the age of 7-12 and the level of mastering the reading skill at school. In the process of the research, we have detected the core neuropsychological criteria correlating with the level of reading technique and text understanding in schoolchildren. The neuropsychological research was made using A.R. Luria’s battery of tests, by G.M. Glosman’s method, adapted to childhood. We also used A.N. Kornyev and O.A. Ishymova’s method of dyslexia diagnostics; texts for the research have been translated into Ukrainian. We have pointed out two age groups of children andanalyzed how neurodynamic deficiency and audio-verbal and visual memory level influence the formation of dyslexia determinants in both of them. In addition, we have addressed the link between child’s development under the age of 1, parents’ complaints at the actual time and the level of a child’s reading technique.