Neuropsychological Test Scores Research Articles

Association between plasma osteopontin level and mild cognitive impairment in patients with type 2 diabetes mellitus

Objective: To analyze the influencing factors of type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI), and to explore the association between plasma osteopontin (OPN) levels and MCI. Methods: A retrospective analysis was conducted on the clinical data of 254 patients with T2DM admitted to Zhongda Hospital Affiliated to Southeast University from October 2021 to May 2023. The patients were divided into MCI group (n=106) and normal cognitive function control group (n=148) according to whether they had MCI. Clinical data were collected, cognitive function was assessed using neurological scales and plasma OPN levels were measured by enzyme linked immunosorbent assay. A multivariate logistic regression model was applied to analyze the influencing factors of MCI in T2DM patients. Interaction terms between gender, age, body mass index (BMI), and OPN were established to verify their significance levels. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of OPN for MCI in T2DM patients. The mediation model of OPN-FPG-montreal cognitive assessment(MoCA) was constructed with fasting plasma glucose (FPG) as the mediating variable to test the mediating effect, and the mediating effect percentage was calculated. Results: A total of 254 patients were included, including 162 males and 92 females, with an average age of (61.5±7.5) years old. Compared with the control group, the patients in MCI group were older[63.0(59.0, 69.0) years vs 60.0(54.2, 66.8) years], had a greater proportion of females [(43.4%(46/106) vs 31.1%(46/148)], shorter years of education[12(9, 12) years vs 12(9,15) years], longer duration of diabetes[15.0(8.0, 20.0) years vs 10.0(5.0, 15.0) years], and higher levels of FPG[7.78(6.07, 10.23) mmol/L vs 6.86(5.36, 8.59) mmol/L], insulin resistance index[2.93(2.47, 3.98) vs 2.79(2.27, 3.25)], glycated hemoglobin (HbA1c) [9.24%(7.89%, 10.96%) vs 7.97%(7.00%, 9.45%)], total cholesterol(TC)[(4.51±1.17) mmol/L vs (4.19±0.99) mmol/L], and OPN [11.30(8.68, 12.84) ng/ml vs 9.69(7.82, 11.74) ng/ml] (all P<0.05). The scores of various neuropsychological tests in MCI patients were lower than those in control group with normal cognitive function (all P<0.05). Spearman correlation analysis showed that age(r=-0.212), duration of diabetes mellitus(r=-0.156), duration of hypertension(r=-0.132), FPG(r=-0.207), insulin resistance index(r=-0.171), HbA1c(r=-0.271), OPN(r=-0.238), and total cholesterol (r=-0.125) were negatively correlated with MoCA scores, whereas years of education(r=0.285) were positively correlated with MoCA scores(all P<0.05). Multifactorial logistic regression analysis showed that age, years of education, duration of diabetes mellitus, HbA1c, TC and OPN levels were the influencing factors of T2DM patients with MCI, and the risk of MCI increased by 15% for every 1 ng/ml increase in OPN (OR=1.15, 95%CI: 1.021-1.295, P=0.021), and the relationship was not affected by age, gender and BMI(The interaction effects are all P>0.05). The area under the curve (AUC) of the working curve of subjects with OPN predicting combined MCI in patients with T2DM was 0.612 (95%CI: 0.541-0.682), and the AUC was 0.702 (95%CI: 0.638-0.767) after the combination of HbA1c and OPN. The results of the mediated effect model showed that FPG partially mediated the correlation between OPN and MoCA in T2DM patients, and the mediated effect accounted for 11.34% of the total effect. Conclusions: Plasma OPN level is associated with MCI in patients with T2DM,and the higher the OPN level, the higher the risk of T2DM patients developing MCI.

Mode of delivery and behavioral and neuropsychological outcomes in children at 10 years of age.

Previous studies have reported that mode of delivery, particularly cesarean delivery (CD), is associated with neurodevelopmental outcomes in children. This study evaluates behavioral and neuropsychological test scores in children based on mode of delivery. Children enrolled in the Raine Study from Western Australia, born between 1989 and 1992 by instrumental vaginal delivery (IVD), elective CD, and non-elective CD, were compared to those with spontaneous vaginal delivery (SVD). The primary outcome was the Child Behavior Checklist (CBCL) administered at age 10. Secondary outcomes included evaluations of language, motor function, cognition, and autistic traits. Multivariable linear regression was used to evaluate score differences by mode of delivery adjusted for sociodemographic and clinical characteristics, and Poisson regression was used to evaluate for increased risk of clinical deficit. Of 2,855 children, 1770 (62.0 %) were delivered via SVD, 480 (16.8 %) via IVD, 346 (12.1 %) via elective CD, and 259 (9.1 %) via non-elective CD. Non-elective CD was associated with higher (worse) CBCL Internalizing (+2.09; 95 % CI 0.49, 3.96; p=0.01) scores, and elective CD was associated with lower (worse) McCarron Assessment of Neuromuscular Development (MAND) (-3.48; 95 % CI-5.61,-1.35; p=0.001) scores. Differences were not seen in other outcomes, and increased risk of clinical deficit was not observed with either the CBCL Internalizing or MAND scores. Differences in behavior and motor function were observed in children delivered by CD, but given that score differences were not associated with increased incidence of clinical deficit, clinical significance may be limited.

A multimodal learning machine framework for Alzheimer’s disease diagnosis based on neuropsychological and neuroimaging data

Alzheimer’s disease (AD) is the most prevalent form of dementia, with no current cure. Early screening and intervention are vital. In multimodal AD data, besides neuroimaging dimensions, neuropsychological tests based on cognitive domains also provide the clinical information for diagnosing AD. However, previous multimodal methods often fuse these neuropsychological test scores with other data, losing the rich clinical details inherent in each test, including videos, speech, images, and text. To address this, we propose a novel framework with an entropy-based polynomial dimension expansion function that restores this critical information by accurately calculating the optimal polynomial degree. Additionally, the proposed framework offers a series of cognitive-based Extreme Learning Machine (ELM) models to better utilize the detailed clinical insights from neuropsychological tests, reducing diagnostic redundancy and noise. Finally, we design a boosting ensemble strategy that combines diagnostic models from various dimensions and cognitive domains, automatically optimizing weights to enhance diagnostic accuracy. Tested on the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset, our approach achieves over 98% accuracy and F1 scores, with no observed bias between mild cognitive impairment (MCI) and AD groups. Therefore, our framework can offer clinicians more logical recommendations for diagnosing and managing the disease.

Cognition Assessment in Virtual Reality (CAVIR): Associations with neuropsychological performance and activities of daily living in patients with mood or psychosis spectrum disorders

BackgroundMore ecologically valid tools are needed to better capture daily-life cognitive impairments in patients with mood or psychosis spectrum disorders in clinical settings and cognitive treatment trials. We developed the Cognition Assessment in Virtual Reality (CAVIR) test, which assesses daily-life cognitive skills in an immersive virtual reality kitchen scenario. This study investigated the validity and sensitivity of CAVIR, including its association with activities of daily living (ADL) ability. Methods70 symptomatically stable patients with mood or psychosis spectrum disorders and 70 healthy controls completed CAVIR and standard neuropsychological tests and were rated for clinical symptoms, functional capacity, and subjective cognition. In addition, patients' ADL ability was evaluated with the Assessment of Motor and Process Skills (AMPS). ResultsHigher global CAVIR performance correlated moderately with better global neuropsychological test scores (rs(138) = 0.60, p < 0.001) and showed a weak to moderate association with better ADL process ability in patients (r(45) = 0.40, p < 0.01), also after adjusting for sex and age (ps ≤ 0.03). In comparison, neuropsychological performance, interviewer- and performance-based functional capacity, and subjective cognition were not significantly associated with ADL process ability (ps ≥ 0.09). Further, CAVIR was sensitive to cognitive impairments in patients and was able to differentiate between patients with and without the ability to undertake regular employment. LimitationsThe modest sample size and concomitant medication. ConclusionOur results indicate that CAVIR is a sensitive measure of daily-life cognitive skills in patients with mood or psychosis spectrum disorders.

ERP biomarkers for go/no-go tasks to detect potential cognitive impairment in community-dwelling older adults

With an aging population, detecting cognitive dysfunction at an early stage is important. However, no current neurophysiological assessments examine brain activity status in community-dwelling older adults. Therefore, this study aimed to characterize event-related potential (ERP) during go/no-go tasks in older adults with potential cognitive impairment living in the community. The participants were 34 young adults and 46 older adults. They underwent a go/no-go task to measure ERP. The older adults were divided into two groups for analysis based on the results of the Japanese version of the Montreal Cognitive Assessment (MoCA-J): cognitively normal and cognitively impaired. N2 latency was significantly delayed in the cognitively impaired group compared to the cognitively normal and younger groups. Furthermore, the younger group exhibited a significant increase in P3 amplitude and shorter latency compared to both older adult groups. The results of the correlation analysis between ERP and neuropsychological test scores showed that N2 latency correlated with neuropsychological test scores. The results also suggested that receiver operating characteristic curve analysis can measure cognitive function. These results indicated that N2 latency reflected potential cognitive dysfunction in community-dwelling older adults. Furthermore, P3 amplitude may be useful in detecting age-related inhibitory function decline.

Disrupted cognitive network revealed by task-induced brain entropy in schizophrenia.

Brain entropy (BEN), which measures the amount of information in brain activity, provides a novel perspective for evaluating brain function. Recent studies using resting-state functional magnetic resonance imaging (fMRI) have shown that BEN during rest can help characterize brain function alterations in schizophrenia (SCZ). However, there is a lack of research on BEN using task-evoked fMRI to explore task-dependent cognitive deficits in SCZ. In this study, we evaluate whether the reduced working memory (WM) capacity in SCZ is possibly associated with dynamic changes in task BEN during tasks with high cognitive demands. We analyzed data from 15 patients with SCZ and 15 healthy controls (HC), calculating task BEN from their N-back task fMRI scans. We then examined correlations between task BEN values, clinical symptoms, 2-back task performance, and neuropsychological test scores. Patients with SCZ exhibited significantly reduced task BEN in the cerebellum, hippocampus, parahippocampal gyrus, thalamus, and the middle and superior frontal gyrus (MFG and SFG) compared to HC. In HC, significant positive correlations were observed between task BEN and 2-back accuracy in several brain regions, including the MFG and SFG; such correlations were absent in patients with SCZ. Additionally, task BEN was negatively associated with scores for both positive and negative symptoms in areas including the parahippocampal gyrus among patients with SCZ. In conclusion, our findings indicate that a reduction in BEN within prefrontal and hippocampal regions during cognitively demanding tasks may serve as a neuroimaging marker for SCZ.

High-Frequency rTMS Broadly Ameliorates Working Memory and Cognitive Symptoms in Stroke Patients: A Randomized Controlled Trial

Objective To explore the efficacy and tolerability of high-frequency repetitive transcranial magnetic stimulation (rTMS) in the treatment of post-stroke working memory (WM) impairment and its changes in brain function. Methods In the present randomized, double-blinded, sham-controlled design, 10 Hz rTMS was administered to the left dorsolateral prefrontal cortex (DLPFC) of patients with post-stroke WM impairment for 14 days. Measures included WM (primary outcome), comprehensive neuropsychological tests, and the functional near-infrared spectroscopy test. Patients were assessed at baseline, after the intervention (week 2), and 4 weeks after treatment cessation (week 6). Results Of 123 stroke patients, 82 finished the trial. The rTMS group showed more WM improvement at week 2 (t = 5.55, P < .001) and week 6 (t = 2.11, P = .045) than the sham group. Most of the neuropsychological test scores were markedly improved in the rTMS group. In particular, the rTMS group exhibited significantly higher oxygenated hemoglobin content and significantly stronger functional connectivity in the left DLPFC, right pre-motor cortex (PMC), and right superior parietal lobule (SPL) at weeks 2 and 6. Dropout rates were equal (18% [9/50 cases] in each group), and headaches were the most common side effect (rTMS: 36% [18/50 cases]; sham: 30% [15/50 cases]). Conclusions High-frequency rTMS was effective in improving post-stroke WM impairment, with good tolerability, and the efficacy lasted up to 4 weeks, which may be due to the activation of the left DLPFC, right PMC, and right SPL brain regions and their synergistic enhancement of neural remodeling.

Integrative role of attention networks in frequency-dependent modular organization of human brain.

Despite converging evidence of hierarchical organization in the cerebral cortex, with sensory-motor and association regions at opposite ends, the mechanism of such hierarchical interactions remains elusive. This organization was primarily investigated regarding the spatiotemporal dynamics of intrinsic connectivity networks (ICNs). However, more effort is needed to investigate network dynamics in the frequency domain. We aimed to examine the integrative role of brain regions in the frequency domain with graph metrics. Phase-based connectivity estimation was performed in three frequency bands (0.011-0.038, 0.043-0.071, and 0.076-0.103Hz) in the BOLD signal during rest. We applied modularity analysis to connectivity matrices and investigated those areas, which we called integrative regions, that showed frequency-domain flexibility. Integrative regions, mostly belonging to attention networks, were densely connected to higher-order cognitive ICNs in lower frequency bands but to sensory-motor ICNs in higher frequency bands. We compared the normalized participation coefficient (Pnorm) values of integrative and core regions with respect to their relation to higher-order cognition using a permutation-based t-test for multiple linear regression. Regression parameters of integrative regions in relation to three cognitive scores in executive functions, and working memory were significantly larger than those of core regions (Pfdr < 0.05) for salience ventral attention network. Parameters of integrative regions in relation to intelligence scores were significantly larger than those with core regions (Pfdr < 0.05) in dorsal attention network. Larger parameters of neuropsychological test scores in relation to these flexible parcels further indicate their essential role at an intermediate level in behavior. Results emphasize the importance of frequency-band analysis of brain networks.

The role of neuropsychology in the care of patients with functional neurological symptom disorder.

Functional neurological symptom disorder (FNSD) is a neuropsychiatric condition characterized by signs/symptoms associated with brain network dysfunction. FNSDs are common and are associated with high healthcare costs. FNSDs are relevant to neuropsychologists, as they frequently present with chronic neuropsychiatric symptoms, subjective cognitive concerns, and/or low neuropsychological test scores, with associated disability and reduced quality of life. However, neuropsychologists in some settings are not involved in care of patients with FNSDs. This review summarizes relevant FNSD literature with a focus on the role of neuropsychologists. A brief review of the literature is provided with respect to epidemiology, public health impact, symptomatology, pathophysiology, and treatment. Two primary areas of focus for this review are the following: (1) increasing neuropsychologists' training in FNSDs, and (2) increasing neuropsychologists' role in assessment and treatment of FNSD patients. Patients with FNSD would benefit from increased involvement of neuropsychologists in their care.

A mediation approach in resting-state connectivity between the medial prefrontal cortex and anterior cingulate in mild cognitive impairment

Mild cognitive impairment (MCI) is recognized as the prodromal phase of dementia, a condition that can be either maintained or reversed through timely medical interventions to prevent cognitive decline. Considerable studies using functional magnetic resonance imaging (fMRI) have indicated that altered activity in the medial prefrontal cortex (mPFC) serves as an indicator of various cognitive stages of aging. However, the impacts of intrinsic functional connectivity in the mPFC as a mediator on cognitive performance in individuals with and without MCI have not been fully understood. In this study, we recruited 42 MCI patients and 57 healthy controls, assessing their cognitive abilities and functional brain connectivity patterns through neuropsychological evaluations and resting-state fMRI, respectively. The MCI patients exhibited poorer performance on multiple neuropsychological tests compared to the healthy controls. At the neural level, functional connectivity between the mPFC and the anterior cingulate cortex (ACC) was significantly weaker in the MCI group and correlated with multiple neuropsychological test scores. The result of the mediation analysis further demonstrated that functional connectivity between the mPFC and ACC notably mediated the relationship between the MCI and semantic fluency performance. These findings suggest that altered mPFC-ACC connectivity may have a plausible causal influence on cognitive decline and provide implications for early identifications of neurodegenerative diseases and precise monitoring of disease progression.

Choroid plexus volume as a novel candidate neuroimaging marker of the Alzheimer’s continuum

BackgroundEnlarged choroid plexus (ChP) volume has been reported in patients with Alzheimer’s disease (AD) and inversely correlated with cognitive performance. However, its clinical diagnostic and predictive value, and mechanisms by which ChP impacts the AD continuum remain unclear.MethodsThis prospective cohort study enrolled 607 participants [healthy control (HC): 110, mild cognitive impairment (MCI): 269, AD dementia: 228] from the Chinese Imaging, Biomarkers, and Lifestyle study between January 1, 2021, and December 31, 2022. Of the 497 patients on the AD continuum, 138 underwent lumbar puncture for cerebrospinal fluid (CSF) hallmark testing. The relationships between ChP volume and CSF pathological hallmarks (Aβ42, Aβ40, Aβ42/40, tTau, and pTau181), neuropsychological tests [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Neuropsychiatric Inventory (NPI), and Activities of Daily Living (ADL) scores], and multimodal neuroimaging measures [gray matter volume, cortical thickness, and corrected cerebral blood flow (cCBF)] were analyzed using partial Spearman’s correlation. The mediating effects of four neuroimaging measures [ChP volume, hippocampal volume, lateral ventricular volume (LVV), and entorhinal cortical thickness (ECT)] on the relationship between CSF hallmarks and neuropsychological tests were examined. The ability of the four neuroimaging measures to identify cerebral Aβ42 changes or differentiate among patients with AD dementia, MCI and HCs was determined using receiver operating characteristic analysis, and their associations with neuropsychological test scores at baseline were evaluated by linear regression. Longitudinal associations between the rate of change in the four neuroimaging measures and neuropsychological tests scores were evaluated on the AD continuum using generalized linear mixed-effects models.ResultsThe participants’ mean age was 65.99 ± 8.79 years. Patients with AD dementia exhibited the largest baseline ChP volume than the other groups (P < 0.05). ChP volume enlargement correlated with decreased Aβ42 and Aβ40 levels; lower MMSE and MoCA and higher NPI and ADL scores; and lower volume, cortical thickness, and cCBF in other cognition-related regions (all P < 0.05). ChP volume mediated the association of Aβ42 and Aβ40 levels with MMSE scores (19.08% and 36.57%), and Aβ42 levels mediated the association of ChP volume and MMSE or MoCA scores (39.49% and 34.36%). ChP volume alone better identified cerebral Aβ42 changes than LVV alone (AUC = 0.81 vs. 0.67, P = 0.04) and EC thickness alone (AUC = 0.81 vs.0.63, P = 0.01) and better differentiated patients with MCI from HCs than hippocampal volume alone (AUC = 0.85 vs. 0.81, P = 0.01), and LVV alone (AUC = 0.85 vs.0.82, P = 0.03). Combined ChP and hippocampal volumes significantly increased the ability to differentiate cerebral Aβ42 changes and patients among AD dementia, MCI, and HCs groups compared with hippocampal volume alone (all P < 0.05). After correcting for age, sex, years of education, APOE ε4 status, eTIV, and hippocampal volume, ChP volume was associated with MMSE, MoCA, NPI, and ADL score at baseline, and rapid ChP volume enlargement was associated with faster deterioration in NPI scores with an average follow-up of 10.03 ± 4.45 months (all P < 0.05).ConclusionsChP volume may be a novel neuroimaging marker associated with neurodegenerative changes and clinical AD manifestations. It could better detect the early stages of the AD and predict prognosis, and significantly enhance the differential diagnostic ability of hippocampus on the AD continuum.

Late Life Depression is Not Associated With Alzheimer-Type Tau: Preliminary Evidence From a Next-Generation Tau Ligand PET-MR Study

To investigate whether tau accumulation is higher in late life depression (LLD) compared to non-depressed cognitively unimpaired (CU) older adults. To situate these findings in the neurodegeneration model of LLD by assessing group differences in tau and grey matter volume (GMV) between LLD, non-depressed CU and mild cognitive impairment due to Alzheimer's Disease (MCI). Monocentric, cross-sectional study. University Psychiatric hospital, memory clinic and outpatient neurology practice. A total of 102 adults over age 60, of whom 19 currently depressed participants with LLD, 19 with MCI and 36 non-depressed CU participants completed neuropsychological testing and tau PET-MR imaging. PET-MRI: 18F-MK-6240 tracer SUVR for tau assessment; 3D T1-weighted structural MRI derived GMV in seven brain regions (temporal, cingulate, prefrontal and parietal regions); amyloid PET to assess amyloid positivity; Neuropsychological test scores: MMSE, RAVLT, GDS, MADRS. ANCOVA and Spearman's rank correlations to investigate group differences in tau and GMV, and correlations with neuropsychological test scores respectively. Compared to non-depressed CU participants, LLD patients showed lower GMV in temporal and anterior cingulate regions but similar tau accumulation and amyloid positivity rate. In contrast, MCI patients had significantly higher tau accumulation in all regions. Tau did not correlate with any neuropsychological test scores in LLD. Our findings suggest AD-type tau is not higher in LLD compared to non-depressed, cognitively unimpaired older adults and appears unlikely to contribute to lower gray matter volume in LLD, further underscoring the need to distinguish major depressive disorder from depressive symptoms occurring in early AD.

Neuropsychological and neuroanatomical underpinnings of the face pareidolia errors on the noise pareidolia test in patients with mild cognitive impairment and dementia due to Lewy bodies

ABSTRACT Objective Prior research on the Noise Pareidolia Test (NPT) has demonstrated its clinical utility in detecting patients with mild cognitive impairment and dementia due to Lewy Body Disease (LBD). However, few studies to date have investigated the neuropsychological factors underlying pareidolia errors on the NPT across the clinical spectrum of LBD. Furthermore, to our knowledge, no research has examined the relationship between cortical thickness using MRI data and NPT subscores. As such, this study sought to explore the neuropsychological and neuroanatomical factors influencing performance on the NPT utilizing the National Alzheimer’s Coordinating Center Lewy Body Dementia Module. Methods Our sample included participants with normal cognition (NC; n = 56), LBD with mild cognitive impairment (LBD-MCI; n = 97), and LBD with dementia (LBD-Dementia; n = 94). Archival data from NACC were retrospectively analyzed for group differences in neuropsychological test scores and cognitive and psychiatric predictors of NPT scores. Clinicoradiological correlates between NPT subscores and a small subsample of the above LBD participants were also examined. Results Analyses revealed significant differences in NPT scores among groups. Regression analysis demonstrated that dementia severity, attention, and visuospatial processing contributed approximately 24% of NPT performance in LBD groups. Clinicoradiological analysis suggests a potential contribution of the right fusiform gyrus, but not the inferior occipital gyrus, to NPT pareidolia error scores. Conclusions Our findings highlight the interplay of attention and visuoperceptual functions in complex pareidolia in LBD. Further investigation is needed to refine the utility of NPT scores in clinical settings, including identifying patients at risk for visual illusions and hallucinations.

The Effect of Acupuncture on Brain Iron Deposition and Body Iron Metabolism in Vascular Cognitive Impairment: Protocol for a Randomized Controlled Trial.

Vascular cognitive impairment (VCI) persistently impairs cognition and the ability to perform activities of daily living, seriously compromising patients' quality of life. Previous studies have reported that disorders of serum iron metabolism and iron deposition in the brain can lead to inflammation, abnormal protein aggregation and degeneration, and massive neuronal apoptosis in the central nervous system, which in turn leads to a progressive decline in cognitive processes. Our previous clinical studies have found acupuncture to be a safe and effective intervention for treating VCI, but the specific mechanisms require further exploration. The objective of the trial is to evaluate the clinical efficacy of Tongdu Xingshen acupuncture and to investigate whether it can improve VCI by regulating brain iron deposition and body iron metabolism. In total, 42 patients with VCI and 21 healthy individuals will participate in this clinical trial. The 42 patients with VCI will be randomized into acupuncture and control groups, while the 21 healthy individuals will be in the healthy control group. Both the control and acupuncture groups will receive conventional medical treatment and cognitive rehabilitation training. In addition, the acupuncture group will receive electroacupuncture treatment with Tongdu Xingshen for 30 minutes each time, 6 times a week for 4 weeks. Meanwhile, the healthy control group will not receive any intervention. All 3 groups will undergo baseline assessments of brain iron deposition, serum iron metabolism, and neuropsychological tests after enrollment. The acupuncture and control groups will be evaluated again at the end of 4 weeks of treatment, as described earlier. By comparing neuropsychological test scores between groups, we will examine the efficacy of Tongdu Xingshen acupuncture in treating VCI. Additionally, we will test the correlations between neuropsychological test scores, brain iron deposition, and body iron metabolism indexes to explore the possible mechanisms of Tongdu Xingshen acupuncture in treating VCI. Participants are currently being recruited. The first participant was enrolled in June 2023, which marked the official start of the experiment. As of the submission of the paper, there were 23 participants. The recruitment process is expected to continue until June 2025, at which point the processing and analysis of data will begin. As of May 15, 2024, up to 30 people have been enrolled in this clinical trial. This study will provide data on the effects of Tongdu Xingshen acupuncture on cerebral iron deposition as well as somatic iron metabolism in patients with VCI. These results will help to prove whether Tongdu Xingshen acupuncture can improve VCI by regulating brain iron deposition and body iron metabolism, which will provide the clinical and theoretical basis for the wide application of acupuncture therapy in VCI rehabilitation. China Clinical Registration Agency ChiCTR2300072188; https://tinyurl.com/5fcydtkv. PRR1-10.2196/56484.

Functional connectivity density aberrance in type 2 diabetes mellitus with and without mild cognitive impairment.

The objective of this study was to investigate alterations in functional connectivity density (FCD) mapping and their impact on functional connectivity (FC) among individuals diagnosed with Type 2 diabetes mellitus (T2DM) across different cognitive states. Moreover, the study sought to explore the potential association between aberrant FCD/FC patterns and clinical or cognitive variables. A total of 211 participants were recruited for this study, consisting of 75 healthy controls (HCs), 89 T2DM patients with normal cognitive function (DMCN), and 47 T2DM patients with mild cognitive impairment (DMCI). The study employed FCD analysis to pinpoint brain regions exhibiting significant FCD alterations. Subsequently, these regions showing abnormal FCD served as seeds for FC analysis. Exploratory partial correlations were conducted to explore the relationship between clinical biochemical indicators, neuropsychological test scores, and altered FCD or FC. The FCD analysis revealed an increased trend in global FCD (gFCD), local FCD (lFCD), and long-range FCD (lrFCD) within the bilateral supramarginal gyrus (SMG) among individuals with DMCN. Additionally, significant lFCD alterations were observed in the right inferior frontal gyrus and left precuneus when comparing DMCN to HCs and DMCI. When comparing individuals with T2DM and healthy controls (HCs), it was revealed that DMCN exhibited significant improvements in FCD. This suggests that the brain may employ specific compensatory mechanisms to maintain normal cognitive function at this stage. Our findings provide a novel perspective on the neural mechanisms involved in cognitive decline associated with T2DM.

Reduced functional connectivity induced by longitudinal alterations of structure and perfusion may be associated with cognitive impairment in patients on maintenance hemodialysis.

Hemodialysis (HD) leads to cognitive impairment; however, the pathophysiology of maintenance HD remains unclear. This study aimed to investigate the longitudinal alterations in gray matter volume (GMV) and cerebral blood flow (CBF) in patients on HD at follow-up compared with baseline, examine the alterations in functional connectivity (FC) by defining co-changed brain regions as seed points, and investigate the correlation between the co-changed brain regions and neuropsychological test scores. Twenty-seven patients with HD and 30 healthy controls were enrolled in this study. All participants underwent high-resolution T1-weighted imaging, arterial spin labeling, and functional MR imaging to measure GMV, CBF, and FC. The patients on HD were assessed at baseline and 3years subsequently. The right and left medial superior frontal gyrus (SFGmed.L) exhibited significantly lower GMV and CBF in patients on HD at follow-up compared with baseline and lower FC between the SFGmed.L and left middle temporal gyrus (MTG.L). FC between the SFGmed.L and MTG.L was positively correlated with neuropsychological test scores in the HD group at follow-up. Reduced GMV and CBF may result in decreased FC between the SFGmed.L and MTG.L, which may be associated with cognitive impairment in patients on maintenance HD. Our findings provide unique insights into the pathological mechanisms of patients on maintenance HD with cognitive impairment.

Adoption of the International Cognition and Cancer Task Force recommendations for harmonizing studies of cancer-related cognitive impairment: A systematic review of published literature.

e24043 Background: This abstract presents a review of published research literature to determine research investigators’ rate of adoption of the International Cognition and Cancer Task Force (ICCTF) recommended criteria for defining cancer-related cognitive impairment (CRCI). Published in 2011, the ICCTF recommendations were intended to identify psychometric standards that would facilitate harmonization of neuropsychological test data across studies for improved accuracy of estimating prevalence of CRCI in cancer populations. The ICCTF recommended standards could help decipher variability or stability of CRCI prevalence across various cancer groups, such as individuals within a diagnostic classification (e.g., lung or breast cancer) or type of cancer treatment (e.g., chemotherapy, immunotherapy, or radiation therapy). However, since publication in 2011, the use of the ICCTF recommendations in CRCI research has not been examined. Methods: Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we restricted study selection to only published studies that examined CRCI using standardized neuropsychological tests (vs. self-report measures). We then identified studies that used the ICCFT recommendations based on the ICCTF psychometric definition of cognitive impairment: In a standard battery of neuropsychological tests, one neuropsychological test score &gt;2 standard deviations (sd) below the mean of a healthy control sample, or 2 neuropsychological test scores of &gt;1.5 sd’s below the control mean, is considered a case of cognitive impairment. Results: We screened 146 CRCI studies published since 2011, with 93 manuscripts that utilized neuropsychological tests to evaluate CRCI. Of those, 35 (37.6%) incorporated the ICCTF recommendations in their methodology and data analysis. Between 2011 and 2022, there was a gradual adoption of ICCTF recommended standard of defining CRCI, ranging from 0% of published studies in 2011 to 56.2% in 2022, but a decline to 40% in 2023. With respect to cancer populations, ICCTF guidelines were most often used in studies of individuals with breast cancer (n = 17;18%). Conclusions: This review demonstrates increased use of the ICCTF recommended definition of CRCI in empirical investigations since their 2011 introduction but a decline in 2023. Use of the ICCTF recommendations can improve accuracy of estimating CRCI prevalence across different cancer disease populations and/or groups of individuals undergoing different cancer therapies. Greater adoption of the ICCTF definition of CRCI is encouraged especially considering a 2023 drop in its use. Broadening the study of CRCI using ICCTF recommendations among cancer populations beyond breast cancer is encouraged to better understand the breadth of impact CRCI across the spectrum of disease.

Subgroups of mild cognitive impairment based on cognitive function among Chinese older adults

Abstract Background: Due to the heterogeneity of mild cognitive impairment (MCI), the key points for nonpharmaceutical therapies cannot be determined. Examining impairment characteristics among different MCI subgroups would therefore be beneficial to the development of nonpharmaceutical therapies. Objective: To characterize the subgroups of older Chinese with MCI and examine factors associated with the membership of distinct subgroups. Methods: This cross-sectional study was conducted between October 2018 and June 2022 in Fujian, East China, with 1017 older adults with MCI deemed eligible. Exclusion criteria included any diagnosis of other neurological or psychiatric conditions that could affect cognition. Participants underwent a neuropsychological test that assessed memory, language, attention, and executive function(s) and completed a questionnaire collecting their socioeconomic and clinical variables. Neuropsychological test scores were transformed into z-scores, which were then examined using latent class analysis. Associations between socioeconomic and clinical variables, and MCI subgroups were assessed using multinomial logistic regression analysis. Results: Three MCI subgroups were identified: G1 “Minimally impairment” (56.64%), G2 “Moderate impairment” (36.28%), and G3 “Worst impairment” (7.08%). Age, place of residence, marriage status, living status, and participation in intellectual activities differed significantly across the 3 MCI subgroups (P&lt;0.05). Compared with the minimally impairment group, participants with the worst impairment were less likely to participate in intellectual activity and more likely to live in a nursing home. Conclusion: Cognitive function is a suitable foundation for establishing classifications among individuals with MCI. Nonpharmalogical therapies may target older adults at higher risk of moderate or worst impairment.

Deep learning model for individualized trajectory prediction of clinical outcomes in mild cognitive impairment.

Accurately predicting when patients with mild cognitive impairment (MCI) will progress to dementia is a formidable challenge. This work aims to develop a predictive deep learning model to accurately predict future cognitive decline and magnetic resonance imaging (MRI) marker changes over time at the individual level for patients with MCI. We recruited 657 amnestic patients with MCI from the Samsung Medical Center who underwent cognitive tests, brain MRI scans, and amyloid-β (Aβ) positron emission tomography (PET) scans. We devised a novel deep learning architecture by leveraging an attention mechanism in a recurrent neural network. We trained a predictive model by inputting age, gender, education, apolipoprotein E genotype, neuropsychological test scores, and brain MRI and amyloid PET features. Cognitive outcomes and MRI features of an MCI subject were predicted using the proposed network. The proposed predictive model demonstrated good prediction performance (AUC = 0.814 ± 0.035) in five-fold cross-validation, along with reliable prediction in cognitive decline and MRI markers over time. Faster cognitive decline and brain atrophy in larger regions were forecasted in patients with Aβ (+) than with Aβ (-). The proposed method provides effective and accurate means for predicting the progression of individuals within a specific period. This model could assist clinicians in identifying subjects at a higher risk of rapid cognitive decline by predicting future cognitive decline and MRI marker changes over time for patients with MCI. Future studies should validate and refine the proposed predictive model further to improve clinical decision-making.

Single-value brain activity scores reflect both severity and risk across the Alzheimer's continuum.

Single-value scores reflecting the deviation from (FADE score) or similarity with (SAME score) prototypical novelty-related and memory-related functional magnetic resonance imaging (fMRI) activation patterns in young adults have been proposed as imaging biomarkers of healthy neurocognitive aging. Here, we tested the utility of these scores as potential diagnostic and prognostic markers in Alzheimer's disease (AD) and risk states like mild cognitive impairment (MCI) or subjective cognitive decline (SCD). To this end, we analyzed subsequent memory fMRI data from individuals with SCD, MCI, and AD dementia as well as healthy controls (HC) and first-degree relatives of AD dementia patients (AD-rel) who participated in the multi-center DELCODE study (N = 468). Based on the individual participants' whole-brain fMRI novelty and subsequent memory responses, we calculated the FADE and SAME scores and assessed their association with AD risk stage, neuropsychological test scores, CSF amyloid positivity, and ApoE genotype. Memory-based FADE and SAME scores showed a considerably larger deviation from a reference sample of young adults in the MCI and AD dementia groups compared to HC, SCD and AD-rel. In addition, novelty-based scores significantly differed between the MCI and AD dementia groups. Across the entire sample, single-value scores correlated with neuropsychological test performance. The novelty-based SAME score further differed between Aβ-positive and Aβ-negative individuals in SCD and AD-rel, and between ApoE ε4 carriers and non-carriers in AD-rel. Hence, FADE and SAME scores are associated with both cognitive performance and individual risk factors for AD. Their potential utility as diagnostic and prognostic biomarkers warrants further exploration, particularly in individuals with SCD and healthy relatives of AD dementia patients.